A new Supreme Court decision could mean Social Security benefits won’t be reinstated for Americans who become the victims of fraud.
The highest court declined to hear a case over the Social Security Administration’s (SSA) redetermination filings for disability benefits.
In the case of Mary Elizabeth Sexton vs. Martin O’Malley, the commissioner of Social Security, the Supreme Court rejected Sexton’s petition, which could affect delays for benefits for Americans.
In 2006, Sexton applied for and received Supplemental Security Income benefits via her Kentucky-based attorney, Eric C. Conn. Sexton originally applied due to intellectual challenges as well as anxiety and seizures during that time period. Later, it was revealed that Conn earned benefits for his clients based on fraudulent disability applications.
Pedestrians walk past the Social Security Administration office in downtown Los Angeles, on October 1, 2013. The Supreme Court declined hearing a new Social Security disability benefits case.
FREDERIC J. BROWN/AFP via Getty Images
While the government first became aware of the potential fraud that year, the SSA did not begin redetermination hearings until 2015 and 2016.
Sexton was found to not have sufficient evidence for her disability, and she sued for a second redetermination hearing in 2022, which found once again Sexton was not disabled at the time of her application.
In the case, Sexton argued that the SSA violated a law that requires the agency to “immediately” act by holding the redetermination hearing 15 years after Conn’s fraud was first discovered.
“The Social Security Administration’s practice of waiting nine years or more to hold redetermination hearings violated the requirements of the Social Security Act, and the delay caused harm to Social Security beneficiaries who were not participants in the fraudulent scheme,” read Sexton’s petition for writ of certiorari.
Certiorari is a court process to seek a judicial review of a decision of a lower court or government agency.
Newsweek has reached out to Sexton and O’Malley’s attorneys for comment via email.
In challenging the denial of her Social Security disability benefits, Sexton alleged that the SSA was not following proper legal guidelines when determining eligibility.
“Sexton believes her benefits were wrongfully denied, especially given the SSA’s strict interpretation of eligibility rules, which often leads to high denial rates which stand at or about 65 percent,” Kevin Thompson, a finance expert and the founder and CEO of 9i Capital Group, told Newsweek.
Thompson said that while the Supreme Court has not offered a reason for its rejection of Sexton’s case, it is possible the court didn’t want to open the door to a flood of similar appeals.
“Accepting this case could open a Pandora’s box and more disability claims being brought before the court,” Thompson said.
“This outcome is a setback for SSDI [Social Security Disability Insurance] beneficiaries like Sexton. However, it reflects the SSA’s rigorous process, designed to ensure that only those [who are] truly disabled receive benefits.”
Alex Beene, a financial literacy instructor for the University of Tennessee at Martin, said Sexton’s case shows the severe consequences of the SSA’s delays, which have prevented beneficiaries from obtaining crucial medical evidence for hearings and resulted in substantial overpayments.
“This situation has created a difficult situation for many and highlights the urgent need for reform to ensure that those who rely on these benefits are treated fairly and without unnecessary barriers,” Beene told Newsweek.
