Welfare Fraud: What You Need to Know
by: Northwest Justice Project
What is welfare fraud?
The welfare office will suspect fraud if they feel:
- you have intentionally misstated some information about
your circumstances or
- you have failed to reveal information which affects your
eligibility for benefits.
Why would the Welfare office accuse me of
fraud?
The Department of Social and Health Services (DSHS) asks you
- to provide lots of information about your family when you
apply, and
- to report later changes.
This is because federal government monitors DSHS to see if
they make mistakes in issuing benefits (called an error rate), Welfare
staff must make checks on your information. They do checks on all
recipients. They also often ask for additional information, or
verification, to make sure you are eligible for benefits. If the
information you gave was wrong, they may think you lied. They may
then establish an "intentional overpayment" if you got benefits that
you were not eligible for.
What kinds of things does the Welfare office
check?
They usually contact an employer or a landlord to verify your residence
and rent and who lives in the household. They regularly check
what wages are reported to your social security number. Example:
they continue to check the social security numbers of people receiving
benefits to see if there are new earnings reported to those
numbers. They look at state and national computers which may have
information about you or your family. The welfare office will
also check whether child support is being paid. They check for
unreported bank accounts.
How does the office decide whether I lied or
it was just a mistake?
The welfare office looks for evidence in the case record
which
shows your intent. They will decide it was an intentional
overpayment if:
- You knew what facts or changes to report
- You knew when to report the changes
- You had an opportunity to report, and
- You chose not to.
They may also send a FRED investigator out to gather more
facts.
What is a FRED investigator?
The welfare office has a special unit called F.R.E.D. (Fraud
Early Detection). FRED investigates when a welfare office worker
believes someone applying for assistance is not being truthful about
their situation. They may send an investigator out to your home to
interview you or your neighbors. The information they gather can be
used to cut off your cash, food stamps and medical benefits and to
establish an "overpayment" of past benefits.
IF you are being accused of fraud, request a copy of your
"FRED
report." Your attorney should speak with the investigator to find
out what s/he concluded and why. Sometimes the investigator comes to a
conclusion based on false information from a third party. Other
times they may draw incorrect conclusions from what they see.
Example: if they
see someone else's car parked outside your home they may conclude that
person is living with you. But it may be that the car has broken down
and is parked outside your home.
What are my rights if I am being investigated?
If you have been accused of fraud and you are being
investigated,
contact an attorney about your individual case to make sure you provide
any defenses you may have. Generally, you have the following
rights:
- You do not have to talk to a FRED investigator (you should
talk first to an attorney so that you can be sure your case is
presented clearly);
- If the FRED investigator comes to your home, you do not
have
to let a FRED investigator in (ask the investigator to come
back another time when your representative is present with you) unless
the investigator has a search warrant;
- You must be told of these rights both orally and in
writing, in the language you speak (this information must be given to
adult recipients, not to children);
- You cannot be denied benefits just because you refuse to
talk to the investigator or let him into your home; AND
- You have a right to look at your file (and get copies of
any papers in it) to see why the FRED referral was made and why the
Welfare office thinks you were not truthful.
What should I do if I have an overpayment?
If the office believes the overpayment happened due to your mistake,
they will call it a "household error" and ask you to pay it back. If
they
determine that you provided all the information correctly but they made the mistake, they will
call it an "administrative error" or "agency error."
If you have been accused of an overpayment - getting benefits that you
were not eligible for - our publication How
to Fight an Overpayment of Cash Assistance, Medical Assistance or Food
Stamps gives information about the different kinds of
overpayments. Our publication How
to Present an Equitable Estoppel Defense tells how to
try to get an overpayment cancelled so that you do not owe anything.
What can I do if the Welfare office accuses
me of getting an intentional overpayment?
If you have been accused of a willful
or intentional
overpayment, or if the welfare office accuses you of fraud, they may
refer you for prosecution. For the DSHS office to determine that
you have an intentional overpayment in food stamps there must be an
Administrative Disqualification Hearing to determine an "Intentional
Program Violation." If you are on Temporary Assistance for Needy
Families (TANF) or Medical Assistance, DSHS can send a notice of
intentional overpayment without such a hearing.
It is important to find out why the office is accusing you of
fraud. Tell your worker right away that you want a "fair hearing"
if you disagree. Sometimes the office is asking you to pay back
benefits because you did not report income that you or a family member
received. You may be able to show that no money is owed, or that
you did provide the information but the Welfare office lost it.
Or you may be able to explain that you did not provide certain
information because you did not realize you needed to.
Get legal advice before you talk to DSHS about what happened.
Otherwise you may find that you not only owe the welfare office money,
you are also being accused of a serious crime.
I am confused about what information I need
to provide. I have heard that I do not have to report some kinds
of income.
You should report all income and assets to the welfare
office. The rules are complex and often change. If you
believe the welfare office is counting income or resources they
should not, contact a supervisor or legal services office for
help.
If you are getting public assistance, you must report all changes in
your income, resources, family size etc. within 10 days. You should report in writing and keep a
copy (with a date stamp from the welfare office).
What if I have not reported the income
because
another person, for instance, the parent of my children, has made
threats against me?
If you are afraid to report income or other information
because
of domestic violence, seek legal help right away. Ask
a lawyer or domestic violence program advocate to help you get a
protection order to keep you and your children safe. Also discuss
with your lawyer or advocate what to do about your public assistance
(including past assistance) and whether to seek child support.
What if I need more income to take care of my
family?
If you need additional income because of unexpected costs, ask
your welfare office about emergency assistance. Our publications
on emergency assistance - Additional
Requirements, Consolidated
Emergency Assistance Program and Diversion
Cash Assistance ? have more information.
Remember:
if you are denied these benefits, you can request a fair hearing and
ask your legal services office for advice.
I am an immigrant. If I am
convicted of fraud, can it affect my immigration status in the United
States?
Yes! If you have not yet become a citizen, you may
be deported if you are convicted of certain crimes, including welfare
fraud. This can happen, even if your family is here and you have
lived in the United States for a long time.
Even if a crime will not make you deportable, it may prevent
you
from meeting the good moral character requirement necessary to become a
citizen. If you are accused of any crime, make sure you are
represented by an attorney and make sure the attorney speaks with an
immigration lawyer about the effect of the crime on your immigration
status.
Note:
Language and cultural barriers often lead to misunderstandings and
cause accusations of fraud. Be sure to tell the Welfare office
that you need translated notices and a qualified interpreter if you
do not speak English.
This publication provides general information
concerning your rights and responsibilities. It is not intended as a
substitute for specific legal advice.
This information is current as of the date of its printing,
May 2011.
© 2011 Northwest Justice Project.
1-888-201-1014
(Permission for copying and distribution granted to the Alliance for
Equal Justice and individuals for non-commercial use only.)
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