Complaint 1

United States District Court

Western District of Texas

San Antonio Division

United States of America,

Plaintiff,

v. No. 5:20-CV-00601

Troy F. Jones, Jr., Defendant.

Complaint

1. The mission of the United States Department of Veterans Affairs (“VA”) is to care for 

United States military veterans and their eligible dependents. As part of that mission, the VA is 

charged with comprehensive aspects of managing the veteran’s disability compensation program. 

2. A veteran that is disabled, as a result of a personal injury or disease while in active 

service may be eligible, under 38 C.F.R. Part 3, Subpart A, to receive monetary support from the 

VA in the form of VA disability compensation. In determining eligibility for disability 

compensation, the VA relies extensively on the factual representations of the veteran concerning 

his or her disability. The VA then uses a rating schedule that represents, as far as can practicably 

be determined, the reductions in earning capacity from specific injuries or combination of injuries 

resulting from a disability. 38 C.F.R. §§ 3.321, 1155. Disability compensation claims must also be 

accompanied by adequate medical evidence, or a VA examination will be authorized. 38 C.F.R. § 

3.326. 

3. Social Security disability insurance benefits are authorized by Title II of the Social 

Security Act and are funded by Social Security taxes. The disability insurance program provides 

income to individuals who are caused to be placed into involuntary, premature retirement, provided 

they are both insured and disabled, regardless of indigence. A claimant for Social Security 

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disability insurance can collect benefits for up to twelve months of disability prior to filing an 

application. See 20 C.F.R. §§ 404.131, 404.315. 

4. Applicants seeking benefits under this statutory provision must prove “disability” 

within the meaning of the Social Security Act. See 42 U.S.C. § 423(d); 20 C.F.R. § 404.1505(a). 

Under Title II, disability is defined as “the inability to engage in any substantial gainful activity 

by reason of any medically determinable physical or mental impairment which can be expected to 

result in death or which has lasted or can be expected to last for a continuous period of not less 

than 12 months.” 42 U.S.C. § 423(d)(1)(A). Determinations as to Social Security disability benefit 

eligibility, like eligibility for VA disability benefits, rely extensively upon factual representations 

by the applicant. 

5. This action seeks triple damages and civil money penalties under the False Claims Act 

based upon the false claims and false records or statements made or used by Defendant, Troy F. 

Jones, Jr., in order to obtain benefits from both the VA and the Social Security Administration 

(“SSA”). Alternatively, this action seeks damages for payment by mistake of fact, unjust 

enrichment, and conversion.

Parties

6. Plaintiff is the United States of America. 

7. Defendant is Troy F. Jones, Jr., a resident of Boerne, Texas. 

Jurisdiction and Venue

8. This Court has jurisdiction under 31 U.S.C. § 3732(a) and 28 U.S.C. § 1345. 

9. Venue is proper in the Western District of Texas under 28 U.S.C. § 1391(b) and 31 

U.S.C. §3732(a) because the conduct which gave rise to this complaint occurred here.

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Complaint 3

Statement of the Case

10. On August 24, 2017, the SSA received information that Troy F. Jones, Jr., had been 

fabricating symptoms of a physical disorder to gain financial compensation pursuant to Title II, 

Disability Insurance Benefits (DIB) and VA disability compensation. 

11. Jones is a Veteran of the Gulf War Era and Peacetime. He served in the Air Force from 

June 30, 1988 to August 28, 1996, and the Army from November 26, 2012 to April 3, 2014, and 

June 2, 2014 to September 10, 2014. 

12. Jones was deployed to Germany with the Texas Air National Guard in June 2014. 

While in Germany, Jones called emergency services and reported he was experiencing headaches 

and numbness in his left extremities. He was discharged from the hospital after multiple medical 

tests showed no abnormalities. In August 2014, Jones returned to Texas with a slight limp. 

13. Jones filed his initial claim for SSA disability benefits online on October 31, 2014, 

alleging an onset date of July 14, 2014, stemming from a claimed stroke in Germany. His claimed 

illnesses, injuries, or conditions were listed as S/P1 stroke, left side paralysis – below knee, left 

arm weakness and control problem, peripheral vision loss in left eye, hearing loss in left ear, back 

pain, and inability to drive. 

14. On March 2, 2015, Jones attended a consultative examination at Presidio Medical 

Management, Inc. based on a request from the Department of Assistive and Rehabilitative 

Services, Disability Determination Services (DDS) at Presidio Medical Management, Inc. During 

the examination, Jones reported that he could not perform activities such as shop without 

assistance; travel without a companion for assistance; ambulate without the use of an assistive 

 1 S/P is a shorthand medical term for after. 

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device; or drive an automobile. Jones claimed he could not lift or carry more than 20 pounds and 

could not sit or stand more than an hour or walk more than two hours. 

15. SSA found Jones disabled on March 6, 2015. Jones was awarded DIB with an onset 

date of July 14, 2014. When he began receiving monthly payments, they were retroactive to the 

onset date. 

16. Jones filed an initial claim for VA disability benefits on or about September 21, 2015. 

The VA issued a rating decision on March 25, 2016, with an effective date of October 20, 2015. 

The decision granted service connection for several different disabilities, one of which was a 100% 

rating for left upper and lower extremity hemiplegia2 with loss of use, complex migraines, and left 

shoulder degenerative arthritis. As a result of this rating decision, Jones began to receive $4,180.65

per month on November 1, 2015. He also received a retroactive payment of $22,815.73. 

17. On August 29, 2016, Jones filed a claim for increased evaluation. This claim was 

primarily to request an increase in Jones’ Special Monthly Compensation payments related to his 

100% service-connected rating for hemiplegia. He also requested an increase in compensation for 

vision loss (he was rated at 10% at the time of the request). On December 28, 2016, Jones received 

a rating decision granting that claim, with an effective date of August 29, 2016. As a result, he 

began to receive $4,887.42 per month on September 1, 2016. He also received a retroactive 

payment of $1,097.86. 

18. On September 20, 2017, the SSA Office of the Inspector General (“OIG”), following a 

tip regarding fabricated symptoms, executed an undercover operation consisting of a continuing 

disability review in an effort to obtain video and audio statements from Jones regarding his 

 2 Hemiplegia is commonly defined as total or partial paralysis of one side of the body that results 

from disease or injury to the motor centers of the brain.

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functional limitations and ability to continue to receive DIB. During the interview, the Claims 

Representative asked Jones a series of questions regarding Jones’ medical conditions and daily 

activities. Jones reported his primary physical conditions are left side hemiplegia (paralysis), 

severe migraines, pain in lower back, left eye peripheral vision loss, and issues of bladder control. 

19. On October 16, 2017, the SSA OIG interviewed Jones’ former spouse, Deeda “Dee” 

Ackermann. According to Ms. Ackermann, by mid-August 2014, one month after the incident in 

Germany that allegedly caused Jones’ claimed paralysis and provided the basis for his application 

for DIB, Jones regained complete physical functionality. In support of this statement, Ms. 

Ackermann provided SSA OIG with several photographs taken between August 2014 and June 

2015 that show Jones making ice cream for children with a manual crank, raking leaves, and 

walking without assistance. 

20. Ms. Ackermann also provided information related to her marriage to and honeymoon 

with Jones, which occurred in April 2015. Ms. Ackermann related that the couple actively hiked 

together in Albuquerque, New Mexico. One month prior to that, Jones had sought healthcare 

services for his medical condition, claiming to medical professionals that he could not perform 

activities like shopping without assistance, traveling without assistance, ambulating without the 

use of an assisted device, and driving an automobile. Ms. Ackermann denied that Jones suffered 

any functional limitations and provided a video of their marriage ceremony in which Jones 

ambulates without assistance.

21. Ms. Ackermann also provided home surveillance video taken in May 2017 showing 

Jones’ ability to ambulate without assistance and showing full physical functionality. 

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22. In February 2018, the VA OIG and SSA OIG interviewed Jones’ primary care

physician, Dr. Stephen Short. After viewing the May 2017 video, Dr. Short opined that based on 

his medical knowledge, Jones appeared to be fabricating symptoms of his physical disorder.

23. Later the same month, VA OIG and SSA OIG interviewed Jones’ neurologist, Dr. 

Santiago Palacio, regarding allegations that Jones was possibly malingering. After viewing the 

May 2017 video, Dr. Palacio stated that someone who suffers from left-side hemiplegia would 

require the use of a wheelchair or, possibly a cane to ambulate. Based on the videos and Dr. 

Palacio’s previous examination of Jones, Dr. Palacio called into question Jones’ claim that he had 

suffered a stroke.

24. A local day spa that Jones frequented between January 2015 and May 2018 also 

confirmed that Jones did not use a wheelchair or any other type of assistive device to ambulate or 

walk when he would enter the spa and treatment room. Jones’ credit card receipts and cash 

withdrawals correspond with the day spa’s appointment book. 

25. Based on this investigation, both the VA OIG and the SSA OIG determined that Jones 

had fraudulently obtained benefits. Specifically, the agencies concluded that Jones was able to 

ambulate without the use of assistive devices.

26. Jones should not have received any compensation from SSA, because the entirety of 

the benefits Jones received was based on his false assertion that he could not ambulate. The rate 

of overpayment to Jones and his dependent children (S. Jones and A. Jones) by the SSA is indicated 

in the chart below:

Beneficiary Eff. Date New Rate Old Rate x Months Overpayment

T. Jones 02/2015 $ 0.00 $ 3,034.00 1 $ 3,034.00

T. Jones 03/2015 $ 0.00 $ 1,517.00 5 $ 7,585.00

T. Jones 08/2015 $ 0.00 $ 1,137.70 3 $ 3,413.10

T. Jones 11/2015 $ 0.00 $ 1,162.50 1 $ 1,162.50

T. Jones 12/2015 $ 0.00 $ 1,140.00 12 $ 13,680.00

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T. Jones 12/2016 $ 0.00 $ 1,042.50 6 $ 6,255.00

T. Jones 06/2017 $ 0.00 $ 1,390.00 6 $ 8,340.00

T. Jones 12/2017 $ 0.00 $ 1,421.00 5 $ 7,105.00

S. Jones 04/2015 $ 0.00 $ 1,516.00 1 $ 1,516.00

S. Jones 05/2015 $ 0.00 $ 379.00 6 $ 2,274.00

S. Jones 11/2015 $ 0.00 $ 390.00 1 $ 390.00

S. Jones 12/2015 $ 0.00 $ 380.00 12 $ 4,560.00

S. Jones 12/2016 $ 0.00 $ 381.00 12 $ 4,572.00

S. Jones 12/2017 $ 0.00 $ 388.00 5 $ 1,940.00

A. Jones 04/2015 $ 0.00 $ 1,516.00 1 $ 1,516.00

A. Jones 05/2015 $ 0.00 $ 379.00 6 $ 2,274.00

A. Jones 11/2015 $ 0.00 $ 390.00 1 $ 390.00

A. Jones 12/2015 $ 0.00 $ 380.00 12 $ 4,560.00

A. Jones 12/2016 $ 0.00 $ 381.00 12 $ 4,572.00

A. Jones 12/2017 $ 0.00 $ 388.00 5 $ 1,940.00

Voluntary Federal Income Tax 

Withholdings $ 8,745.00

Total Overpayment $ 89,249.00

27. The amount of overpayment to Jones by the VA is demonstrated in the chart below. 

The rate Jones should have received is reflected in the chart below as the “new rate.” The 

difference annotated in the chart below is the amount of compensation that Jones was not entitled

to receive:

Eff. Date New Rate Old Rate Difference x Months Overpayment

10/01/15 $ 1,328.09 $ 2,301.48 -$973.39 1 $ 973.39

11/01/15 $ 1,328.09 $ 4,613.16 -$3,285.07 10 $ 32,850.70

09/01/16 $ 1,328.09 $ 4,887.42 -$3,559.33 1 $ 3,559.33

10/01/16 $ 1,328.09 $ 4,887.42 -$3,559.33 2 $ 7,118.66

12/01/16 $ 1,331.27 $ 4,902.08 -$3,570.81 12 $ 42,849.72

12/01/17 $ 1,357.52 $ 3,918.23 -$2,560.71 1 $ 2,560.71

Total 

Overpayment $ 89,912.51

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28. On June 22, 2017, Jones also received from the VA an automobile grant for $20,235.20, 

because of his 100% loss of use rating. Like Jones’ other federal claims for benefits, because of 

misrepresentations regarding his physical condition, Jones was not entitled to this grant. 

29. As a result of Jones knowingly making, using, or causing to be made or used, a false 

record or statement material to an obligation to pay or transmit money or property to the 

Government, or knowingly concealing or knowingly and improperly avoiding or decreasing an 

obligation to pay or transmit money or property to the Government, the VA and SSA paid benefits 

to which there was no entitlement in the amount of $199,396.71.

First Cause of Action

False Claims Act, 31 U.S.C. § 3729(a)(1)(B)

30. The United States re-alleges and incorporates the preceding paragraphs.

31. By means of the acts described above, Defendant knowingly made or used, or caused 

to be made or used, a false record or statement, which was submitted to the VA and the SSA, and 

that false record or statement, which was material to the compensation obtained, caused the 

payment of compensation that would otherwise have been denied.

32. The United States suffered actual damages of at least $199,396.71 and is entitled to 

treble damages ($598,190.13) and civil penalties under the False Claims False Claims Act, 31 

U.S.C. § 3729 et seq. as amended.

Second Cause of Action

False Claims Act, 31 U.S.C. § 3729(a)(1)(G) 

33. The United States re-alleges and incorporates the preceding paragraphs.

34. By virtue of the acts described above, Jones knowingly made, used, or caused to be 

made or used, a false record or statement, or omission material to an obligation to pay or transmit 

money or property to the Government, and knowingly concealed or knowingly and improperly 

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avoided or decreased an obligation to pay or transmit money or property to the Government, all in 

violation of the False Claims Act, 31 U.S.C. § 3729(a)(1)(G).

35. The United States suffered actual damages of at least $199,396.71, and is entitled to 

treble damages and civil penalties under the False Claims Act, 31 U.S.C. § 3729 et seq. as 

amended.

Third Cause of Action

Payment by Mistake of Fact 

36. The United States re-alleges and incorporates the preceding paragraphs.

37. As a result of the conduct described above, Jones obtained federal funds that were not 

properly payable to him. 

38. At the time such payments were made, the United States, through the VA and SSA, 

was not aware of Jones’s wrongful conduct. Had the VA and SSA known that Jones was not

disabled to the extent that he represented, the agencies would not have approved payment of his 

VA or SSA benefits. All payments made based on Jones’s assertions of his disability were done 

by mistake of fact.

39. As a consequence, the United States is entitled to recover those funds, which were 

obtained by Jones, in the amount of $199,396.71.

Fourth Cause of Action

Unjust Enrichment

40. The United States re-alleges and incorporates the preceding paragraphs.

41. As a result of the conduct described above, Jones obtained federal funds to which he 

was not entitled.

42. In consequence of the acts set forth above, Jones has been unjustly enriched at the 

expense of the United States under circumstances directing that in equity and good conscious, the 

money should be returned to the United States.

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Fifth Cause of Action

Conversion

43. The United States re-alleges and incorporates the preceding paragraphs.

44. This is a claim for conversion of government property.

45. Jones obtained funds belonging to the United States. 

46. Jones retained, dissipated, and failed to return VA and SSA benefit funds to the United 

States.

47. Jones wrongfully exercised dominion and control over VA and SSA benefit funds to 

the exclusion of and inconsistent with the rights of the United States.

48. Jones acted with malice.

49. Jones’s continuous and long-term acceptance, taking, and dispensing of funds was 

wanton and malicious.

50. Jones is liable to the United States for actual and exemplary damages, in amounts to be 

determined at trial.

Conclusion

WHEREFORE, Plaintiff prays that that the Court grant judgment for the United States against 

Jones as follows:

• For civil penalties for each false claim, pursuant to 31 U.S.C. § 3729(a);

• For three times the amount of actual damages proved, pursuant to 31 U.S.C. § 3729(a);

• For damages proved for payments made under mistake of fact, unjust enrichment, and 

conversion; 

• For reasonable attorney’s fees, costs, and expenses incurred by the United States in 

prosecuting this action;

• Post-judgment interest at the rates permitted by law; and

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• For such other and further relief as may be appropriate and authorized by law.

Respectfully submitted,

John F. Bash

United States Attorney

By: /s/ Lacy L. McAndrew

Lacy L. McAndrew

Assistant United States Attorney

Florida Bar No. 45507

601 N.W. Loop 410, Suite 600

San Antonio, Texas 78216

(210) 384-7340 (phone)

(210) 384-7212 (fax)

lacy.mcandrew@usdoj.gov

Attorneys for the Plaintiff

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