How to Report Fraud?

[kilee]

We know a man "Bill" who we are absolutely sure is committing fraud and want someone to at least look into it. He is a relative of my dh's and he agrees it's time someone looks closer at "Bill".

"Bill" was in a car accident about 3 yrs ago. This was a pretty minor accident and "Bill" was able to drive his car home from the scene and not go to the hospital until the next day for back pain.

Fast forward 3 yrs and "Bill" is no longer working and was awarded permanent disability recently through social security and he still has a lawsuit against the insurance company. I never thought in a million years he'd win the first one, because he is NOT disabled.

"Bill" claims his back is so bad he can longer function, lift anything, stand for more than a few minutes, or walk for more than a 100 feet at a time. However since the accident "Bill" plays horseshoes, walks for hours at a time, has completely remodeled an entire house including hanging drywall on the ceiling (lifting it up there and hanging it), he has worked extensively on his car. He wears a back brace and walks w/ a cane only when he's where he thinks people will see him. A few months ago we were on a camping trip w/ him and he used none of these things and helped carry wood and stuff.

Anyhow, for the car insurance company I found a phone # to call and report possible fraud, but I cannot find anything for SSDI. Does this sound like the type of thing that would be reported? Should we stay out of it?

 

[hereyago]

I believe there is fraud contact information on the Social Security official website.

And no, you shouldn't stay out of it, because people like that are stealing from the U.S. taxpayer.

 

[PUZZLDY5]

Not to mention people like my husband (who are permanently disabled from back problems ) are fighting tooth and nail for disability with social security. (and have been turned down twice already!) It's awful for people to "take advantage" of the system when there are people out there that do need it and can't seen to get it. OP please, for my husbands sake, call and report him.

 

[buckler]

This link has some good info.
http://www.ehow.com/how_5027053_report-social-security-disability-fraud.html

If you decide to proceed, the fraud report form is here:
https://www.socialsecurity.gov/oig/public_fraud_reporting/form.htm

One good piece of advice I found on one link is:
"Not all disabilities are visible to our eye, so you need to be careful before you report someone to the administration."

 

[kilee]

Thank you for the link, though it looks like it's mostly for OIG employee fraud.

 

[manning]

Not sure about social security but you better believe the insurance company has or will have enough on him that may put him into prison. They don't take fraud lightly!!

 

[jlewisinsyr]

Contact your State Department of Insurance, since you live in NY, it would be:

http://www.ins.state.ny.us/fdidxcon.htm

or

1-888-FRAUDNY

 

[Cheshire Figment]

The form states, on the top:

You can use this online form to report allegations of fraud, waste, and abuse concerning SSA programs and operations. Our office also addresses allegations of criminal activity and serious misconduct involving Social Security employees. Moreover, we have jurisdiction to investigate allegations of work and assets concealment, representative payee misuse and trafficking of Social Security numbers and cards.

Note that it is for any fraud, waste or abuse. The second sentence states they also (emphasis added) investigate employees.

So this is the proper form for reporting. Basically you would fill in Section II with as much information as you have, and then in Section IV basically put the information that you showed in the original post.

 

[a1tinkfans]

Ins fraud is very serious and can have huge penalties
If what you are saying is accurate, and I don't mean to doubt it...it is very serious indeed. As far as SSI goes they are generally very stringent with testing before awarding full disability...so potential fraud would be reviewed very very diligently.
Ins carriers use in-house units that specialize in potential fraud claims or outside vendors that do the same, when notified
Sad!

 

[hereyago]

I remember a few years back about a commercial about insurance fraud. It showed people doing stuff I think with the faces blurred out.

 

[legalsea]

We know a man "Bill" who we are absolutely sure is committing fraud and want someone to at least look into it. He is a relative of my dh's and he agrees it's time someone looks closer at "Bill".

"Bill" was in a car accident about 3 yrs ago. This was a pretty minor accident and "Bill" was able to drive his car home from the scene and not go to the hospital until the next day for back pain.

Fast forward 3 yrs and "Bill" is no longer working and was awarded permanent disability recently through social security and he still has a lawsuit against the insurance company. I never thought in a million years he'd win the first one, because he is NOT disabled.

"Bill" claims his back is so bad he can longer function, lift anything, stand for more than a few minutes, or walk for more than a 100 feet at a time. However since the accident "Bill" plays horseshoes, walks for hours at a time, has completely remodeled an entire house including hanging drywall on the ceiling (lifting it up there and hanging it), he has worked extensively on his car. He wears a back brace and walks w/ a cane only when he's where he thinks people will see him. A few months ago we were on a camping trip w/ him and he used none of these things and helped carry wood and stuff.

Anyhow, for the car insurance company I found a phone # to call and report possible fraud, but I cannot find anything for SSDI. Does this sound like the type of thing that would be reported? Should we stay out of it?

As one whom works for Social Security, I say: be not so quick to call fraud.

Folks, we have virtually no information. How old is the person? Education? Past work experience?

Many people in auto accidents do not have symptoms until days or weeks later.

If "bill" is 58 years old, has a limited grade education and mainly unskilled past work, then even if he can do 'light work' he could be found disabled.

Do not get carried away from the op's story.

Fraud? Sure, I see it all the time. Maybe that is the case here. But do not get carried away on such thin information.

 

[hereyago]

As one whom works for Social Security, I say: be not so quick to call fraud.

Folks, we have virtually no information. How old is the person? Education? Past work experience?

Many people in auto accidents do not have symptoms until days or weeks later.

If "bill" is 58 years old, has a limited grade education and mainly unskilled past work, then even if he can do 'light work' he could be found disabled.

Do not get carried away from the op's story.

Fraud? Sure, I see it all the time. Maybe that is the case here. But do not get carried away on such thin information.

If he hang his own drywall in his house on the ceiling when he isn't supposed to be able to , ding ding we might have a winner.

 

[buckler]

If he hang his own drywall in his house on the ceiling when he isn't supposed to be able to , ding ding we might have a winner.

For all we know he hung one drywall panel a day over the period of a month to accomplish the job. A drywall lift can be used to raise the panel to the ceiling. I'm partially disabled and I'm quite creative at figuring out ways to do things around the house when necessary. Instead of lifting, I'll slide things along the floor, bump them down the stairs etc.

 

[legalsea]

If he hang his own drywall in his house on the ceiling when he isn't supposed to be able to , ding ding we might have a winner.

Let me say this: read the OP's statement again. Then, imagine that he or she said the person 'parked in a disabled parking space' instead of receiving disability.

Why, we would have DIS people coming out of the woodwork saying "You can't make such quick judgments! People with depression can park in disabled parking spaces! Many of us have 'hidden' disabilities!"

The original poster is making all sorts of presumptions, as are others here, based on incomplete or misleading facts (e.g., maybe the person in question does, in fact, get disability for depression; or, maybe the person is 56 years old, etc).

 

[hereyago]

If the only time he wears a back brace and uses a cane is when he thinks someone is watchng him, ding ding.

If he is lifting firewood, ding ding.

ANd if you read the OP's original post, you would see that "Bill" lifted the drywall himself and hung it. And drywall isn't lite.

IF the OP saw him do these things and knows what his supposed limitations are, then guess what? He might be a big ol fraud. Sometimes a duck is a duck.

I'm just saying.

 

[kaytieeldr]

Understood - but respectfully, the person asking for information about reporting fraud is NOT quick to judge in any way. She's deliberate and fair, and if anything, extremely reluctant to make snap decisions (based on other posts).

Now, my own opinion: okay, sure, fine, "Bill" may have hung one sheet of drywall from the ceiling per month, over a period of months, using a variety of aids. Understood. But he's remodeled the entire house in less than three years? And works on his car? And can carry wood (not, apparently, one small log at a time a few feet at a time - or kilee would have said that) and even just GO camping, and walk for hours at a time?

No, he may not be faking. Absolutely. But since, if he is, WE'RE all supporting him, I have no objection to the companies and agencies responsible investigating further. That's it - just investigating. If they find his claim is legitimate, so be it. If they find he's been cheating, that's HIS problem.

 

[kaytieeldr]

Why, we would have DIS people coming out of the woodwork saying "You can't make such quick judgments! People with depression can park in disabled parking spaces! Many of us have 'hidden' disabilities!"

Except, ya can't At least not in Massachusetts. The ENTIRE purpose of a disabled parking space is to get the eligible person out of the flow of traffic as quickly and safely as possible. The eligible person must meet one of several physical conditions.

 

[buckler]

Understood - but respectfully, the person asking for information about reporting fraud is NOT quick to judge in any way. She's deliberate and fair, and if anything, extremely reluctant to make snap decisions (based on other posts).

Now, my own opinion: okay, sure, fine, "Bill" may have hung one sheet of drywall from the ceiling per month, over a period of months, using a variety of aids. Understood. But he's remodeled the entire house in less than three years? And works on his car? And can carry wood (not, apparently, one small log at a time a few feet at a time - or kilee would have said that) and even just GO camping, and walk for hours at a time?

No, he may not be faking. Absolutely. But since, if he is, WE'RE all supporting him, I have no objection to the companies and agencies responsible investigating further. That's it - just investigating. If they find his claim is legitimate, so be it. If they find he's been cheating, that's HIS problem.

I'm not familiar with the OP, so I wasn't questioning her decision, just cautioning to be extra sure before reporting him. I was a witness against someone in an insurance fraud case and he went to jail for it, so it's serious business. It was not the same situation as the OP's case.

 

[JerseyJanice]

It might be just me, but I wouldn't turn a relative in. It'd be no skin off my nose that he was collecting SS benefits or insurance money, so I wouldn't want the bad karma.

I would feel jinxed forever if I did what the OP wants to do.

 

[The Mystery Machine]

I guess I have to say something since my dh is suffering from back problems right now, going on a yr.

He may look fine however he is not fine. Unless you have access to his medical files, I cannot see making a judgement on the condition of his back based on what you see.

Just because he is doing these things, doesn't mean he SHOULD BE doing these things. YMMV, I just had to throw my 2 cents in.