Sep 18, 2007

$120.4 Million In Underpayments To SSI Claimants

From a recent report by Social Security's Office of Inspector General (OIG) (emphasis added):
The majority of SSI underpayments occur because of changes in recipients' non-medical eligibility factors such as income (earned or unearned) or living arrangements. As changes in these factors occur, recipients' SSI eligibility and payment amounts can change from month-to-month. An underpayment occurs when the amount due to a recipient is greater than the amount paid to a recipient during a period of eligibility. ...

When a claimant files for SSI, a supplemental security income record (SSR) is created. The SSR typically remains open as long as the claimant is in current pay status and for up to 12 months when in nonpayment status. SSA terminates SSRs for a variety of reasons such as after the recipient has been ineligible to receive payments for over 12 months or when changes in the recipient's eligibility factors require a new SSR to be established. These terminated SSRs are considered current until a new SSR is established. Once a new SSR is established, the terminated SSR is considered a prior SSR. ...

We reviewed a random sample of 250 SSRs that contained underpayments between $250 and $24,999. In addition, we reviewed a random sample of 33 SSRs with underpayments $25,000 and greater. ...

We found SSA's internal control of relying on FO staff to manually identify and resolve SSI underpayments on prior SSRs is not adequate. The control is not adequate because FO staff did not always perform the necessary actions to identify and resolve the underpayments. Specifically, for our population of 90,497 prior SSRs that contained underpayments between $250 and $24,999 totaling $120.4 million, we project:

79.3 percent of prior SSRs have underpayments totaling $92.3 million that should have been paid to recipients or offset to existing overpayments, and

23.1 percent of prior SSRs have underpayments totaling $27.9 million that are not due to the recipients and need to be removed from the prior SSRs to avoid improper payments or improper offsets to recipients' overpayments.

2 comments:

Anonymous said...

I have worked SSI cases for over 30 years. The SSI program is completely out of control. Most Claims reps who have to do SSI have no more than a passing knowlewdge of policy and regulations and even less knowledge of systems, and so cases get "cleared" any way they can, as long as the statistical goals are met. It would take a massive influx of manpower to even begin to get a handle on the over 7 million current SSI cases, which isn't happening any time soon.

Anonymous said...

I just hope they used journeyman SSI claims reps to analyze these underpayments.

I do not believe the SSI system is 'out of control' but I do see that there are fewer employees who fully understand computation of benefits. So many computations are now automated, SSI CR's don't have the hands on experience with computations that helps them to understand problems and find errors. When we had to perform many manual actions, those computations were more prone to math error, but also provided the experience needed for the CR to fully understand the computation. It's easy to add with a calculator, but it helps if you can also add with a pencil and paper.