Does the SSA Use Surveillance to Substantiate Claims?
Aug. 18, 2022
It’s not uncommon for persons who go on workers’ compensation disability benefits, or on long-term disability (LTD) insurance benefits, to discover that the underwriting insurance company will literally spy on them to make sure their claims are not fabricated, or exaggerated beyond the point of qualifying.
Spying can include actual surveillance by investigators – who may snap photos or videos – and by scouring social media accounts for evidence that the claimant is not as disabled as the application states.
But does the Social Security Administration (SSA), which administers two federal disability programs – Supplemental Security Income (SSA) and Social Security Disability Insurance (SSDI) – resort to such tactics? The answer is that they can both legally and logistically, but they are far less likely to make it a widespread tactic. The agency usually resorts to surveillance only when fraud or deceit is suspected.
If you are a Social Security disability recipient in or around Raleigh, North Carolina, and you suspect you’re being surveilled, contact me at the Lloyd King Law Firm PLLC. I am a former Social Security Disability Judge who can help you assemble the medical evidence and supporting documentation to present a solid claim for disability. If your benefits are initially denied or later challenged by surveillance, I can help you navigate the administrative process to protect your benefits.
I also proudly serve disability clients throughout Roanoke Rapids, Fayetteville, and Greensboro.
Is Surveillance Legal?
Under legal standards, it is perfectly acceptable for an insurance company or the SSA and their agents to track you, follow you, photograph you, record you or otherwise take notes on your daily activities so long as there is no “reasonable expectation of privacy.”
This means that other than being in your home, your business or another private residence, you are likely wide-open game for investigators. They can even follow you into a supermarket, a church, temple or synagogue, a nightclub, a restaurant or other venue where just about anyone is welcome.
Once you pull out of your driveway, they can even follow your vehicle to where you’re going. Once you stop and get out, they can continue the surveillance on foot so long as where you go has no “reasonable expectation of privacy.”
The goal of the investigators, obviously, is to catch you doing something that runs counter to your claimed disability. If you’re out on benefits because of a bad back that prevents you from lifting objects, and you’re caught dancing away at a nightclub, that can be used to challenge your claim. Likewise, if they find you out on a long jog that runs counter to your claim of immobility, that can be another strike against you.
Surveillance, of course, does not stop at just observing you and your daily activities. It also involves monitoring your social media accounts. If that dance-away nightclub outing somehow shows up on a Facebook page or other social media account, whether your own or a friend’s, that can be used as evidence against your claim. Sometimes, even innocent posts or comments can raise the suspicion of investigators.
When Is Surveillance Illegal?
Surveillance is illegal if investigators somehow follow you on to your private property or another person’s private property, but be cautious because investigators can pay you a home visit so long as they announce the intention of the visit, which is to discuss your medical condition with you regarding your benefits claim.
Investigators cannot, of course, hack into your accounts of whatever nature, nor can they wiretap your phones. They don’t have the powers of the police or the FBI. Their activities are limited to instances where you are out in public.
When Does the SSA Resort to Surveillance?
The SSA is required to periodically review claims for disability benefits, but the agency’s first method is often what is called a Continuing Disability Review (CDR). A CDR generally involves both a work review to determine if your income, if any, surpasses guidelines, along with a medical review to determine if your disability still qualifies.
However, if the SSA suspects what it calls “possible fraud or similar fault,” it can refer matters to its Cooperative Disability Investigations Unit (CDIU) for a Report of Investigation (ROI). This triggers a multi-phase investigation of all evidence available, including by surveillance.
Fraud is considered to be intentional lies and deception, while similar fault refers to submitting incomplete or inaccurate statements, or concealing information. The difference lies in intent – fraud is deemed purposely done.
The SSA website that discusses CDIU investigations clearly states: “Surveillance information in both video and narrative form can provide snapshots of an individual’s observed functional ability.” Surveillance, if employed, will be used to support other investigative results, including reviews of medical evidence, school and employment records, and more.
The resulting ROI does not recommend any specific action, but provides the SSA with more information to make a determination about continuing that person’s disability benefit. The SSA permits challenges to determinations based on the following factors listed on its website:
Declaring that the activities depicted in the ROI occurred in isolated instances in which the individual’s symptoms were in temporary remission;
Declaring that the individual was able to overcome normally debilitating pain;
Calling witnesses to testify that the individual’s activities normally differ from those depicted in the ROI evidence; or
Submitting evidence concerning temporary periods of remission or subsequent worsening.
Experienced Guidance When You Need It Most
If you feel your disability benefits are under threat because of surveillance or other investigative activities, you do have options to challenge any findings or determinations. Don’t just passively await what happens, but contact me immediately so we can develop a strategy to preserve and protect your benefits.
I am a former Social Security DisabilityJudge who knows the inner workings of the whole system. I stand ready to help and defend your benefits. Contact me immediately at the Lloyd King Law Firm PLLC if you are in the Raleigh, Roanoke Rapids, Fayetteville or Greensboro areas of North Carolina.