What to Do If You’re Investigated for SSDI Fraud

The Social Security Administration (SSA) takes disability fraud seriously. They want to prevent people from scamming the system, so they can and do investigate people suspected of SSDI fraud.

When you’re making a claim for disability benefits, the prospect of being investigated is upsetting. Could you be investigated, even if you’ve done nothing wrong? What happens if you’re suspected of fraud?

Let’s dig into SSDI fraud: what it is, how investigations start, and what to do if you find yourself under investigation.

What Is SSDI Fraud?

Social Security disability fraud involves lying, falsifying information, or withholding information from the SSA in order to receive benefits you wouldn’t otherwise be entitled to.

There are a couple of different main types of SSDI fraud:

Lying on your application

If you lie on your Social Security disability application, this is a form of fraud. An example of this would be listing your monthly income as higher than what it actually is in order to increase your monthly benefits payments.

Falsifying medical records

Creating false medical records and lying about your health condition is SSDI fraud. An example of this would be lying to the doctor to make your disability seem worse than it is, in order to get benefits.

Failing to notify the SSA of changes to your condition

Because you’re only entitled to benefits for as long as you are disabled, a failure to notify the SSA of changes to your condition is considered fraud. This is especially the case if you fail to notify the SSA of medical improvement, which would make you ineligible for SSDI benefits.

Failing to let the SSA know about changes to your employment and income

Social Security disability benefits are only available to people whose disabilities prevent them from working. If you begin working again, you must notify the SSA of your employment status and income. Failing to report income—say, by getting paid “under the table”—is fraud.

Failing to let the SSA know the actual recipient of benefits has died

Another type of SSDI fraud involves failing to notify the Social Security Administration of the recipient’s death. For example, if your spouse passed away and you continued to cash their benefits checks, this would be fraud. (Survivor benefits may be available, but you would need to apply to the SSA directly, not continue cashing the checks.)

How SSDI Fraud Investigations Start

Investigations into someone’s SSDI claim can start in any number of ways. (There’s even an anonymous hotline to report fraudulent activity.) Commonly, they are started by SSA employees who notice inconsistencies in the person’s application or suspect lying.

Investigations can take place before the claim is finalized and benefits are awarded. They can also take place during the Continuing Disability Review process (when the SSA reviews your claim every few years).

In an SSDI fraud investigation, the SSA takes a hard look at your claim for inconsistencies. They may look at your social media pages for photo or video evidence of fraud. They may talk to your neighbors, your family members, and your friends. They may follow you, record your activities and statements, or show up at your house. Doing this, they are hoping to find evidence that you are committing fraud—such as faking or exaggerating your disability or engaging in substantial gainful activity.

What to Do If You’re Investigated for SSDI Fraud

It’s understandable the SSA wants to avoid fraud: that’s money stolen from real people with disabilities who need and deserve benefits. However, the unfortunate fact is that sometimes, people who aren’t lying find themselves under investigation.

This can happen if, for example, you make a mistake on your application or if someone at the SSA makes a mistake. (Mistakes can make it look like you’re lying.) Unnecessary fraud investigations can also happen if someone (say, a doctor or neighbor) incorrectly suspects fraud and reports you to the SSA.

If you are being investigated for SSDI fraud, it’s important to get help. In this case, it’s best to talk to an attorney about your case. Having an experienced, knowledgeable attorney on your side can make all the difference. A qualified attorney can help prove your claim and be your advocate in and out of the courtroom.

SSDI fraud is serious business, and the penalties are steep. Those who are found guilty of “theft of public funds” (a felony!) will lose access to SSDI benefits, be forced to pay hefty fines, and even face jail time.

Call Us Today

You don’t have to go it alone!

Call us today to schedule a consultation with one of Casper & Casper’s experienced Social Security Disability attorneys. We’re here to help you, whether you need to file a claim or defend yourself during an SSDI investigation.