Jul 26, 2016

Those Cheating Grannies

     From a recent report by Social Security's Office of Inspector General (OIG):
We reviewed a random sample of 250 Title II spousal or widow(er) beneficiaries to determine whether they reported their marriages to SSA while they were receiving Title XVI payments as single individuals. Of the 250 beneficiaries, we identified 41 who did not appear to have reported their marriages to SSA while they were receiving Title XVI payments and may have received improper Title XVI payments because of spousal income.
We referred these 41 beneficiaries to our Office of Investigations (OI) to investigate their living arrangements while they were receiving Title XVI payments. OI determined seven beneficiaries were not living with their spouses so were not overpaid, and one beneficiary had potentially committed fraud, resulting in a $104,998 overpayment.
OI did not pursue investigations on the remaining 33 beneficiaries because the potential overpayments were below the applicable U.S. Attorneys’ thresholds for prosecution and/or the periods of potential overpayment were outside the statute of limitations. Since OI did not pursue investigations, we referred these 33 beneficiaries to SSA to assess any overpayments. Of the 33 beneficiaries, SSA determined
  • 22 were not living with their spouses so were not overpaid, and
  • for 7, there was insufficient evidence to proceed with a review. For the remaining four beneficiaries, SSA’s review was ongoing as of July 2016.
Given that our audit did not identify a significant number of beneficiaries who were living with their spouses and overpaid while receiving Title XVI p ayments, we are not making a recommendation.
     Potentially, there are many people who would be affected if Social Security were to start trying to catch widows and widowers who failed to report marriages to the agency. There could be many overpayments and criminal prosecutions. Is Social Security willing to go there? Does Congress want them to? Is disability fraud the only fraud that Congress is interested in?

6 comments:

Anonymous said...

This isn't just talking about widows and widowers. I think if you ask any SSI rep what the most common fraud is, it is concealing marriage or claiming separation when that is not the case. The crazy thing is that the claimants often forget that they lied to us previously. They have been prosecuted in the past. The problem is it is very hard to prove and there is nothing really to go on besides there allegation. Hence you see the 22 who were supposedly not living with their spouse when referred to the field office. They probably just called them and the beneficiary realized they should lie about it. These are the realities, I won't get into how to change it.

Margaret Kibbee said...

We're talking about title XVI? Usually there isn't that much money to worry about.

Anonymous said...

Could be $700-900 a month, depending on where they live.

Anonymous said...

@9:14 I think if any SSI rep what the most common fraud is they would accurately cite the last CE report they reviewed where the "doctor" stated he found no severe impairment.

I still recall a doctor who said a claimant's glass eye gave her 20/20 vision in both eyes (with equal and round pupils) and the one who said a claimant's dismembered foot had; healed, allowed standing for 8 hours, and could stoop constantly.

Anonymous said...

Because of his horrible personality and bedside manner, our community had a cardiologist who did CE's which took 12 minutes from the time the claimant went into the waiting room door until they exited. Three of my clients who had one eye that had been diagnosed by several ophthalmologists as having "no sight" or being able to only "distinguish light from dark." This bozo reported that all had 20/200 vision in the blind eye.

Tim said...

5:32 Did the judge ignore the cardiologist?