Here's a table from a recent report filed with Congress by Social Security's Office of Inspector General (OIG). Notice the huge disparity between the number of allegations received and the number of actual investigations much less criminal convictions. No, I don't think that disparity is because OIG fails to aggressively pursue cases of fraud. I think it's because there's little substance to most allegations of fraud. Republicans can spin it all they want but given Social Security's size, the amount of verifiable fraud at the agency is tiny.
umm no. It's a fact that OIG won't pursue cases of fraud unless it either hits the national news or some other authority has already pressed charges.
ReplyDeleteThe same is true when OIG or Agency heads are presented with results from other Federal investigations which confirm evidence of employee misconduct, including criminal, and they choose to do absolutely nothing about it; or in certain circumstances, even provide assistance to other employees who were targets/victims of the misconduct. To say a housecleaning is in order is an understatement.
ReplyDeleteThat's interesting, Charles. Seems you beleive OIG is the only component of SSA doing its job 100 percent correctly/justly, while each other component/section is doing a poor job and is just out to not pay claimants. Funny, that.
ReplyDeleteSorry, Charlie, but you are so dead wrong it turns my stomach. I worked in SSI for over 35 years and encountered many instances of fraud, but OIG would not pursue even the most egregious cases, including up to six figures worth. Many more cases could have been uncovered and pursued if we had any hope that OIG would act, but it just doesn't. So, we just tried to get the overpayments back and moved on. SSI is a taxpayers' h#llhole.
ReplyDeletei have personally submitted three examples of fraud to OIG. Without getting into details, they are such clear cut examples of fraud that they would make the news if publicized and cause general public outrage. Each case dealt with SSI recipients working and/or participating in significant physical activity that would have nullified their eligibility for benefits.
ReplyDeleteEach time, I received a response within 3 days saying something like "thanks, but we will not go into this further."
Despite your insistence to the contrary, the facts are clear, OIG fails to aggressively pursue all but the largest, most blatant or politically motivated fraud.
You would have to know a lot to be sure that something just complained about was actual fraud. There are plenty instances of people with mental disabilities who don't accurately comprehend their reporting duties. Plenty of cases where a person's severe physical symptoms might be intermittent, or where they might on rare occasion try to do things their doctor legitimately recommends they should not. Do you consider those to be fraud? To think you know whether it is fraud without doing a very thorough investigation is not reasonable.
ReplyDeleteUndoubtedly there is some fraud that is not caught, or which OIG chooses not to prosecute. However, Chuck's point is that, despite a few anecdotal claims, there is no proof that fraud constitutes any significant percentage of SSA benefits. That is particularly true if you compare the percentage of fraud involving SSA benefits to other government agencies and bodies (including, sadly, Congress).
One case I remember was a mother receiving SSI benefits for a year and a half for a child she had given up for adoption at birth. Benefits were ceased for failure to cooperate. I had the case at the recon level (of course Mom asked for benefit continuation) and discovered this to be the case when I wrote to the hospital where the baby was born and the pediatrician they sent records to. Not only was there fraud on her part but her parents and other relatives withheld information.
ReplyDeleteChuck's point is a good one especially when you put it into perspective and consider the numbers. Currently there are about 8.9 million SSD beneficiaries and about 8.3 million SSI beneficiaries in pay status. Some legitimately get both. The OIG reports less than 600 cases of "confirmed fraud" out of those numbers.
ReplyDeleteMost would agree that you would consider yourself lucky to find government programs where there is not at least 1 per cent fraud. So do the math. What is 1 percent of 8.9 million? It's 89,000. How many confirmed cases of fraud according to the OIG? Less than 600. Think about that, 89,000 is 1 per cent, and less than 600 cases of confirmed fraud.
By my count, even if there were really 100 times the number of confirmed fraud cases over what the OIG reported, it would still be less than 1 per cent of beneficiaries (600 x 100 is 60,000), a figure which most government bodies or programs would wish they could aspire to.
Don't get me wrong. I agree that all those committing fraud should be punished. Spending more on detection and enforcement is fine. However, it is worse than ridiculous to claim fraud is out of control in SSD and SSI when the proven cases of fraud don't even begin to approach 1 per cent.
@ 6:12. If you don't investigate for fraud, it's pretty easy for the "confirmed" fraud cases to be less than 1%. Think about it
ReplyDeleteTo be fair, the OIG doesn't operate in a vacuum, and no one should be surprised if the local US Attorney's have imposed criteria on fraud cases before it'll rise to a level that they will take it on. That was discussed at the hearing earlier this year. So you do have external filters and pressure that take what could be a large number of potential cases and puts them on a shelf. There is a limit on what OIG can do independently or working with SSA attorneys, so there go another chunk of cases.
ReplyDeleteWhat we need is better transparency. All the cases mentioned here that kind of went away shouldn't be allowed. Why isn't there a publicly available listing of the generic info (to avoid privacy disclosure) on each submitted fraud case that links to it's disposition? And the disposition should include the reason why it went no further. Yes, the bad guys would see what avenues might work for a while but an open government is important. We could have another agency's OIG do the review of these cases and see how good a job the SSA OIG is doing and like an auditor who certifies a companies financial statement, we could get some numbers we could trust and use to make evaluations of efficacy.
So, $270,000,000.00 is not anything to worry about? Probably slightly more than your law firm makes..
ReplyDeleteCharles, you are keenly aware that it is very difficult to prove all the points of fraud required for a clear conviction. You are also aware that the bulk of cases of potential fraud are not pursued because they fall into the "similar fault" catch-all category. It is much easier to have a claimant allowed by tweaking their application, ADLs and 3369 past work forms so that they can slide into a med voc grid approval, after which there is less that 1/2 of 1% chance they will ever be ceased. The vast majority of similar fault cases swing toward allowances or denials depending largely on where the agency pendulum is swinging at any given moment. In my 17 years at the agency, in multiple states, I observed the allowance and denial rates of claims with similar fault elements to lean in the same direction as the political leanings of that particular state, with more allowances on the west coast, more denials in Texas, etc. The agency's behavior has tended to go those ways for at least the past couple decades. Individual states CDI unit's have always been more accurate in tracking this.
ReplyDelete"So, $270,000,000.00 is not anything to worry about? Probably slightly more than your law firm makes.."
ReplyDeleteNobody is saying don't go after the fraud and the $. Everyone agrees on that. If necessary hire more investigators, make them more efficient, job done.
What we're pointing out is that there is no evidence of a need for any changes or cuts in the disability programs when the proven cases of fraud are a fraction of a percent. Those trying to convince and mislead the public otherwise have an agenda that involves cutting our Social Security, which is something that Americans disapprove of by a large majority.
There have been studies that indicate that 20% of on SSD/SSI are not actually disabled. This same study shows that 40% who were denied benefits actually WERE disabled. It is not that uncommon to have people die while waiting for benefits. Or die of theirisability after being told they are not disabled.
ReplyDeleteThe levels of accuracy in granting benefits would improve if you flipped a coin rather than putting people through the completely crazy process of applying for SSDI.
At the state level, some SS employees get BONUSES for finding ways to deny benefits to the truly disabled.
ALJS will ignore evidence, engage in unwarranted ad hominem attacks on the potential beneficiary, not follow SS rules of evidence, etc., to keep truly disabled people from receiving the benefits they paid for.
SSDI practices recission and the disabled end up losing their homes, living on the street, and getting much sicker and dying much sooner due to the wretchedness of their lives.
Wasn't Social "Security" established to prevent exactly this?