Jun 6, 2014

OIG Receives Many Allegations But Few Pan Out

     An excerpt from the annual report of Social Security's Office of Inspector General (OIG).

9 comments:

Anonymous said...

All that means is oig is either too lazy or lacks the funds to prosecute. Absolutely no inference can be made about oig rarely investigating equating invalidity of the fraud accusations.

Anonymous said...

Charles, you do realize that OIG investigations take place during the disability application process as well, which can help prevent ineligible individuals from being granted benefits in the first place -- those cases would often not result in arrests/indictments.

Anonymous said...

Right, and there's no way to determine the amount of bogus investigations that simply tar and feather legitimate claimants. If we could put a dollar amount on the number of claims denied illegally, then we'd have some meaningful data.

Anonymous said...

to say that OIG's failure to prosecute (or come to some other unfavorable finding) equals a fraud claim being invalid is laughable.

I report fraud regularly, but I can guarantee it is never investigated (much less followed through to conclusion to stop payment of SS funds due to fraud). OIG picks and chooses what to investigate and almost never goes after the small fish (unless it is for the purposes of making a training video). Lot's of PR, but not much results, despite an abundance of legitimate fraud complaints.

Anonymous said...

All of you who keep insisting upon vast incidents of "fraud" remind me of the prosecuting attorneys who stubbornly insist that the defendant was guilty despite the fact that the conviction was later overturned because of DNA evidence.

Anonymous said...

The number of claims denied illegaly would be miniscule.

The number of claims that are denied in situations where a reasonable person could reach a different conclusion or where more evidence would result in a favorable outcome are not insignificant (although much less than representatives want to believe).

Anonymous said...

Most of the fraudulent activity in SSA programs occurs in SSI. OIG virtually ignores SSI fraud cases. There you have it.

Anonymous said...

The lack of prosecutions does not mean there is little fraud. There are relatively few prosecutions in federal court because the loss threshold is quite high before the US Attorney's will accept a case for prosecution. Thus, cases that do not meet the federal threshold must be prosecuted at the local level. However, local prosecutions are also relatively few because they have other cases, such as drug sales, robberies, rapes and murders, which are higher priority. Consequently, many "fraud" cases are treated as civil actions or overpayments.

Conversely, Social Security policy creates and encourages institutionalized fraud, similar to the recent VA fiasco. Among other things, the recent West Virginia scandal happened because SSAs top priority is production, to the extent top management actively ignores any evidence of wrongdoing if it interferes with production until a scandal erupts that cannot be ignored.

Likewise, the across-the-board 500-700 production goal for ALJs is another example. While some ALJs in some offices can reach this goal without sacrificing quality, many cannot. For example, ALJs in offices with large files, where the record is usually 400 pages or more, cannot dispose of 500 cases per year unless they do not fully read their files, such that some claimants are wrongfully paid and some are wrongfully denied. That is a form of institutionalized fraud that top SSA management created and continues to encourage.

Anonymous said...

Buckle up everybody. Darrell Issa takes his rolling witch hunt into the disability program appeals process next Tuesday and Wednesday. Anybody out there think Issa will be handing out atta boys?