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New York – NYC Disability Fraud Lawyers

Understanding Social Security Disability Fraud

Social security disability is a benefit given to those who need assistance owing to a serious medical status that makes them unable to work for at least one year. Sometimes people breach the law by fabricating their medical condition to receive disability benefits. The following are the requirements for SSDI benefits, some of the forms of disability fraud, penalties, and the measures you can take to report the offense.

Eligibility for SSDI Benefits

To be eligible for SSDI benefits, an applicant must have worked in jobs that offer social security cover. Applicants are also required to have a medical condition that satisfies SSA’s description of disability.

SSDI benefits normally continue until a beneficiary resumes work on a full time basis. There are special rules known as “work incentives” that give beneficiaries continued health care coverage and benefits to enable them resume their normal work schedule.

Forms of Disability Fraud

Making False Claims on a Disability Case

When people are applying for social security assistance, they are required to state that the data they provide is correct and true. If someone makes a false statement, they are guilty of fraud.

For example:

  • An applicant states they are blind and not able to drive an automobile when in fact the person has a valid driver’s license and is seen driving
  • An applicant indicates that they have no income when in fact they generate income from other sources such as an insurance policy or rental income
  • An applicant indicates that they are not married when they are

Concealing Facts That Affect Eligibility For Disability Claims

It is considered fraud when an individual conceals certain facts from the social security administration knowing well that it will affect benefits.

For example:

  • An applicant does not report that they are serving jail time
  • An applicant does not report that they returned to work
  • An applicant does not inform SSA when a beneficiary dies but continues to receive the cash of the deceased person

Misuse of Benefits by a Representative Payee

In some cases, the people who get social security benefits cannot handle their financial affairs. In such cases, after conducting investigations, SSA will appoint an organization, individual, friend, or relative to take over their social security matters. However, when a representative payee uses the beneficiary’s funds to meet their personal expenses, or puts the beneficiary’s funds in their own personal account, or charges the beneficiary for managing their funds, or misuses the beneficiary’s benefits in any other unreasonable way, they are liable for social security disability fraud.

What You Need to Confirm Before Claiming Fraud

Firstly, you should realize that an accusation of SSDI fraud is serious and may lead to criminal or civil penalties against the alleged defendant. Ensure that your facts are accurate and that you have sufficient information about the alleged defendant’s situation. It is worth noting that some physical disabilities are not obvious and some are not physical. Therefore, it may be difficult to determine whether a person is actually disabled.

Secondly, you need to bear in mind that a beneficiary of SSDI is permitted to work for a minimal amount. Therefore, if you see someone working who is receiving disability benefits, do not be quick to accuse them of fraud. Settlements awarded for SSI can be revoked, according to Steve Raiser – one of our New York personal injury lawyers.

What Information is Used to Prove Disability Fraud?

If you believe that a person is committing disability fraud, the first step to make is to contact SSA. You can report the incident through an online form available at the SSA portal, by sending a mail or fax, or by calling a fraud hotline. When making your claim, you are required to provide details such as the name of the alleged defendant, their address, their phone number, their social security number, and their date of birth. Additionally, you should state how you think the alleged defendant has committed fraud or is falsely receiving benefits, the period within which they have been committing the crime, and any witnesses to this crime.

Although this report can be anonymous, SSA will require your physical information to make further inquiries and to inform you when they complete investigations.

Penalties for Social Security Disability Fraud

There are severe penalties for SSD fraud. Criminal penalties can amount to fines of up to $250,000 or 5 years in jail. Civil penalties can amount to fines of up to $5,000 and the suspension of one’s professional license.


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