NYC Disability Scam Case Spotlights Advisers’ Role

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Esposito, Hale, Minerva and Lavallee deny the charges, which include allegations of collecting a combined $20,000 to $50,000 from each successful applicant. The men’s lawyers have said their clients were doing their jobs by helping benefits seekers. Many of the 102 recipients arrested also have pleaded not guilty; others are awaiting arraignment.

Dubious disabilities benefits are a focus of the Social Security Administration’s anti-fraud efforts, accounting for about 40 percent of the nearly 8,000 fraud probes closed last year. While there are other sweeping disability fraud cases, including at least 75 arrests this summer in a probe in Puerto Rico, authorities think the ongoing New York investigation could ultimately involve as many as 1,000 people and $400 million.

It’s entirely legal, and long established, for a lawyer or other representative to help someone apply for benefits. Social Security Administration regulations include a list of do’s and don’ts and cap such agents’ fees at $6,000 in most instances. The fees are based on the benefits awarded.

“There’s absolutely a role for attorneys and non-attorney representatives, but they have to follow the code of conduct,” said Beatrice Disman, the agency’s New York regional commissioner. “You have to be honest as to the facts of your case.”

Portland, Ore., benefits representative Mellani Calvin says she won’t tell clients what to say. But she will, for example, ask a client housebound with a blood infection why his application says he goes outside every day. When he explains that he ducks out to his porch, she’ll explain that officials might assume he means getting out and about in the community.

“My ‘coaching’ is to explain what this form is and how important a thorough explanation is,” Calvin said.

Reiss, the psychiatrist, has seen some questionable behavior from benefits applicants, such as one who claimed post-traumatic stress disorder but was delighted, not rattled, by a nearby fireworks display. Another time, a lawyer joked about how well he’d taught a client what the proper symptoms were, Reiss said.

“There’s a percentage of manipulators, without doubt,” he said, but most people aren’t overplaying their problems.

“Overall, you have a lot more who are underplaying” them, he said.

(AP Photo:  In this Jan 2, 2014 file photo, New York City Police Commissioner William J. Bratton gestures as he speaks about his job during a news conference.)

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