Welfare fraud in California refers to when a person fraudulently offers false information to receive government benefits they are not entitled to. These benefits include Medi-Cal or food stamps, among others. Government employees or officials can also be charged with welfare fraud. This happens when they distribute or assign benefits to persons not qualified to receive them. When found to have violated the law and committed welfare fraud, you will be charged with a misdemeanor or felony offense. The prosecutor, while charging you, he or she looks at the circumstances of the crime and how often you have committed it.

The penalties for a guilty verdict include jail sentences, fines, and probations, among others. When faced with welfare fraud charges, a San Jose Criminal Attorney Law Firm lawyer can assist you with your defense.

Defining Welfare Fraud According to the Law

The law that describes welfare fraud is found under Welfare and Institutions Code 10980. The crime takes place when a person or people give false information or deliberately fail to provide critical information when seeking public programs. These programs are designed by the government to help certain people, and one must be qualified to benefit from them. You can be charged with this offense when you:

  • Deliberately misstate information or fail to provide crucial information necessary in obtaining, having, or increasing welfare benefits that you do not deserve.

  • Apply to receive these benefits by using multiple names and applications to receive numerous benefits.

  • Use, transfer, acquire, buy, sell, possess, alter, or counterfeit authorizations needed to get food stamps or to do this to the actual food stamps.

  • Are employed by the government, and you fraudulently allocate the benefits to persons not deserving.

When charged with the offense, the prosecutor must prove the above elements for one to be sentenced.

Welfare Programs in California

California has various programs designed to assist eligible participants. These include:

  • CalWORKs - This is known as California Work Opportunities and Responsibility to Kids. This program works to support needy families that require short-term assistance of cash when faced with housing, food, clothing, hospital bills, and utility needs.

  • CalFresh – This is the program known as food stamp aid. Through this program, the participants are issued with monthly benefits electronically to assist them in buying foodstuffs.

  • In-home services – This program is designed to assist individuals that fall under the following categories:

    1. Victims of domestic violence may require counseling, medical care, training in parenting skills, information on public health, relocation services, and financial planning.

    2. Substance abuse victims are assisted through treatment and evaluation.

    3. Those persons suffering from mental health conditions and need rehabilitation and treatment. It also works in assisting persons suffering from anxiety or depression.

  • Greater Avenues for Independence (GAIN) – This is a program that provides support to participants in CalWORKs. They assist them in finding jobs, retaining their jobs, and moving to better-paying employment.

  • General Relief or Assistance (GA/GR) – This program supports adults that are poverty-stricken and not under the support of other programs belonging to the public.

  • Medi-Cal – This is the program for giving medical aid by providing public health coverage for persons with low income, both children and adults. Although Medi-Cal is a welfare benefit, any fraud committed through it is charged under another law.

As earlier stated, not everyone is eligible for the welfare benefits from the above programs. However, some persons will fabricate information to qualify for welfare benefits. Employees of these programs can also fraudulently direct the benefits to undeserving persons for their benefit.

The Process of Investigating Welfare Fraud

When a case is reported to the prosecuting agencies, an investigation must be carried out to establish if the allegations are true. These allegations require thorough investigation, making it necessary for some prosecuting offices to have departments or units dedicated to welfare cases. The prosecutors in these units receive the case referrals from:

  • Persons that call the hotlines dedicated to receiving welfare fraud cases or through their websites,

  • Social service agencies tasked with the distribution of the welfare benefits,

  • Tips received through the reporting hotlines given to the public.

  • Other agencies that suspect welfare fraud is committed.

After a report is made, the investigators begin by getting in touch with the recipients of the benefits. The investigators question them on the benefits received and the details they gave to the particular programs to qualify for the benefits. Additionally, the investigators ask the beneficiary’s colleagues, family, neighbors, or friends to get more information necessary in determining welfare fraud.

Sometimes during these investigations, other offenses often are discovered that include elder abuse, child neglect or abuse, drug crimes, or domestic violence. These make it necessary to have other agencies incorporated in the investigation. These may include adult protective services, child welfare services, among others.

Once the necessary information is compiled, it is presented to the deputy district attorney for evaluation. After thorough review and questioning, it is then determined if there is sufficient evidence to file a criminal case against the accused person.

If there is sufficient evidence, a criminal case is filed according to WIC 10980. If the evidence is not enough, the investigator seeks more information, or the claim is rejected.

Types of Welfare Frauds

Welfare fraud in California can be committed in two fronts: the internal and recipient fraud categories.

  1. Recipient Fraud

According to WIC 10980, recipient fraud is that which is committed by the beneficiary of the welfare. The person that attempts or receives the benefits of the program fraudulently is the one accused of recipient fraud.

Recipient fraud is committed in various ways, with some being more prevalent compared to others. The standard methods include:

  • When the recipient claims to be raising their children alone, yet the other parent lives with them.

  • The offense is also committed when the recipient fails to report any other benefits or additional income they receive

  • Recipient fraud can also be committed when the recipient claims to have a child living with them, yet that is not the case or claiming to have more children living with them than is the truth.

  • When the recipient of the benefits also receives benefits, a different state on top of those from California.

The person committing this offense aims to receive more benefits than they are entitled to fraudulently.

  1. Internal Fraud

This type of fraud is committed by the employees of the state agency charged with disbursing welfare benefits. In this case, the employee may attempt to collect or unlawfully direct the benefits to another party. This type of fraud is otherwise referred to as an inside job. It happens when an employee falsified details in an application for ineligible family and friends and shares the proceeds. Employees can also create fictitious minors and distort claims on income or facts that disqualify their family or friends from having the benefits.

If an employee does this, he or she will face two criminal cases, not one. They will be charged with welfare fraud as well as embezzlement. When the amount embezzled by a social worker is significantly high, he or she will face felony charges and penalties that include state imprisonment for three years or less.

Legal Defenses

When allegations are made, it does not mean the person is guilty. After the prosecutor’s office carries out investigations and is satisfied, the person has a case to answer; a lawsuit is filed. When you are charged with welfare fraud, whether as an employee or recipient, the state allows you to fight the allegations. An experienced criminal attorney will study the case and the prosecutor’s evidence and advise you on the way forward. He or she will interview you, carry out their independent investigation, and formulate defense strategies in your favor. Some legal defenses will include:

  1. You had no Fraudulent Intent

One of the critical elements a prosecutor must prove in a fraud case is your fraudulent intent. When your actions were not intentional to steal from the agency, then you are innocent of welfare fraud. Your defense attorney may challenge the prosecutor’s case by arguing that:

  • To the best of your knowledge, you submitted legitimate claims to receive benefits. If you omitted or gave incorrect statements, they were not intentional. This argument can be used in defense of both recipients and internal fraud cases.

  • As a recipient, when faced with these allegations for not reporting some earnings, your lawyer can argue against that. It can be argued that you were not aware that lottery winnings, inheritance or gifts are supposed to be reported.

  • Your lawyer can also say that you innocently forgot to change your status when a child became ineligible to benefit from the program.

Your lawyer must present a strong argument and, where possible, back it with evidence. This is critical if the jury is to find you innocent. If the court is convinced that your intentions were not to defraud the welfare program, and the prosecutor is unable to prove these intentions, you will be found innocent. In this case, the charges against you are dismissed.

  1. Insufficient Evidence

A prosecutor needs to prove their case beyond a reasonable doubt. This is done by producing convincing evidence of your fraudulent activities in court. If for instance, you are faced with internal fraud charges, your boss may have reported you after noticing:

  • You had several duplicate files

  • Your files, for some cases, often missed documents.

  • Your association with some applicants was suspicious.

This evidence may seem incriminating. However, more investigations must be carried out to ascertain these claims because the evidence must be conclusive. Your employer may strongly believe you were stealing from the welfare program, but that is not enough. Actual proof must be provided to the court to show you are guilty of the crime.

Your defense attorney will look at the prosecutor’s case and challenge the evidence provided while producing proof that you never embezzled funds. If no sufficient evidence is presented, you will be exonerated from the charges.

  1. Mistaken Identity or False Accusations

Mistaken identity or false accusations are suitable defenses for both the recipient and internal fraud cases. If you are an employee of the welfare program, you do not have to be the one guilty of fraud even when the claims are legitimate. Sometimes, applicants that are well known to you may want to misuse you without your knowledge. They could have submitted falsified information when applying to receive benefits, and you never thought they could provide false information, and you never verified it.

In this case, you were negligent in performing your duties, but you were not intentionally defrauding the agency. This may cost you your employment, but it is not a criminal offense.

When you are charged with recipient fraud, it could be because your application listed a fictitious minor. Someone in the company may have forged or altered the form when you asked them to submit it for you.

It is also possible someone used your social security number and your name to apply for the benefits. This happens when your identity has been stolen and used for fraud. Your attorney can argue you did not know that your identity was stolen and used to defraud.

Additionally, clerical error from the welfare office may get you wrongly accused of the offense. When a mistake is made, it is not your fault, and on proving it, the charges against you are dropped. There are many reasons and ways to accuse a person of welfare fraud falsely. Your lawyer, following their investigation and studying the case, will formulate defenses that will expose the false allegations. When this is proven in court, you will be found innocent of offense.

  1. Restitution Agreements

One of the primary goals of a prosecutor is to recover the money stolen from the state or county. If you offer to repay all the money or a significant part of it, the charges against you may be reduced. Your lawyer will negotiate with the prosecutor to reduce the charges and thus reduced penalties.

For instance, if accused of earning $20,000 fraudulently, and you offer to pay $15,000, the prosecutor will consider a charge reduction. In this case, he/she may reduce the charges from felony to misdemeanor without pursuing a jail sentence.

Various Offenses Under WIC 10980 in California

Under this statute, a person can be accused of welfare fraud when they commit one of the following offenses. When found guilty of giving false statements or misleading ones to gain benefits, you will face misdemeanor charges. A guilty verdict will see you pay fines of up to $500 as well as imprisonment for not more than six months. Other offenses you can commit under this statute include:

Filing Falsified Applications

When accused of making fraudulent applications, the offense is a wobbler when:

  • Found to have made several applications for one person.

  • Found to have made an application for a person that doesn’t exist to be added benefits.

  • Found to have used another person’s information to apply for benefits.

When the prosecutor charges you with a felony for this offense, you face the following penalties:

  • A minimum of 16 months in county prison or 2 or 3

  • Additionally, you will be ordered to pay a fine of $5,000 or less

Depending on your criminal history and circumstances of your crime, the prosecutor can opt to charge you with a misdemeanor for the same offenses. A conviction will result in the following penalties:

  • County imprisonment for not more than a year

  • Paying of a fine not exceeding $1,000

Retaining or Obtaining Benefits

If you received benefits that you obtained fraudulently, you would face misdemeanor charges. These will happen if:

  • You obtained and kept the fraudulent benefits.

  • The benefits you kept amounted to $950 or below.

When found guilty of the misdemeanor offense, the judge is likely to sentence you to:

  • Six months or less in a county jail

  • Pay fine of not more than $500

However, this offense can be prosecuted as a felony and punished with felony penalties if the amount obtained was over $950. These penalties include:

  • County jail imprisonment for 16 or 2 or 3 years

  • Payment of a fine not exceeding $5,000

Offenses Regarding Food Stamps

Welfare fraud can also be committed concerning food stamps. When found engaging in activities that have blank authorizations to benefit from food stamps, the offense is a felony. A guilty verdict will result in:

  • County incarceration for not less than sixteen months or more than three years

  • You will be charged to pay a fine not exceeding $5,000.

This offense can, however, be a wobbler if you are accused of using, transferring, selling, buying, or possessing food stamps unlawfully. When one electronically moves food stamp benefits to another unlawfully, they also face these charges.

When the food stamps value is below $950, you will be charged with a misdemeanor offense. The penalties upon conviction will also be a jail time not exceeding six months in addition to a fine of $500 or less.

If the value, however, exceeded $950, the offense becomes a felony. In this case, your jail time is longer to a minimum of sixteen months and a maximum of three years. Additionally, you will be required to pay a fine of no more than $5,000.

When the Benefits are Transferred Electronically

Under WIC 10980, you can also be charged with fraudulently transferring benefits electronically. When accused of welfare fraud, the charges are enhanced if the scam involved the electronic transfer of benefits. The additional sentences served consecutively you face include:

  • A year of imprisonment if the benefits transferred exceeded $50,000

  • If the benefits were over $150,000, two more years will be added to your jail sentence

  • A transfer of over a million dollars will earn you an additional three years incarceration and

  • Above $2.5 million will earn you a further four years incarceration.

Other Consequences for Welfare Fraud

Aside from the discussed penalties above, when one is convicted of welfare fraud, they are subjected to other consequences. These include:

  • When you have a professional license, you will receive disciplinary action from the board that regulates your license. All professional licenses are affected by criminal convictions, primarily when the crime is classified under crimes of moral turpitude. Welfare fraud offenses in California are classified as such.

  • If you committed the crime and are an immigrant, you are likely to be removed or deported.

  • You will also be disqualified from receiving public aid in the future.

All these consequences and penalties are harsh, and fighting to avoid a conviction is critical.

Restitution instead of Criminal Prosecution

As earlier stated, the primary objective of a prosecutor is to recover the stolen monies for the state or county. Your lawyer can negotiate with the prosecutor not to pursue a jail sentence but instead let you pay restitution. Some counties in the state of California offer diversion programs to individuals accused of welfare fraud.

These programs vary from one county to the next, but they are generally provided to persons without prior criminal convictions and have not taken substantial amounts from the state. The defendant gets a chance to pay back the money, and the charges against them are dismissed.

However, the defendant must take a guilty plea for the offense. If one completes the diversion program successfully and pays back the money, the charges are dismissed. If this is not attained, they are sentenced for the offense according to the law.

Sometimes, prosecutors may refuse to give you a deal when you offer to pay back. However, your lawyer can present your offer before the judge during the trial. This typically goes a long way in convincing the court to reduce the sentence you receive.

Find a Criminal Attorney Near Me

When one faces a criminal charge, especially for the first time, the experience can be confusing and scary. Despite all these, one can overcome the allegations by presenting an aggressive defense against the charges. An experienced criminal attorney can assist in formulating smart arguments that will see you acquitted of the charges, or you receiving more lenient penalties. When charged with this offense, get a San Jose Criminal Attorney Law Firm lawyer to defend you. Call us at 408-622-0204 to discuss your case and schedule an appointment.