What You Can Do If You Suspect a Fraudulent SSDI or SSI Claim

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Social Security Disability Insurance (SSDI) benefits and SSI disability benefits are granted to those who become disabled and are unable to work. These benefits are an important safety net for Americans who are disabled, but unfortunately, they sometimes provide an opportunity for dishonest people to take advantage of the system in order to collect benefits and avoid work. SSDI fraud costs taxpayer money and harms not only the Social Security system and the truly disabled, but also the taxpayers as a whole. If you suspect SSDI fraud, you can take action to report it.

Recognizing SSDI or SSI Fraud

Social Security disability fraud is defined in several ways. Examples of disability fraud include:

  • False statements: Fraud can simply be making a false statement on the disability application, like saying you are married when you are not, or lying about a source of income.
  • Falsified documents: Fraud can also take the form of the use of a fraudulent document, like a Social Security card that has been altered or falsified.
  • Concealing information: Concealing information, like not reporting improvement in your medical condition to the SSA, is another form of fraud. Anything that may affect eligibility for benefits must be reported to the SSA. If the beneficiary dies, then that must be reported right away as well, since cashing checks of a deceased person is illegal and constitutes fraud.
  • Misuse of benefits by representative payee: A payee is appointed by the SSA to make sure that the funds are used for beneficiaries with disabilities. If the payee uses these funds for himself or others, then that is fraud.

Confirming SSDI or SSI Fraud

First, you need to realize that such an accusation is a serious one and may result in criminal and civil penalties. Make sure your facts are correct and that you have enough information about the person's situation. Remember, all physical disabilities are not visually obvious and not all disabilities are physical; some may be mental (cognitive, psychological, psychiatric). This means it can be hard to really know if a person is disabled.

Second, know that a person receiving SSDI or SSI disability benefits is allowed to work a minimal amount (the SGA amount). So just because you know that someone is working or collecting a paycheck doesn't mean they're necessarily committing fraud.

Reporting Fraud

If you believe there is a possibility that someone you know is committing fraud against the Social Security Administration (SSA), there are several things you can do.

If you have enough facts and you are confident the person is committing fraud, visit the SSA website. Here you will see that there are several ways to report fraud. There is an online form, a mailing address, a fraud hotline you can call (800-269-0271), and a FAX number (410-597-0118). When making the report, give as many details that you can, especially the name of the person committing fraud and his or her address, phone number, birthdate, and Social Security number. Explain how you think the person is committing fraud or falsely claiming benefits, a general timeline if you are aware of it, and include the names of other people who may also be aware of the fraud.

This report can by anonymous, but the SSA doe request your contact information. If you provide your contact information, the SSA can contact you for further information. The agency may need to contact you before completing the investigation.

Penalties for SSDI Fraud

There are severe penalties for Social Security card fraud and disability fraud.

Felony criminal penalties can be up to $250,000 in fines and/or up to five years jail time. On top of the criminal penalties, there may be civil penalties as well. A person found guilty of fraud may be sued in civil court and have to pay a large fine, and may have his or her professional license suspended. Each false statement a person made by signing a form or statement while knowing that he or she was not eligible can result in fines up to $5,000.

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