It's not uncommon for the Social Security Administration (SSA) to find that a disability applicant or recipient has given false or inaccurate information for the purpose of getting Social Security benefits. When that happens, the agency must re-determine whether the person is actually entitled to benefits, and will do so while disregarding any evidence that was inaccurate or misleading.
The Social Security Administration (SSA) uses two names to describe this type of wrongdoing: "fraud" and a "similar fault" to fraud.
Fraud is when a claimant gives false information related to a disability claim. To be convicted of fraud, the SSA must prove that the person intended to defraud the government. (For more information on what constitutes fraud, see our article on disability fraud.)
Similar fault differs from fraud because the person does not need to have intended to defraud the SSA.
The SSA defines similar fault (SF) as when a claimant (applicant) either:
In addition, any other person (like a doctor or interpreter) involved in the claim can commit a similar fault to fraud as well.
The SSA describes similar fault in more detail in its policy ruling SSR 22-2p.
The SSA calls information that's important to determining whether someone is eligible for benefits "material"—information that could help the SSA decide a claimant's eligibility for either SSDI (Social Security Disability Insurance) or SSI (Supplemental Security Income).
To knowingly provide false or inaccurate information means to do so with the awareness that the information is false, inaccurate, or incomplete. The SSA must have reason to believe the person knew that the evidence provided was false or incomplete.
To find that a similar fault occurred, Social Security needs more than "mere suspicion, speculation, or a hunch." But the SSA no longer needs to show that similar fault occurred by a "preponderance of evidence." In May 2022, Social Security changed that standard so that the agency now only needs "reason to believe" that a similar fault occurred. Reason to believe means that the agency has reasonable grounds to suspect that similar fault was involved in the application or in providing evidence.
Here are some examples where a claimant or another person related to the claimant committed similar fault.
If the SSA determines that a fault similar to fraud occurred in a disability claim, the SSA can:
If the SSA decides your claim contained evidence based on similar fault, the agency will send you a decision letter that contains:
If the SSA accuses you of committing fraud or a similar fault, consider contacting a disability lawyer immediately.
Updated May 20, 2022
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