Medicare Enrollment Penalty Mistakes

      From a report by Social Security’s Office of Inspector General:

SSA and the Centers for Medicare and Medicaid Services share administrative responsibilities for Medicare. …

SSA enrolls beneficiaries, establishes applicable premium penalties, and collects premiums from individuals who receive Social Security benefits. If an individual signs up for Part B after their Initial Enrollment Period, they may have to pay a late enrollment penalty. 

We identified 101,516 OASI beneficiaries who enrolled in Part B during the 2023 and/or 2024 General Enrollment Periods and whom SSA penalized for late enrollment. We reviewed a random sample of 200 of these beneficiaries. 

SSA employees accurately processed 177 of the 200 Part B applications we reviewed. However, SSA employees did not accurately process the applications for the remaining 23 beneficiaries. As a result, SSA’s systems improperly assessed approximately $24,000 in Part B premium penalties. 

Based on our sample results, we estimate SSA employees accurately processed approximately 90,000 beneficiaries’ applications and did not accurately process 12,000 beneficiaries’ applications. As a result, SSA’s systems improperly assessed about $12 million in Part B premium penalties. 

These errors occurred because SSA employees did not consider Group Health Plan coverage, the impact of U.S. residency and lawful presence start dates on Initial Enrollment Period determinations, deemed enrollment, Exceptional Conditions, Special Enrollment Periods, and equitable relief. …

     What I’ve seen over the years is that you can almost always find a legitimate way to avoid the late enrollment penalty. I don’t know why they even try to apply a penalty. It’s not worth the trouble.

41% Error Rate On Widow And Widower Claims

     From a recent report by Social Security’s Office of Inspector General:

The Old-Age, Survivors, and Disability Insurance program provides benefits to wage earners and eligible family members. The Agency uses the wage earner’s Primary Insurance Amount (PIA) to determine monthly benefit amounts. The eligibility year SSA uses to determine the PIA is usually the year a wage earner attains age 62, becomes disabled, or dies. However, an alternative PIA computation for widow(er)s—the widow(er)’s indexing (WINDEX) PIA—may apply when wage earners die before they attain age 62. 

When a claimant applies for Old-Age, Survivors, and Disability Insurance benefits, the application usually covers all benefits for which the claimant is eligible unless they specifically limit the scope of the application. For example, widow(er)s may limit the scope of the application to only include widow(er) benefits and exclude retirement benefits to maximize future benefits. 

We reviewed 2 samples totaling 120 beneficiaries who, as of November 2023, either did not have a WINDEX PIA (from a population of 54,843 beneficiaries) or were dually entitled to widow(er)s and retirement benefits (from a population of 7,253 beneficiaries).

SSA paid 71 (59 percent) of the 120 widow(er) beneficiaries we reviewed the appropriate monthly benefit amounts. For the remaining 49 (41 percent), we found the following. 

• SSA employees did not apply the WINDEX PIA appropriately when they manually processed cases for 11 widow(er) beneficiaries and, as a result, did not pay the appropriate monthly benefits. We could not determine why SSA employees did not appropriately apply the WINDEX PIA for these widow(er) beneficiaries. Based on our random sample, we estimate SSA underpaid 8,618 widow(er)s approximately $50.4 million.
• SSA overpaid one widow(er) because employees used the incorrect PIA.
• SSA employees did not document in the Agency’s system regarding whether they informed 37 widow(er) beneficiaries of their option to receive widow(er) benefits only and delay filing for retirement benefits. Therefore, we could not determine whether SSA appropriately paid these widow(er) beneficiaries despite reminders SSA issued to employees. We estimate 5,367 widow(er)s would have been eligible for $113.8 million in additional benefits had they chosen to delay their retirement claims. …

Man Arrested For Threatening Social Security Employees

      From WWNY:

A Watertown [NY] man is accused of threatening to shoot employees at the Social Security Administration.

City police charged Charles Brown, 26, with a misdemeanor count of making a threat of mass harm. 

According to police, Brown called the Social Security Administration on Bellew Avenue in Watertown on Tuesday and became upset with the service he received.

He allegedly told the employee on the phone that he planned to shoot the worker in the head and then shoot the rest of the staff at the office. …

That’s A Long List

      From the Washington Examiner:

Some Social Security offices are closed or limiting in-person services across 12 states, potentially delaying access to benefits and other services. According to the Social Security Administration’s emergency operations webpage, the SSA has temporarily closed or shifted several field offices to phone-only service. …

Offices in Yuma, Arizona; Mission Viejo, California; Fort Walton Beach, Florida; Wailuku, Hawaii; Decorah, Iowa; Elizabethtown, Kentucky; Detroit College Park, Michigan; Glasgow and Havre, Montana; Bloomsburg, Pennsylvania; Del Rio, Texas; and Logan, West Virginia, are operating on a phone-only basis. …

    That’s way more than can be explained by ordinary office repair type issues. I have to guess it’s lack of staff in most cases.

What Is The Public To Do?

      From Forbes:

Last October, my mother walked into the family room of her rural North Carolina house and found my dad, her husband of nearly 60 years, sitting motionless in the recliner. 

In the days that followed, as our family processed our shock and grief, we had to deal with some very practical issues, including money. As retirees, my parents had relied largely on their individual Social Security checks and his small pension to pay the bills. We assumed that, following my dad’s death, she could continue to draw income from those two sources. Plus, my mom had me—an estate and tax lawyer and journalist who has advised dozens of families and written extensively about Social Security—to help make sure the transition went smoothly. 

Instead, it took five months, numerous phone calls, letters and faxes and help from my mom’s Congressman, to get all of the Social Security she was owed. Along the way, we got contradictory answers from the Social Security Administration (SSA) on the phone and conflicting letters in the mail, including one advising my mom to call a toll-free number that was disconnected. 

 We also saw Social Security payments appear and disappear from her bank account and began to fear that her health coverage might lapse too, since she was paying her Medicare premiums (as the majority of seniors do) through deductions from her Social Security check.

Sadly, our experience was not all that unusual. Even as the number of Americans eligible for Social Security has been rising, the SSA has shed thousands of employees. After President Donald Trump set billionaire Elon Musk’s Department of Government Efficiency loose on the federal workforce in January 2025, more than 7,200 positions were eliminated. Additional cuts have left the agency with just 52,045 workers as of January, down almost 20% over the last decade. …

       The article goes on to document all the problems caused by inadequate online systems and inadequate personnel. If even transactions like this which should be simple are so difficult, what is the public to do? You know that somewhere down the road when we have a truly independent Inspector General there will be report after report showing that huge numbers of people have been underpaid billions of dollars.

A Horror Show

      A report by the Library of Congress has interesting tables showing Social Security’s staffing levels by month by state since the beginning of last year. I’d love to reproduce the table here but it’s just too big. It’s  fascinating and horrifying. You’ll have to click on the link to see for yourself.

They Say He Stole From Poor Mentally Ill People

      From Fox News:

… The U.S. Attorney’s Office for the District of Maryland announced today that a federal grand jury indicted Najee Alexander Corbett, 37, of Baltimore, in connection with a Social Security disability theft scheme. …

As part of the alleged scheme, prosecutors said Corbett targeted SSI claimants diagnosed with mental health disorders and altered claimant records in the SSA database to include bank accounts he controlled and his residential mailing address so he could receive their benefit funds.

Prosecutors also said Corbett changed the date of benefit eligibility payments for selected claimants in the database, generating back payments in the claimants’ names. Authorities said he then caused SSI benefit payments to be transmitted to bank accounts he controlled and mailed to his home.

Federal prosecutors said Corbett received $116,537.62 in SSI disability payments through the scheme and retained $71,304.62. …

Critical Payment Errors

      From a report by Social Security’s Office of Inspector General:

An SSA employee initiates a critical payment when an Old-Age, Survivors, and Disability Insurance beneficiary or representative payee alerts SSA of a critical case or special situation when SSA is not paying regular monthly benefits, additional benefits are due, or a beneficiary reports they did not receive a monthly benefit. These include dire need, court orders, legislative mandates, and preliminary and expedited payments. …

We reviewed a random sample of 175 critical payments from a population of 3,549 issued in Fiscal Year 2023 …

We estimate SSA employees accurately processed about 44,000 (62 percent) of the 70,980 critical payments and did not accurately process about 27,000 (38 percent)—making over 28,000 errors when they processed the payments. About 2,800 of these errors resulted in the payments being incorrectly documented on beneficiaries’ records. For the remaining errors, we estimate the following. 

• Field office employees improperly paid approximately 6,900 beneficiaries about $1 million, but processing center employees identified the special situations and deductions from payment calculations during their post-payment review and adjusted future benefits due. 

•  About 8,100 of these errors resulted in SSA improperly paying beneficiaries $12 million because employees did not accurately adjust beneficiary records.

• SSA issued approximately 10,500 beneficiaries a Form SSA-1099, Social Security Benefit Statement, with a benefit total that was over- or understated by about $14 million because employees did not manually adjust records for replacement checks. …