§1011 — Title 42 The Public Health and Welfare | U.S. Code

Summary

Lying or hiding facts to get or keep Social Security benefits is a crime. That includes making false statements on an application, using false information to win benefits, failing to report events that change your or someone else’s right to benefits, taking benefits meant for another person, or planning with someone else to do any of these things. If someone is convicted, a federal court may order them to pay back money to the Commissioner of Social Security, in addition to or instead of other penalties, when the crime caused a wrongful payment or caused a person to lose money because their appointed representative payee (see section 1007(i)) misused funds. Rules in sections 3612, 3663, and 3664 of title 18 apply, and the Commissioner counts as the victim. If the court refuses or only orders part of the payback, it must explain why on the record. Money paid as restitution generally goes to the Treasury, except that money paid because a payee caused a person’s loss must be used to repay that person up to the amount received or their outstanding loss, reduced by any overpayment the person owes under the listed subchapters.

Title 42, §1011

The Public Health and Welfare — Source: USLM XML via OLRC

(a)Whoever—

(1)knowingly and willfully makes or causes to be made any false statement or representation of a material fact in an application for benefits under this subchapter;

(2)at any time knowingly and willfully makes or causes to be made any false statement or representation of a material fact for use in determining any right to the benefits;

(3)having knowledge of the occurrence of any event affecting—

(A)his or her initial or continued right to the benefits; or

(B)the initial or continued right to the benefits of any other individual in whose behalf he or she has applied for or is receiving the benefit,

(4)having made application to receive any such benefit for the use and benefit of another and having received it, knowingly and willfully converts the benefit or any part thereof to a use other than for the use and benefit of the other individual; or

(5)conspires to commit any offense described in any of paragraphs (1) through (3),

(b)(1)Any Federal court, when sentencing a defendant convicted of an offense under subsection (a), may order, in addition to or in lieu of any other penalty authorized by law, that the defendant make restitution to the Commissioner of Social Security, in any case in which such offense results in—

(A)the Commissioner of Social Security making a benefit payment that should not have been made, or

(B)an individual suffering a financial loss due to the defendant’s violation of subsection (a) in his or her capacity as the individual’s representative payee appointed pursuant to section 1007(i) of this title.

(2)section 3612, 3663, and 3664 of title 18 shall apply with respect to the issuance and enforcement of orders of restitution under this subsection. In so applying such sections, the Commissioner of Social Security shall be considered the victim.

(3)If the court does not order restitution, or orders only partial restitution, under this subsection, the court shall state on the record the reasons therefor.

(4)(A)Except as provided in subparagraph (B), funds paid to the Commissioner of Social Security as restitution pursuant to a court order shall be deposited as miscellaneous receipts in the general fund of the Treasury.

(B)In the case of funds paid to the Commissioner of Social Security pursuant to paragraph (1)(B), the Commissioner of Social Security shall certify for payment to the individual described in such paragraph an amount equal to the lesser of the amount of the funds so paid or the individual’s outstanding financial loss as described in such paragraph, except that such amount may be reduced by any overpayment of benefits owed under this subchapter, subchapter II, or subchapter XVI by the individual.

Notes & Related Subsidiaries

Editorial Notes

Prior Provisions

For

Prior Provisions

, see note set out under section 1001 of this title.

Amendments

2015—Subsec. (a). Pub. L. 114–74, § 813(b)(2), inserted before period at end of concluding provisions “, except that in the case of a person who receives a fee or other income for services performed in connection with any determination with respect to benefits under this subchapter (including a claimant representative, translator, or current or former employee of the Social Security Administration), or who is a physician or other health care provider who submits, or causes the submission of, medical or other evidence in connection with any such determination, such person shall be guilty of a felony and upon conviction thereof shall be fined under title 18, or imprisoned for not more than ten years, or both”. Subsec. (a)(5). Pub. L. 114–74, § 813(a)(2), added par. (5). 2004—Subsec. (b). Pub. L. 108–203 amended heading and text of subsec. (b) generally. Prior to amendment, text read as follows: “If a person or organization violates subsection (a) of this section in the person’s or organization’s role as, or in applying to become, a representative payee under section 1007 of this title on behalf of a qualified individual, and the violation includes a willful misuse of funds by the person or entity, the court may also require that full or partial restitution of funds be made to the qualified individual.”

Statutory Notes and Related Subsidiaries

Effective Date

of 2004 AmendmentAmendment by Pub. L. 108–203 applicable with respect to violations occurring on or after Mar. 2, 2004, see section 209(d) of Pub. L. 108–203, set out as a note under section 408 of this title.

§1011 Penalties for Fraud

Summary

Title 42, §1011

Notes & Related Subsidiaries

Editorial Notes

Prior Provisions

Prior Provisions

Amendments

Statutory Notes and Related Subsidiaries

Effective Date

Citations & Metadata