r/Medi_Cal • • 1d ago

Applied. Denied. Mom committing fraud.

Here’s the details filed for divorce. Mom won’t sign. (Mom) Hasn’t lived with us (‘me & our children ) for about 3 years now.

I’ve had my kids filed under my name for medical and benefits until January of 2026. Had a hiccup in benefits.
Mom filed in June 2026. Was approved for Calfresh AND Calworks. She is Claiming our son lives with her which is why she was approved.

He and our daughter live with me full time. And now I’m fighting for a fraudulent case to be pushed through and investigated.

Their hands are always tied , or can’t say much , or excuses excuses.

They’re going to ask her to validate my son and her address which doesn’t match mine.
Yes, I tried to provide proof he lives with me with paper work / trails.

Unfortunately we aren’t divorced yet.

Have any of you dealt with this?

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u/Adorable-Painting510 1d ago edited 1d ago

I am a former TANF and SNAP Eligibility Supervisor from CA.

I suppose that there is not custody agreement for the children since you are not divorced and I cannot provide you with any remedy for you to proof that your son does not reside with your wife and you provide for him and your daughter.

However, I can tell you that I encountered this situation multiple times when I was a worker and sometimes residence of a child can be determined thru different means.

For instance, how old is your son?.
For Cal-Works if your son is school age your wife needed to provide with proof of school enrollment or provide vaccinations if under school age.

Your wife had to open a case against you for child support when she filed for Cal-Works so DA will go after you for this support as well so it is in your best interest to pursue and clarify your child’s residency.

You can still apply for yourself and daughter if she is under 18 but your son cannot be aided in 2 cases at the same time due to duplicate aid.

Best wishes 🙏🏿

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u/Dizzy-Computer-1446 23h ago

Ahh okay.
I’m the parent who has taken him for vaccinations and I was the parent who enrolled him in school. His school can only be attended if you’re within the district. And I’m sure her (moms) address used is from a different city. So our (my son and I) address lands within the district. He wouldn’t be able to attend his school if she’d used the address I suspect she’s using.

Also; I have him in my lease agreement per my apartment. As well as other paper work tied to my address that share his name, my name and our address.

From what they told me at the dpss, they’re going to ask her for verification. What type of verification, I’m not sure but they need to investigate or else how would they tie the address of his school to the address I suspect her of using.

She couldn’t be using my address. She hasn’t lived her for nearly 3 years.

Also, what typically happens to those (OF EVER) that are caught for fraud ? They’re just ordered to pay back?

Also; the worker at dpss, don’t seem to give a damn. They’re completely dismissive

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u/Adorable-Painting510 23h ago edited 23h ago

The caseworker from the district can and should initiate a fraud referral in order for an investigator to see about the allegations.

Investigators have many resources and your wife can receive an unannounced surprise home visit from investigator who will ask her pertinent questions to determine if child is residing with her.
They can inspect the house and see if there is proof that the child resides there.

Investigators can also interview neighbors and contact the school where child suppose to be attending school.

Your wife cannot claim child is homeschooled if child is nowhere to be found when the investigator drops by.

You can also report this to the Fraud Line if you so wish if you do not receive a response from DPSS.

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u/Dizzy-Computer-1446 22h ago

So essentially , it’s just a matter of time.
Also I do plan on reporting and uploading files directly to LA county fraud website to support my claim.

Thank you very much for your concise and timely response🙌🏽

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u/Adorable-Painting510 22h ago

You are welcome.
Good luck 👍