Compiled documentation must support your findings that the case meets the initial criteria for a potential administrative sanction case as defined in GN 02604.405. If your case might contain fraud or findings of similar fault, documentation must support this information as well.

IMPORTANT: SSA does not require a finding of fraud or similar fault to impose an administrative sanction. For more information on how administrative sanctions differ from fraud or similar fault, see GN 02604.405D.10.

See also:

GN 04020.010 Unrestricted Reopening for Determinations or Decisions Involving Fraud or Similar Fault

SI 04070.020 Fraud and Similar Fault - SSI

Documentation includes, but is not limited to, the following evidence:

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  The misrepresented information or the omission of a material statement on an SSA application or form;

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  Form SSA-5002 (Report of Contact) or RPOC screens that documents the person’s false statements.

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  Fraudulent or false documents that the person submitted as evidence;

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  Documentation that supports your conclusion that the person knowingly made a false or misleading statement or failed to disclose information, and that the person knew or should have known that the failure to disclose material information was misleading;

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  SSA records or reports that support your conclusion that the person knowingly submitted, or concealed, false or misleading statements, or documents;

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  SSA records that document the amount of any overpayment resulting from the misrepresentation or omission;

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  SSA records that document a prior determination of fraud or similar fault; and

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  Any other paper or electronic evidence that supports your finding.

Establish and store all documentation in a temporary program integrity file as described in GN 04111.060.