Fraudulent medical evaluations earn psychologist 25-year prison term

A former clinical psychologist received a 25-year prison sentence and was ordered to pay $93 million in restitution to HHS and the Social Security Administration (SSA) for his participation in a scheme to obtain over $550 million in fraudulent federal disability payments. In addition to the prison sentence, the clinical psychologist was ordered to pay restitution of over $93 million to the SSA and HHS.

The scheme was initiated by an SSA administrative law judge (ALJ) who reassigned, to himself, pending disability cases associated with a particular attorney. The ALJ contacted the attorney and urged him to provide either physical or mental medical documentation supporting disability determinations, regardless of the actual disability status of the claimants. In cases where medical documentation was required, the clinical psychologist participated in the scheme. The clinical psychologist signed medical evaluation forms prepared by the attorney, without reviewing those forms. The attorney paid the ALJ more than $609,000 for granting benefits in his cases and nearly $200,000 to the clinical psychologist for his participation. The attorney received over $7 million in attorney’s fees.

As a result of the scheme, the SSA paid more than $550 million in lifetime benefits to claimants. The ALJ and the attorney pleaded guilty, receiving sentences of four and 12 years, respectively. Subsequently, the attorney absconded from electronic monitoring and is now considered a fugitive.