The Social Security Administration (SSA) enforces penalties for individuals who knowingly make false or misleading statements or withhold material information.
In this blog post, we will explain the reasons for imposing these penalties, the consequences, and the process for appealing the decision.
- Why would SSA penalize me?
You may be subject to a penalty by the SSA if you knowingly make false or misleading statements or withhold information that is material to determining your initial or continuing eligibility for monthly insurance benefits under title II or benefits or payments under title XVI.
- What is the penalty?
The penalty results in nonpayment of benefits under title II and ineligibility for cash benefits under title XVI (including State supplementary payments made by SSA according to § 416.2005).
- How long will the penalty last?
The duration of the penalty depends on the number of times you’ve been penalized:
- Six consecutive months for the first time
- Twelve consecutive months for the second time
- Twenty-four consecutive months for the third or subsequent time
- Will this penalty affect any of my other government benefits?
The penalty only affects your eligibility for benefits under titles II and XVI. It does not impact your eligibility for benefits under titles XVIII and XIX, nor the eligibility or amount of benefits payable to another person under titles II or XVI.
- How will SSA make its decision to penalize me?
The SSA will base its decision on the evidence and reasonable inferences drawn from that evidence, considering factors such as physical, mental, educational, or linguistic limitations you may have had at the time. They will also assess the significance of the false or misleading statement or omission in terms of its likely impact on your benefits.
- What should I do if I disagree with SSA’s initial determination to penalize me?
If you disagree with the SSA’s initial determination, you have the right to request reconsideration of the penalty decision, which includes the opportunity for a face-to-face conference. You can choose between a case review, informal conference, or formal conference. If you still disagree with the reconsidered determination, you can follow the normal administrative and judicial review process.
- When will the penalty period begin and end?
The penalty period generally begins the first day of the month for which you would otherwise receive payment of benefits under title II or title XVI were it not for the imposition of the penalty. However, there are additional limitations based on whether or not you request reconsideration of the initial determination. The penalties will not run concurrently if more than one penalty has been imposed.
Example: John’s Case with SSA Penalties
John has been receiving Social Security Disability Insurance (SSDI) benefits for a few years due to a severe back injury. Recently, he started working part-time and earning income that would impact his eligibility for benefits. However, he decided not to report this income to the SSA.
A few months later, the SSA discovered John’s unreported income during a routine review. They found that John knowingly withheld material information about his income, which would have affected his eligibility for SSDI benefits. As a result, the SSA imposed a penalty on John for making false or misleading statements.
Since this is the first time John has been penalized, the duration of the penalty is six consecutive months. During these six months, John will not receive any SSDI benefits. Additionally, if John were eligible for any cash benefits under title XVI, he would be ineligible for those as well.
John disagrees with the SSA’s decision and decides to request reconsideration of the penalty. He attends a face-to-face informal conference with SSA representatives to present his case. However, after reviewing the evidence, the SSA upholds its decision to impose the penalty. John’s penalty period will begin on the first day of the month following the reconsideration decision and last for six consecutive months.
In this example, John faced penalties for knowingly withholding material information that affected his eligibility for SSDI benefits. It’s essential to provide accurate and complete
Conclusion: It is crucial to provide accurate and truthful information to the SSA to avoid penalties for false or misleading statements. If you face a penalty, understanding the process and your rights can help you navigate the situation effectively.
https://www.ssa.gov/OP_Home/cfr20/404/404-0459.htm
At Hugo Fierro & Michael Perez, our firm is built upon a foundation of comprehensive knowledge and expertise in guiding clients through the nuanced aspects of Social Security disability claims. Our adept team is dedicated to delivering valuable insights and support, tailored to each client’s unique circumstances, to facilitate a thorough understanding of the complexities surrounding their specific case.