https://crsreports.congress.gov
March 25, 2025
Social Security Fraud Overview
Social Security Programs
The Social Security Administration (SSA) administers
Social Security, a social insurance program that protects an
insured worker and his or her eligible family members
against a loss of income due to the worker’s retirement,
disability, or death. SSA also administers Supplemental
Security Income (SSI), a means-tested program for adults
and children with little or no income and resources and who
have a disability or blindness or are age 65 or older. In
January 2025, SSA paid more than $126 billion in Social
Security benefits and more than $5.5 billion in SSI to over
73 million individuals who received Social Security, SSI, or
both.
Social Security Fraud Defined
Precise definitions may vary, but at a basic level fraud is a
“knowing misrepresentation or knowing concealment of a
material fact made to induce another to act to his or her
detriment.” Depending on the context, fraud may violate
various federal criminal laws, including those focused on
Social Security programs. For example, Section 208 of the
Social Security Act criminalizes various forms of fraud
involving Social Security, including among others:
• making certain false statements;
• with intent to defraud, concealing or intentionally failing
to disclose information that would affect eligibility for
benefits or the amount of payments (or conspiracy to
commit these offenses);
• as a representative payee, using payments other than for
the use and benefit of the beneficiary;
• providing false information to obtain a Social Security
Number (SSN); fraudulently using the SSN system; or
unlawfully disclosing, using, or compelling the
disclosure of the SSN of any person in violation of U.S.
laws.
Section 1632 of the act provides a similar list of criminal
penalties relevant to SSI, omitting the SSN system
instances of fraud. Various federal laws also prohibit other
acts involving false or fraudulent statements or claims
before a government agency. SSA also identifies other
related conduct in the act or federal criminal statutes subject
to criminal prosecution, including:
• false representation as an employee of the U.S.
government;
• unauthorized access of SSA computer records;
• unauthorized disclosure of information from SSA’s
systems of records; and
• receiving or soliciting a bribe, illegal gratuity, or
contribution to or supplementation of salary for U.S.
government service.
The act also allows for civil monetary penalties. Section
1129 prohibits false statements, false representations, and
omissions of material fact with respect to eligibility and
amount of payments. Under the act, fraud does not
necessarily require that payment be made by SSA. Section
1140 is a consumer protection law that prohibits misleading
consumers by giving a false impression of association with,
or authorization or endorsement by, SSA.
Distinction from Improper Payments
In contrast to fraud, an improper payment results from a
mistake in computing a payment, a failure to obtain or act
on available information affecting a payment, or a
beneficiary failure to report an event or report correctly. An
improper payment is an overpayment if the amount paid to
an entitled individual is more than the amount that should
have been paid. For example, overpayments may happen
when SSA does not impose deductions, for example, for
Medicare premiums; SSA does not suspend, reduce, or
terminate benefits; or there is a technician error. The Social
Security Act addresses overpayments for Social Security in
Section 204 and overpayments for SSI in Section 1631(b).
SSA noted in a report on its expenditures on fraud and
improper payment prevention activities that distinguishing
between specific efforts to reduce fraud and improper
payments is difficult because they are both part of program
integrity workloads. SSA further notes that “most improper
payments we detect do not involve any evidence of intent to
commit fraud.” Similarly, the Government Accountability
Office (GAO) notes the distinction between improper
payments and fraud: “Improper payments can have fraud-
related root causes and impacts, but not all are caused by
fraud.”
Detecting and Preventing Fraud
As part of its independent oversight of SSA’s programs and
operations, SSA’s Office of the Inspector General (OIG)
conducts criminal investigations into allegations of fraud
and misconduct related to SSA programs, operations, and
employees. SSA also employs several types of strategies to
detect and prevent fraud. These include:
• mandatory annual training for all agency and state
disability determination services (DDS) employees on
detecting fraud and reporting to OIG;
• the Cooperative Disability Investigations program, a
joint effort by SSA and the OIG with state DDS
agencies and state and local law enforcement agencies
to review questionable disability claims and investigate
cases of suspected disability fraud;
• data analytics and predictive modeling to detect and
prevent fraud before issuing payments; and
