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Disability fraud is the receipt of payment(s) intended for the disabled from a government agency or private insurance company by one who should not be receiving them or the receipt of a higher amount than one who is entitled to them should be receiving. There are various acts that may constitute disability fraud. These include feigning a medical problem in order to be declared disabled, exaggeration of an existing medical problem that potentially can but in reality does not render the person disabled, continuing to receive payments after having recovered from a medical problem, or continuing to receive payments while working (usually unreported) above the allowable level for those receiving the payments.
Disability fraud can be harder to detect than other forms of fraud, as the majority of people receiving disability payments (at least 90%) do not use a wheelchair or walker, while at the same time, many people who need wheelchairs would not qualify for disability payments. Since most disabilities are "silent" (meaning that they cannot be seen by others), it is not easy to visually determine if a person receiving disability is not disabled. Such people are often able to perform physical activities, but have some other underlying cause of their disability. It is therefore common for people to believe they must report a neighbor who they see, for example, climbing on the roof while collecting disability payments. But this is not always the case.
Meanwhile, true disability fraud cases exist, for which it is hard to determine the cause as being fraudulent. Often, the perpetrator claims to have a medical condition to be declared disabled. Some medical conditions are truly debilitating and make it impossible or difficult to work if one has them, but are hard to prove against one's own word that one does not have them. These include chronic fatigue syndrome, chronic pain, or various mental disorders. Even if one with one of them is viewed engaging in some other "work-like" activity not for pay, they may have difficulty holding a job.
It is possible that the illegal recipient of the disability payments is not truly disabled, and may have a case of work aversion, which in many countries is not alone considered a valid reason for being declared disabled, or the person may otherwise lack a work ethic. Others who are receiving payments are actually working, but are not reporting their employment and collecting their income in a manner that cannot easily be detected.
Disability fraud can result in denial of future benefits as well as criminal prosecution.
The Social Security Administration does not accept reports from callers who think that a person receiving benefits does not "appear" disabled.