If the Social Security Administration (SSA) discovers that you knowingly lied or misrepresented any information related to your claim or eligibility for disability benefits, you may face criminal charges for disability fraud.
Recognizing SSDI or SSI Fraud
Social Security disability fraud is defined in several ways. Examples of disability fraud include:
False statements: Fraud may be making a false statement on the disability application, like saying you’re married when you’re not, or lying about a source of income.
Misuse of benefits by representative payee: A payee should ensure that the funds are utilized for beneficiaries with disabilities. There is fraud if the payee uses these funds other than for such purpose.
Concealing information: Concealing advice, such as not reporting improvement in your medical condition into the SSA, is another form of fraud. If the beneficiary dies, the fact must be reported since cashing checks of a deceased person is illegal and constitutes fraud.
A material fact is one that the SSA relies on to help determine the outcome of your claim. If you do any of the following to obtain SSI or SSDI benefits, you commit fraud: lying to about a material fact, misrepresenting a material fact, or causing anyone else to lie about or misrepresent a material fact. Here are more illustrative examples:
A claimant (applicant) filed for SSI, the program for people with low income and low assets. The claimant owned a trailer that she rented the same to a relative. This asset made her ineligible for SSI. So that she could qualify for benefits, however, the claimant intentionally withheld this information.
A claimant filed for disability based on depression and anxiety. To help win his claim, he made false statements to his therapist and physician on how his everyday life was affected. Such false statements constitute fraud.
The SSA uses your earnings to determine whether you’re eligible for SSI or for SSDI. You commit fraud if you lie about your income or induce someone to lie about your income to get benefits. Below are a few examples.
A claimant reported that she had been able to work in February of 2014 after the claimant filed for disability. On the other hand, the plaintiff had returned to work earlier. In an attempt get more back pay for disability benefits, the claimant lied.
The claimant was a landscaper and registered for disability because of a back injury. He was not eligible for SSDI because he had not paid Social Security tax on his earnings. Because the net earnings from his self-employment were over the limit for SSI, in addition, he didn’t qualify for SSI. But the claimant did not report his earnings to the SSA to try to qualify.
Right to Payment
You commit fraud if you hide or fail to report anything which could impact your right to benefits Here are some examples.
The claimant was receiving both Social Security and Railroad Retirement according to her work history. When her husband died, she didn’t report it since she knew that she would stop receiving her husband’s benefits.
The claimant, a woman, had been receiving SSI benefits. Sometime after her gains started, she married, and her spouse worked full-time. Because of his income, the plaintiff was no longer qualified for SSI. The claimant knew that her benefits would be stopped by the change in her situation, so she did not report her marriage to the SSA.
Disability payments were received by the individual on behalf of a minor child. The child moved out of the home; so that he could continue to receive the child’s benefits, the individual did not report that the child no longer lived with him.
An adult child was the representative payee for the father. After her father died, in order that she could continue to get his rewards, the daughter failed to notify the SSA.
Social Security Disability Fraud Penalties
Social Security fraud and disability fraud have serious penalties. Criminal penalties can be up to $250,000 in fines and/or up to five years imprisonment. In addition to the penalties, there might be civil penalties as well.
Remember to provide as much info as you can. This includes the name, address, birth date, phone numbers, and Social Security number (if you know it) of the individual suspected of committing fraud. The more information you supply, the sooner the SSI fraud investigation procedure can begin. You should explain in detail to the SSA in what type of fraudulent activity you suspect a person is involved in.
In addition to losing the ability to collect benefits, further penalties may be also issued by criminal and civil courts. In addition to fines and restitution, the criminal prosecuted can be ordered to pay a penalty fee from the number of overpayments he or she obtained. Imprisonment may be imposed in the most extreme cases of disability insurance fraud. A two hundred and fifty thousand dollars fine may also be incurred.
Social Security Numbers
If you knowingly use false information to obtain a Social Security number to establish a Social Security record, you commit fraud. In addition, you commit fraud if you use a fake Social Security number or a number that isn’t yours to qualify for disability benefits or to increase the number of advantages. Below are a few examples.
An individual didn’t have a Social Security number because he lived in the U.S. illegally. Without a Social Security number, the person could not apply for disability. The individual used a fake birth certificate to get a Social Security number, which he then used on his application for disability to qualify for benefits.
Since she had an outstanding felony warrant for fleeing prosecution, the claimant was ineligible for disability benefits. To receive benefits, the person filed using a stolen Social Security number.
Penalty for Social Security Fraud
You could be fined or incarcerated for up to 15 years, or both, depending if you are convicted of Social Security fraud. Keep in mind that you may be prosecuted even if the SSA never paid you benefits (in other words, even if you were denied disability benefits).
The SSA must prove that you defrauded them to have someone convicted of fraud. If you are accused of fraud or lying on your application, contact a lawyer right away.
Help from a Disability Lawyer
It is important to immediately seek the advice and counsel of an attorney who can defend you and possibly help you recover benefits to which you’re eligible, if pertinent to your own situation, in case you have been accused of disability fraud.