TN 5 (12-92)

Citations:

Social Security Act - Section 205(c)(5)(E)

A. POLICY

SSA can revise an E/R at any time if the amount entered on our records is erroneous because of fraud.

The NH does not have to be involved in the fraud. The same criteria are used for revising the E/R as for administrative finality. See GN 04020.010B.

Fraud must be established by clear and convincing evidence of an intent to deceive. Fraud cannot be inferred.

SSA may correct an entry on the E/R where the entry is erroneous because of fraud even if SSA does not start criminal proceedings. (see GN 04020.010B.)

B. REFERENCE

Action to follow when an E/R may be revised because of fraud, GN 04020.010 and GN 04110.010.