68 Arrests In Alleged Disability Fraud In Puerto Rico

     From the Wall Street Journal:

Federal agents arrested 68 people in Puerto Rico on Wednesday morning as part of an investigation into alleged abuse of the Social Security Disability Insurance program, two people familiar with the operation said. 

More arrests are expected. The bust appears to be one of the largest disability fraud cases ever assembled by federal investigators. 

The identity of those arrested couldn't be learned immediately. One person familiar with the arrests said it included two psychiatrists, one physiatrist, a secretary, and a person who works to help people win disability benefits. The person said the probe centers on alleged abuse of the federal program over several years that could have helped scores of people obtain benefits who should not have qualified.

     Update: From an Associated Press article:

Those charged include three doctors and 71 Social Security claimants accused of receiving more than $2 million in disability benefit payments. But the biggest haul allegedly went to a former Social Security worker accused of taking $2.5 million while directing claimants to doctors who would file false claims. ...

The former Social Security worker claimed to help clients seeking benefits and directed them to doctors who would earn up to $500 for each fake claim, said Ed Ryan, New York-based special agent in charge of the Inspector General's office of the Social Security Administration's investigations office.

Rodriguez said agents took videos of people that belied their claimed ailments. She said one who claimed back problems was a gym owner who posted a picture of himself on Facebook lifting a girl above his head. ...

Rep. Sam Johnson, a Texas Republican and the Social Security chairman of the Ways and Means Subcommittee, said he will discuss the Puerto Rican case during a September hearing.

"Clearly this isn't a case of just a few bad apples," he said in a statement. "That such fraud could occur in the first place raises serious and troubling questions regarding Social Security's management of the disability program."

AFGE Newsletter

     The American Federation of Government Employees (AFGE) union local that represents most Social Security employees has gotten around to issuing its first newsletter of the year. The tone of the newsletter could be a bit less antagonistic toward the agency than prior newsletters. If so, that might be related to the departure of Michael Astrue as Commissioner of Social Security.

The Universal Identifier

     From WHEC in Rochester, NY:

I-Team 10 has a warning of how important it is to protect your identity. The problem happens to millions of Americans.

In this case, the woman didn't do anything wrong. It was the federal government that gave her social security number away and since then, it's been a nightmare.

Her name is Jennifer Lavigne and her nightmare started when she was 10-years-old. That's when the Social Security Administration mistakenly gave her social security number to a woman in Florida with the exact same name. To this day, the Rochester Jennifer is getting hounded for debts racked up by Florida Jennifer.

Jennifer Lavigne said, “I did not like to open the mail because I'd get summons for, you owe this amount and we need to get it by this date.”

The problems started when Jennifer Lavigne got to college. Suddenly, her student loan got canceled and her credit was so bad she couldn't get a new one. She couldn't get a credit card or a car.

Treasury Agrees To Scale Back Paper Check Threats

     From the Columbus Dispatch:

Seniors who were threatened with the loss of their benefits if they did not trade in their paper checks for Social Security benefits paid through a debit card or electronic deposit might be getting a reprieve.

The Treasury Department has agreed to make it easier for them to request a waiver to the electronic requirement, after a hearing held by Sen. Bill Nelson, D-Fla., chairman of the Senate’s Special Committee on Aging. ...

The Treasury Department already had said it would waive the electronic conversion for seniors who were 90 years old as of May 1, 2011. But in a letter to Nelson last week, the department said it will stop using threatening language in letters to beneficiaries who have not embraced electronic access. ...

Treasury reported granting roughly 3,000 automatic waivers based on age as of June, said Rebecca Vallas, representing the National Consumer Law Center, National Senior Citizens Law Center and the Senior Law Center. Yet, more than 300,000 Social Security beneficiaries are 92 or older, she said.

The department also is supposed to grant waivers to people with a mental impairment or who live in an area so remote that an electronic payment would hinder their access to benefits.

New POMS Transmittal On Suspension Or Disqualification Of Representatives

     Social Security has issued a transmittal to its Program Operations Manual Series (POMS) dealing with "Suspension or Disqualification of Representatives." The changes mostly concern the new requirement that those who represent claimants deal with the agency electronically as much as possible. Agency employees can share their experiences but I haven't heard anything suggesting that there have been serious problems getting compliance with this new requirement. The biggest problem I've seen has been that Social Security's systems often make it impossible to file an appeal electronically.

SDM Works Great But It Must Die?

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

Our review of 3,900 sample cases from the SDM [Single Decision Maker] prototype, SDM II and Non-SDM sites showed initial claim processing times were shorter in SDM sites than in the Non-SDM sites.

The 20 pilot sites, as well as the National Association of Disability Examiners and the National Council of Disability Determination Directors, provided feedback on the SDM model. These entities noted improved public service, DDS case processing times, and employee morale.

We noted evidence of SDM-user positive feedback and decreased case processing times for initial disability claims with the use of SDM. However, based on SSA studies showing higher initial and overall (after all appeals) disability allowance rates with the use of SDM, the Office of the Chief Actuary (OCACT) estimated significant program benefit savings to the Trust and General Funds with the gradual termination of the SDM pilot.

     I guess it makes sense to eliminate SDM if reducing benefit payments is your main goal but I thought that making fair decisions promptly was supposed to be the main goal.

No Punishment For Aiding And Abetting Illegal Aliens

     From an audit report by Social Security's Office of Inspector General (OIG) (footnotes omitted, emphasis added):

Because the Social Security Administration (SSA) calculates future benefit payments based on the earnings an individual has accumulated over his/her lifetime, it is critical that the Agency accurately record those earnings. SSA’s ability to do so, however, depends, in part, on employers and employees correctly reporting names and Social Security numbers (SSN) on Forms W-2, Wage and Tax Statement. SSA uses automated edits to match employees’ names and SSNs with Agency records to ensure it properly credits earnings to the Master Earnings File. SSA places wage items that fail to match name and SSN records in its Earnings Suspense File (ESF). ...

[W]e obtained ESF data for TYs [Tax Years] 2007 through 2009. These data represented the most complete tax data available at the start of our audit, given the inherent lag in posting annual wage information. We then identified the 100 employers who contributed the most wage items to the ESF for the 3-year period. We also identified the 100 employers (with a minimum of 100 employees)who had the highest percentage of suspended wage items for TYs 2007 through 2009. For the 200 employers selected, we analyzed ESF data to identify reporting irregularities, such as SSNs that SSA either had never issued or assigned to another individual. We also contacted Employer Service Liaison Officers (ESLO) to obtain information on their experiences with employers who provided names and/or SSNs that did not match SSA’s records. ...

For TYs 2007 through 2009, the 100 employers who had the most suspended wage items had submitted over 2.3 million wage items for which the employees’ names and/or SSNs did not match SSA’s records. These wage items represented $15.7 billion in suspended earnings over the 3-year period. In total, 18 percent of the wage items these employers submitted did not match names/SSNs in SSA’s files. ...

In previous reports, SSA acknowledged unauthorized noncitizens’ intentional misuse of SSNs has been a major contributor to the ESF’s growth. SSA staff told us employers hired unauthorized workers because nothing prevented them from doing so. That is, employers know SSA had no legal authority to levy fines and penalties, and they were not concerned about potential IRS sanctions. Several of the employers and industry associations we contacted acknowledged that unauthorized noncitizens contributed to SSN misuse. For example, one employer told us his and many restaurants would close if they did not hire unauthorized noncitizens. A temporary labor service employer acknowledged that some of his former employees were unauthorized noncitizens who used invalid, unassigned, and deceased individuals’ SSNs. Furthermore, the president of a large growers’ association stated that farm labor contractors employed a large number of unauthorized noncitizens.

     The offending employers are not named in the audit report.

"It Is A Frustrating Bureaucracy"

     From some Arizona newspaper that hides its name on its website:

Gaye Kelley spent 50 years in the workforce, doing many jobs: teacher, flight attendant and, eventually, Salt River Project customer-service representative for 30 years.

When the Mesa resident retired in 2011, she had accrued a full two years of vacation pay and sick days from SRP. She looked forward to retirement. But instead of fully enjoying it, Kelley was forced to do battle with a big government agency, the Social Security Administration.

“It is a frustrating bureaucracy is what it is,” she said.

When Kelley retired in April 2011, she started receiving Social Security benefit checks totaling $1,352 a month. But the following year, she began receiving notices that she owed the agency $10,857 in overpayment of benefits.

Social Security demanded the money back immediately. Kelley was flabbergasted.

In their notices, Social Security asserted that Kelley was working and collecting benefits at the same time, which is against the law. The truth is she was retired and receiving accrued vacation and sick pay from SRP.

Her former employer apparently had lumped the vacation and sick pay together and reported it to the Internal Revenue Service as income. This set off months of back-and-forth communications between Social Security Administration representatives and Kelley.

“It was eight months of insanity,” Kelley said. ...

“I have found that the people in the phone center (Social Security reps), as polite as they are, are empowered to do nothing for you. What boggles my mind in this whole thing is that I had to come to you!” Kelley said.