The Inspector General for the Social Security Administration, Gail S. Ennis, announces the addition of four new investigative units to the Cooperative Disability Investigations (CDI) program. CDI is a nationwide joint effort between the Social Security Administration and its Office of the Inspector General (OIG) to fight disability fraud and save money for taxpayers. The four investigative units recently opened offices in Omaha, Nebraska; Las Vegas, Nevada; Manchester, New Hampshire; and Cheyenne, Wyoming. ...
Just how much fraud are you expecting to find in New Hampshire and Wyoming? Do they really need their own dedicated offices? And why are you saying this is directed at "disability fraud"? I think that most fraud cases detected at Social Security involve retirement benefits.
Social Security is closing down field offices which provide service to the public while opening new offices to hunt for fraud even in low population areas. What does that tell us about the priorities contained in Social Security's operating budget?
12 comments:
you'll love this--heard from a HQ contact that Terrie and the gang think the upcoming transition from Skype to Teams will yield untold increased productivity such that they think they may be able to eventually drop staff and building numbers significantly.
lol, love it when clueless older folks think an existing and not-that-impressive technology is going to like double their productivity overnight.
Good luck OHO folks: it's only going to get more and more like it's been getting these last couple years.
I think the bipartisan budget act of 2015 requires a CDIU in every state. It makes no sense but it got Republicans to approve a reallocation of trust fund revenues so the DI program could stay solvent and it was a lot less bad than the other things they were suggesting.
What are the initial claim approval rates for NE, NH, and WY...if they are higher than average, then you know what their driver is...
Likely predominantly telework , with small office space and staff.
They do not really open new offices. They have a DO person, a DDS person, and a local police person who all carry on with their other duties. They then have a OIG person from a regional Office who also works with all the other states in their region. I do not know what else the regional person might do.. Since a large part of what they do is observe people when they come into the DO not much will likely happen with it until the DOs open.
So many cowboys falling off horses and claiming disability in Wyoming. Have to investigate that.....
Any stats on the success rate of finding fraud in these CDI investigations. In my experience, they usually happen for 1 major reason - a nosy neighbor or relative anonymously rats on a claimant when seeing something suspicious (e.g. using a cane sometimes and other times not).
I saw much more levels of fraud when doing California workers comp cases. Almost every major insurance company would break out a private investigator recording at a deposition. Sometimes the applicant was caught obviously faking. Do not see this much in the CDI reports.
Was wondering how they come up with their cases mainly?
7:07, from the last SSA OIG semiannual report (these are not only CDI cases but all OIG matters):
467,946 allegations received
2,139 cases opened
2,148 cases closed
455 convictions
31 civil monetary penalty actions
So less than half a percent of allegations result in an investigation. Most investigations don't result in a conviction or a CMP. The report to conviction ratio is more than 1000:1. And of those convicted, many are SSA staff, rep payees, bank employees, relatives of beneficiaries, or other people who are not claimants or beneficiaries.
And yet SSA spends about 1 out of every 8 dollars of its administrative expenditures on "program integrity"...which doesn't include stuff like making sure public assistance households don't have their benefits reduced for in-kind support, effectuating benefits promptly, checking for underpayments...
Savings result not so much from convictions but more from investigations that result in denials or cessations. For example a person that is mute or cannot walk or is bizarre at the CE but is able to communicate normally, walk, run, ski go horseback riding according to their investigation.. A person who says she does not leave her room but is self. Employed or paid off the books. They can prove the activity but not necessarily that they earn vast amounts so they do not bring charges. Other times they can show the person is lying or faking but we can allow or continue benefits anyway because of other aspects of their condition.
I have seen a pattern to CDI investigations in Colorado. They seem to be triggered by: 1. the fact that the claim is not the first (e.g., prior claim is on appeal to USDC); 2. ALJ wants it; or 3. nosy neighbors. The typical set up is so common that I warn all of my clients who are in a second or 3rd claim to expect to be scheduled for a CE, and expect to be followed both to and from the CE, and expect that at the CE site, to be approached by a stranger and asked for directions. The CDI investigator when then copiously note the fact that the person smiled, or lifted their arm to point, or pushed the button on the elevator. Like clockwork, this is always their MO. Really guys, you need to get more creative than this.
@ 9:20
Great stats. So out of the 460K allegations received how did they come to the SSA? Was wondering if it was more nosy neighbors, doctors, or the SSA triggered the allegations. I assume most allegations come from outside the SSA probably nosy neighbors.
The CDI report does kind of stick out like a sore thumb at an OHO hearing. Most do not end much of anything. But I believe it puts an ALJ on notice to question credibility.
Referrals are not usually made by DDS due to subsequent applications but these end gup being referred often because there is a higher likelihood of inconsistent statements being made about education, past work, how person presented at the DO and at medical places. Referrals due to multiple family members often come about again because of inconsistent statements. Each person for example says they do nothing but the other person does everything for them. Someone gets an IQ of 46 at a CE but records show past skilled work, no difficulty understanding or communicating at other exams etc
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