Social Security Disability Fraud Ring Busted in Puerto Rico

The FBI’s website ran a piece last week reporting on the arrest and indictment in Puerto Rico of 75 persons, including 3 physicians and a former Social Security employee, who are suspected of committing fraud on Social Security disability claims. The arrests capped two years of FBI investigation into suspicious Social Security Disability (SSD) claim activity on the island, where SSD claim volume and other historical data suggested possible illegal activity.

The former SSA employee would allegedly complete SSS applications for claimants in a manner he knew would be likely to meet SSA requirements, and upon SSD claim approval, would collect up to $6,000 for his efforts.

The doctors would allegedly evaluate, treat, diagnose and provide medical records in a manner calculated to satisfy the medical criteria required for SSD claim approval. Their fee for submitting the bogus medical reports was up to $600.

At least one of the doctors arrested this week has been the treating provider on a number of private insurer Long Term Disability claims on the island in recent years. For the sake of everyone involved – including consumers, whose premiums rise due to insurance fraud like this - here’s hoping that this situation serves to discourage others who might be similarly inclined to lie on their claim applications, whether for SSD or private insurer plans.