This is an excerpt from Acting Commissioner Colvin's written testimony given to the House Social Security Subcommittee today:
In fiscal year ( FY ) 2013, we made over 22,500 disability fraud referrals to the OIG [Office of Inspector General]; the OIG opened about 5,300 cases based on these referrals. To date, the OIG has referred over 100 of these cases to United States Attorneys’ Offices for criminal prosecution.If I understand this correctly, about 77% of the time when OIG is sent a disability fraud referral, OIG immediately decides that the fraud allegation has no merit and refuses to even open a file. Even when OIG opens a file, there's only a 1.8% chance that OIG will refer the case for criminal prosecution. In the end, 99.6% of the time that a disability fraud referral is made, OIG decides not to recommend prosection. Left unmentioned is the fact that even when OIG recommends prosecution sometimes the United States Attorneys refuse to prosecute the cases.
This can be interpreted in different ways but it's a fact that while there's a lot of disability fraud being alleged, only a tiny, tiny percentage of those allegations result in prosecution.
You will probably hear this from other Employees, but our OIG agents are rather ineffective. If the case does not meet the $10000 loss threshhold, most will not take the case. there are a few excellent agents that take the smaller cases to local prosecutors and get convictions, but these agents are few and far between.
ReplyDeleteIllegal immigration is also against the law and the percentage prosecuted is very low. Do you really think that illegal immigration isn't going on in large numbers?? the arguement is not based on logic. If a man isn't arrested for beating his wife, does that mean it doesn't happen? OGC should be theones getting their butts kicked over this, they have encouraged it bynot prosecuting it. This discourages SSA employees from taking the time to document and support the allegations in the first place. One of the biggest areas of Government Fraud is in the IRS Earned Income allowance. Just because the IRS doesn't put a stop to it doesn't mean it isn't happening by the thousands almost daily..
ReplyDeleteIn my time at SSA there was also a mandate that fraud referrals were made on minor items. An example would be a one month non-receipt allegation that resulted in a duplicate check negotiation. No chance it would ever be prosecuted but enhanced the number of cases sent to OIG.
ReplyDeleteNot to mention, even though prosecution is rare...cutting off benefits by SSA is even rarer.
ReplyDeleteA11:25: Same here during my time there, too (retired 2009). There were two reasons for this. 1, they were huge work units, which as we know, helps with future staffing. 2, OIG was looking for ways to justify its staffing as well, so we were encouraged to report even mild instances of possible fraud. The bad part was when areal case was uncovered, the AUSAs wouldn't take the case because of the $10K threshold or that it wasn't "sexy" enough (i.e., would result in good PR for SSA and DOJ). Very frustrating for my staff members who worked hard on these fraud cases, because the majority of the "investigations" are actually done by FO staff. These fraud hearings should include a Justice official to explain why cases aren't prosecuted rather than put all the onus on SSA.
ReplyDeleteGiven that it takes a year or two before that process works all the way through to a decision by a prosecutor, that means the odds are much higher that the person accused of fraud will PASS AWAY during the wait.
ReplyDeleteMemo from CALJ Bice today indicates that two of the doctors involved with Eric Conn have been determined to have committed "similar fault" by signing RFC assessments pre-completed by Conn's law firm without a diligent and independent review of the findings contained therein.
ReplyDeleteToo bad SSA will not apply this principle more broadly, since signing MSSs completed in advance or which contain opinions not supported by treatment records is a common practice.
I believe the 100 number is the cases referred for federal prosecution. I believe OIG more often refers cases for state prosecution.
ReplyDeleteOIG is woefully understaffed. There are so many more cases than agents, and the cases that those agents manage to process are more than what the few attorneys can handle. Couple that with US Attorneys who will not touch cases unless they have a very high dollar value (due to their own workloads), and you get the current crisis.
ReplyDeleteI have advocated for years for more hiring for OIG. The return on the salary investment would be huge. However, the problem is that the salaries do not come from the same budget pots as the ones that receive recovered funds. Perhaps with the increased interest in fraud due to the recent negative publicity, maybe OIG will get some backing from Congress and the agency.
Pursuit of fraud is a joke because of the U.S. Attorney's office and OIG cuts short the number they refer based upon what they are told by USAO.
ReplyDeleteJust over 2 years ago I referred a case for fraud involving a beneficiary receiving a disability pension and OPM annuity based upon disability. Found the NH was working under his older son's SSN when his SSN actually applied for disability after a work accident. The loss was over $190k over a period of 14yrs. SSA did everything OIG usually requests, no overpayment notice, NH signing a statement in the field office admitting to what he had done so his son's earnings record could be corrected, etc.
Was reminded of this a few months ago while clearing out my e-mails that the USAO refused to prosecute because it involved two different federal benefits (but that has never stopped it before!?), which seriously pissed the agent off.
It is even worse when after securing a conviction, an order of restitution is made and the USAO caves and tries to limit what SSA recovers to only $50 of their monthly benefits instead of the full check. Let alone that the DOJ and USAO do nothing to assist in recovery of assets on death reclamation cases where Sec 207 prevents us from recovering benefits from the offender's own claim.
I even heard that one region in the west for SSA does not even track their restitution cases!
All the fraud referrals have merit. As said above it is OIG resources and the USAO which limit indictments and prosecutions. Charles you really should get out to a SSA office and speak to the staff.
ReplyDeleteThis is nothing new, almost 40 years ago we were making similar referrals that went nowhere. And they had to be reasonably developed before you'd send them in, so you did a lot of work. I understood why the 87 year old grannie who was stiffing us on SSI was unlikely to be chased down, but the SSI recipient who was working at the old Comisky Park in their scoreboard (he hit the button for the fireworks and changed the numbers)and who never reported it to us certainly had merit. As did the mob operated junkyard that was used to pay "ghost" employees salaries that they never really earned to both rebut the tax man and so that their survivors got benefits when they turned up dead in a van on the North Side (true story, hand to god). Seems some things never change.
ReplyDelete@9:45, where did you find the time to read 22,500 fraud referrals? And what criteria did you use to determine they all had merit?
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ReplyDeleteMaybe if the agency allocated more money to the people on the frontlines, who are interacting with claimant's in the FOs, DDSs, then there would be a lesser need for OIG to get involved in fraud allegations. Instead, the agency keeps throwing money at headquarters in Baltimore and Falls Church (good money after bad) to fix over and over again problems caused by underfunding the FOs and DDSs. Tightening funding at the FO/DDS levels serves the interests of whom? Not claimants or the public, that's for sure.
ReplyDelete@12:27--SSA staff does not make referrals that lack merit. They may lack investigation level/prosecution levels by OIG and the USAO. Staff is encouraged to refer all possible fraudulent activity so OIG may assess, look for trends, etc. even if they choose not to pursue.
ReplyDeleteI was investigated for fraud a few years back. My participation in Ticket to Work was counted in another social security department as fraud because I got social security while I trained. My check was stopped. My Medicare was stopped. I was threatened with jail.
ReplyDeleteFor a long I had no income or health insurance. During that time I went through untreated pneumonia and an untreated brain blood clot. That led to further disability.
What cinched it for me was that only 1 month before the you owe us notice I got a huge check for back payment due to social security oversight
I could not .have over and under payment at the same time.
If it ever happens again I will probably kill myself to keep from doing again that agonizing suffering
My ex gets almost $900 a month in disability and has for years now due to mental/physical problems. His dad died about two years ago and left him a bunch of rental properties. He makes everyone pay him in cash but I have been collecting all the receipts and rental lease agreements. He gets about double in rent what he gets in SSA. When we split up, I turned him in to the SSA and they have ignored all my complaints. Anybody know why they won't take these receipts when I have done all the work for them and at least look into my claims?
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