Social Security Disability Insurance (SSDI) is a program designed to financially assist those who are unable to retain employment due to their disability. But a significant number of these claims are fraudulent, and the Social Security Administration (SSA) works hard to crack down on them. You may wonder how getting terminated due to fraud can affect SSDI eligibility.
If a claimant is found to be involved in fraud, their benefits are immediately terminated, and they are forced to repay any of the benefits they received based on fraud, along with heavy fines and penalties.
This article talks in more detail about SSDI fraud and how it affects future disability benefits eligibility.
Different Ways to Commit Disability Fraud
It is possible to try to get government benefits in different ways, even if you do not qualify. Some of these may appear to be “white lies,” but the consequences for making a knowingly false statement regarding a substantial fact can be extremely severe, both criminally and through harsh civil fines.
1. Misleading or False Statements
There are numerous forms of false statements that would be considered disability fraud. Some examples include making a fraudulent claim for a lower income than you actually earned or making a false report of a physical or mental disability that you do not truly have in order to receive benefits.
2. Withholding or Concealing Details
Another obvious kind of disability fraud is withholding important, accurate information in order to avoid being disqualified or having your payments reduced.
3. Submitting Fraudulent Documents
This type of disability fraud frequently involves the use of fraudulent identification documents, which are usually used to fraudulently claim benefits under another person’s name without their knowledge or permission.
This is also how some people find out that someone else has secretly claimed their identity when they apply for a benefit.
4. Representative Payee Theft or Misuse
Most payees are trustworthy, loyal family members or caretakers. However, not all representative payees put the disabled person’s needs ahead of their own when it comes to spending disability money.
A payee is considered guilty of disability fraud if they take the payments from the beneficiary and use them for their own self-interest.
Consequences Of Disability Fraud
There are harsh criminal and civil consequences for those found guilty of disability fraud under federal law.
If you are found guilty of committing any of the following offenses with full knowledge and intent, you could face a maximum sentence of five years in federal prison and a maximum fine of $250,000:
- making a false statement or causing a false statement to be made about an important fact in an application for a disability benefit or in a decision-making process about their rights to such a benefit;
- failing to disclose or hide knowledge of an incident that affects their right to be granted benefits they aren’t entitled to;
- receiving more benefits than they are qualified for with the intent to obtain such benefits fraudulently
Those who accept a fee for services rendered in connection with any determination regarding benefits are subject to the possibility of being subjected to more severe penalties.
Anyone who makes money from their involvement in disability fraud is subject to a punishment of up to ten years in federal prison as well as the payment of large fines. This includes:
- the beneficiary’s legal representative
- translator
- individuals currently or formerly working in the Social Security
- beneficiary’s healthcare or primary physician who created or provided false documents for the eligibility of the beneficiary
The consequences for someone who defrauds the government of disability benefits may extend beyond the criminal case conviction. The government has the option to initiate a civil lawsuit to recover all of the unlawfully obtained benefits, together with interest and penalties. There is a maximum penalty of $5,000 for every incident of fraud.
When false statements and documents have been submitted on multiple occasions over the course of several months or years, this is an especially dangerous situation and can have major repercussions or consequences.
It is possible for the licensing board that oversees a profession to suspend or revoke a license to practice that profession for individuals who hold professional licenses, such as doctors, nurses, and lawyers.
How Accidental Fraud Can Affect People
According to some estimates, the exact number of fraudulent claims is much less than the Social Security Administration estimates. In most cases, people who get charged for a fraudulent claim do not have criminal intent. Instead, the fraud is due to a technical mistake on the applicant’s end without any criminal intent.
Consider the following examples of people who committed fraud unknowingly:
Case 1
A woman from Chicago was informed by federal agents that she was in trouble when they knocked on her door four years after her long-term partner died of kidney cancer. She continued to receive disability benefits from Social Security, which should have been terminated upon her partner’s passing.
According to the agents, she believed the $1,400 check that was deposited every month into an account she could access was payment for some land her partner had leased. The money had already gone for rent, clothing, and presents for her grandkids.
She ended up being charged $119,392, which is almost three times the amount she received by mistake, by the inspector general’s office, which investigates disability fraud and attempts to recover funds for the government.
Case 2
A woman from New Jersey collected approximately $47,000 in benefits, but she didn’t declare a house that she inherited from her father that was worth $120,000 and car loans that she co-signed for her children. As a result, she is now responsible for nearly $435,000 in fines and repayments.
Unfortunately, these incidences of disproportionate fines are not uncommon. By the middle of 2019, 83 individuals were charged a total of $11.5 million in a seven-month period, which is a significant increase from the less than $700,000 that was charged for the entire year of 2017 for fraudulent claims.
Conclusion
The Social Security Administration takes fraudulent claims very seriously and immediately terminates them. This is why it’s important to take measures that can prevent you from being involved in accidental fraud.
