From a recently released report by Social Security's Office of Inspector General (OIG):
... SSA’s controls that identified potentially fraudulent iClaims were generally effective. However, the number of undetected fraudulent iClaims is unknown. Of the 70,173 potentially fraudulent iClaims OAFP [Office of Anti-Fraud Programs] identified, SSA determined 3,807 were fraudulent, 48,062 were likely fraudulent, 4,825 were not fraudulent, 11,289 were inconclusive, and 2,190 were pending. ...Almost 60,000 known cases where they can't tell for sure whether there was fraud or not. They admit that they have no idea how many unknown fraud cases there are. Still, they call that "generally effective"? What would ineffective look like? No, iClaims fraud is a big problem and Social Security doesn't have a handle on it.
3 comments:
Actually, if you look at it without the preconceived desire to find fault, it really isn't that bad. If someone said this about fraud on SSDI you would blow a gasket.
SSA set up an entire DC level organization just due to this fraud and then combined all the other fraud quality control groups into the organization. It was obvious and expected before iClaim was implemented but it was a great claim to fame (pun intended) when initiated.
I have had several claims flagged possibly fraudulent when none have actually turned out to be so. Can't figure out why so many are flagged that aren't. Sometimes it appears little things like place of birth (Los Angeles vs Van Nuys) can trigger a flag.
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