Apr 19, 2017

Hearing On Stopping Disability Fraud

     From a press release:
House Ways and Means Social Security Subcommittee Chairman Sam Johnson (R-TX) announced today that the Subcommittee will hold a hearing, entitled “Stopping Disability Fraud: Risk, Prevention, and Detection,” on Wednesday, April 26, at 10:00 AM in room 2020 of the Rayburn House Office Building. At the hearing, Members will discuss the status of the Social Security Administration’s efforts to prevent disability fraud after several high-profile multi-million-dollar fraud schemes. On the day of the hearing, the Government Accountability Office (GAO) will release a new report to update Members on the SSA’s efforts to fight disability fraud. ...
In 2015, the GAO created the Fraud Risk Framework as a guide to federal agencies in developing antifraud strategies by using leading practices for managing fraud risk. As part of the framework, the GAO recommends that agencies like the SSA conduct a fraud risk assessment and develop their antifraud strategies based on identified fraud risks. In response, Chairman Johnson requested the GAO to conduct a study of the SSA’s implementation of the Fraud Risk Framework and to provide an analysis of the SSA’s antifraud activities. GAO will release the findings of its study at the Subcommittee’s April 26 hearing.

22 comments:

Anonymous said...

Will they be looking into fraud by VEs, CEs and ALJs who repeatedly issue legally insufficient decisions?

Anonymous said...

Senator Sam will Fix it! Just prop him up in his chair and wind him up! I wish we could sic him on Wall Street and the pentagon. Theyi would be shaking in their boots I betcha!

Anonymous said...

Every three seconds in America someone commits social security fraud. Tic tic tic. Do you know where your claimants are?

Anonymous said...

Has there been more than one multi-million dollar fraud scheme? The announcement states there have been several, but I'm only aware of Conn.

Athena said...

6:22--This is another big one

https://mobile.nytimes.com/2014/01/08/nyregion/retired-new-york-officers-and-firefighters-charged-in-social-security-scheme.html

Anonymous said...

Gotta hold a fraud hearing every year or so, or the Koch bros astroturf groups that want to cut Social Security will stop sending all that money!

Anonymous said...

@6:22 There are over 14 million people getting disability benefits. 2 fraud rings, or even 20, would be an extremely small percentage of beneficiaries. Not that all fraud should not be investigated or punished, but anyone who things that proves fraud is rampant in the system is ignorant. https://www.ssa.gov/policy/docs/quickfacts/stat_snapshot/

Rosa mario said...

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Anonymous said...

I most sincerely doubt there is a representative here that can say they have never represented a client that could work, but they got them benefits anyway. While it is not outright fraud because they do meet requirements, it has the same effect. I most sincerely doubt there is a disabled person on the blog that hasn't worked for cash or knows a disabled person that works some for cash to supplement the SSDI or SSI they get to make ends meet once in a while.

Large fraud cases are rare and an overall tiny fraction of all SSDI or SSI fraud. The others are smaller death by a thousand paper cuts is still death.

Tim said...

9:39 AM I find it interesting that I NEVER hear those who complain loudly about fraud talk about those wrongly denied! Those who complain about the high paying ALJs NEVER complain about low paying ALJs. Even some who say "We need to protect SSD for the 'truely disabled,'" really mean "We meed to cut benefits." Sure, there are some lawyers trying to get anyone they can on benefits, but I'm guessing that's the exception, not the rule. By the way, just because an ALJ claims you can do a job, it doesn't mean that you can!

Anonymous said...

@7:53

Thanks! I was genuinely confused what the announcement was referencing.

@9:39

I've never seen a client that could NOT work a day or two on an irregular basis. But that isn't the standard, the inability to engage in substantial gainful activity is. If it becomes clear a client can engage in substantial gainful activity our standard practice is to recommend to them we withdraw the claim, even if this becomes clear the day before his hearing (as once was the case). Your suggestion that representing claimants who can "meet the requirements" but still can work has the same effect of supporting fraud is insane. If you believe only those who are capable of working and earning a penny, but incapable of engaging in substantial gainful activity, should be denied the benefits they paid for, write congress and have them change the standards.

Anonymous said...

11:10 is correct. Most of my clients can do something now and then, and that's preferable to going to a loan shark to scrape by until the next check. The standards for disability are hard. You have to be very limited not to be able to be a ticket taker or order caller although there are very few of those jobs in the national economy. And then there's the sit/stand option for unskilled work not provided for in the DOT but observed by most VE's. The very few questionable approvals I have witnessed were cut off on review. I fail to see a big 'problem' with SSDI. A criminal here and there doesn't signal a massive fraud problem.

Anonymous said...

I guess its okay if they get "cut off" after the check has been cashed by the representative.

Anonymous said...

SSA/Medicare shouldn't be left to investigate any fraud as some who are not only denying legitimate claims but also not giving the beneficiaries ALL of their SSA money. Then there's Medicare not paying for injuries or illnesses because of how workers comp claims adjuster's along with some in the SSA/Medicare committing fraud saying the carrier is paying WC money and WC medical care when they are not. A match made in hell with insurance fraud by WC carriers & those in SSA/Medicare. Those who are industrially disabled get the short shrift by all three insurances. Perhaps billions are made on those totally disabled.

Anonymous said...

11:10 isn't as careful with their language as I would hope someone who reps claimants would be.

Engaging in SGA is not the same thing as working on a regular and continuing basis, which is defined as 8 hours 5 days a week or an equivalent schedule. One could be engaging in SGA and work a few hours a week, which would generally render them not disabled. Pretty important distinction here: SGA bars you from coming in the door; being able to engage in SGA likely does not. It's the ability to work on a regular and continuing basis that we have to establish affirmatively to say not disabled, which is what the rep poster was getting at by saying most everyone can work a full day here and there.

Come on, guys, do you know the law you practice?

Anonymous said...

@5:48 Your distinction between engaging in SGA at step one and ability to engage in SGA at step five is valid. However, in the example 11:37 provided the person irregularly able to work a day here or there would not likely be found to be engaging in SGA at step one even if their income was above the presumed SGA levels. Their inability to keep working the job because of their disability would typically create a series of unsuccessful work attempts, which would exclude the work-related income from consideration. Then, even not considering unsuccessful work attempt rules, there would be the question of whether the presumption of SGA created by income was overcome by the actual work activity performed. There are examples where sporadic ability to work could still support a finding of engaging in SGA, but often they do not.

Anonymous said...

@5:48 this is 11:10, I DO NOT represent claimants, not even a little, I may file initials and recons for a few consumers but never represent. I get them the goods and services before, during and after the process of disability. I follow the board to understand the problem my consumers are having. I may only work on 1-200 SSDI and SSI claims a year, but handle a lot of the day to day things while they wait and handle the conversion from Medicaid to Medicare when eligible, something not as good as it sounds. I see many many folks and what they have to do to survive.

Anonymous said...

IT IS THE ECONOMY STUPID.
SSD/SSID function as a fill-in for people excluded by a chronic less than full employment economy. That is, the USA economy. - Not China or Mexico.

Many of the invisible [uncounted] unemployed, under employed, and a goodly number number rolls SSD/SSID would be productively employed, IF this were 1942. There were factories working three shifts, orders and needing workers.

Anonymous said...

11:10 here, I didn't post the comment at 9:40.

That is disturbing.

In any event, in regard to 5:48's comment that I was not careful with my language, that is valid and a distinction that I should have made more clear. The performance of SGA will terminate a claim, whereas the ability to perform work on a regular and continuing basis is the ultimate question of disability.

I meant to say, if a client is found to BE performing SGA, or it becomes clear that they can perform or are capable of performing work on a regular and continuing basis, we recommend withdrawal of the claim immediately.

Anonymous said...

The frauds are from those within SSA Regional Offices and their ADO who advocate diversity for a livinng, yet make it a hell-hole on earth for those who are crying for diversity and justice!! These ugly phonies must be drained from the swamp!!!

Anonymous said...

While we are on the subject of fraud, this is my other take on another Khoa bad of fraud committed by SSA employees,

As a retired former union's shop steward, who believes in true fairness and equal diversity, I know exactly why the Democrats are not in power now and possibly for a long time to come because they've always used the old the minority in the majority "race card". Yet, in this election, most other groups of voters finally saw through them!

Just like all of the Regional OCREO and HR components at SSA such as the ones in Dallas, Atlanta, or Boston, their typical thinking is that it is acceptable to allow racial bigotry to go unchecked the way they like it.

True examples: it is ok to overlook an African-American female supervisor who keeps picking on a male Muslim-American employee. Or, it is more than fine for a straight male white supervisor to harass an Asian-American gay male employee. Or, it is even better to have a Spanish male District Manager to pick on an older female employee with Native-American ancestry. Or, it is trendily fine for a female Mexican-American supervisor to bully an older white male employee. Finally, it is just ok for an Asian-American female Assistant District Manager
to constructively demote another Asian-American male employee.

All these true frightening stories told are not enough for one to throw in any support for the "drain the swamp concept" yet, but it would surely raised enough anger for calls to have leadership changes and serious staff overhaul at those components within SSA. After that, some type of disciplinary actions for those who are accountable!!

Anonymous said...

If SSA wants to save money they should get rid of the lazy, incompetent ALJ's that permeate the agency.