I submit, on average, one allegation per month. They all get the same response, something like "thank you, we have decided not to take any action."
They are evenly split between ID theft (someone using a claimant SSN fraudulently), rep payee fraud (typically blatant evidence of a party not spending ANY money to support the disabled beneficiary) or "double-dipping" (claimant alleging disability, but also reporting self-employment). The last type of situation is usually for the purposes of claiming the earned-income-tax credit and does not represent actual work activity. So they are lying to the IRS.
Now, I get that these are small-value cases, but they are quite common and in all cases should be investigated/corrected/stopped.
I've submitted a handful for investigation at the hearing level, and unless you have a CE lined up in the future, they basically say, "Thanks, but no thanks." As the previous poster suggested, an unwillingness to investigate should not be translated into a lack of fraud.
I would also submit that if more than 25% of the cases investigated in some adverse action (there may be some overlap, it's unclear from the data), it's not completely ineffective or a waste of time or resources.
10:27 I assume you are a claims rep. There are administrative actions available to you to take if OIG fails to investigate. We had a ID theft case in California in which the thief, with a stolen Texas birth certificate and alot of nerve, managed to live a life as the other woman, even to the point of qualifying for SSI AND obtaining a valid US Passport. It came to a head when the real woman filed her retirement claim in Texas and provided enough information and documents for SSA to consider her the real person. Case referred to us to investigate the California woman. She came to the office, showed her documents and said she was the real person. I asked her about siblings (was going to look up their ID info). She said she forgot their names and ages. Yeah right. OIG went to her place to talk to her. She wouldn't let them in. OIG told us to do nothing until they were finished. A few months later, the agent came to the office and said OIG couldn't do anything unless the woman confessed! WTF??
I said we can do an administrative decision and she can appeal. So I made the decision that the SSN did not belong to her and all payments made since day one ($70,000) were overpayments and stopped her checks. I could impoverish her, whoever she was.
SSA will never see the $70,000 because it is attached to the SSN of the real person. We never learned the real identity of the other woman. Had to call the debt uncollectable under the other SSN because we could not collect it from the real person.
She needed to confess before being prosecuted? Really?
I have also imposed 100% withholding for SSI fraud cases that will not be prosecuted, like the 70 year old man who took not one, not two, not three, but four many months long trips to Pakistan and neglected to report leaving the US. Within 4 years, he had been paid wrong more often than paid right. I did allow him a small amount of money so he could pay room rent and buy some food, but that was it. Of course, when he appealed to the ALJ, the ALJ took pity on him because of age and language and waived most of the overpayment. OIG wouldn't touch it.
This chart is only describing what happened over a 6-month time period. Incidentally, it is part of another chart. The full OIG report and complete chart is here:
Understaffed as is the rest of SSA. Handicapped by having to plead with DA's to take cases...often involving disabled and aged perpetrators (even when the dollar value of fraud is substantial). :-(
While there are undoubtedly meritorious cases that don't get pursued, I wonder how many of those convictions were of unrepresented, mentally impaired beneficiaries who could not afford a lawyer.
Yeah, I reported to OIG and House Oversight that ATL OGC failed to properly redact SSN or names for all claimants who received a hearing in Greensboro, NC, from sometime in 2009 to sometime in 2011, when OGC turned over reams of data in an employment discrimination case. These claimants' PII, including handfuls of draft decisions with medical information about mental illness, DAA, suicide attempts, reproductive organ issues, and so on, were readily available to anyone with PACER access (Bolton v. Colvin, USDC MDNC). I reported in December. Still no response.
I submit, on average, one allegation per month. They all get the same response, something like "thank you, we have decided not to take any action."
ReplyDeleteThey are evenly split between ID theft (someone using a claimant SSN fraudulently), rep payee fraud (typically blatant evidence of a party not spending ANY money to support the disabled beneficiary) or "double-dipping" (claimant alleging disability, but also reporting self-employment). The last type of situation is usually for the purposes of claiming the earned-income-tax credit and does not represent actual work activity. So they are lying to the IRS.
Now, I get that these are small-value cases, but they are quite common and in all cases should be investigated/corrected/stopped.
I've submitted a handful for investigation at the hearing level, and unless you have a CE lined up in the future, they basically say, "Thanks, but no thanks." As the previous poster suggested, an unwillingness to investigate should not be translated into a lack of fraud.
ReplyDeleteI would also submit that if more than 25% of the cases investigated in some adverse action (there may be some overlap, it's unclear from the data), it's not completely ineffective or a waste of time or resources.
How can the "Case Opened" exceed the "Cases Closed"?
ReplyDelete@1:44. Some cases closed during that time period were opened earlier and some opened in that time period will be closed later.
ReplyDelete10:27 I assume you are a claims rep. There are administrative actions available to you to take if OIG fails to investigate. We had a ID theft case in California in which the thief, with a stolen Texas birth certificate and alot of nerve, managed to live a life as the other woman, even to the point of qualifying for SSI AND obtaining a valid US Passport. It came to a head when the real woman filed her retirement claim in Texas and provided enough information and documents for SSA to consider her the real person. Case referred to us to investigate the California woman. She came to the office, showed her documents and said she was the real person. I asked her about siblings (was going to look up their ID info). She said she forgot their names and ages. Yeah right. OIG went to her place to talk to her. She wouldn't let them in. OIG told us to do nothing until they were finished. A few months later, the agent came to the office and said OIG couldn't do anything unless the woman confessed! WTF??
ReplyDeleteI said we can do an administrative decision and she can appeal. So I made the decision that the SSN did not belong to her and all payments made since day one ($70,000) were overpayments and stopped her checks. I could impoverish her, whoever she was.
SSA will never see the $70,000 because it is attached to the SSN of the real person. We never learned the real identity of the other woman. Had to call the debt uncollectable under the other SSN because we could not collect it from the real person.
She needed to confess before being prosecuted? Really?
I have also imposed 100% withholding for SSI fraud cases that will not be prosecuted, like the 70 year old man who took not one, not two, not three, but four many months long trips to Pakistan and neglected to report leaving the US. Within 4 years, he had been paid wrong more often than paid right. I did allow him a small amount of money so he could pay room rent and buy some food, but that was it. Of course, when he appealed to the ALJ, the ALJ took pity on him because of age and language and waived most of the overpayment. OIG wouldn't touch it.
@ 1:06. I made the original post at 10:17. Not a claims rep, I work at the hearing level.
ReplyDeleteThis chart is only describing what happened over a 6-month time period. Incidentally, it is part of another chart. The full OIG report and complete chart is here:
ReplyDeletehttps://oig.ssa.gov/semiannual-reports/spring-2018
Understaffed as is the rest of SSA. Handicapped by having to plead with DA's to take cases...often involving disabled and aged perpetrators (even when the dollar value of fraud is substantial). :-(
ReplyDelete1:06, Thanks for doingvyour job. There should be more like you.
ReplyDeleteWhile there are undoubtedly meritorious cases that don't get pursued, I wonder how many of those convictions were of unrepresented, mentally impaired beneficiaries who could not afford a lawyer.
ReplyDeleteYeah, I reported to OIG and House Oversight that ATL OGC failed to properly redact SSN or names for all claimants who received a hearing in Greensboro, NC, from sometime in 2009 to sometime in 2011, when OGC turned over reams of data in an employment discrimination case. These claimants' PII, including handfuls of draft decisions with medical information about mental illness, DAA, suicide attempts, reproductive organ issues, and so on, were readily available to anyone with PACER access (Bolton v. Colvin, USDC MDNC). I reported in December. Still no response.
ReplyDelete