Miami Benefits Fraud Attorney

Whether you or a loved one has been arrested or is under investigation for benefits fraud, it is critical to consult with an experienced Miami benefits fraud attorney as soon as possible to ensure your rights are protected. You need the counsel of an experienced fraud crimes attorney to guide you through the process and maximize your chances of resolving your case with a favorable outcome.

What is Benefits Fraud?

Benefits fraud is dishonestly claiming or receiving government-funded benefits to which one is not entitled. This can involve making false or misleading statements on a benefits application, failing to report changes in circumstances that affect eligibility for benefits, or continuing to receive benefits after one becomes ineligible. Benefits fraud can also involve obtaining benefits under someone else’s name or using false documents to support a benefits claim.

Types of Government Benefits Subject to Fraud

There are many different types of government-funded benefits that people may be charged with fraudulently claiming, including:

  • Unemployment benefits: These benefits are paid to individuals who are out of work and seeking employment.
  • Social Security benefits: These include retirement and disability benefits for eligible workers, as well as benefits for certain family members and survivors.
  • Medicare and Medicaid: Medicare generally covers eligible people age 65 or older and certain younger people with disabilities or specified medical conditions. Medicaid provides health coverage to eligible low-income people and other qualifying groups under federal and state rules.
  • Food stamps: This program provides financial assistance to help low-income individuals and families buy food.
  • Public housing assistance: This program provides financial assistance to help low-income individuals and families pay for housing.
  • Child care assistance: This program provides financial assistance to help low-income families pay for child care.
  • Education grants and loans: These programs provide financial assistance to help students pay for college or vocational training.

The list above lists the most common government benefits for which one can be charged with fraudulently obtaining. However, you can be charged with benefits fraud for allegedly fraudulently obtaining any government-funded benefits.

If the allegations concern false medical bills submitted to Medicare or Medicaid, see our healthcare fraud page for a discussion of billing schemes, kickbacks, and federal investigations.

Common Types of Benefits Fraud

Common types of benefits fraud include:

  • Falsely claiming to be single or have no other source of income when one is married or has other sources of income that would make them ineligible for certain benefits.
  • Failing to report changes in circumstances, such as getting a new job or an increase in income, would affect eligibility for benefits.
  • Continuing to receive benefits after becoming ineligible, such as when a recipient’s income exceeds the maximum allowed for a particular benefit.
  • Claiming benefits through the unauthorized use of another person’s identifying information, which may also lead to identity theft charges, or using false documents to support a benefits claim.
  • Concealing assets, such as property or savings, to qualify for benefits one would otherwise be ineligible for due to financial resources.
  • Claiming benefits for a fictitious person or a real person who is not entitled to the benefits.

Fraudulently receiving benefits is a serious crime that can result in criminal charges, fines, and repayment.

Penalties for Benefits Fraud

Benefits fraud is considered a serious crime and can carry significant penalties, including:

  • Criminal charges: The charge and possible sentence depend on the law involved. Under Florida’s public assistance fraud statute, the value involved during any 12 consecutive months generally determines the offense level: less than $200 is a first-degree misdemeanor; $200 to less than $20,000 is a third-degree felony; $20,000 to less than $100,000 is a second-degree felony; and $100,000 or more is a first-degree felony. Federal Social Security offenses under 42 U.S.C. § 408(a) generally carry up to five years in prison, with a ten-year maximum for certain people involved in benefit determinations, including specified paid representatives and healthcare providers. Other federal charges may carry different penalties.
  • Fines: An individual convicted of benefits fraud may be required to pay fines as part of their sentence. These fines can be substantial, depending on the extent of the scam.
  • Repayment of fraudulent benefits: An individual convicted of benefits fraud may be required to repay any benefits received fraudulently.
  • Loss of benefits: An individual convicted of benefits fraud may lose their eligibility for government-funded benefits for a period of time.
  • Damage to reputation: A conviction for benefits fraud can significantly impact an individual’s reputation, making it more difficult to find employment or housing in the future.

The above are just a few examples of possible penalties for benefits fraud. The penalties depend on the facts and whether you face federal criminal charges or a case in state court.

Defenses to Benefits Fraud

Benefits fraud can be defended in several ways, depending on the specific circumstances. Some possible defenses include the following:

  • Lack of knowledge or intent: Prosecutors must prove the knowledge or intent required by the specific charge. An honest reporting mistake or a genuine misunderstanding of eligibility rules may defeat that proof. An overpayment alone does not establish criminal fraud, although the agency may still seek repayment.
  • Mistaken identity: If the individual was not the person who committed the fraud, they might be able to defend themselves by showing that they were not responsible for the fraudulent actions.
  • Insufficient evidence: To convict an individual of benefits fraud, the prosecution must present sufficient evidence to prove the individual’s guilt beyond a reasonable doubt. This may be a defense if the prosecution’s case is weak or lacks sufficient evidence.
  • Duress: In federal court, this defense generally requires an immediate threat of death or serious bodily harm, a reasonable belief that the threat would be carried out, and no reasonable chance to escape or seek police help. Pressure from another person alone is insufficient.
  • Entrapment: In federal court, this defense requires government inducement and a lack of predisposition to commit the crime before that inducement. An undercover officer’s involvement alone does not establish entrapment.

Contact an Experienced Miami Benefits Fraud Lawyer

If you are charged with benefits fraud, it is crucial to hire an experienced criminal defense attorney as soon as possible. An experienced Miami benefits fraud lawyer:

  • Will be familiar with the laws and legal procedures related to benefits fraud cases and can provide knowledgeable, effective representation.
  • Will be able to identify any weaknesses in the prosecution’s case and use them to your advantage in negotiating a plea bargain or fighting the charges in court.
  • Will be able to advise you on the potential penalties you may face if you are convicted and will work with you to develop a strategy to minimize those penalties.
  • Will be able to provide you with emotional support and guidance as you navigate the criminal justice system.

In short, hiring an experienced criminal defense lawyer can significantly improve your chances of obtaining a favorable outcome in your benefits fraud case.

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