Edwardo came to us for assistance with his Social Security disability claim. After working for many years in restaurants he became disabled and unable to work in 2008 and qualified for Social Security disability payments. However in 2017 he received a letter from Social Security informing him that one of his doctors from 2008 was arrested and convicted of fraud. As a result, although no fraud was alleged on his part, Social Security voided his benefits and ordered him to pay back $102,107 for all of his payments and stopped his ongoing benefits. He was suddenly left with no means of support and in serious debt. To make matters worse, Edwardo’s Medicare and Medicaid benefits which were connected to his disability payments were also terminated.
CCLA attorney Amanda Sorge immediately filed a new disability claim for Edwardo. She obtained his records and got opinion statements from his doctors showing that he was disabled and unable to work. The response from Social Security was a determination that Edwardo was disabled but only eligible for limited SSI payments of $771 and not the $1000 per month he had been receiving. Sorge appealed this determination.
Meanwhile, Sorge filed a waiver for repayment of the $102,107. She detailed proof of Edwardo’s financial situation and his ignorance of his doctor’s fraud. Social Security eventually granted the waiver, saving Edwardo from having to pay back any of the money.
Sorge continued to fight to increase Edwardo’s SSI payments back to the original $1000 amount. This was challenging because she could no longer use the fraudulent doctor’s records and had to make her case with the records that remained. However, she was ultimately able to satisfy Social Security that Edwardo qualified for reinstatement of the $1000 amount of benefits, full reinstatement of his health coverage, and the $102,107 debt was waived.
*Names have been changed to protect the privacy of our clients.
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