Welfare Fraud: What You Need to Know
Authored By: Northwest Justice Project
- Read this in:
- Spanish / Español
7116EN - This publication answers common questions about welfare fraud and offers important information that you should know if you are being accused of welfare fraud.
- What is welfare fraud?
- Why would the Welfare office accuse me of fraud?
- What kinds of things does DSHS check?
- How does DSHS decide whether I lied or it was just a mistake?
- What is a FRED investigator?
- I am being investigated. What are my rights?
- I have an overpayment. What should I do?
- DSHS has accused me of getting an intentional overpayment. What can I do?
- I am confused about what information I need to provide. I have heard that I do not have to report some kinds of income.
- What if I have not reported the income because another person, for example the parent of my children, has made threats against me?
- What if I need more income to take care of my family?
- I am an immigrant. If I am convicted of fraud, can it affect my immigration status in the United States?
- What if I need legal help?
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
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
The federal government monitors DSHS to see if they make mistakes in issuing benefits (called an error rate), so Welfare staff must make checks on your information. They do checks on all recipients. They also often ask for more 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 you were not eligible for.
They usually contact an employer or a landlord to double-check 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 getting 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. DSHS will also check whether you are getting child support. They check for unreported bank accounts.
DSHS 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 AND
You knew when to report the changes AND
You had a chance to report AND
You chose not to
They may also send a FRED investigator out to gather more facts.
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 have been accused of fraud, ask for a copy of your "FRED report." Your lawyer 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. It may be that the car has broken down and its owner parked it outside your home.
If DSHS has accused you of fraud and they are investigating you, contact a lawyer about your case. 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 (talk first to a lawyer to be sure you present your case clearly); AND
If the FRED investigator comes to your home, you do not have to let them in (ask the investigator to come back another time when your representative is present with you) unless the investigator has a search warrant; AND
You must be told of these rights both verbally and in writing, in the language you speak (this information must be given to adult recipients, not to children); AND
DSHS cannot deny you 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 DSHS made the FRED referral and why they think you were untruthful.
If DSHS 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 has 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.
If you have been accused of a willful or intentional overpayment, or if DSHS accuses you of fraud, they may refer you for prosecution. For DSHS 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.
You must 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 DSHS 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 DSHS 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 DSHS. The rules are complicated and often change. If you believe DSHS 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 changes exactly as described in the notices you get from DSHS. Be sure you have read and understand all of the reporting requirements for each of the public benefit programs you get benefits from. If you have any questions about the reporting requirements, contact a lawyer. When you report a change, you should report in writing, get a date stamped copy from DSHS and keep this copy with your records.
What if I have not reported the income because another person, for example the parent of my children, has made threats against me?
If you are afraid to report income or other information because of domestic violence, get 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 talk to your lawyer or advocate what to do about your public assistance (including past assistance) and whether to seek child support.
If you need more income because of unexpected costs, ask DSHS about emergency assistance. Our publications on emergency assistance - Additional Requirements, Consolidated Emergency Assistance Program, and Diversion Cash Assistance – have more information.
- 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 U.S. 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 get a lawyer. Make sure the lawyer 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 DSHS 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 April 2014.
© 2014 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.)