[smae]

Hey there.

The other day, I got some information in the mail about Medicaid. In SD, when someone is approved for SSI, he or she automatically gets Medicaid as well. As I was reading through the information, I found something that said if a person is aware of someone who is receiving Medicaid fraudulently, he or she should report it. There was a phone number to a tip line of sorts.

That got me thinking.

If a person knows of someone who is receiving SSI... yet would be able to work and is lying to the government, is he/she under obligation to report it? HOW would one report it?

If there is a person who claims that he or she cannot work, yet is working on vehicles and riding motorcycles and things... does that need to be reported?

It is hard to explain without getting into too much detail, but I know that if a person can get down on the ground and fix cars every day and go ride a motorcycle, he or she could work a sit down job at a gas station or other place.

Also, this person most likely has resources exceeding $2,000. There have been many hints, but I can't prove it for sure.

I am not sure if this is the same as Medicaid... is there a way to report suspicion? Is a person obligated to report it, or no? Does anyone have this information?

[Shellback]

Fraud hurts all of us who really need SSDI and or SSI but be careful when thinking about blowing the whistle on someone who you may suspect of fraud. If they are the type of person who would commit fraud, they could be capable of anything if you catch my drift.

[smae]

Originally Posted by Shellback

Fraud hurts all of us who really need SSDI and or SSI but be careful when thinking about blowing the whistle on someone who you may suspect of fraud. If they are the type of person who would commit fraud, they could be capable of anything if you catch my drift.

That's where it gets tricky. I am 100% it is fraud. I just don't have physical evidence to prove it. But I know this person is capable of holding down a job and choose not to. There are plenty of people who all see this and agree... but that individual is not ever going to come out and say "You're right--I am cheating the government".

But I am just wondering if there is an obligation to report it or not.. and if there is a way or not.. it isn't so much about this particular case, but just the general two questions.

I know a lot of people who need the help and cannot get it--and it makes me mad that there are people who do not need it and take advantage of the system.

[Janke]

Originally Posted by smae

Hey there.

The other day, I got some information in the mail about Medicaid. In SD, when someone is approved for SSI, he or she automatically gets Medicaid as well. As I was reading through the information, I found something that said if a person is aware of someone who is receiving Medicaid fraudulently, he or she should report it. There was a phone number to a tip line of sorts.

That got me thinking.

If a person knows of someone who is receiving SSI... yet would be able to work and is lying to the government, is he/she under obligation to report it? HOW would one report it?

If there is a person who claims that he or she cannot work, yet is working on vehicles and riding motorcycles and things... does that need to be reported?

It is hard to explain without getting into too much detail, but I know that if a person can get down on the ground and fix cars every day and go ride a motorcycle, he or she could work a sit down job at a gas station or other place.

Also, this person most likely has resources exceeding $2,000. There have been many hints, but I can't prove it for sure.

I am not sure if this is the same as Medicaid... is there a way to report suspicion? Is a person obligated to report it, or no? Does anyone have this information?

There are invisible disabilities. There are mental illnesses that don't stop someone from working on a car or riding a motorcycle but do affect a person's ability to get along in a work situation. Those of us who don't have mental problems may believe that tough love or a good kick in the butt will force some people to work. For a few maybe. Others who are not able/willing to suck up their problems long enough to stay on the job also end up incarcerated and the government supports them too.

Lots of people in the country who do nothing and have never done anything to contribute to the GNP and live on the fringes of society. We can ignore them, we can give them handouts, we can shoot them (well, no not really).

It's possible that this person you are observing may have a diagnosis of a mental illness and sees no reason to tell you or the rest of the world about it. So you really have nothing to report since you don't know enough. Is the person fraudulently getting benefits? IMO, a significant percentage of current beneficiaries could be doing routine, sedentary work. Can't point the finger at anyone here since I know nothing about them beyond what they say, but I think if we could all read each other's medical files and compare levels of disability, I think we'd find that there are many many recipients who just don't seem to be that disabled.

But call OIG if you feel the need. You will not be informed about the outcome.

[smae]

Look people--I wasn't asking your opinion on the diagnosis of this person.

I am fully aware of this person's medical problems and other issues, and this person does not have disabilites that keep them from work OR mental illnesses. I know all about invisible diseases--I have more than 10 of them.

But like I said, I wasn't asking anyone to form an opinion on this person. You will probably never come in contact with this person.


I simply was asking two questions.

1) Is there an obligation to report things? and if so,

2) How do they get reported?

If anyone has answers to those questions, I would appreciate it. Otherwise, I didn't ask for opinions on whether this person is disabled or not. This isn't some random acquaintance of mine that I don't know. I know full well the limitations this person has.

I just want an answer to my questions.

[Rrae]

Why don't you just check with the number on your SSI papers that you received.??? They provided you with a phone number and everything.
Ask THEM these question!

Is there really a need to bite these people's heads off who are trying to help the best they can??

C'mon Sarah, lets put our 'friendly' hats on and remember this is a SUPPORT group

Try to get some REST.....you have a very important procedure coming up.

Caring (and concerned)
Rae

[Jomar]

[1) Is there an obligation to report things? and if so,

2) How do they get reported?]


I don't know if there is a legal obligation for sure or not, but most likely more of a moral or ethical obligation - each person has to make that decision for themselves...

If reported there would probably be an investigation and be found to be within the rules or not.


SSI fraud reporting- info links list -
http://www.google.com/search?q=SSI&i...8733203d1b4e27

[Janke]

Originally Posted by smae

Look people--I wasn't asking your opinion on the diagnosis of this person.

I am fully aware of this person's medical problems and other issues, and this person does not have disabilites that keep them from work OR mental illnesses. I know all about invisible diseases--I have more than 10 of them.

But like I said, I wasn't asking anyone to form an opinion on this person. You will probably never come in contact with this person.


I simply was asking two questions.

1) Is there an obligation to report things? and if so,

2) How do they get reported?

If anyone has answers to those questions, I would appreciate it. Otherwise, I didn't ask for opinions on whether this person is disabled or not. This isn't some random acquaintance of mine that I don't know. I know full well the limitations this person has.

I just want an answer to my questions.

1. Obligation by who? Legal, moral, ethical? I cannot think of a legal obligation that applies to a casual observer. Only you can decided if you have a moral or ethical obligation.

2. Well, you are a lay person attempting to report medical evidence. There is the OIG hotline. If you actually have access to this person's medical or work records and can provide documents showing that he has medical improvement or is working for pay, those documents would be extremely helpful. Has he told another government entity (a family or criminal court) that he is not disabled? Has he told anyone that he is not disabled? Those kinds of documents might be helpful. If you are reporting that you have observed him riding a motorcycle or working on cars, I am not sure what you could provide to OIG other than your statement. Disability decisions are based on medical evidence and your statements by themselves may be insufficient for SSA to start an investigation. But if you think you have a moral or ethical obligation, make the phone call.

If he is on SSI and you think there are excess resources, make a list of those resources providing addresses of property, license numbers or VINS of vehicles owned, locations of bank accounts and account numbers, any documents that support your contention that he is over the resource limit. If you are just reporting a suspicion, there is little for SSI to investigate since they ask the same questions when they took the claim. He may be good at lying and hiding. If he is on SSDI, there is no resource limit.

[carlacanel]

I know a person who was awarded ssdi for back problems in May then in June took off on a 58 day motorcycle trip cross county - said they are enjoying retirement

[ginnie]

When people take advantage of the system, they are hurting everybody who really needs the help. I do not know if it is necessarily an obligation to report it, but it is a moral decision. I think the last person to reply said that if he did that, maybe he would do something negative to you. Perhaps there is a way he could be exposed without you giving your name. If he can walk, and play under the car all day, I think you are right in your assumptions. I also think medicare and or medicade does check up on people now and then. ginnie