SSI recipients may live with individuals, such as a spouse or parent, who themselves are not eligible for SSI payments. SSA refers to these individuals as ineligible deemors, and their income can affect the recipients’ SSI eligibility and payment amounts. Past investigations have shown that some recipients have falsely reported separations from deemors when their income could adversely affect the recipients’ SSI payments. Given that recipients self-report their living arrangements, it is difficult to differentiate false from legitimate reports of separations. ...
[W]e identified 691 recipients who reported they had separated from ineligible deemors. However, their addresses still matched the deemors’ addresses at least 1 year after the reported separation, and the deemors had at least a $2,000 increase in wages in at least 1 year before or after the year of the reported separation. We reviewed a random sample of 100 of the 691 recipients. ...
For 39 of the 100 recipients we reviewed, the deemors’ income would have affected the recipients’ SSI payment amounts had the recipients and deemors continued or resumed living together after their reported separations. For 20 of the 39 cases, SSA found information in its systems to support, or our Office of the Investigations concluded, the recipients and deemors continued or resumed living together. SSA paid the 20 recipients approximately $496,000 in SSI payments after their reported separations. Estimating our results to the population, approximately 2,800 recipients may have falsely reported their separations from the deemors, and SSA paid them approximately $69 million after their reported separations....
I'm sure there are some people fibbing in order to get higher benefits. However, I'm also sure that it's more complicated than OIG imagines. Let me describe a hypothetical situation. The wife kicks the husband out of the house because he's drinking or using drugs or his psychiatric problems are causing too many problems in the household. However, she allows him to stay in a trailer or a camper at the same address. He's allowed to come inside to use the bathroom. Are they living together? I'd say they aren't but they have the same address. What do you say? I'm sure some readers think I'm describing something that rarely happens. Wrong. At any given time, I've got two or three clients who are in this situation and sometimes it's the wife or the son or daughter living in the camper. Sometimes, the claimant continues to get mail at the old address even while staying in a homeless shelter or living in a tent in the woods. Life is more complicated than OIG can imagine. Unless you're going to send out investigators, you'll never know the truth and you may not find out the truth even if you sent out an investigator. Cutting people's benefits because of some possibly misleading "information" in your system will cause many injustices. Be careful.
20 comments:
Well, they may not be living together in the situation you desrcibed, but who owns the trailer? That matters when making a determination. Also, what if they "kick out" the spouse or child for 2 weeks or a month or two and lets them back in? Talk about messing things up...start dating records is rarely done correctly in my experince. We have to completely rebuild records when a deemor is removed or added.
Living arrangements are a horrible part of the SSI program and very hard to actually get right epecially when the person giving you the information changes the story multiple times.
The SSI program needs an overhaul in general. I think anyone in the field will agrre with that.
A classic example of the baked in rules that are designed to be harsh as an "ordeal" to endure and the OIG coming in and viewing life through rules based blinders saying SSA is failing by not enforcing these harsh rules. Yeah, that's their job but they help drive any inkling of humanity out of the system.
I think whether the hypothetical addict is living with the wife isn't the relevant question, and OIG is wrong to assume a shared address is sufficient. There are lots of issues that can affect deeming of income. For example, the addict may or may not be sharing a household with the wife (i.e. sharing an ownership interest of the place the addict resides).
If the addict and wife keep their finances separate, that's going to potentially make deeming difficult.
Seems like the SSA should be more concerned about the relationship and how much the so-called deemor (how do they come up with that word?) contributes to the claimant.
Here in California that seems like a big deal. Believe California is the still the highest SSI monthly payments at around $900-1000 per month. But this gets adjusted heavily based on how much money they give them each month. Always tell my SSI clients how this could be adjusted based on who is paying their bills.
This exposes one of the most fundamental flaw with disability and most welfare programs. The majority of recipients needed and qualified for assistance through most of the programs at 1 time. So I believe in almost all welfare programs. The problem is checking up on those already on disability or other programs. This is very lacking.
For some reason, I thought they scrutinized SSI recipients fairly severely. At least they seem to do here in California maybe because it is the highest payment in the country.
Any welfare reform is not to eliminate any programs. They need to allocate more funding to checking up on those already on them because some stay on too long.
Actually, OIG is correct...if theyare married and sharing the residence they are together for SSI purposes and deeming applies.
Your hypothetical reminded me of a Title II case I had in WA many years ago. Wife was not married to husband the requisite ten years, not short by much. Wife divorced husband because he would not stop drinking, but never moved out nor kicked him out, reconciled but never remarried. They continued to live together many more years and he died. Wife comes to hearing unrepresented but accompanied by former sister-in-law. They both testified, when led, that couple continued to hold out that they were married. There is no common law marriage in WA. I asked wife what other states she had travelled to. Montana. Sister in law confirmed that couple had come to Montana and stayed for periods of time with relatives, never reporting divorce, and holding out as married. This was credible testimony since it was apparent neither woman understood the line of questioning. I sent a staff lawyer off to research Montana law, and the couple met the test for common law marriage, so denial became allowance.
Having a mailing address does not prove that you reside at that address. My mail goes to a Post Office box and I don't live at the post office. If a spouse is being forced to "couch surf" so the other spouse can get or maintain medicaid eligibility to obtain treatment for a serious impairment, that spouse may very well opt to retain his/her original mailing address while not physically living at that address.
Sorry Charles but there are plenty of low level fraud cases like this where separation is the issue. Some go to great lengths to hide the fact of living together for a higher benefit and perhaps a greater sense of independence. Simplification of many rules is needed including this one. I am reminded as an SSI CR many years ago, a spirited defense of separation by a recipient who at last stated that you can share the same bed and still be separated.
It is hard to meet all of the FLA-A requirements. You pretty much have to lie about something to get the full SSI amount. Just lie consistently so it isnt a constant month to month overpayment underpayment rollercoaster.
@6:19
Thank you.
The quoted summary says OIG identified a random sample of 100 out of 691 recipients, all of whom had declared separation but still shared the address of the deemor. Out of those 100, deemor income would make a difference for 39 recipients if they were actually still living with the deemor. In 20 of those 39 cases, corroborating data or OIG investigation confirmed continued "living together" despite the declaration of separation. So no, OIG is not saying anyone with the same address is living together fraudulently. In fact, OIG identified 20% of its sample where this was the case based on other evidence.
About 8 million people get SSI according to the monthly statistical snapshot.
Over a 6-year period, they found 691 who reported separation but still had the same address as the deemor, of which about 39% (so 269 people) could have led to an overpayment. But of the 39 in the sample, SSA found there were reasonable explanations for all but 14. So we are looking at about 97 people over 6 years who might have been overpaid in this way. Out of about 8 million people who get benefits each month.
How much would it cost to make it stricter? It easily could increase administrative costs more than it saves.
And how many people would be underpaid while SSA did additional development on their legitimate separations, and what additional costs would society have to bear (bankruptcy, homeless services, additional SNAP or housing subsidies, etc.) as a result?
One must word it properly. I've been a roommate throughout the years, and they wanted THEIR information! I wasn't going to disclose my disabilities to my roommates! I found out that, in fact, I lived in my own household, as I had a private room, paid my own utilities, and we did not share food, therefore, I was relieved of having to tell 3 roommates my problems. The proper wording is " I live with people who are roommates, however, I live in a separate household in my own room, my own utilities, and my own rent and food", it's always helpful to give them as MUCH information as possible, and they will determine whether or not you live in your own household, even though one may have roommates. I found out, however, that doesn't always fly with family. I told them in the beginning thet I shouldn't have to disclose my disability to mere roommates. A nice customerservice rep explained from there, what to do...back in the days when they were actually helpful when one called the 800 number. So, that's my experience. One CAN have their own household, and live in the household of others. Family however, is a bit more sticky.
@12:41
No. The dispute is that OIG is assuming that the identified entire 20% is living fraudulently together based on the fact that the recipient declared they had separated from their spouse, yet the recipient was receiving mail at an address they had previously shared with their ex-spouse. The OIG (and you) are confusing geographic separation with separation for deeming of income purposes, and in fact they are presuming the place they are registered to receive mail at establishes residency.
4:27 highlights a lot of the elements that are required for deeming purposes. Does the ex-spouse and recipient share expenses/resources? What about ownership rights to the property? Lots of issues preclude deeming of income, it's a very complicated system, and cross-checking address versus marital status is a pretty absurd way to do it.
Re WA couple who went to Montana--common law marriage laws were established so that couples could live as married until the judge, priest, minister, etc came around and could actually marry them. There has to be an intent to marry. It's hard to believe people have the intent to marry and live as if married in the US for long when they never do marry. They enjoy some of the benefits of being married without the legal duties.
@5:06
Before you decide what it is that I'm (@12:41) presuming, perhaps you should read the summary again. 100% of the 691 recipients still had the same address as the deemor a year after reporting separation. The same is obviously true of 100% of the random sample. This was the starting point. 20% of the sample were found to have continued or resumed living together, contrary to their assertions. Nothing in this says that OIG or I presume living together based solely upon a shared address. Whether the evidence is there to support the conclusion is another matter, of course, but please don't try to use straw man arguments to support your own conclusion that the system is rigged. Also, without having read the actual report, nothing in the summary seems to distinguish between mailing address and residence address, which is reflected in SSA systems (with varying degrees of accuracy).
@5:02
5:06 here. I didn't straw man you. A straw man would be mischaracterizing your argument in order to more easily rebut it and then rebutting the mischaracterized argument. My presumption did not make your argument more easily to defeat, it did however provide a logical bridge necessary to understand your argument. Regardless, I presumed the basis of your post was that you believed it was inconsistent to report a marital separation, yet continue to share the same address. Your subsequent post confirms this presumption, specifically when you say "20% of the sample were found to have continued or resumed living together, contrary to their assertions." As best as I can tell you took my presumption as an ad hominem attack. It's not. As to whether I believe the system is rigged, no not particularly.
Someone reporting they have separated from their spouse is not inconsistent with continuing to share an address (mailing or even residing at the address) with their ex-spouse.
To establish deeming of income you have to establish the spouse and recipient are living in the same "household," which understandably seems like "residence." It's not. Without going into further details, any number of the following things effects whether it is a shared household:
Whether or not the recipient and/or ex-spouse share an ownership interest in the residence, or are liable to the landlord for rent.
Whether or not the recipient and/or ex-spouse are paying pro rata shares of household expenses.
Whether or not the recipient and/or ex-spouse are on public assistance.
This is why merely sharing an address with an ex-spouse is not only not inconsistent with a reported separation, it's not even relevant to the deeming of income.
@654 Who said anything about ex-spouses? Much of the time they are still married and living in the same house, saying they are separated. Or they never bothered to marry and are just holding out as man and wife but have changed nothing.
Ex-spouse infers divorce...this rport is referencing separation. In addition, SSI has it's own policy called "holding-out" so even if a married couple divorces and continues to live together, the agency can still cionsider them "married" and impose deeming.
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