The following are some examples of situations in which a finding that the person knowingly
provided false or misleading information or failed to disclose material information
may be appropriate. REMINDER: Each potential sanction situation is unique, and the outcome of a particular case
and factors not summarized below may influence the case.
EXAMPLE 1. After we deny an SSI claim, a person applies for benefits in another office. In the
second SSI application, they omit a significant resource that they reported in the
first application so that we will approve the claim.
EXAMPLE 2. A person presents altered documents in support of a claim, or uses someone else’s
document that they represent as their own.
EXAMPLE 3. After SSA requests that an SSI claimant report all income and resources, they report
one bank account with a balance of $1,000, but fail to report another bank account
with a balance of $15,000, which we discovered through the Access to Financial Institutions
EXAMPLE 4. Someone other than the claimant takes part in a redetermination or a medical examination
on behalf of the claimant, while pretending to be the claimant. We may also sanction
the claimant if they are aware of the deception.
EXAMPLE 5. A claimant reports that they are not working in response to a request for such information,
but an observation reveals them working for a period of time that overlaps with the
EXAMPLE 6. A claimant alleges and exhibits physical impairments during an interview in a field
office (FO), but an observation reveals the claimant taking part in activities that
are clearly inconsistent with the alleged impairments. During the interview, the claimant
uses a wheelchair or crutches for an impairment that would limit a wide range of activity.
Shortly thereafter, an observation reveals the claimant participating in vigorous
physical activity without the wheelchair or crutches.
EXAMPLE 7. A claimant reports that they are living at an address, which we later verify is a
vacant lot. The FO then determines that the claimant is living outside of the country.
This report may constitute both a false statement and a failure to report living outside
EXAMPLE 8. A claimant misrepresents or omits information regarding their living arrangement.
The claimant asserts that they are living alone after we advise them of the income
rules and income deeming at the time of application and again during redetermination
reviews. FO personnel verify that the claimant did not live alone during the time
of the representations. They also verify the other person living with the claimant
had income that would affect the claimant’s payment amount.
EXAMPLE 9. We suspend an SSI recipient’s payment because they left the country for more than
30 days. They leave the country again for more than 30 days but omit this information
when asked during a subsequent redetermination interview.
EXAMPLE 10. A Title II beneficiary alleges that they have an illegitimate child and claim benefits
for that child. Evidence reveals that the beneficiary is not the father and that they
knowingly made a false statement in order to gain additional benefits on behalf of
EXAMPLE 11. A beneficiary reports a nonreceipt of their original check. SSA issues a replacement
check and the beneficiary cashes both checks. Evidence indicates the beneficiary knowingly
and falsely stated that they did not receive the original check. We may impose a sanction
for that false statement. We may also impose a sanction for a failure to report the
receipt of a duplicate check if the evidence supports a finding that the person knew
or should have known that failure to disclose receipt of a duplicate check was misleading.
EXAMPLE 12. A person receiving benefits for having a child in care neglects to report that the
child intermittently leaves their care. We determine that not having a child in care
would affect their benefits.
EXAMPLE 13. A disability beneficiary, whose benefits we partially offset due to the receipt of
workers' compensation (WC), neglects to report an increase in his WC payment amount.
At the time we awarded the claim, we advised the beneficiary that they must report
any change in his WC payments.
EXAMPLE 14. A disability beneficiary fails to report that they returned to work. The award letter
informed the beneficiary that they must report future work.
EXAMPLE 15. When applying for spouse’s benefits, a claimant falsely answers that they do not qualify
for a pension based on non-covered employment. Several years later, the number holder
(the claimant’s spouse) informs us that their spouse is entitled to a pension based
on his non-covered employment and that they had been entitled, in fact, since before
they claimed spousal benefits. SSA should have applied the Government Pension Offset
to reduce the spousal benefit through the life of their claim.
EXAMPLE 16. A claimant for retirement benefits falsely answers that he is not entitled to a pension
based on non-covered employment. Several years later, SSA becomes aware that at the
time of claiming Social Security retirement benefits he was in fact entitled to a
pension based on non-covered employment from the State of Ohio. SSA should have applied
the Windfall Elimination Provision to reduce his retirement benefit amount.