Fraud
Definition of Suspected Fraud
Fraud is suspected when it is determined that the applicant/recipient, within his/her competence; knowingly failed to report or misrepresented facts, with the apparent intent to defraud. This includes applicants/recipients who:
- Knowingly and with intent to deceive, made false statements or representation to obtain aid, to obtain a continuance or increase of aid, or to avoid a reduction in aid.
- Knowingly and with the intent to defraud, failed to disclose a fact which if disclosed, would have resulted in the denial of, or the reduction, or discontinuance of aid.
- Accept aid knowing he/she was not entitled to it, or accepted any amount of aid knowing it was greater than the amount to which he/she was entitled.
- For the purpose of obtaining, continuing, or avoiding a reduction or denial of aid made statements which he/she knew were not true.
Prevention of Fraud
In efforts to reduce the chance of fraud, the EW must take the following actions:
- Inform the applicant/recipient that it is their responsibility to promptly report, within ten working days, any and all facts regarding changes to their circumstances; so that a correct determination of their eligibility and correct calculation of the grant amount that they are entitled to can be made.
- Review reporting responsibilities with the applicant/recipient at intake, and at each RRR. By doing so, any misunderstandings that the individual might have regarding their reporting responsibilities will be clarified.
- Document the applicant/recipient’s understanding of their reporting responsibilities in a Journal Entry.
- Take prompt action on all information received, or observed, in relation to any changes in the client’s eligibility for aid, or their needs.
Referrals to the Special Investigation Unit
When fraud is suspected, the EW MUST complete a FRED referral to the SIU, and document the action taken in a Journal Entry. [Refer to the Fraud sections in the DEBS BP].
Related Topics
Overpayments Due to Incarceration