Security fraud accounts for a minuscule portion of the Social Security Administration’s (SSA) payouts, according to the agency. Despite this, fraud is still a big problem that affects a huge number of people.
The consequences of stealing or committing fraud to receive Social Security Disability Insurance (SSDI) benefit payments might include a fine, criminal accusations, and/or jail time. Most of the time, felony punishments carry a $250,000 fine and a prison sentence of five years at maximum. Additionally, you can be required to repay the benefits you were paid.
Learn more about the most typical forms of disability fraud and the consequences that come with them below.
What Is Social Security Disability Fraud?
Any attempt to receive benefits based on false statements can be considered fraud. Disability insurance fraud includes, among other activities, concealing work activity or medical improvement while receiving disability benefits, making false statements on claims, concealing facts or events that affect eligibility for benefits, misusing benefits (by a representative payee), or failing to notify the SSA of the death of a beneficiary and continuing to receive the deceased person’s benefits.
The SSA considers the following four actions to be fraudulent:
4 Examples of Social Security Disability Fraud
Several different instances may be classified as committing disability fraud, so it’s important to understand what constitutes fraud. This way, you may spot it and, if necessary, amend your application to prevent sending false information.
The following are some of the most common types of fraud committed:
1. Medical Condition Misrepresentation
Giving the SSA inaccurate information about the nature of your medical condition is regarded as fraud. It involves fabricating symptoms and altering medical records to make your health appear worse.
2. Falsifying Medical Records
This information relates to your age, address, level of education, past employment history, income, assets, and other factors that may affect your eligibility for disability payments. It is considered fraud to claim you have less income and property than you do to be considered eligible for benefits.
One example would be if a person has a friend who is a doctor and, together, they fabricated medical records to exaggerate that person’s condition and how it affects that individual’s capacity to work. In such a case, the doctor and that individual both committed fraud, and they may both face consequences.
3. Hiding Important Information
Giving false information on your application for social security benefits is also illegal. Some people omit important information because doing so would disqualify them from getting disability benefits.
For instance, you might have committed fraud if you returned to work but didn’t inform the Social Security Administration. You must notify the SSA if your income or assets increase, you become imprisoned, your health significantly improves, or you start receiving other benefits.
Your eligibility for benefits will be examined, and not notifying them can be considered fraud.
4. The Falsification of Wages
Your salary is one of the key elements that determines whether you are eligible for Social Security benefits. Fraud is committed if you provide misleading information about your income to obtain disability payments.
How To Report Suspected Social Security Disability Fraud
The SSA should be notified right away if you suspect someone is committing social security disability fraud. The Office of the Inspector General accepts reports online, or you can contact them at 800-269-0271, which is the hotline for reporting social security fraud.
You have the option of filing a confidential report or an anonymous one. You provide the SSA with your contact information in a confidential report and give them permission to call you for more information; they will only disclose your contact information where compelled by law, such as in response to a subpoena or court order.
Even in the event of a court order or subpoena, the SSA will not get your name or contact information if you file an anonymous report, keeping your identity a secret.
Additionally, you can give the SSA your name and contact details, along with your consent to release them as necessary.
Penalties for Committing Disability Fraud
Fraudulent use of social security benefits is a serious crime. False information in your report could result in both criminal and felony charges against you. Scammers can also be found guilty of civil fines in addition to the criminal penalties described in this article above.
There are also penalties that apply if your fraudulent disability application causes harm to another individual. You could face a civil lawsuit and possibly higher fines. You risk paying up to $5,000 for each time you fraudulently claimed that your information was accurate when it was not. The consequences are self-evident: Social Security fraud never pays financially and is highly punishable.
How Cooperative Disability Assessments Work
Only when they get a report of fraud or when a claimant is suspected of lying on their disability application will the Social Security Administration typically send a cooperative disability investigator, an FBI-trained officer who represents the Social Security investigation unit.
The Social Security Administration investigates the person’s medical records and condition in great detail to make sure that their disability is supported by medical evidence in cases where a person who applied for disability benefits was reported to not actually have a disability.
Such instances, which are incredibly uncommon, often result from a family member or acquaintance reporting that they saw the person engaging in activities that go against their declared condition.
The investigations are highly in-depth, and they may involve secretly watching the person. However, the SSA has only encountered a few such investigations in the past few years that have dealt with Social Security matters.
Conclusion
Fraudulent use of Social Security benefits is a serious offense, and individuals found guilty may face harsh penalties such as heavy fines, jail time, and criminal accusations.
Even though there aren’t many cases of disability fraud, the Social Security Administration takes these issues seriously and has systems in place to investigate and punish violators.
It is also possible that despite strict measures taken by the SSA to ensure authentication, they still miss out on fraudulent activity, which you might know of. Thus, to preserve the integrity of the system and enforce the law, it is essential to report suspected fraud as soon as possible.
2 Responses
I am an attorney who handles SSA disability claims. Recently a claimant I represented and who is currently receiving disability benefits has become the focus of an investigation by the SSA Office of Inspector General located in Durham NC. Can you refer me to an attorney with experience involving such cases?
Thank you for reaching out; however, we are not aware of anyone that specializes in this type of matter.