Eleven Individuals Indicted in Puerto Rico for Social Security Disability Fraud

August 28, 2018

From the U.S. Attorney’s Office, District of Puerto Rico:

SAN JUAN, P.R. – On Aug. 23 and 24, 2018, a Federal Grand Jury in the District of Puerto Rico returned seven separate indictments charging 11 individuals with fraud against the Social Security Administration (SSA) disability insurance benefits in Puerto Rico, announced U.S. Attorney Rosa Emilia Rodríguez Vélez for the District of Puerto Rico. These cases were investigated by the Social Security Office of Inspector General (SS-OIG) with the collaboration of the Department of Homeland Security Office of Inspector General, U.S. Health and Human Services-Office of Inspector General, and the Puerto Rico Police Department.

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.

Six indictments charged 10 individuals with 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. The seventh indictment charges Teresa González-Hernández with 40 counts of wire fraud against SSA.

The defendants who are alleged to have accepted by fraud the Social Security Disability Insurance Benefit payments, knowing that they were not entitled to the same, are: Evelyn Morales-Calderón and Victor Soriano-Morales (son of Evelyn Morales) received $190,110.00; Mario Zayas-Rodríguez and Elvin Santiago-Rodríguez (employer of Mario Zayas) received $118,098.20; José Alcazar-Román received $97,004.80; Alvin Alvelo-Crespo received $92,101.50; Abraham Burgos-Torres and Karla Burgos-Colón (daughter of Abraham Burgos) received $90,335.50; Nelson Concepción-Santana received $41,261.00; Wanda Rivera-Martínez received $41,204.40; and Teresa González-Hernández received $57,947.00.

Defendant Alvin Alvelo-Crespo was also charged with healthcare fraud. The defendant fraudulently caused Medicare to pay approximately $8,545.33 based on fraudulent claims. This defendant is also facing one count of Fraud in Connection with Major Disaster (Hurricane María) or Emergency Benefits. Alvelo-Crespo falsely represented to FEMA that his combined family pre-disaster gross income was $9,264.00 and that the residence located at Almirante Norte in Vega Baja, Puerto Rico was his primary residence when Hurricane María struck Puerto Rico. In fact, however, the defendant’s combined family pre-disaster gross income was higher than $9,264.00 and the residence located at Almirante Norte was not his primary residence at the moment Hurricane María struck Puerto Rico. The defendant received $500.00 for Critical Needs Assistance; $14,282.79 for Home Repair Assistance; $10,431.15 for Personal Property Assistance; and $1,486.00 for Rental Assistance, for a total of $26,699.94. All this assistance was authorized, transported, transmitted, transferred, disbursed or paid by, electronic fund transfers into his bank account.

Defendant Teresa González-Hernández was a social worker at Entity A, an entity located in San Juan, Puerto Rico that assists homeless individuals. Her victim with initials J.L.M, was a client or beneficiary of Entity A. On or about Sept. 4, 2008, González-Hernández abused her position of trust as a social worker for J.L.M. and opened a joint account with J.L.M. at Scotiabank of Puerto Rico. On Oct. 28, 2010, J.L.M. requested SSA that his disability benefits, which were later automatically converted to retirement benefits, be directly deposited into the joint account. After J.L.M. died on Nov. 19, 2010, González-Hernández failed to notify SSA about his death, and the DIB and Retirement benefits belonging to J.L.M. continued to be deposited into the joint account. González-Hernández embezzled the benefits that SSA issued to J.L.M., benefits which she knew she was not entitled to. As a result of the scheme, between Jan. 26, 2011, and continuing through Nov. 23, 2016, SSA made 71 electronic payment transactions to the joint account totaling $57,947.00.

“We will aggressively investigate and prosecute anyone who seeks to defraud or exploit the federal assistance programs established to help the most vulnerable of our communities,” said United States Attorney Rosa Emilia Rodríguez-Vélez. “The Department of Justice is committed to investigate and prosecute those who engage in fraudulent schemes. This round of arrests should discourage more people from getting involved in these types of schemes, because we will continue investigating these crimes.”

Social Security Administration, Office of the Inspector General, Special Agent in Charge John F. Grasso stated: “The Office of the Inspector General is the law enforcement arm of the Social Security Administration and protects agency programs from fraud, waste and abuse, including the Disability Insurance program. This program is intended to support individuals who are truly in need of this important and earned benefit. The program relies on the truthfulness of disability applicants, and those who provide information to SSA on their behalf. When people lie about their medical condition, work activity, or other relevant facts necessary for SSA to make a proper decision in relation to the payment of benefits, as alleged in these criminal complaints, they are in effect looting from the Social Security Trust Fund. I strongly encourage the public to continue to report suspected instances of Social Security fraud to our dedicated hotline at 1-855-278-5982 or oig.ssa.gov/report, because we cannot do it alone.”

Special Assistant U.S. Attorney Vanessa D. Bonano-Rodríguez is in charge of the prosecution of these cases. If convicted, the defendants charged with SSA fraud could face a maximum penalty of 10 years in prison; the defendant charged with Fraud in Connection with Major Disaster (Hurricane María) or Emergency Benefits faces a maximum penalty of up to 30 years in prison and the defendant charged with wire fraud faces a maximum penalty of up to 20 years in prison. All defendants are subject to a fine 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.