I 
113TH CONGRESS 
2D SESSION 
H. R. 5260 
To amend the Social Security Act to prevent disability fraud, and for other 
purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 30, 2014 
Mr. SAM JOHNSON of Texas (for himself, Mrs. BLACK, Mr. BRADY of Texas, 
Mr. GRIFFIN of Arkansas, and Mr. KELLY of Pennsylvania) introduced 
the following bill; which was referred to the Committee on Ways and 
Means 
A BILL 
To amend the Social Security Act to prevent disability fraud, 
and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Stop Disability Fraud 
Act of 2014’’. 
SEC. 2. TABLE OF CONTENTS. 
The table of contents for this Act is as follows: 
Sec. 1. Short title. 
Sec. 2. Table of contents. 
TITLE I—COMBATING CONSPIRACY FRAUD 
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Sec. 101. Expansion of cooperative disability investigations units. 
Sec. 102. Exclusion of certain medical sources of evidence. 
Sec. 103. Immediate suspension of claimant representatives upon certain con-
victions or disbarment. 
Sec. 104. New and stronger penalties. 
Sec. 105. Review of highest-earning claimant representatives. 
TITLE II—STRENGTHENING PROGRAM PROTECTIONS 
Sec. 201. Pre-effectuation and post-effectuation quality reviews of hearing dis-
positions. 
Sec. 202. Uniform qualification standards for disability determination decision 
makers. 
Sec. 203. Increased transparency. 
Sec. 204. Data exchange standardization. 
TITLE III—MODERNIZING DISABILITY PROGRAMS 
Sec. 301. Updating of medical-vocational guidelines. 
Sec. 302. Research and demonstration projects. 
Sec. 303. Referrals to vocational rehabilitation or other public or private re-
turn-to-work service providers. 
Sec. 304. Online benefit assessment tools. 
TITLE IV—OTHER PROGRAM IMPROVEMENTS 
Sec. 401. Real property acquired by the Trust Funds. 
Sec. 402. Rules relating to distribution of death information furnished to or 
maintained by the Social Security Administration. 
Sec. 403. Reconsiderations of disability cessation determinations. 
TITLE I—COMBATING 
CONSPIRACY FRAUD 
SEC. 101. EXPANSION OF COOPERATIVE DISABILITY INVES-
TIGATIONS UNITS. 
Not later than October 1, 2016, the Commissioner 
of Social Security shall take any necessary actions to en-
sure that cooperative disability investigations units have 
been established that would cover each of the 50 States, 
the District of Columbia, Puerto Rico, Guam, the North-
ern Mariana Islands, the Virgin Islands, and American 
Samoa. 
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SEC. 102. EXCLUSION OF CERTAIN MEDICAL SOURCES OF 
EVIDENCE. 
(a) IN GENERAL.—Section 223(d)(5) of the Social 
Security Act (42 U.S.C. 423(d)(5)) is amended by adding 
at the end the following: 
‘‘(C) In making any determination with respect to 
whether an individual is under a disability or continues 
to be under a disability, the Commissioner of Social Secu-
rity may not consider any evidence furnished by an unli-
censed or sanctioned physician or health care practi-
tioner.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply with respect to determinations 
of disability made on or after the date that is 1 year after 
the date of the enactment of this Act. 
SEC. 103. IMMEDIATE SUSPENSION OF CLAIMANT REP-
RESENTATIVES UPON CERTAIN CONVICTIONS 
OR DISBARMENT. 
Section 206(a)(1) of the Social Security Act (42 
U.S.C. 406(a)(1)) is amended— 
(1) in the third sentence, by striking ‘‘disbarred 
or’’ each place it appears; and 
(2) by inserting after the third sentence the fol-
lowing: ‘‘Upon conviction of an individual for a fel-
ony or a crime of moral turpitude in a Federal or 
State Court or, in the case of an attorney, upon dis-
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barment from any court or bar to which he or she 
was previously admitted to practice, the Commis-
sioner may, after due notice, immediately disqualify 
or suspend the individual from appearing as a claim-
ant representative before the Social Security Admin-
istration, pending an expedited hearing.’’ 
SEC. 104. NEW AND STRONGER PENALTIES. 
(a) CONSPIRACY TO COMMIT SOCIAL SECURITY 
FRAUD.— 
(1) AMENDMENT TO TITLE II.—Section 208(a) 
of the Social Security Act (42 U.S.C. 408(a)) is 
amended— 
(A) in paragraph (7)(C), by striking ‘‘or’’ 
at the end; 
(B) in paragraph (8), by adding ‘‘or’’ at 
the end; and 
(C) by inserting after paragraph (8) the 
following: 
‘‘(9) conspires to commit any offense described in any 
of paragraphs (1) through (8),’’. 
(2) AMENDMENT
TO
TITLE
VIII.—Section 
811(a) of such Act (42 U.S.C. 1011(a)) is amend-
ed— 
(A) in paragraph (3), by striking ‘‘or’’ at 
the end; 
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(B) in paragraph (4), by striking the 
comma and adding ‘‘; or’’ at the end; and 
(C) by inserting after paragraph (4) the 
following: 
‘‘(5) conspires to commit any offense described in any 
of paragraphs (1) through (4),’’. 
(3) AMENDMENT
TO
TITLE
XVI.—Section 
1632(a) of such Act (42 U.S.C. 1383a(a)) is amend-
ed— 
(A) in paragraph (3), by striking ‘‘or’’ at 
the end; 
(B) in paragraph (4), by adding ‘‘or’’ at 
the end; and 
(C) by inserting after paragraph (4) the 
following: 
‘‘(5) conspires to commit any offense described in any 
of paragraphs (1) through (4),’’. 
(b) INCREASED CRIMINAL PENALTIES FOR CERTAIN 
INDIVIDUALS IN POSITIONS OF TRUST.— 
(1) AMENDMENT TO TITLE II.—Section 208(a) 
of the Social Security Act (42 U.S.C. 408(a)), as 
amended by subsection (a), is further amended by 
striking the period at the end and inserting ‘‘, except 
that in the case of a person who receives a fee or 
other income for services performed in connection 
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with any determination with respect to benefits 
under this title (including a claimant representative, 
translator, or current or former employee of the So-
cial Security Administration), or who is a physician 
or other health care provider who submits, or causes 
the submission of, medical or other evidence in con-
nection with any such determination, such person 
shall be guilty of a felony and upon conviction there-
of shall be fined under title 18, United States Code, 
or imprisoned for not more than ten years, or 
both.’’. 
(2) AMENDMENT
TO
TITLE
VIII.—Section 
811(a) of such Act (42 U.S.C. 1011(a)), as amended 
by subsection (a), is further amended by striking the 
period at the end and inserting ‘‘, except that in the 
case of a person who receives a fee or other income 
for services performed in connection with any deter-
mination with respect to benefits under this title (in-
cluding a claimant representative, translator, or cur-
rent or former employee of the Social Security Ad-
ministration), or who is a physician or other health 
care provider who submits, or causes the submission 
of, medical or other evidence in connection with any 
such determination, such person shall be guilty of a 
felony and upon conviction thereof shall be fined 
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under title 18, United States Code, or imprisoned 
for not more than ten years, or both.’’. 
(3) AMENDMENT
TO
TITLE
XVI.—Section 
1632(a) of such Act (42 U.S.C. 1383a(a)), as 
amended by subsection (a), is further amended by 
striking the period at the end and inserting ‘‘, except 
that in the case of a person who receives a fee or 
other income for services performed in connection 
with any determination with respect to benefits 
under this title (including a claimant representative, 
translator, or current or former employee of the So-
cial Security Administration), or who is a physician 
or other health care provider who submits, or causes 
the submission of, medical or other evidence in con-
nection with any such determination, such person 
shall be guilty of a felony and upon conviction there-
of shall be fined under title 18, United States Code, 
or imprisoned for not more than ten years, or 
both.’’. 
(c) INCREASED CIVIL MONETARY PENALTIES FOR 
CERTAIN INDIVIDUALS IN POSITIONS OF TRUST.—Section 
1129(a)(1) of the Social Security Act (42 U.S.C.1320a- 
8(a)(1)) is amended, in the matter following subparagraph 
(C), by inserting after ‘‘withholding disclosure of such 
fact’’ the following: ‘‘, except that in the case of such a 
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person who receives a fee or other income for services per-
formed in connection with any such determination (includ-
ing a claimant representative, translator, or current or 
former employee of the Social Security Administration) or 
who is a physician or other health care provider who sub-
mits, or causes the submission of, medical or other evi-
dence in connection with any such determination, the 
amount of such penalty shall be not more than $7,500’’. 
(d) ESTABLISHMENT
OF SANCTIONS
FOR VIOLA-
TIONS BY CLAIMANT REPRESENTATIVES.— 
(1) IN GENERAL.—Section 206(a)(1) of the So-
cial Security Act (42 U.S.C. 406(a)(1)) is amended 
by inserting after ‘‘or who violates any provision of 
this section for which a penalty is prescribed.’’ the 
following: ‘‘The Commissioner of Social Security 
shall establish rules under which fines and other 
sanctions the Commissioner determines to be appro-
priate may be imposed for failure to comply with the 
Commissioner’s rules and regulations.’’ 
(2) COLLECTION OF FINES.—Section 206(d)(3) 
of such Act (42 U.S.C. 406(d)(3)) is amended by in-
serting after ‘‘under paragraph (1)’’ the following: ‘‘, 
and any fine imposed on the attorney under sub-
section (a)(1),’’. 
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(e) CIVIL MONETARY PENALTY ON CLAIMANT REP-
RESENTATIVES.—Section 1129(a) of the Social Security 
Act (42 U.S.C. 1320a–8(a)) is amended by adding at the 
end the following: 
‘‘(4) Any person (including an organization, 
agency, or other entity) who, while acting as a 
claimant representative pursuant to section 206, 
knowingly charges, demands, receives, or collects for 
services rendered in excess of the maximum fee pre-
scribed by the Commissioner of Social Security or al-
lowed by a court in connection with proceedings be-
fore the court to which section 206(b)(1) is applica-
ble, shall be subject to, in addition to any other pen-
alties that may be prescribed by law, a civil mone-
tary penalty of not more than $7,500 for each viola-
tion. Such person shall also be subject to an assess-
ment, in lieu of damages sustained by the United 
States resulting from the improper payment, of not 
more than twice the amount of any payments so re-
ceived.’’. 
(f) INFLATION ADJUSTMENT
OF CERTAIN CIVIL 
MONETARY PENALTIES.—Title XI of the Social Security 
Act (42 U.S.C. 1301 et seq.) is amended by inserting after 
section 1129B the following: 
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‘‘SEC. 1129C. CIVIL MONETARY PENALTY INFLATION AD-
JUSTMENT. 
‘‘(a) ADJUSTMENT BY REGULATION.—The Commis-
sioner of Social Security shall, not later than 180 days 
after the date of enactment of the Stop Disability Fraud 
Act of 2014, and at least once every 4 years thereafter— 
‘‘(1) by regulation adjust the maximum amount 
of each civil monetary penalty by the inflation ad-
justment described under subsection (b); and 
‘‘(2) publish each such regulation in the Fed-
eral Register. 
‘‘(b) AMOUNT OF ADJUSTMENT.—The inflation ad-
justment under subsection (a) shall be determined by in-
creasing the maximum amount of each civil monetary pen-
alty by the cost-of-living adjustment. Any increase deter-
mined under this subsection shall be rounded to the near-
est— 
‘‘(1) multiple of $1,000 in the case of penalties 
greater than $1,000 but less than or equal to 
$10,000; and 
‘‘(2) multiple of $5,000 in the case of penalties 
greater than $10,000 but less than or equal to 
$100,000. 
‘‘(c) DEFINITIONS.—For purposes of this section— 
‘‘(1) the term ‘civil monetary penalty’ means— 
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‘‘(A) a penalty imposed by paragraph (1) 
or (3) of section 1129(a); and 
‘‘(B) a penalty imposed by paragraph (1) 
or (2) of section 1140(b). 
‘‘(2) the term ‘cost-of-living adjustment’ means 
the percentage (if any) for each civil monetary pen-
alty by which— 
‘‘(A) the Consumer Price Index for all 
Urban Consumers (CPI–U) for the month of 
June of the calendar year preceding the adjust-
ment, exceeds 
‘‘(B) the CPI–U for the month of June of 
the calendar year in which the amount of such 
civil monetary penalty was last set or adjusted 
pursuant to law. 
‘‘(d) APPLICATION
OF
INCREASE.—Any increase 
under this Act in a civil monetary penalty shall apply only 
to violations which occur after the date the increase takes 
effect.’’. 
(g) MANDATORY RESTITUTION IN SOCIAL SECURITY 
FRAUD CASES.— 
(1) AMENDMENTS TO TITLE II.—Section 208(b) 
of the Social Security Act (42 U.S.C. 408(c)) is 
amended— 
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(A) in paragraph (1), by striking ‘‘may 
order’’ and inserting ‘‘shall order’’; 
(B) in paragraph (2), by striking ‘‘3663’’ 
and inserting ‘‘3663A’’; 
(C) by striking paragraph (3); and 
(D) by redesignating paragraphs (4) and 
(5) as paragraphs (3) and (4), respectively. 
(2) AMENDMENTS
TO
TITLE
VIII.—Section 
811(b) of such Act (42 U.S.C. 1011(b)) is amend-
ed— 
(A) in paragraph (1), by striking ‘‘may 
order’’ and inserting ‘‘shall order’’; 
(B) in paragraph (2), by striking ‘‘3663’’ 
and inserting ‘‘3663A’’; 
(C) by striking paragraph (3); and 
(D) by redesignating paragraph (4) as 
paragraph (3). 
(3) AMENDMENTS
TO
TITLE
XVI.—Section 
1632(b) of such Act (42 U.S.C. 1383a(b)) is amend-
ed— 
(A) in paragraph (1), by striking ‘‘may 
order’’ and inserting ‘‘shall order’’; 
(B) in paragraph (2), by striking ‘‘3663’’ 
and inserting ‘‘3663A’’; 
(C) by striking paragraph (3); and 
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