Intentional Program Violations and Welfare Fraud

What is an Intentional Program Violation?

An Intentional Program Violation (IPV) is the Department of Social Services’ way of saying someone lied in order to obtain benefits. DSS may claim that a person has committed an IPV if he or she failed to report information, made a false or misleading statement, or engaged in conduct which violated DSS rules.

There are many reasons for IPVs. However, two of the most common situations involve a public assistance recipient’s failure to report earned income from a job and a recipient’s failure to report a change in household composition, such as when a spouse or parent has returned to the household. Under both these circumstances, the unreported information could result in the recipient receiving more public assistance than he or she is eligible to receive.

What kind of an investigation does DSS conduct when it suspects fraud?

DSS may send an investigator out to meet with any number of people, including an employer, neighbors, or the landlord. DSS may ask the recipient to attend a meeting or interview at the DSS office to discuss the charges. If the recipient fails to attend this interview, DSS can, and often does, treat the absence as a refusal to cooperate. This can result in the closing of the welfare case, and termination of benefits. It can also cause DSS to refer your case to the District Attorney for criminal prosecution. Therefore, in most situations, the recipient should attend the interview. However, even though the recipient may choose to attend the interview, he does not have to answer any questions asked of him, admit to any wrong doing, or agree to sign any documents.

What are the possible penalties for committing an Intentional Program Violation?

The penalties for committing an IPV can be severe. If DSS chooses to sanction a recipient administratively, the sanction may be for six months for the commission of a first public assistance-IPV or for twelve months if it is the second IPV or if the recipient wrongfully received benefits in the amount of $1,000 to $3,900. A third IPV, or an IPV resulting in the wrongful receipt of benefits in an amount over $3,900 may result in a sanction of eighteen months, and a fourth or subsequent IPV may result in a sanction of five years.

If DSS chooses to prosecute the recipient for welfare fraud, the sanctions will be criminal and even harsher. Simple welfare fraud involving receipt of benefits under $1000 is a misdemeanor. Receipt of benefits in excess of $1000 can result in felony welfare fraud charges. Conviction for the crime of welfare fraud can result in jail or prison time.

It should be noted that in many instances, DSS MUST refer a case involving an IPV to the district attorney for criminal prosecution. In these cases, the recipient may be entitled to a court appointed attorney.

What happens if the DSS believes that a recipient has committed an IPV but does not file criminal welfare charges?

DSS must schedule a hearing to determine whether the recipient in fact committed the IPV. The recipient does not have to ask for this hearing. It is brought at DSS’s request. The recipient must be given 30 days advance notice of the hearing. A recipient who cannot attend the hearing on the assigned date may ask for an adjournment but generally must do so within 10 days of the hearing.

At the hearing, the recipient is entitled to numerous procedural safeguards, including the right to a lawyer, the right to view and copy documents, to confront witnesses, to put up a defense, and the right to remain silent. However, DSS is not required to provide the recipient with a lawyer.   The recipient’s failure to appear at the hearing can result in a default, allowing the hearing to proceed in the recipient’s absence. Therefore it is very important that the recipient appear at the hearing. This does not mean that the recipient must answer questions, and it is often best not to answer questions. The recipient may still present witnesses in his own defense and cross-examine DSS’s witnesses.

What is a Disqualification Consent Agreement, and what is its effect on eligibility?

Often times a welfare fraud case that is referred to the District Attorney by DSS for criminal prosecution is resolved by a plea bargain. This plea bargain is called a Disqualification Consent Agreement, or DCA. A recipient who enters into a DCA usually agrees to repay all the money which was allegedly received as a result of the Intentional Program Violation, and agrees to be disqualified from future benefits for a specific period of time. In exchange, the DA usually agrees to put off further prosecution until the recipient has fully complied with the DCA. Once all the conditions of the DCA have been met by the recipient, the DA usually agrees to dismiss the criminal charges.

Although the Disqualification Consent Agreement is usually proposed by the District Attorney, a similar agreement can be reached between DSS and the recipient even if the DA has not gotten involved. In this case, the recipient may waive the right to an administrative hearing, in exchange for DSS imposing a lighter sanction, or DSS allowing the recipient to make installment payments towards the overpayment.   The recipient should be careful not to agree to a settlement which he or she cannot keep. For instance, a recipient who is accused of having received $2000.00 as the result of fraud should only agree to pay back $500.00 if he or she will definitely be able to pay back that amount.

What should a recipient who is charged with welfare fraud do?

It is always important to remember that welfare fraud can result in criminal prosecution, and ultimately time in jail or prison. Consequently, the recipient must be very careful when speaking with DSS, its investigators, and the District Attorney. The recipient has the right to remain silent, and the right to an attorney. If criminal charges are brought, the recipient may be eligible for a court appointed criminal defense lawyer.

If criminal charges are not brought, the recipient should have the opportunity to try to “negotiate” a settlement. The recipient can agree to pay back an overpayment without admitting to fraud. If a deal can be worked out without criminal charges being brought, the recipient should make sure that DSS and the DA promise, in writing, not to prosecute. If this agreement cannot be reached, the recipient should consult with an attorney.

Does the Legal Aid Society Represent Individuals Who Have Been Charged with Welfare Fraud?

If the welfare fraud charge is brought against the recipient in a criminal proceeding in criminal court, LAS will not be able to represent you. However, you may be eligible for legal representation by the Public Defender Service, or by some other Court appointed lawyer.

If DSS pursues the fraud charge through the administrative processes of DSS, LAS may be able to help you. Please call the office to schedule an appointment to discuss the specific facts of your case with a case handler.