Welfare Fraud: What You Need to Know
Authored By: Northwest Justice Project
- Read this in:
- Spanish / Español
- What is welfare fraud?
- Why would they 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 for fraud. What are my rights?
- I have an overpayment. What should I do?
- What can I do if DSHS accuses me of getting an intentional overpayment?
- 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, like my children's other parent, 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 not revealed information that affects your eligibility for benefits.
The Department of Social and Health Services (DSHS) asks you
- to provide 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 check 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 that you were not eligible for.
They usually contact an employer, or a landlord to double-check your home, rent, and who lives in your household. They regularly check what wages are reported to your social security number. They 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 that 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.
It is the welfare office's special unit called F.R.E.D. (Fraud Early Detection). FRED investigates when a welfare office worker believes someone applying for benefits is not being truthful about their situation. They may send an investigator out to your home to interview you or your neighbors. They can use the information 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.
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 outside your home. The owner is leaving it there until they can get it towed.
See a lawyer about your case to make sure you provide any possible defenses.
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 are presenting your case clearly;
If the FRED investigator comes to your home, you do not have to him/her in (ask the investigator to come back another time when your representative is there with you) unless s/he has a search warrant;
They must tell you these rights both verbally and in writing, in the language you speak (this information must be given to adult recipients, not to children);
They cannot deny you benefits just because you refuse to talk to the investigator or let him/her 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 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 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 at a DSHS Hearing 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.
Find out why the office is accusing you of fraud. Tell your worker right away that you want a "fair hearing" if you disagree.
The office may ask you to pay back benefits because you did not report income that you or a family member got. You may be able to show that you do not owe anything, or that you did provide the information but DSHS lost it. 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 change often. 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 that give you benefits. If you have any questions about the reporting requirements, talk to 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, like my children's other parent, 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 additional 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 ask for 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. a long time.
Even if a crime will not make you deportable, it may keep you from meeting the good moral character requirement you need 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.
- Language and cultural barriers often lead to misunderstandings and cause accusations of fraud. Tell DSHS you need translated notices and a qualified interpreter if you do not speak English.
Apply online with CLEAR*Online - http://nwjustice.org/get-legal-help
- Call CLEAR at 1-888-201-1014
CLEAR is Washington's toll-free, centralized intake, advice and referral service for low-income people seeking free legal assistance with civil legal problems.
Outside King County: Call 1-888-201-1014 weekdays from 9:10 a.m. until 12:25 p.m. CLEAR works with a language line to provide free interpreters as needed. If you are deaf or hard of hearing, call 1-888-201-1014 using your preferred TTY or Video relay service.
King County: Call 211 for information and referral to an appropriate legal services provider Monday through Friday from 8:00 am – 6:00 pm. You may also call (206) 461-3200, or the toll-free number, 1-877-211-WASH (9274). 211 works with a language line to provide free interpreters as needed. Deaf and hearing-impaired callers can call 1-800-833-6384 or 711 to get a free relay operator at no cost, who will then connect you with 211. You can also get information on legal service providers in King County through 211's website: www.resourcehouse.com/win211/.
Persons 60 and Over: Persons 60 or over may call CLEAR*Sr at 1-888-387-7111, regardless of income.
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 May 2013.
© 2013 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.)