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Sep 28, 2020

Suspending Benefits With No Explanation Other Than "Miscellaneous" For An Average Of 36 Months With No Controls In Place


      From a recent report by Social Security's Office of Inspector General (OIG):

... When SSA employees suspend benefits, they identify the issue that needs to be resolved by inputting one of dozens of situation-specific suspense codes to the beneficiary’s record. Employees can also use the generic “miscellaneous suspense” code if they do not identify the issue that requires resolution.  

To resolve benefit suspensions, employees complete follow-up actions, which include contacting beneficiaries, employers, or other agencies to obtain information. Once the employee obtains the necessary information, he/she must determine whether to pay the benefits withheld for prior months and whether to resume monthly benefits.From 1 segment of the Master Beneficiary Record, we identified 2,525 beneficiaries for whom SSA suspended OASDI benefits between January 2015 and December 2018 using the miscellaneous suspense code.We reviewed records for 100 randomly selected beneficiaries.

As of February 2020, SSA had not completed follow-up actions to resolve issues that caused it to withhold benefits using the miscellaneous suspense code for 41 of the 100 beneficiaries. As a result, SSA withheld almost $748,000 from these beneficiaries. ...

We project SSA withheld approximately $378 million from almost 21,000 beneficiaries without resolving the issues that caused the benefit suspensions.

SSA does not have controls to monitor beneficiaries in miscellaneous suspense status or an oversight process to ensure employees use the miscellaneous suspense code appropriately. SSA relies on the employee who suspended benefits to create his/her own reminder to take future resolution actions. For these 41 beneficiaries, this process did not ensure SSA completed necessary actions to resolve outstanding issues. ...

On average, SSA withheld benefits for 36 months and will continue withholding benefits from these beneficiaries until it resolves the suspensions. ...

The high rate of unresolved benefit suspension cases we identified is evidence that SSA’s current system of manual reminders is not a reliable control to ensure it resolves miscellaneous benefit suspensions. SSA needs controls, such as systems alerts and management reports, to identify beneficiaries in miscellaneous suspense status and ensure employees take corrective actions timely. ... 

     I've had plenty of clients in this situation. It seems to take a dozen complaints over several months before anyone does something. Social Security agreed with OIG that they need to do something about this situation. Let's hope that doing something doesn't go in their "miscellaneous" file.

12 comments:

  1. If I lost benefits for even i month, I would be homeless! How can that happen? If you loose your job there is a buffer called "unemployment", but where is the buffer if you lose benefits?

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  2. Something that made me especially mad in the report was the person whose benefits were suspended until a new representative payee was located. With very few exceptions, when a payee is terminated and another one isn't yet found, the beneficiary should be in direct pay. And I highly doubt the SSA employee properly worked through the policy and found an exception to direct payment.

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  3. Just more poor work being done by SSA. And, no one cares. Not the employees, not management, not anyone.

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  4. As a technical expert I was constantly dismayed at the coding mistakes by SRs and Cars. I provided training until I was blue in the face. The rep payee situation was the worst. Too many times benefits suspended until a new payee was found. Of course there is always fraud but most benes can have an organization manage
    their affairs if needed. Having payments come to an office to sign for their checks is just as bad. If they don't show up then benefits are suspended.

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  5. Some miscellaneous suspensions are legit--like when someone applies for benefits but has not proven they are a US citizen or permanent resident.
    Agree that most should be reconciled very timely.
    @231PM SSA doesn't just miscellaneously suspend benefits for no reason. This report says SSA should work quickly to resolve the issue and resume payments.

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  6. I guess the claimants don't care either or they would have called to find out what happened to their checks. In many cases there are multiple reasons for the suspension nwhich may be why they put it under miscellaneous. If you cannot locate the claimant you cannot just find a new payee. If they have recorded earnings not reported that is an issue. if they are discharged from jail or a hospital with no forwarding address that is an issue. I am at DDS and our DOs are no longer willing to suspend benefits even for people missing for over a year. In one case PComm showed clmt in pay status and a payee for 20 years but the mental health services reported he had no income and no contact with the reported relatives for many years ...they also reported that the mother who had been payee died several years ago..

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  7. Even worse, when you put in the input to unsuspend the benefit, often times it locks up that record with it still suspended (programming exception). Which requires the payment centers to unravel and fix the record, which of course they always do so promptly and error-free (ha!).

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  8. 11:44 says "I guess the claimants don't care either or they would have called to find out what happened to their checks."

    That assumes:
    *their phone isn't shut off
    * they have enough minutes on their phone to wait on hold
    * they aren't hospitalized or in the midst of a health crisis
    * they have the cognitive skills to find the phone number, remember their SSN and other identifying information, and explain their situation clearly enough that the SSA employee understands it
    * the teleservice center gives them accurate information and records the information correctly (lol) or they manage to find the phone number for the field office
    * the field office actually sees and takes appropriate action on what is conveyed to them (lol again)

    Perhaps not 100% of the people who get benefits because of old age or severe disability can handle this? It's not about them not caring. But you just showed that you clearly don't care.

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  9. I agree with 11:44 to a point but they are unlikely to have been in a health crisis and unable to contact anyone for three years. If they cannot be contacted it is not SSAs fault. Currently I have several CDRs in my caseload where they could not be contacted in over a year or did not cooperate in other ways for that length of time

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  10. 1144 and 1211, Stop being ethnocentric. You both appear to have structured lives with jobs or at least adequate income and stable living situations.

    You need to understand that a significant percentage of claimants don't have those luxuries. They often lead chaotic lives and are overwhelmed by technology. They have difficulty just calling in, never mind working their way through the system.

    I think every Agency employee should have to do field work in a homeless shelter and get a real sense of what life is like for these people.

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  11. @200 I thought the first paragraph you wrote was sarcasm. Surprised to find out it wasn't.

    If they can't contact SSA in three years, I doubt there is anything SSA can do to fix that.

    Everyone could probably do well to walk in someone else's shoes for a while.

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  12. The study was about OASDI and most of us including me were discussing why SSI would be suspended. Nonetheless to pay someone they need to know where they are. Then there was the guy who thought he got a nine month trial work period every year and then was upset after ten years when his benefits were suspended. On the other hand there was the another one who was psychotic and told the IRS he made six million dollars a year so IRS reported that to SSA who sent the case to DDS for a CDR as his TWP,was seemingly over. Some of the same people critical of SSA for suspending benefits are upset when benefits keep getting paid to dead people. SSA is no longer allowed to look up people on line to see if they can locate them

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