disability fraud

Disability fraud is, in US criminal and legal usage, a descriptive umbrella term for fraud committed against the disability benefit programs administered by the Social Security Administration (SSA) — primarily Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). The term covers situations in which a person provides false or misleading information in order to obtain or continue receiving benefits to which they are not entitled, including by concealing work, income or their actual state of health.

It is essential to understand that "disability fraud" is not in itself a freestanding federal criminal offence with a specific section number. The term functions as a legal and administrative umbrella label covering a range of different federal offences that are typically used in prosecuting such cases — for example fraud, making false statements and document forgery.

The SSA's Office of Inspector General (OIG) uses the term for suspected or established fraud in the disability programs and is the principal federal body responsible for investigating and uncovering such cases. The OIG can refer cases to the US Department of Justice for criminal prosecution.

In the case of attorney Eric Conn — described as the largest Social Security fraud scheme in American history — disability fraud took the form of a systematic and organised scheme in which Conn, working together with a federal judge and a physician, secured approval of thousands of unwarranted disability applications using fabricated medical records and false medical certificates. The case illustrates how disability fraud involves not only applicants, but may extend to professionals throughout the administrative system.

Overall, disability fraud differs from individual welfare fraud in its potentially systemic character: when attorneys, doctors and officials are involved, the scale of the fraud can reach a level that undermines the integrity safeguards of the social security system itself.