What Happens When You Report Someone for Disability Fraud

Committing fraud on any federal agency is a serious offense bearing far-reaching consequences. Therefore, you must put serious thought into it when you decide to report someone to the Social Security Administration (SSA) or any law enforcement agency for disability fraud. To make a considered decision in such a case, you must have a broad idea about what constitutes disability fraud, the penalties it entails, and the procedure you must follow to report someone for disability fraud.

What is Disability Fraud?

Disability fraud implies receiving payments from the government or a private disability insurance agency even without meeting the eligibility criteria to qualify for such benefit payments. Disability fraud may be committed by faking an injury or claiming a medical condition that an individual may not have. Similarly, if a person continues filing for disability benefits even after cessation of the qualifying condition, it will constitute disability fraud.

Ways of Committing Disability Fraud

Disability fraud can be committed in several ways, including some of the following acts or omissions-

• False Statements — Furnishing false information about a “material fact” in your disability application package or other communication with the SSA during the disability determination process can constitute a felony. For example, showing less income than you earn, or reporting fake physical or mental impairments to obtain disability benefit payments are clear examples of false statements that can be described as disability fraud.
• Concealing Information — When applying for disability benefits, it is incumbent upon you to furnish truthful information. If an applicant fails to provide truthful, relevant information to avoid revealing that could disentitle them to qualify for disability benefits or reduce benefits, it will constitute disability fraud.
• Using or Presenting False Documents — The SSA determines eligibility for disability benefits based on medical evidence and documentation. Such disability frauds include using or presenting false identity cards, medical documents, and financial documents.
• Theft or Misuse by a Representative Payee — Many Social Security Disability (SSD) benefits recipients are too physically or mentally impaired to manage their own financial or business affairs. So, they nominate a “representative payee” who manages their benefits payments. Such payees are expected to be genuine and honorable. However, a payee who converts such payments to his own use can be deemed guilty of disability fraud.

Penalties for Disability Fraud?

Federal law provides severe civil and criminal penalties for someone convicted of disability fraud.

The following acts are punishable by up to 5 years in federal prison and payment of up to $250,000 in fines:

• making or causing to be made a false statement of a material fact in any application for a disability benefit, or
• making or causing to be made a false statement of material fact for use in determining rights to any such benefit,
• fails to disclose or conceals knowledge of an event affecting their right to receive benefits they are not entitled to, or receive benefits in greater quantity than they are entitled to, with intent to fraudulently secure such benefits, (or fails to disclose the same knowledge about another person on whose behalf they applied or who is receiving benefits),
• converting benefits or any part of the benefit to any use other than for the use and benefit of the intended disabled benefit recipient, or
• conspires to commit any of the above-described offenses.

Higher penalties can be imposed on anyone who receives a fee for services performed in connection with any determination about benefits.

A penalty of up to 18 years in federal prison and the payment of massive fines for any person making money from their involvement in disability fraud, including any

• claimant representative or advocate
• translator
• a current or former employee of the Social Security Administration
• the physician or other healthcare providers who submit or cause the submission of medical evidence or other evidence relating to a determination of someone’s eligibility for benefits.

There can be civil consequences too for disability fraud. The government can institute a civil suit seeking repayment of the fraudulently received disability payments. Moreover, fines of up to $5,000 can be imposed for each separate instance of fraud.

Be Careful to Avoid Mistakenly Accusing a Person of Disability Fraud

As you must have inferred from this blog, there can be serious criminal and civil consequences when you accuse a person of disability fraud.

Apart from the hefty punishments and penalties involved, the entire procedure itself can lead to significant harassment and mental stress for the person accused of disability fraud.

How to Report Disability Fraud

If you want to report someone for disability fraud, the SSA has published the following information: Report fraud, waste, or abuse involving the Social Security or SSI programs to our Office of the Inspector General. Or, report anonymously by Calling our toll-free number at 1-800-269-0271 (TTY 1-866-501-2101), Monday through Friday from 10 a.m. to 4 p.m. ET. Faxing to 1-410-597-0118