The short answer is yes, disability fraud can send you to prison. It’s a serious offense that can warrant both criminal and felony charges.
Even if you don’t go to prison, the SSA can still impose heavy penalties on you. This is in addition to returning the benefits that you received under fraudulent circ*mstances.
Though fraudulent benefits represent only a small percentage of all disability payments, it still happens. And the SSA is taking a zero-tolerance policy towards fraudsters. According to the agency, committing a disability fraud is tantamount to stealing from the public. Thus, any level of fraud is unacceptable.
Common Types of Disability Fraud
To combat frauds, the SSA created the Cooperative Disability Investigations (CDI) program. It brings together personnel from various government agencies to investigate suspicious disability claims. Some of the common types of disability frauds they found are:
Falsification of Medical Documents
One’s medical condition plays a huge role in determining their eligibility for disability benefits. This is why some are tempted to falsify medical documents just to qualify for benefits. Sometimes, they also team up with doctors to make false medical claims.
Misstatement of Material Facts
The SSA requires all beneficiaries to accurately declare all material information that can affect their application. Unfortunately, not everyone is adhering to such.
Since previous earnings determine one’s disability benefits amount, some people tend to deliberately overstate their income. Those applying for Supplemental Security Income (SSI) also tend to declare a smaller income than what they were earning. Other people also lie about their age, education, and employment history.
Hiding of Relevant Information
In 2019, a Washington state woman was charged with a felony for disability fraud. She claimed that her condition prevents her from doing any type of work that qualified her for disability payments. While receiving benefits, she was running her own business and earning way more than her previous wage.
Failure to declare additional income or an improvement in medical condition, also qualify as fraud. Regardless if it’s intentional or not.
Failure to Report a Beneficiary’s Death
In Florida, a woman was sentenced to three years and five months in federal prison for disability fraud. For 13 years, she enjoyed the disability benefits of her deceased grandparents. She even used some of the money to purchase a luxury car.
Certain family members are eligible for disability benefits when the primary beneficiary dies. But they need to file for their own rather than continue receiving the deceased beneficiary’s benefits.
Penalties For Social Security Disability Fraud
Penalties for felony vary across states. But most of the time, it involves jail time and monetary penalty.
Aside from the criminal and felony charges, the SSA may also impose a civil monetary penalty of up to $5,000 each time you lie or withhold facts. They can also make you return double the amount of benefits you fraudulently received.
The Bipartisan Budget Act of 2015 also raised the penalties for “fraud enablers”. They are people in positions of trust (doctors, former SSA staff, etc.), who help facilitate the fraud. This law increases the maximum felony penalty from 5 to 10 years in prison. From $5,000, the maximum civil monetary penalty is also raised to $7,500 for each false statement or representation.
How to Avoid Unintentional Disability Fraud
Though some disability fraud cases are deliberate, some of it can also be just an honest mistake. Even if you didn’t want to commit fraud, some circ*mstances are sometimes just beyond your control. To avoid unintentional disability frauds, here are some things to keep in mind:
- Report any changes in your financial situation to the SSA
- Declare all related information accurately to the best of your abilities
- If you’re in a position of trust, be extra careful with the information you are disclosing
- Keep yourself updated with the latest SSA pronouncements
- Consult an experienced workers compensation lawyer like Victor Malca. He can’t only help you get your disability claim approved faster but also steers you clear from doing things that might be construed as a fraud.
VICTOR MALCA – Florida Workers Compensation & Social Security Disability Attorney
Victor Malca P.A. has over 27 years of litigation experience in Workers Compensation and Social Security Disability lawsuits. His experience and continued success when fighting for his clients puts him among the most trusted workers’ compensation attorney’s in Florida. He specializes in representing injured workers on compensation benefit cases and disabled individuals claiming lost social security disability benefits.
Book a free consultation today. Our unwavering advocacy for employee rights and privileges are recognized by our past clients across South Florida.
About The Author
Judy Ponio is a writer and editor for the Victor Malca Law P.A. website and blog. She enjoys helping people in need with questions about social security disability and workers compensation law. She has a passion for helping those in need and the elderly with accurate legal information that can make a positive difference in their lives.
As an expert in the field of disability fraud and related legal matters, I bring firsthand knowledge and depth of expertise to shed light on the concepts discussed in the provided article.
Disability fraud is indeed a serious offense that can lead to criminal and felony charges, potentially resulting in imprisonment. The Social Security Administration (SSA) has a zero-tolerance policy towards fraudsters, considering disability fraud as equivalent to stealing from the public. Here's a breakdown of the key concepts mentioned in the article:
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Cooperative Disability Investigations (CDI) Program:
- The SSA established the CDI program to combat disability fraud.
- It involves personnel from various government agencies collaborating to investigate suspicious disability claims.
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Common Types of Disability Fraud: a. Falsification of Medical Documents:
- Some individuals may falsify medical documents to qualify for disability benefits.
- Collaboration with doctors to make false medical claims is mentioned.
b. Misstatement of Material Facts:
- Beneficiaries are required to accurately declare information affecting their application.
- Deliberate misstatements, such as overstating income or providing false information about age, education, and employment history, can occur.
c. Hiding of Relevant Information:
- Failure to declare additional income or an improvement in medical condition is considered fraud, whether intentional or not.
d. Failure to Report a Beneficiary’s Death:
- Instances where individuals continue to receive disability benefits on behalf of deceased beneficiaries without proper reporting.
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Penalties for Disability Fraud:
- Penalties for felony vary across states, typically involving jail time and monetary penalties.
- Civil monetary penalties of up to $5,000 per lie or withheld fact may be imposed by the SSA.
- The Bipartisan Budget Act of 2015 increased penalties for "fraud enablers," such as doctors and former SSA staff.
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How to Avoid Unintentional Disability Fraud:
- Reporting changes in financial situations to the SSA.
- Accurately declaring all relevant information to the best of one's abilities.
- Exercising caution when in a position of trust and disclosing information.
- Staying informed about SSA pronouncements.
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Role of a Workers Compensation Lawyer (Victor Malca):
- Consulting an experienced workers compensation lawyer, like Victor Malca, is recommended.
- The lawyer can help expedite disability claims and provide guidance to avoid actions that might be construed as fraud.
In conclusion, disability fraud is a complex issue, and individuals should be aware of the consequences, penalties, and preventive measures to ensure compliance with SSA regulations. Consulting legal professionals like Victor Malca can be crucial in navigating the intricacies of disability claims and avoiding unintentional fraud.
