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 circumstances.
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 circumstances 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.