Understanding SSI Disability Fraud

When it involves other people, Social Security Disability Insurance (SSDI) fraud may seem trivial. However, if you or someone you love relies on SSDI, the defrauding of this program affects you directly.

Compared to all U.S. governmental agencies, the Social Security Administration (SSA) makes the third-largest amount of improper payments, and those improper payments include fraud. In 2015, the total estimated amount of improper SSA payments reached $9.8 billion. This means that $9.8 billion was spent that should not have been, and $9.8 billion was not available to spend on legitimate SSI/SSDI claims. Retirement, survivors, and disability insurance fraud, along with other improper payment types, made up about $5 billion of that amount.

SSA considers the following activities fraud:

• Making false statements on a claim – When applying for SSDI benefits, this includes providing information that you know is false or not wholly true.
• Concealing facts or events – Similar to false statements, this involves the failure to disclose information that could affect your eligibility—an omission is fraud, when done in bad faith.
• Misuse of SSDI benefits by a representative – Sometimes, SSDI benefits are paid to what is known as a “representative payee.” If an incapacitated person receives SSDI benefits, but a relative or friend handles the benefits, SSA considers it fraud if this fiduciary representative-payee mishandles these benefits.
• Buying or selling real or fake Social Security Cards or Numbers – stealing or purchasing Social Security Numbers that the agency did not officially assign to you, and using them to obtain SSI/SSDI benefits, constitutes fraud.
• Criminal behavior by SSA employees – Employees of SSA may have access to files and information that lay individuals would not have. These accesses are for official purposes. Using insider access to obtain illegal SSDI benefits or to help another person obtain illegal benefits constitutes fraud.
• Impersonation of an SSA employee – Calling individuals who receive SSDI and impersonating an SSA official to obtain confidential information for your benefit is fraud. Older people are especially vulnerable to this form of fraud.
• Bribery of an SSA employee – When SSA employees accept gifts for favors in their official capacities, they commit fraud.
• Violating standards of conduct – As with any job, SSA employees are subject to official standards of conduct. When they violate these rules, knowingly or unknowingly, it sometimes results in fraud.
• Workers’ compensation fraud – This is related to the failure to disclose material information on your claim. If and when someone receiving SSDI benefits becomes entitled to workers’ compensation benefits, it must be reported to the SSA. Knowingly failing to disclose this information is fraud.

Other examples, as provided by the Office of the Inspector General, include:

• Concealing work activity while receiving disability benefits
• Receiving Social Security benefits for a child not under your care
• Failing to notify SSA of the death of a beneficiary and continuing to receive and cash the checks of the deceased
• Concealing your marriage or assets from SSA while receiving Supplemental Security Income payments
• Residing overseas and receiving Supplemental Security Income payments

What to Do if SSDI Fraud Has Victimized You

Fraud is not always a crime against the government. Sometimes, individuals are defrauded out of their own SSDI benefits because they fell victim to an SSA impersonator or some other perpetrator of fraud.

The SSA is governed out of the Office of the Inspector General (OIG). If you feel that someone has defrauded you out of SSDI benefits, the OIG requires that you submit a fraud inquiry. This includes reporting the following information about the victim and the alleged suspect if you know that person. If not, report the following information about the victim(s):

• Name(s)
• Addresses
• Telephone numbers
• Dates of birth
• Social Security Numbers

The OIG also requests, but does not require, any known information about the nature of the alleged fraud, which can include:

• Description of the fraud
• Location where the fraud took place
• When the fraud took place
• How the fraud was committed
• Why the person committed the fraud (if known)
• Who else has knowledge of the potential violation

Other Issues Related to SSDI Fraud

Fraud is a fancy word for wrongdoing as it relates to receiving benefits—actions or inactions that lead to people receiving benefits to which they’re not legally entitled.

When something happens, however small, let someone know. If you lose your SSI card, notify someone immediately. If you were a victim of identity theft, call SSA immediately. If you notice errors with your Social Security Number on tax return documents, even in the case of good-faith mistakes, which happen, let someone know. The sooner you speak, the less likely that major damage will result.

The OIG provides the following resources for reporting, or learning more about, issues related to SSI Disability Fraud:

Social Security Administration

If you have questions about your Social Security account, requests for new or replacement Social Security Number (SSN) cards, or issues involving the granting or denial of benefits, contact SSA:

Phone: 1-800-772-1213 (toll free)

Online:  https://www.ssa.gov/agency/contact/

Medicaid or Medicare Fraud

If you wish to report Medicare or Medicaid fraud, please contact the Department of Health and Human Services, Office of Inspector General:

Phone: 1-800-447-8477

Online: https://oig.hhs.gov/fraud/report-fraud/index.asp

Lost or Stolen SSI Card

Our office does not investigate the loss or theft of personal property including wallets and purses containing personal identification. If your wallet or purse containing your Social Security Card is stolen, contact your local police department immediately to file a theft report. You should also contact SSA directly at 1-800-772-1213 to request a replacement Social Security Card.

Misuse of Social Security Numbers on Federal Tax Returns

If someone incorrectly listed your Social Security Number or your child’s Social Security Number on their tax return, or if the IRS has notified you that your refund cannot be processed because someone else has already used your Social Security Number on their tax return, you should contact the IRS toll-free at 1-800-829-1040.

Identity Theft

If someone uses your Social Security number to obtain credit, loans, telephone accounts, or other goods and services, contact the Federal Trade Commission (FTC). The FTC collects complaints about identity theft from those whose identities have been stolen.

Elder Abuse

For information on elder abuse and financial exploitation, including available resources and services, please visit the Department of Justice’s Elder Justice website at http://www.justice.gov/elderjustice/.

Were You the Victim of SSI Disability Fraud? Contact the Top-Rated Disability Insurance Lawyers at DarrasLaw!

At DarrasLaw, our experienced disability insurance lawyers and ERISA attorneys—led by America’s top disability insurance lawyer, Frank N. Darras—have seen, evaluated, and resolved more individual and long-term disability cases than any other lawyer or firm in America.

If you feel that you were a fraud victim, or if you are unsure and have some questions you’d like answered, reach out to us for a free conversation to discuss your options. We offer free policy analysis and claims consultations. Call us today at 800-898-7299 or contact us online.