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

Social Security disability insurance (SSDI) and Supplemental Security Income (SSI) disability benefits are important safety nets for American workers and people with disabilities. These programs ensure you have some income if you become disabled and can't work. Unfortunately, they sometimes provide an opportunity for dishonest people to take advantage of the system.

Defrauding the system to collect benefits and avoid working is illegal—and it's not a victimless crime. SSI and SSDI fraud causes harm because it:

• threatens the integrity of the system
• makes getting benefits more difficult for the truly disabled, and
• costs taxpayer money.

If you suspect SSDI or SSI fraud, you can take action to report it. Here's what you need to know to recognize and report Social Security disability fraud.

How to Recognize SSDI or SSI Fraud

Anytime someone knowingly misrepresents or omits facts to fool Social Security and get SSDI or SSI benefits, it's considered fraud (or a similar fault to fraud). Social Security disability fraud can take several forms. Examples of disability fraud include:

• Making false statements: Fraud can simply be making a false statement on the disability application, like saying you're married when you're not, or lying about a source of income.
• Using falsified documents: Fraud includes using a fake document or one that's been altered, like:
  
  • a Social Security card that has been altered or isn't yours, or
  • changing the information on a medical test or doctor's report.
• Concealing information: Not reporting required information is another form of fraud. Anything that might affect eligibility for benefits must be reported to Social Security, including when:
  
  • your medical condition improves
  • you move
  • your marital status or living arrangements change (for SSI)
  • you start working or begin earning more income, or
  • the Social Security beneficiary dies (cashing the checks of a deceased person is illegal and constitutes fraud).
• Misuse of benefits by representative payee: Social Security may appoint a representative payee to make sure that a disabled person's SSDI or SSI benefits are used for that person's needs. Any other use of the disability benefits is considered fraud.

Be Sure It's Disability Fraud—Avoid Making False Accusations

First, you need to realize that accusing someone of Social Security fraud is serious and could result in criminal and civil penalties. Make sure your facts are correct and that you have enough information about the person's situation before you file a fraud report.

Remember, physical disabilities aren't always visually obvious. And not all disabilities are physical—some can be mental, including impairments that are:

• cognitive
• psychological, and
• 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.

How to Report Social Security Fraud

If you have enough facts and you're confident that someone you know is committing SSDI or SSI fraud, you can file a report with the Office of the Inspector General (OIG).

Where to Report Social Security Fraud

You can contact OIG to report suspected disability fraud in the following ways:

• use Social Security's online form for fraud reporting
• call the fraud hotline at 800-269-0271 (TTY 866-501-2101)
• FAX your fraud report to 410-597-0118, or
• write a letter and mail it in.

Information You Need to Report Social Security Fraud

When making the report, give as many details as you can, especially the name of the person committing fraud and, if you know it, that person's:

• address
• phone number
• birthdate, and
• Social Security number.

Be prepared to explain the following:

• what makes you think the person is committing fraud or falsely claiming benefits
• a general timeline (if you're aware of it), and
• the names of other people who might also be aware of the fraud.

How to Report Disability Fraud Anonymously

When you report suspected Social Security fraud, you have the option to request anonymity. You can also ask for confidentiality, which places restrictions on how Social Security and IGO can use your contact information.

To keep your identity confidential, you must provide your name and contact information to Social Security. And you give permission for an OIG analyst or investigator to contact you if additional information is needed. But Social Security won't share anything that would identify you unless compelled to do so by law (court order or subpoena).

If you wish to remain completely anonymous, you don't have to give Social Security your name or contact information. If you do this, no one will know you filed the fraud accusation, but investigators won't be able to contact you if more information is needed to complete the investigation.

What Happens When You Report Someone for Social Security Fraud?

Social Security takes all allegations of disability fraud seriously. No matter which method you use to report your suspicions, OIG will log and review your fraud report. Based on the information you provide, the agency will take appropriate action, which could include any of the following:

• opening a case
• trying to obtain more information
• referring the matter to Social Security
• referring the case to another federal agency, or
• closing the allegation (with or without further investigation).

Any fraud allegation could also result in audits, reviews, or investigations on a broader scale—meaning OIG could look into Social Security processes or the actions of certain personnel.

Penalties for SSDI or SSI Fraud

Both Social Security card fraud and disability fraud carry severe penalties, including both civil and criminal punishment. Someone convicted of a felony for defrauding Social Security could face criminal penalties of up to:

• $250,000 in fines, and
• five years of jail time.

On top of the criminal penalties, there can be civil penalties as well. Someone found guilty of fraud can be sued in civil court, which could result in:

• a large fine
• having a professional license suspended, or
• both.

And the penalties can add up. If you know you're not eligible for Social Security disability, each false statement you make by signing a form or statement could result in a fine of up to $5,000. Make ten such false statements, and you could face up to $50,000 in fines.

If you're accused of disability fraud or your application for SSDI or SSI was denied because Social Security says your statements weren't credible, consider contacting a disability lawyer right away.

_{Updated January 25, 2023}