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Working While Claiming Unable to Work

Working While Claiming Unable to Work

WorkersCompensation-WorkersDisability-13
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

A Maine woman has been sentenced for defrauding the state’s disability assistance program after investigators discovered she was employed full time while collecting benefits reserved for individuals unable to work. According to the Maine Attorney General’s Office and the Department of Health and Human Services (DHHS), the defendant falsely reported that she was medically unable to maintain employment while simultaneously earning income under an assumed identity.

Prosecutors allege the woman received disability payments for more than three years by submitting falsified medical documentation and omitting employment information during required eligibility reviews. During the same period, she reportedly worked at multiple businesses across southern Maine, receiving wages deposited into accounts not disclosed to the state.

The fraud was uncovered during a data-matching initiative that cross-checked disability benefit recipients against quarterly wage reports submitted by employers. Analysts flagged earnings tied to a variation of the defendant’s name and Social Security number. Surveillance and employer records later confirmed the employment activity overlapped with periods when she certified that she was unable to work.

“This defendant intentionally misled the system to obtain benefits she was not entitled to,” said Maine Attorney General Aaron Frey. “Disability programs exist to help people who truly need them — not those who knowingly provide false information.”

Further investigation found the defendant had kept working details separate from benefit records by using alternate contact information and failing to report income changes during recertification. Authorities estimate the fraud resulted in more than $120,000 in improper payments.

As part of sentencing, the defendant was ordered to repay the misappropriated funds and is prohibited from receiving future disability benefits for a set period. DHHS has since expanded its wage matching and identity verification processes to detect undisclosed employment sooner.

The case underscores the importance of continuous eligibility monitoring, cross-agency data integration, and identity consistency checks in safeguarding disability assistance programs from fraud and misuse.

Today’s Fraud of the Day is based on reporting from the Maine Attorney General’s Office and the Maine Department of Health and Human Services regarding disability benefit fraud.

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