Redetermination Under 405[u] for “Fraud or Similar Fault” – NOSSCR 2026 Fall National Conference – Track II (Presented by National Organization of Social Security Claimants’ Representatives)

The statute’s reach is the shock. Under 42 U.S.C. §405(u), enacted in 1994, claimants can be subjected to draconian “redetermination” proceedings regardless of their own complicity in any alleged “fraud or similar fault.” The claimant’s innocence is not a defense to the proceeding itself.

The history shows how the statute gets used. Since enactment, SSA has targeted large numbers of claimants — in Puerto Rico, in New York, and, beginning 16 years ago, in Kentucky. A representative whose region hasn’t seen a wave has no assurance it won’t; the statute that reached those claimants reaches everywhere.

This talk covers what a representative facing one of these proceedings needs: the rules governing redetermination under §405(u), and the current litigation testing those proceedings — where the challenges stand and what they may change.