Social Security Fraud Attorneys
Our Health Law group has extensive experience in providing aggressive legal representation to those accused of or potentially connected to fraud in any capacity.
Our expertise spans both inside and outside of the courtroom as our attorneys are experts in advising clients on everything from compliance with complex social security fraud laws to a relentless defense once a charge has been brought.
What is “Social Security Fraud?”
Social security fraud is a type of fraud to collect disability benefits from the Social Security Administration (“SSA”).
Social security fraud generally occurs when one falsifies a medical condition, income, assets, previous employment, age, and other criteria that affect one’s eligibility to obtain such benefits.
Social security fraud is a very serious offense and can be charged as a felony punishable by fine and/or imprisonment.
Federal Social Security Fraud
Social security fraud is punishable under many federal statutes.
42 U.S.C. 1383(a), Sec. 1632
42 U.S.C. 1383(a), Sec. 1632 punishes social security fraud by fine and/or imprisonment of up to five (5) years for knowingly and willfully falsifying a material fact.
If the individual is a healthcare provider, fine/imprisonment up to ten (10) years for submitting or facilitating the submission of evidence to support an application for benefits containing falsified information, additionally, the individual may be ordered to pay restitution.
The False Claims Act of 31 U.S.C. 3729
The False Claims Act of 31 U.S.C. 3729 also punishes one who knowingly presents or facilitates the presentation of a fraudulent application for benefits or approval of payment, or knowingly creates or facilitates the creation of a false record or statement material to a fraudulent claim for benefits.
18 U.S.C. 1001
18 U.S.C. 1001 punishes social security fraud by fine and/or imprisonment of up to five (5) years for knowingly and willfully falsifying or concealing a material fact, or participating in such scheme; advancing a materially false statement, or making/using any fraudulent writing which one knows contains any materially false statement.
42 U.S.C. 1307 – Misdemeanor Fraud
42 U.S.C. 1307 is a misdemeanor and makes it illegal to make a false statement is punishable by a fine of up to $1,000.
Who Regulates Social Security Fraud?
The Department of Justice (“DOJ”) has long demonstrated a firm commitment to preventing and pursuing the maximum punishment for social security fraud.
The DOJ remains steadfast in such commitment as it views preventing and punishing such fraud as one of its most significant duties to the American public.
To further its policy of zero tolerance, law enforcement has advanced tools in place to detect and combat social security fraud.
Such anti-fraud tools continue to develop and evolve to prevent fraud.
This year, the SSA and its Office of the Inspector General (“OIG”) created three investigation units to detect and combat fraud as part of the nationwide Cooperative Disability Investigations Program (“CDI”).
The CDI is one of the most successful anti-fraud programs in the realm of social security. As such, a great defense is critical to escaping these heavily prosecuted charges.
Social Security Fraud in the Context of Healthcare
Healthcare providers can be found liable for social security fraud if they knowingly provide false evidence to support a fraudulent claim for benefits or assist the creation of a fraudulent claim for benefits in any way knowing such application for benefits contains materially false information.
The penalties suffered by such individuals have comprised a loss of liberty, heavy fines sometimes consisting of hundreds of thousands of dollars for restitution, as well as the loss of hard-earned reputations and licenses arduously acquired by such individuals.
Social Security Benefits Fraud In The News
The U.S. government continues to build a strong track record of convictions of social security fraud. In recent times, a federal judge convicted a clinical psychologist for participating in social security fraud scheme.
The doctor was found to have submitted thousands of falsified medical documents to advance the fraudulent claims of patient-applicants.
In making its decision, the assistant attorney general emphatically condemned the doctor for “abus[ing] the trust placed in him as a professional for personal gain” and attributed the success of securing a conviction on law enforcement’s years-long dedication in investigating the case. (citation).
Such case exemplifies a pattern of convictions the federal government has been successful in securing against healthcare providers.
However, in spite of such success, a good defense has proven successful in helping healthcare providers avoid imprisonment.
Recently, a former psychiatrist successfully avoided imprisonment for social security fraud.
The doctor was charged with social security fraud for submitting medical reports to support an application for disability benefits.
The doctor earned substantial financial benefits for his participation.
He was earning thousands of dollars for his visits, the preparation, and submission of medical reports, which included backdated medical records to falsify a longer record of treatment.
The doctor was able to successfully avoid a potentially decade-long imprisonment.
Defenses to Social Security Fraud
Lack of Intent
One of the most effective yet most difficult defenses to charges of social security fraud would be to prove that the accused did not have the intent to defraud.
A skillful attorney would need to prove that the accused did not knowingly or willingly falsify evidence to support a fraudulent application for benefits.
In the context of healthcare providers, one would have to prove that the records submitted were not intentionally based on false information or created with the intent to deceive.
Another possible defense would be to prove that there is insufficient evidence on which the conviction can be based. To secure a conviction, the prosecution would have to prove that the accused commit social security fraud “beyond a reasonable doubt.”
Under this standard, evidence may be found to be insufficient if it can be proven that the accused’s records contain medical opinions which do not necessarily amount to facts and are thus, not actionable as fraud.
A highly skilled and experienced defense attorney can determine the effectiveness of these defenses.
The Best Defense Is a Good Offense
If you suspect that you may have committed social security fraud, are being investigated, have been charged, or are simply looking for ways to avoid any connection to social security fraud, our attorneys are uniquely suitable to protect your high-stakes interests.
Not only do our attorneys bring decades of expertise in securing acquittals for fraud, but they have also cultivated a rare foresight as to the prosecution’s processes in building a case against you as well as other potential strategies.
Many of our attorneys are former prosecutors. As such, they have certain insights which can and have lead to highly favorable outcomes for our clients.