I-1-3-1. Criminal Violations of the Social Security Act and Other Federal Statutes

A. General

The Social Security Act prescribes criminal penalties for violation of its provisions concerning fraud, disclosure of certain information, and representation. The purpose of these criminal provisions is to protect Social Security beneficiaries and the general public, as well as governmental interests in maintaining the integrity of the claims process and the Trust Funds. In addition, among other things, the Federal Criminal Code generally proscribes acts involving false claims against the government and false or fraudulent statements made in matters before an agency. (Also, see HALLEX TI I-5-1-15 which provides guidance, in question and answer format, on processing cases involving issues of potential fraud, similar fault, and abuse.)

B. General Violations Subject to Criminal Prosecution

The following violations are subject to criminal prosecution for fraud:

1. Furnishing false information of identity in connection with the establishment and maintenance of Social Security records, or with the intent to gain information as to the date of birth, employment, wages, or benefits of any person;

2. Forging or falsifying Social Security Administration (the Agency or SSA) documents;

3. Conspiring to obtain or allow a false, fictitious or fraudulent claim;

4. Using a Social Security number obtained on the basis of false information or falsely using the Social Security number of another person, for the purpose of obtaining or increasing a payment under Social Security or any other federally funded program, or for any other purpose;

5. Altering, buying, selling, or counterfeiting a Social Security card;

6. Disclosing, using, or compelling the disclosure of the Social Security number of any person for unauthorized purposes;

7. Making or causing to be made a false statement or representation of a material fact for use in determining rights to Social Security benefits, Medicare, or Supplemental Security Income;

8. Making or causing to be made any false statement or representation of a material fact in any application for any payment or for a disability determination under the Social Security Act;

9. Making or causing to be made any false statement or representation as to:

   • Whether wages were paid or received, the amount of such wages, the period during which wages were paid or received, or the person to whom such wages were paid; or

   • Whether net earnings from self-employment were received, the amount of such earnings, the period during which such earnings were received, or the person who received them;

10. Concealing or failing to report any event affecting the initial or continued right to payment received or to be received by a person individually or on behalf of another;

11. Converting all or any part of a payment received on behalf of a beneficiary to a use other than for the use and benefit of that beneficiary;

12. Falsely representing oneself to be an employee of the U.S. Government;

13. Accessing Agency computer records without authorization;

14. Disclosing unauthorized information from the Agency's systems of records;

15. Receiving or soliciting a bribe, illegal gratuity, or contribution to or supplementation of salary for U.S. Government service.

A party may be subject to criminal prosecution even when the attempted fraud was unsuccessful and the Government has not made payment as a result. The penalty upon conviction for violation of the criminal provisions of the Social Security Act may be a fine, imprisonment, or both.