It seems to be a common practice here in MA. A public employee will be granted a “disability” pension, because he/she is unable to perform their job, due to physical injury. A doctor will usually supply a statement to the pension board, certifying that the subject is indeed, unable to work. So, this person retires with a nice pension. then you read about the person, later taking a job as a carpenter, roofer, laborer, etc. Does this mean that the person is no longer disabled? And, if this is so, why isn’t this fraud? i can see someone genuinely becoming disabled and unable to work. but a fireman or policeman who gets a disability pension (as the result of a “back injury”), who later turns up working in heavy construction-something is wrong! Should these individuals be charged with fraud, and forced to return their pension payments/
It’s not legal in some cases. I’d say it would depend on exactly how the disability is issued. IANAL-DSR( disability specialist/recipient)
The issue is really that there aren’t enough folks that seem to be investigating that there is fraud, and going after them. If they are being paid cash “under the table,” it would require an investigator to follow them around, watching for fraud. It happens, just not enough.
Once in a while you hear about a case, but it’s not that often.
My father was in fact out on a short term disability from a quasi-state agency (transportation related), but really watched out for the type of work he COULD do. He has a couple of part time jobs that he needed to discuss with management to see if he could continue while he was on his disability, so as to not cause any issues with his retirement benefits (he was about 1 year from retirement anyway). One of his biggest fears is that it would have been one of these investigative reports that ended up on the front page of the Herald. He’s an overall honest guy though, and didn’t want to screw up his financial future.
Ralph, it’s one of the more common forms of disability fraud that someone claims inability to perform necessary parts of his accustomed job due to disability, when such is not actually the case. However, there are also degrees of disability. It is not a “you’re disabled; he’s not” black-and-white situation.
If a man, formerly capable of lifting and nailing in place 30-pound two-by-fours for eight hours a day, wrenches his back in such a way that he is now capable of lifting only 10 pounds, or of lifting a 30-pound two-by-four for an hour, with lifting a heavier weight or continuing to lift the required weight for a longer time causing severe pain, he is partially disabled – he cannot perform his expected job duties (30#, 8 hours/day) – even though he can perform them at a lower weight or for a shorter period. Disability judgments take this into account.
Former workers’ compensation attorney here (who used to represent employers/insurers)
One of the toughest things to get employers to understand is the concept that a person’s disability may be sufficient to entitle them to a determination of permanence (with resulting compensations of one sort or another) but still not prevent them from engaging in other occupations or activities. The question that needs to be answered in any case of improper award of benefits would be: what in particular was the permanent disability that the Dr. certified, and is the current activity complained of actually in excess of that disability?
And even then, it may not matter, since the time within which to modify the original award may have expired.
For example:
Joe, the tree surgeon, injures his leg. As a result, Joe’s doctor certifies that he is unable to work at heights because of instability. Joe is thus permanently disabled and will get an award on that basis, which in California’s scheme would be significant because of his occupation. Joe is later seen out on the golf course golfing. Has Joe committed any wrongdoing? Probably not, because you don’t need any particular stability to play golf, per se. However, if Joe’s doctor certified the instability on the basis of Joe’s statements that he isn’t able to stand comfortably on two legs without support of some type, THEN Joe’s golfing may get him in trouble.
The same sorts of discussions would apply to things like the benefits police officers and firefighters get from permanent preclusion from working in those occupations, to social security disability determinations, etc.
And, of course, in general, to establish “fraud” one would have to show some effort by the worker to have mislead the system, through lying, etc., into giving him the benefits he wasn’t really entitled to. As an example of non-fraud, Joe is evaluated by a doctor who determines that anyone with Joe’s condition should be precluded from standing on his feet for more than 30 min. at a time. Joe’s disability award is based on this Dr.'s conclusion. Joe is then seen standing on his feet and/or walking for the four hours needed to play golf. Has Joe committed fraud? Not unless Joe told the Dr. he couldn’t do that; if the Dr.'s advice was prophylactic in nature, the evidence of what Joe CAN do isn’t really relevant to the Dr.'s conclusions.
Ain’t disability fun?