SAN JUAN, P.R. – On December 6, 2016, a Federal Grand Jury in the District of Puerto Rico returned five separate Indictments charging seven individuals with fraud against the Social Security Administration (SSA) disability insurance benefits in Puerto Rico, announced United States Attorney for the District of Puerto Rico, Rosa Emilia Rodríguez Vélez.
The SSA is responsible for the implementation of the Disability Insurance Benefits Program. The SSA provides monetary benefits to workers with severe, long-term disabilities, who have worked in SSA covered employment for a required length of time. Spouses and dependent children of disabled workers may also be eligible to receive benefits.
Pursuant to SSA regulations, a claimant must prove to SSA that he or she is disabled by furnishing medical and other evidence with the application. The application and supporting evidence would then be evaluated by SSA to determine the individual’s medical impairments and determine the effect of the impairment on the claimant’s ability to work on a sustained basis.
The five indictments charge seven individuals of theft of government property, concealment or failure to disclose work activity to SSA and false statements or representations to the SSA. These defendants knowingly and willfully embezzled, stole, and converted to their own use the Social Security Disability Insurance Benefit payments to which the defendants knew that they were not entitled.
Two of the seven individuals, namely, Arturo Santiago-Acevedo and Erick Malavé-Hernández, were also charged with health care fraud. These defendants, as part of their SSA disability benefits, became eligible, applied for and received benefits under the Medicare Program.
Once a person is receiving SSA disability benefits for 24 months he/she automatically starts receiving Part A of the Medicare Program (hospitalizations) and they become eligible to apply for Part B and C of the Medicare Program. If they decide to apply for Part B and/or C of the Medicare Program, the monthly premium is deducted from their monthly disability benefits.
The other five defendants are: Ferdinand Negrón-Candelaria, a.k.a. “Yuca;” Jorge M. Bultrón-Casas, a.k.a. “Ernesto Bultrón Casas,” a.k.a. “George Bultrón;” Nancy López-Villanueva; Aracely Amadeo-Pumarejo and Luz B. Hiraldo-Rivera. They reported during a Continuing Disability Review (CDR) that the disability beneficiary had not been able to work due to different health conditions, when in truth they were working.
“This is a great example of ongoing efforts by the Government to deter fraud against the social security programs,” said United States Attorney Rosa Emilia Rodríguez-Vélez. The Department of Justice is committed to investigate and prosecute those who engage in fraudulent schemes. Hopefully this round of arrests will discourage more people from getting involved in these types of schemes, because we will continue investigating these crimes.”
SSA-OIG Special Agent-in-Charge John Grasso said: “The Social Security Disability Insurance program is intended to support individuals truly in need of this important and earned benefit, not those who are willing to lie about their true condition to steal from the Social Security Trust Fund. I am very grateful for the efforts of all of our law enforcement partners involved in this investigation, and for the continued commitment from the United States Attorney’s Office for the Commonwealth of Puerto Rico to aggressively pursue these important cases. I strongly encourage the public to report suspected instances of Social Security fraud to the OIG’s Fraud Hotline at 1-800-269-0271 or https://oig.ssa.gov/report.”
These cases were investigated by the Social Security-OIG with the collaboration of Health and Human Services-Office of Inspector General, and the Puerto Rico Police Department and were indicted by Special Assistant United States Attorney Vanessa D. Bonano-Rodríguez.
If convicted, the defendants could face a maximum penalty of 10 years of imprisonment and/or fines of up to $250,000.00. Indictments contain only charges and are not evidence of guilt. Defendants are presumed to be innocent unless and until proven guilty.