NEW YORK (AP) — When dozens of former police officers and firefighters sought disability benefits, advisers provided a playbook for faking mental illness — how to describe daily routines of languishing dysfunction, flunk simple concentration tests convincingly, dress down for benefits interviews, even how to link their supposed symptoms to 9/11, prosecutors say.
The decades-long scam netted more than $20 million in Social Security disability payments for more than 100 people and tens of thousands of dollars in kickbacks for the benefits experts who helped them, the Manhattan district attorney’s office said this week in unveiling a case that points up the complicated role consultants play in a system that helps sustain more than 10 million people nationwide.
Experts say advisers can give people valuable help in understanding what’s needed, compiling information and navigating bureaucratic complexities. But they acknowledge the boundary between explaining and gaming the system can be tricky, and sometimes crossed.
“A lot of times, a person really does need a lawyer or someone to guide them through the system. But once you have that, they have a financial interest in the case succeeding,” says Dr. David Reiss, a San Diego, Calif., psychiatrist who has evaluated first responders and other applicants for disability, workers’ compensation and other benefits. At times, he thinks consultants’ conduct begs a question: “Where’s the line between helping someone to express what’s going on emotionally, and where is it planting seeds?”
In the New York case, benefits advisers Joseph Esposito, Thomas Hale, and John Minerva and lawyer Raymond Lavallee are accused of supplying a veritable forest of fibs.
Many applicants had physical injuries that qualified them for police or firefighter disability pensions, but not for federal disability benefits that require being unable to work at any job for at least a year, District Attorney Cyrus R. Vance Jr. said.
Esposito, a retired officer who’d gotten the benefits himself, told applicants to claim psychiatric problems stemming from their work, often specifically from their response to the Sept. 11 attacks, according to prosecutors.
And, they said, he detailed how to do it.
“They’re liable to say … ‘Spell the word “world,’” so you go, ‘W-R-L-D,’” Esposito told one applicant preparing to meet with benefits officials, according to prosecutors’ court papers. If asked to subtract seven from 100, answer 86 or 85; if asked to remember three everyday items, forget two, the papers quote him as saying.
“No jewelry, no cellphone,” and no looking directly at the interviewer, Esposito added, according to the papers. “You’re just trying to show that, you know, you’re depressed.”
But while claiming they could barely care for themselves, benefits recipients piloted helicopters, rode motorcycles, trained martial arts students, played softball, went fishing, hit blackjack tables in Las Vegas and worked in jobs ranging from security to baking, prosecutors said.