If you've recently suffered a debilitating illness or injury and are planning on seeking federal disability benefits in the near future, you may be curious about how difficult it will be to obtain approval of your claim. Indeed, the Social Security Administration (SSA) is working on tightening up eligibility requirements and making the approval process more stringent in order to reduce fraudulent or duplicative benefits. However, the SSA cannot be everywhere at once, and depends largely upon anonymous reports by concerned citizens to ferret out specific instances of fraud. Read on to learn more about disability fraud and what you should do if you know someone who is committing fraud.
What is Social Security Disability fraud?
There are several ways an individual can commit disability fraud.
The first involves the creation of a false disability, or the exacerbation of an existing disability. In some cases, an individual may withhold medical information from the SSA that indicates he or she is able to perform paid work, or even collude with medical personnel to falsify medical records to establish a disability that does not exist.
Another common type of fraud deals with Supplemental Security Income (SSI). This program differs slightly from SSD in that it is available only to those who don't have the requisite work credits to obtain SSD. Because the benefit amount is not based on an individual's work and earnings history (like SSD), the amount of your monthly SSI payment is generally very low. The SSI recipient is also subject to an asset test -- if the recipient ever obtains more than $2,000 in liquid assets (or $3,000 if married), the SSI payments will cease.
To commit SSI fraud, recipients simply fail to report any assets over the $2,000 threshold. Because SSA employees are overworked and are largely unable to monitor individual cases, they rely on self-reporting of income or asset changes. If an individual does not self-report, he or she may spend years collecting SSI payments to which he or she is not entitled.
The U.S. Government Accountability Office estimates that in 2014, more than $5 billion in "improper" SSI claims were paid -- largely due to this under-reporting of assets or the failure to report assets at all.
Why is it important to report suspected fraud?
Reporting suspected disability fraud is important for a number of reasons.
First, the Social Security Disability Fund is in trouble. Some estimates have this fund running completely dry in mid-2016 -- meaning that the only way the SSA will be able to pay outstanding SSI and SSD obligations is to directly funnel this money from payroll receipts. Without a change in the way funds are deposited, or changes in the amount of Social Security Disability taxes collected, current recipients could find their benefits being cut by as much as 20 percent.
By reporting suspected fraud when you stumble across it, you can help preserve future SSD and SSI funds for those who truly need them -- saving time and money.
What should you do if someone you know is committing disability fraud?
Your first step may be to confront the individual you believe is committing fraud. In some situations (particularly with a failure to report assets), this person may not even be aware he or she is in violation of the law. In some situations, a gentle reminder may be all that is needed in order to correct the situation.
If this isn't an option, you can also contact the SSA's Office of Inspector General to make an anonymous report. The Inspector General has an entire fraud division devoted to tracking down fraud through anonymous tips and other information.
If you have more information, contact experienced social security attorneys in your area.