Is Social Security Fraud Keeping You from Getting Benefits?

Social Security fraud

The SSA’s disability benefits program is often accused of being a hotbed for Social Security fraud. News outlets even try catching fraudsters in the act, using phrases like “extra cash” and “milking the system.” But are they right? Is the Social Security disability program overrun by con artists stealing disabled people’s money?

The answer isn’t simple, and opinions on the subject vary depending on who you ask. Below, we’ll explore the numbers to see whether Social Security fraud is as rampant as people believe.

What Is Social Security Fraud?

This question may seem obvious, but in the world of Social Security, “fraud” has many definitions. Some people don’t even realize they’re committing acts that may fall under the fraud or misuse categories. According to the Office of the Inspector General (OIG), these may all be considered as Social Security fraud:

  • Making false statements on claims
  • Concealing facts or events that affect a claimant’s eligibility
  • Misusing benefits as a representative payee
  • Buying or selling counterfeit or legitimate Social Security cards
  • Social Security Number (SSN) misuse involving any terrorist groups or activity
  • Crimes involving Social SSA employees
  • Scams involving the impersonation of any SSA employee
  • Bribing any SSA employee
  • Fraud or misuse of a grant or contracting funds
  • Standards of conduct violations by SSA employees
  • Workers’ compensation fraud

As you can see, Social Security fraud impacts more than just program beneficiaries. Even Social Security Administration (SSA) employees aren’t safe from investigation when fraud accusations happen. When you apply for disability benefits, the SSA requires truthful answers about your condition and limitations. Failure to do so could result in a criminal investigation or termination of your benefits. Of course, the agency also trusts that SSA employees will follow the program’s code of conduct.

How is Social Security Fraud Recorded?

Every six months, the Office of Inspector General (OIG) releases a semiannual report to Congress. This report sheds light on the department’s fraud investigation and recovery efforts. The SSA releases both Spring (October-March) and Fall (April-September) editions — accounting for the prior fiscal year. If you’d like to check out the report yourself, you can find a summary on the OIG’s website. These reports can better explain how fraud affects different Social Security programs. In addition, these reports list all monetary recovery efforts. In addition, tracking these statistics maintains the integrity of the program by weeding out individuals that abuse Social Security funds. The OIG covers fraud investigations and recovery efforts for the following programs:

  • Social Security disability insurance (SSDI) benefits
  • Supplemental Security Income (SSI) benefits for lowest-income Americans who are blind, disabled or aged 65+
  • Social Security number (SSN) misuse
  • Old-age survivors insurance
  • Threats/employee safety
  • Employee-related theft

The OIG received a total of 192,030 Social Security fraud-related allegations in fiscal year 2018. These allegations were distributed among the categories above, including 42,465 allegations specifically about SSDI fraud.

The 2018 Fiscal Year Investigative Results Into Social Security Fraud

Now that you know what a fraud allegation is, let’s explore the OIG’s investigative results for 2018. Below, we’ve mapped out exactly how many allegations were received. We’ll also list the total opened cases, how many the OIG closed, and any penalties levied against alleged fraudsters.

  • Total allegations received: 192,030
    • Allegations specifically about Social Security Disability Insurance (SSDI) fraud: 42,465
    • Allegations specifically about Supplemental Security Income (SSI) fraud: 22,030
    • Percentage of all fraud allegations specifically related to disability benefits: 33.5%
  • Cases opened: 5,585
  • Cases closed: 6,004
    • Arrests: 274
    • Indictments/informations: 733
    • Criminal convictions: 776
    • Civil Action/CPMS: 82
  • Projected SSA savings: $251.9 million

What Does The Social Security Fraud Data Actually Mean?

In 2018, there were approximately 192,030 allegations of Social Security fraud. However, the OIG only opened 5,585 cases for investigation. This means just 2.9% of allegations warranted further investigation by the OIG. While there’s no indication why the agency opened so few investigations, lack of evidence may play a role. Understaffed agencies with few resources available may report such low numbers. Recent funding cuts to both the SSA and OIG seem to support this conclusion.

On the flip side, we noted that of 6,004 closed cases, 1,865 resulted in arrests, indictments/informations, criminal convictions or civil actions/CMPs. This means nearly 1 in 3 (31%) closed cases resulted in some form of prosecution. While these numbers don’t represent most closed cases, it shows that the OIG is taking action against criminals actively trying to scam the nation’s Social Security programs.

The SSA investigations came from an OIG and SSA initiative known as the Cooperative Disability Investigations (CDI). The efforts put forth by the CDI resulted in nearly $252 million in projected SSA savings. These savings are a huge accomplishment! That money can now potentially help address agency staffing issues or go directly to those who need it most.

Our Take on Social Security Fraud

So, is Social Security fraud really as bad as it seems? The numbers say otherwise. Let’s put it this way: In 2018, about 62.9 million people collected benefits from the Social Security program. Yet the OIG received just 192,030 Social Security fraud allegations that same year. For perspective, that means just .3% sparked any notion of suspicious activity. This small number speaks volumes about the program’s overall integrity. There will always be some tiny fraction of fraud, waste and abuse in any government program. The lesson here is that it doesn’t represent anything close to most people who apply for and receive Social Security benefits today.

Remember: We’re listing the accusation numbers the OIG determined had any merit and were worth investigating here. But there will always be a few criminals who manage to fall through the cracks. If you suspect fraud, don’t be afraid to report it! The OIG and SSA encourage citizens to speak up and not ignore any warning signs. Visit the SSA’s website to report any fraud, misuse or abuse cases that you suspect. You can report your suspicions anonymously, whether it’s a private individual or business. The OIG will investigate any allegations with merit, and publish their results in an upcoming semiannual report. You don’t have to include any personal information to report what you suspect may be Social Security fraud.

You May Qualify for Legal Assistance

When you apply for disability benefits, it’s crucial to be honest on your claim. Exaggeration or lack of documentation can raise red flags with Disability Determination Services (DDS). In fact, it’s the exact thing that gets some claims flagged for Social Security fraud reviews. If you’re worried about making a mistake on the claim form, talk to a Social Security attorney today. These lawyers always work on contingency, which means you’ll pay nothing for legal assistance now. And having a lawyer file your claim makes you 2x more likely to get approved for benefits on your first try! If the lawyer does help you win benefits, you’ll only pay a small, one-time fee.

Ready to see if you may qualify? Click the button below to start your free benefits evaluation now.

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