The Social Security Administration (SSA) receives applications for disability benefits and a whole host of other support options on a regular basis. Unfortunately, some claims are fraudulent. As such, the SSA has developed ways of identifying fraudulent claims before they can be approved. While this can help prevent fraud, some legitimate claims end up incorrectly flagged as fraud. If this happens to you, you should contact a lawyer for help.
Your claim might be flagged as fraud if certain details in your application do not add up or contradict each other. This might be due to typos in your initial application, missing paperwork, or incomplete application materials and documentation. Many of these are correctable errors. Others might require a hearing to correct. Even something as minor as missing information might lead the SSA to suspect that you are concealing material facts or providing misleading or false details. This can lead to serious trouble, and you may need an attorney to help you sort everything out.
For a private, free review of your situation, call our Arkansas disability benefits attorneys at (479) 316-0438.
What Happens if Your SSDI Claim is Believed to Be Fraud?
Applications for Social Security Disability Insurance (SSDI) benefits tend to be met with heavy scrutiny. If the SSA suspects a claim is not legitimate, it may flag it as fraud.
If your claim is flagged for fraud, the SSA will likely deny the claim. You might not even know that your claim was flagged for fraud until you receive an official denial letter in the mail. While you can file an appeal, this will take more time, and you will have to go even longer without the benefits you need.
In some cases, claimants who file fraudulent claims face legal penalties. According to 42 U.S.C. § 1383a(a), a person who knowingly and willfully makes false statements or representations of material facts in any application for Social Security benefits may be fined and possibly imprisoned for up to 5 years.
You should hire a lawyer immediately if you have not done so already. Your claim might not even be fraudulent, but you stand a better chance of defending yourself and getting your claims approved if you have an experienced attorney on your side.
Common Examples of Fraud in SSDI Cases in Arkansas
Knowing what kind of fraud the SSA is looking for can help you avoid being unnecessarily flagged. If you have already been flagged for fraud, you might be dealing with one of the following common scenarios.
False or Misleading Statements
Your application may be flagged as fraud if the SSA believes it contains false or misleading information. For example, the SSA might suspect that your medical records are faked or that material facts about your medical conditions have been falsified or embellished.
It is also possible that the SSA thinks you provided false or misleading information about your ability to perform substantial gainful activity. Our Arkansas disability benefits attorneys may need to present additional evidence of these details to prove that they have not been falsified.
Concealing Facts
Rather than providing false or misleading information, the SSA might believe that you are not including all necessary information in your application. Hiding details about your condition or ability to work is also considered a form of fraud and may cause your claim to be flagged or denied.
This might happen if you forgot to inform the SSA of changes in your condition if you are currently receiving SSDA benefits. Alternatively, you might not have provided the most recent copies of medical records about your conditions, even if your medical condition has not changed.
To you, these are minor errors. To the SSA, this may be fraud.
Identity Theft
The SSA may immediately flag your application as fraud if it believes you are using someone else’s information to file for SSDI benefits. Not only is this going to lead to a speedy denial, but identity theft is a serious criminal offense that can lead to severe penalties. You might also face penalties for allowing someone else to use your information to file for SSDI benefits.
This can sometimes occur when a family member applies for benefits on behalf of another family member who might be in such poor health that they cannot prepare or submit the claim on their own.
How to Prove Your SSDI Claim Was Not Fraud
One way to prove that your claim was not fraudulent is to request a hearing. According to the SSA, you have 60 days to request a hearing after receiving a determination or decision about your claim. If you do not submit your request on time, you may have to explain why and hope that you are granted an extension.
You and your lawyer should prepare evidence that directly addresses the fraud issues. If the SSA believes claims about your medical condition are misleading or false, we should get the most recent copies of your medical records available and written statements from doctors proving otherwise.
Common Reasons Why SDDI Claims Are Flagged for Fraud in Arkansas
Minor mistakes when you file your application may lead to being flagged for fraud. While some problems can be corrected quickly, others might require more time and effort.
Application Errors
Many claims are flagged for fraud because of typos in important information, like Social Security numbers. Using the incorrect name or discrepancies in other identifying information are not unusual. This can happen when people have recently changed their name, moved to a new address, or other important information has very recently changed.
Incomplete Evidence
Some claims are flagged for fraud because of missing or incomplete documentation, like medical records and employment information. When information is missing, the SSA might believe that you are intentionally withholding or concealing important facts. This may be particularly problematic when important details are provided, but they are too vague, arousing suspicion.
Not Following Your Doctor’s Orders
The SSA will check to see that you are complying with your doctor’s treatment plans. If you are not, the SSA might believe that you are making your own injuries worse.
In some cases, the SSA might believe that you are not complying with your doctor’s orders because you do not need to, because your injuries are not real or not as bad as you claim.
Contact Our Arkansas Disability Benefits Lawyers for Legal Help Today
For a private, free review of your situation, call our Bella Vista, AR disability benefits attorneys at (479) 316-0438.