# Will she be done for fraud?



## Askaquestion123 (12 Oct 2016)

Someone claiming illness benefit went back to work but kept claiming as had high costs. Now wants to come clean and repay to DSP. Can they do this?


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## gipimann (13 Oct 2016)

There are two issues here - the person continued to claim after they had returned to work, and the GP continued to issue medical certs declaring the person unfit for work (as medical certs are needed to claim illness benefit).

The person should contact Illness Benefit section for advice on how to repay the money.


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## Askaquestion123 (13 Oct 2016)

gipimann said:


> There are two issues here - the person continued to claim after they had returned to work, and the GP continued to issue medical certs declaring the person unfit for work (as medical certs are needed to claim illness benefit).
> 
> The person should contact Illness Benefit section for advice on how to repay the money.


Thanks. Will she be prosecuted if she comes clean?


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## gipimann (13 Oct 2016)

It would be better for her to contact the Department rather than doing nothing.


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## elcato (13 Oct 2016)

She will be prosecuted if she is caught. I presume she didn't need to get a doctors cert and we are talking a short term here ? If she comes clean she may be able to avoid any prosecution.


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## Firehead (14 Oct 2016)

If the GP was providing certs could he/she be prosecuted also I wonder?


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## noproblem (14 Oct 2016)

Anything IS possible. Could you tell us how much is involved, you don't have to be exact but near enough.


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## T McGibney (14 Oct 2016)

Firehead said:


> If the GP was providing certs could he/she be prosecuted also I wonder?


How can the GP be prosecuted?


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## noproblem (14 Oct 2016)

I'd imagine if the GP was issuing sick certs for someone who had gone back to work it might not be looked at as inside the law, therefore possibly fraud. I'm told it happens.


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## T McGibney (14 Oct 2016)

noproblem said:


> I'd imagine if the GP was issuing sick certs for someone who had gone back to work it might not be looked at as inside the law, therefore possibly fraud. I'm told it happens.


But the country is full of people who exaggerate symptoms and tell fibs to doctors.


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## Gerry Canning (14 Oct 2016)

If she wasn,t @ it for years and it ain,t huge and she wants to sort , very very unlikely she will be prosecuted.
If she had (hardship) and (used) system to survive , who would prosecute?

It is great for HER that she is prepared to sort issue.Most just hope to get away and when it blows up , as it probably will, they are really then in trouble.
Get her or some-other , to approach DSW , I would be very surprised if they don,t just go for a refund time-frame.


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## Leper (15 Oct 2016)

1. The GP won't be prosecuted.  All that happened was that the patient was issued with a Soc Wel Cert advising that the patient should not work. What the patient did after leaving the doctor is not the GP's business.

2. Fraud occurred as the patient returned to work (presumably paying PAYE and PRSI) and continued claiming Illness Benefit. You don't have to be an artist to draw conclusions here. The Dept of Soc. Prot. is advised that PRSI deductions are now coming in from the client regularly.  It is only a matter of a short time before the Department's computer system shows up that an Illness Benefit payment every week is being dispensed. 

I can't speak for the Dept of Soc. Prot. but once they go after you coldly they will want their money returned in one or two lump sums.  Get to them before they get to you and perhaps payments can be spread out. It would be foolish not to contact the Department immediately.


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## amtc (15 Oct 2016)

I wouldn't be so sure that the person would be caught. I was on sick pay for a number of months and my employer paid me on salary so I just gave them my Illness benefit. So my PAYE prsi records looked as if I were in work. I' be also worked in DSP and I wouldn't believe that records were clashed automatically. How did the person go back to work without a final cert?


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## Leper (15 Oct 2016)

1. I don't know when you were sick amtc, but you presented your Social Welfare award to your employer which is not unusual.  You got paid your wages minus the Social Welfare award and probably you don't know if your employer paid back the award. If anything otherwise happened your employer should be approached by Dept. of Social Welfare. Afterall, it's the tax payers money.

2. I don't work for the Dept of Social Welfare, but I am in constant contact with them regarding such queries as Illness Benefit. The contact is a two way street, on a telephone call they take my word for something while I take theirs. If I were to hide those falsely claiming Illness Benefit then the trust in me would be lost and genuine claimers lost also.
3. Final Certs are generally for Dept of Social Welfare use  and in normal circumstances the employer would depend on a normal doctor's certificate so no problem in returning to work under the Social Welfare radar in the short term.
4. I have no doubt that depending on amounts awarded (usually €188.00 per week, more depending on dependents).  If the Department of Social Welfare hunts the payee down, I reckon no mercy will be shown and her future claims will be investigated thoroughly.  Believe me, you don't need to fall foul of the Dept of Social Welfare.

The phrase Penny Wise, Pound Foolish comes to mind.


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## amtc (15 Oct 2016)

This was 2012. It was a public service organisation so was usual to be paid full salary, minus illness benefit. I did need a final cert and a letter of fitness from my doctor plus a visit to company doctor to certify fitness to return (it was a back issue). 

I would very much disagree that records are clashed. There are spot checks.


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## Leper (16 Oct 2016)

If the Dept. of Social Protection does not have a computer system that "talks" to itself, then there is something amiss and opens the door for nearly everybody to play Social Welfare Roulette with Illness Benefit awards.  Where I work the Dept of Social Welfare writes to us advising of amounts paid to our employees as a result of their sick leave.  We do the calculations of amounts deducted from wages and refund/deduct the difference where applicable.

I hope the Department is not relying on spot checks where computerised hard checks are easier to do. I am not disputing what amtc said, I just hope he is wrong and if he is right then the SW coffers will be drained while those abusing the system double pay themselves (i.e. pay from their employer and gaining Illness Benefit payments simultaneously).


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## JoeRoberts (16 Oct 2016)

Leper said:


> 1. I don't know when you were sick amtc, but you presented your Social Welfare award to your employer which is not unusual.  You got paid your wages minus the Social Welfare award and probably you don't know if your employer paid back the award. If anything otherwise happened your employer should be approached by Dept. of Social Welfare. Afterall, it's the tax payers money.



Why would employer pay it back to social welfare ? I've never heard of it.
In a situation where employer provides a topup:

If employee keeps the IB, the employer taxes the IB, pays the adjusted gross salary depending on company policy and makes a net deduction. So ideally with a full topup policy, net pay +IB = normal weekly net pay.
If employee gives it to the company the employer keeps it and pays the normal salary ensuring that the IB is recorded as being separatley identified and taxed as part of the normal gross.


There is nothing wrong with getting IB and a payment from employer as long as it is taxed properly and as long as employee is not working.( I know this is not the OPs case)


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## amtc (16 Oct 2016)

I am a she...and I am right. It was part of a process inspection I did for DSP as a consultant in 2015. Might be fixed

Oh I never said my previous employer paid it back. I gave it to them


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## Gerry Canning (18 Oct 2016)

Askaquestion 123.

From the information I take from the threads .

Contact DSW and sort before they sort her !


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