Disability fraud can be defined as one person (or a group of people) who willingly accepts and collects disability payments from either a place of business, social security office, insurance company/financial institution, or by other places of business when they are not actually disabled. Disability fraud can also be executed when someone takes a paid family leave claiming to be suffering from an injury or if a family member needs to be cared for when in fact these claims are false. Often times, criminals that commit disability fraud can be hard to capture.

This is due to the fact that it is not always obvious to detect who is actually disabled versus someone who is not. Unless someone is seen using a device that aids their disabled state (i.e. a walker or wheelchair), it is difficult to decipher as many people walking around freely could still be considered disabled in some way or another.

In fact, nearly ninety percent of people on disability do not require the need of a wheelchair or walker, making it much more difficult to determine who is actually disabled or who may just be faking disability as a means to commit disability fraud. Reports concluded that between the years of 1994-1995, that more than twenty million Americans qualified for disability, and approximately only two million of them needed wheelchairs or walkers.

The term “invisible disabilities” can be used to define disabilities that are not visually recognizable to others. Some forms of invisible disabilities can include: mental illness, chronic pain, chronic dizziness, and chronic fatigue.

When criminals find a way to obtain easy money, they are likely to take advantage of it. Disability benefits fraud is one of the most common forms of fraud in the United States, and it is committed by millions of criminals yearly. Criminals commit disability benefit fraud by filing false disability claims within social security offices in order to collect disability benefits. Disability benefits fraud is also considered a form of government benefit fraud disability fraud detection.

 

 

There have also been reports of cases where people have filed a claim for US Veteran's disability benefits under false pretenses as a way of committing disability benefits fraud.  Fraud investigators can more easily provide evidence of this type of disability fraud by conducting a records search.

The Social Security Administration (SSA) has tried to make changes in their legal outlines in regards to disabilities in an effort to prevent disability fraud from occurring. If a criminal is prosecuted of such crimes, they can succumb to a variety of penalties. One penalty usually given out for the crime of disability insurance fraud is restitution.

 

 

Restitution is when a court orders that the criminal be required to pay back the amount of benefits that were collected while committing disability insurance fraud. Depending on the severity of the crime, additional fines may be added. When disability insurance fraud is carried out that is considered to be especially heinous, the criminal in question may also be sentenced to probation, community service, or even jail time.

 

 

Jail time can include up to thirty years in a state penitentiary. This is especially true if there is an excessive financial amount accrued or, if somehow, it involves taking advantage of a child or the elderly.

 

 

Reports have shown that the SSA has tried to step up penalties by laying out certain guidelines and enforcing more concrete laws when it comes to filing false statements within disability paperwork. The penalties given out for such offenses are stated as: a criminal committing a first offense of filing false statements while filing for disability is to be sentenced to six months of loss of disability payments, a second offense will result in twelve months, and a third offense will result in twenty four months.

 

 

In additions to losing the ability to collect benefits for a long period of time, civil and criminal courts may also issue additional penalties. In addition to fines and restitution, the criminal prosecuted may also be ordered to pay a twenty-five to thirty percent penalty fee from the amount of over-payments they received. In most cases of disability insurance fraud where penalties are issued in the form of prison sentence and fines, these sentences are about five years in prison and usually up to about two hundred and fifty thousand dollars in fines.

Statistics show that more and more married couples are teaming up every year to commit a form of disability fraud by not reporting marriage. Both of the individuals involved claim being "single" in order to receive more money in return when attaining their SSI (Social Security Income) from the government at the expense of the taxpayers. By making false statements, this is also considered document fraud, and can be tried in court under the Fraud Enforcement and Recovery Act of 2009.

 

 

If an individual(s) is found guilty of this kind of social security disability fraud, depending on how long the act of fraud has taken place and how many over-payments have been collected from the government, the prosecuted may face severe penalties including: jail time, fines, restitution, probation, and restrictions on collecting future disability benefits. 

 

Criminal will often not report their income as a means to commit disability fraud. This is considered disability fraud when an individual who is not supposed to be working due to a disability, or a person on disability claims to be unemployed when in fact they are employed, but does not report their income.

This allows the criminal to illegally collect disability benefits while also collecting payments from their place of employment. This crime occurs whether the criminal is not reporting checks or if they get paid “under the table,” and do not claim this either. The criminals will even go as far as to set up unreported bank accounts to keep the unclaimed cash flow from their jobs.

The Social Security Administration (SSA) works hard to detect this type of fraud by monitoring checks and by using the method of redetermining to decide if over-payments or fraudulent activities may be occurring. If the SSA feels that something is amiss in an individual’s wage claims, this may lead to a fraud investigation. If too many benefit checks and employment checks are being cashed by the same person, then an investigation may be conducted.

Fraud investigators will most likely be hired as a means to conduct surveillance on the suspect in question to determine if they are unlawfully accepting unreported payments while also accepting disability payments. Fraud investigations may also be used to research the suspect’s background information, records, and employment history to determine if the suspect is, in fact, a likely candidate to commit disability fraud.

Fraud investigators are often hired by the suspect’s insurance company, place of employment, another individual who suspects the crime, or the government. Disability fraud reporting 

One of the most common disability fraud types 

Disability fraud falling into the category of "reporting blindness" can also include criminals taking advantage of acts intended to help the legally blind return to work. One of these acts can include, "The Blind Persons Return to Work Act of 2010".

 

 

This recently activated act, proposed by Senator John McCain, was meant to serve as a means for people suffering from legal blindness to be able to return to work, while also collecting disability benefits as a result of being blind. This act was meant to serve the disabled party as a means of allowing a transition period for those suffering from blindness to feel that they may still be able to work.

 

 

This is also the case with another program created for the disabled by the government, which enables them to work while still receiving benefits, known as the "Ticket to Work" program. The Ticket to Work program has a trial period where individuals suffering from a disability (there is a category for blindness) can still collect benefits while working no matter how much they make. However, once the trial period ends, the individual claiming disability must only be allowed to still collect if their income does not exceed past a specific amount.

 

 

If a suspect is found guilty of disability fraud, a fraud investigator may be called upon in trial to provide hard evidence proving that the guilty party is, in fact, not legally blind. Penalties may include jail time, heavy fines, denial of future benefits, and restitution.

When a death of a friend or family member occurs, it is important to alert social security offices immediately. This is due in part to stop social security income checks from being issued to the deceased. It is the sole responsibility of the person who is receiving these payments to report the death to the social security offices.

 

 

When some people do not report the death, some individuals will attempt disability fraud against a loved one who has been deceased by continuing to accept the beneficiary's social security income checks/disability benefits/disability claims. Most times, it is family members who illegally collect disability claims on their behalf.

 

 

In an attempt to stop this type of fraud, the Social Security Administration (SSA) compiled a master list which they call, "The Death Master File" to help conduct disability fraud detection 

In order to report disability fraud, there are two main offices that accept disability fraud reporting. These offices include social security offices and state labor offices. The social security offices strongly enforce contacting their offices if a disability scheme has been perpetrated.

 

 

There are three ways that a report can be filed: a report can be filed online, by dialing a hotline provided by social security offices  (Social Security Administration Fraud Hotline: 1-800-269-0271), or in the office itself. If filing a claim with social security, it is most likely that a fraud investigation will be conducted by the office of the social security general inspector.

 

 

It is recommended for the person filing the claim to ensure that the information reported is accurate and documented. It should also be noted that not every disability is obvious, and the victim could be suffering from an invisible disability (a type of disability that may not be able to be seen). In some cases, a person can still function in everyday activities while being considered disabled. One of the most common mistakes committed with disability fraud detection are witnesses making false assumptions.

 

 

It is also important to understand what activities are considered to be acts of fraud in order to report disability fraud. For example, if the party in question is: lying about their work status in order to receive disability benefits, pretending to be ill in order to receive benefits, or they are no longer ill but are still accepting benefits, then these are definite forms of activity that should be released when disability fraud reporting.

 

 

It is also important to disclose as much vital information as possible including: the name and contact information of the person committing the fraudulent act, any names of victims that have suffered due to these criminal acts, the perpetrator's place of employment, when and where the fraud took place, if the person in question has other violations or a criminal history, and why they committed the act of fraud.

 

 

It is also important not to make assumptions, and to report the facts that you know are true. If you are still unsure of where to report disability fraud, contact local law enforcement.

When an individual does not report changes in employment to the social security offices, this is also considered another form of disability fraud. For example, if someone was unemployed while collecting disability, but they recover and start working while failing to report these changes to the government, this would probably be considered a federal offense.

 

 

This is considered fraud because when a person has not reported these changes to the government, than the government is still under the impression that the criminal in question is disabled. This allows the criminal to fraudulently collect both a paycheck and disability benefits.

 

 

Although "disability fraud" and "employee fraud" do not have the same definition, this specific case of disability fraud can fall under the category of employee fraud. Employee fraud is when an employee provides information to their employer that is proven to be false.

 

 

In some cases, employee fraud includes giving in accurate information on a resume, but in the case of disability fraud, employee fraud can be telling an employer they are able to work while the government still believes that they are on disability. Employee fraud can be reported to labor unions and to an employee fraud hotline.

 

 

Many times, social security offices will allow a trial period in which you will be allowed to collect while working as a transition from disability to be employed.  However, unreported income