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What Is Disability Fraud?

July 30, 2021 Disability

One of the most common criticisms levied against the Social Security Disability Insurance program is that many people who receive benefits through the program are not actually disabled. This is not true. A 2018 report by the Social Security Administration’s Office of the Inspector General (OIG) found that less than 1% of the agency’s total payouts were fraudulent. But while fraud is rare, it is not nonexistent. Our Baltimore disability lawyer explains more below.  

Examples of Disability Fraud

Fraud occurs where the perpetrator makes a materially false statement of fact for the purpose of personal or financial gain. In other words, it happens when a person lies in order to attain an undeserved benefit. It is a problem in all sectors of the economy, but public benefits fraud is particularly egregious because it results in theft from the taxpayers. Fraud involves different behaviors in different contexts, but a few examples of disability fraud include: 

  • Misrepresenting your income: Disability benefits are available only for those individuals who are not able to engage in Substantial Gainful Activity (SGA), which generally means work done for pay to support oneself. Lying about how much money you make or concealing sources of income on your disability application is fraud. 
  • Falsifying your medical records: It’s not as easy to lie about your medical condition as it is your income, as the SSA demands detailed medical records to establish the existence of a disability. However, medical records can be falsified to give the appearance that a condition is more serious than it is. An applicant may conceal adverse medical records that show that his or her condition has improved. 
  • Failing to notify the SSA of a change in circumstances: The SSA requires disability benefits recipients to promptly disclose any major changes of circumstance to them, including changes to the recipient’s medical condition, changes in employment status, and changes in income. Failure to do so may be considered to be fraud, particularly where the unreported change would have resulted in a reduction or loss of benefits. 
  • Using disability benefits that do not belong to you: It may sound strange that a person would use someone else’s benefits, but it happens more often than one would expect. One common scenario involves married couples where one spouse receives benefits but subsequently dies and the surviving spouse does not report the death to the SSA. While the surviving spouse may be eligible to receive widow/widower’s benefits, continuing to receive the deceased spouse’s benefits constitutes fraud. 

What Are the Penalties for Disability Fraud? 

The penalty for Social Security fraud for individuals is up to five years in prison and a fine of up to $250,000, in addition to restitution of any benefits payments that should not have been made. 

Contact a Baltimore Disability Lawyer for More Information About Applying for Disability Benefits 

Applying for disability benefits can be an arduous process. To maximize your chances of success, you should consider speaking to an attorney who can help you ensure that you present the strongest application possible, To get started, please contact Baltimore disability lawyer Emmett B. Irwin by calling 443-839-0818 or using our online contact form.