From a recent report by Social Security’s Office of Inspector General:
The Old-Age, Survivors, and Disability Insurance program provides benefits to wage earners and eligible family members. The Agency uses the wage earner’s Primary Insurance Amount (PIA) to determine monthly benefit amounts. The eligibility year SSA uses to determine the PIA is usually the year a wage earner attains age 62, becomes disabled, or dies. However, an alternative PIA computation for widow(er)s—the widow(er)’s indexing (WINDEX) PIA—may apply when wage earners die before they attain age 62.
When a claimant applies for Old-Age, Survivors, and Disability Insurance benefits, the application usually covers all benefits for which the claimant is eligible unless they specifically limit the scope of the application. For example, widow(er)s may limit the scope of the application to only include widow(er) benefits and exclude retirement benefits to maximize future benefits.
We reviewed 2 samples totaling 120 beneficiaries who, as of November 2023, either did not have a WINDEX PIA (from a population of 54,843 beneficiaries) or were dually entitled to widow(er)s and retirement benefits (from a population of 7,253 beneficiaries).
SSA paid 71 (59 percent) of the 120 widow(er) beneficiaries we reviewed the appropriate monthly benefit amounts. For the remaining 49 (41 percent), we found the following.
This is what happens when an agency is understaffed, policies are too complex and convoluted to clearly follow, and management prioritizes quantity over everything else.
ReplyDeleteSSA should rehire former technical exerts to give training and to verify that all the calculations are accurate. The current system is obviously not working.
ReplyDeleteThere's certain things in SSA internal systems where there's no automated flag/alert/diary etc that asks technicians "hey, did you consider this?". These things are extremely error-prone, because unless you're really on the ball, you'll forget, mis-identify, or miss the issue.
ReplyDeleteAnother one that comes to mind is Medicare penalties. Unless they've since fixed this (doubtful), I used to run across a good number of cases where a penalty % should have been considered, but was not. On the flip side, I also hit cases where an existing penalty % should have been cleared off, due to eligibility for new enrollment period, etc, but was not.
In virtually all of these cases, there was nothing prompting me to examine this issue - no alerts in the system, no inquiries from the field, no letters. It was all just good-old-fashioned analysis while working on (unrelated) problems.
The overpayments are calculated wrong, basic retirement wrong, backpay wrong, concurrent claims wrong. thats just what we had in office THIS week.
ReplyDeleteFrom the administration that doesn’t care about calculations.
ReplyDeleteTrump acknowledged having boasted that his efforts to lower drug prices had reduced what consumers pay by “500%, 600%.” But he added, “We also sometimes say 50%, 60%” and called it a "different kind of calculation" that could go up to "70, 80 and 90%."
“People understand that better,” Trump said. “But they're two ways of calculating” and “either way, it doesn't make any difference.”
I wonder if they realize the widows award notice denies all other title II benefits. Any widow application without the statement excluding retirement benefits incorrectly denies retirement benefits, a decison that can be reopened *at any time* as an error on the face of the evidence under administrative finality.
ReplyDeleteAges ago, in the 80s, we were taught to do A vs D compares in order to give the claimant an idea of which benefit they should choose.
DeleteRib-lim, WINDEX, DRCs and more could make things a bit complicated at times.
“We could not determine why SSA employees did not appropriately apply the WINDEX PIA for these widow(er) beneficiaries.”
ReplyDeleteMaybe because A101’s shouldn’t exist. If the PIA is there, it should just be pulled in but everything just HAS to be a scavenger hunt.
I was a technical expert before retirement. They did not expect me to teach my coworkers how to do these calculations. They expected me to just do them all myself. Because the CR's were 50% SR's that they promoted, despite not having the capacity to comprehend the complexities of the job.
ReplyDelete