Busted!

     I have written before to warn that some comments on this blog appear to have been authored by a person or person who pretends to be a current or former Social Security employee with actual knowledge of conditions at Social Security. There are a fair number of these posts which ring false to me but I only call out those that go beyond implausible. Here's one:

One case I remember was a mother receiving SSI benefits for a year and a half for a child she had given up for adoption at birth. Benefits were ceased for failure to cooperate. I had the case at the recon level (of course Mom asked for benefit continuation) and discovered this to be the case when I wrote to the hospital where the baby was born and the pediatrician they sent records to. Not only was there fraud on her part but her parents and other relatives withheld information.

     Let me list the problems here:

• How does the birth mother get SSI benefits for a child she gave up at birth? The child would have to be quite sick. How would the birth mother know what was wrong with the child? How would she know where the child was being treated? Without this information, the birth mother can't get benefits. I can imagine the possibility of an open adoption where the birth mother would have some of this information so I'll just call this improbable.
• Doesn't the disability examiner notice the adoption when reviewing the medical records at the time the claim is filed? I have seen medical records on sick children. Pediatricians pay attention to the parents of sick children and mention facts like adoption in the medical records. In the case of a very sick child, I'm expect that adoption would be prominently mentioned in the medical records. Maybe the disability examiner missed this but it's improbable.
• Why would benefits be ceased for failure to cooperate a year and a half into benefit payments? Normally, a denial for failure to cooperate is something that happens when a case is first being adjudicated. This could happen but it's another improbability.
• The person writing this is posing as a current or former Social Security field office employee but says that he or she wrote to the hospital where the baby was born. That's not something that field office employees do. It's hard to imagine why the field office employee would even want to do this. This one is highly improbable. It sounds like it was written by a person lacking a firm grasp of the role of the field office versus the role of disability determination.
• Most important, there's no benefit continuation for a failure to cooperate cessation. This one is beyond improbable. It's impossible. Even if benefit continuation did exist for this circumstance if the birth mother could ask for benefit continuation she could certainly avoid cessation for failure to cooperate. Again, this sounds like it was written by someone who lacks a firm grasp of basic Social Security law and procedure.

     Be careful when reading comments to this blog. Some commentators are pretending to have knowledge they lack. This seems to happen every time I write about anything relating to the incidence of fraud at Social Security. The poseurs could be Congressional staffers. They could be "think tank" employees. They could simply be paid shills and, yes, people are paid to write comments like this on blogs and newspaper articles. Posing as a government employee with inside knowledge is a common tactic.

Many Allegations But Little Substance

Here's a table from a recent report filed with Congress by Social Security's Office of Inspector General (OIG). Notice the huge disparity between the number of allegations received and the number of actual investigations much less criminal convictions. No, I don't think that disparity is because OIG fails to aggressively pursue cases of fraud. I think it's because there's little substance to most allegations of fraud. Republicans can spin it all they want but given Social Security's size, the amount of verifiable fraud at the agency is tiny.

Misleading AP Story On Overpayments

     Here's the lead sentence from the AP article on the Office of Inspector General (OIG) report on overpayments in Social Security's Disability Insurance Benefits program "Social Security overpaid nearly half the people receiving disability benefits over the past decade, according to a government watchdog, raising questions about the management of the cash-strapped program."

     This could have been the AP lead sentence "Only 3% of Social Security disability benefits are paid incorrectly and the Social Security Administration is able to recoup 85% of the benefits paid incorrectly." That's also what the OIG report showed. Of course, that wouldn't have been the lead sentence because it's boring. It also wouldn't have been the lead sentence because the AP writer was clued into the OIG report by some Republican operative who heavily emphasized the "nearly half" part even though it's misleading. 

     Let's say there was a study showing that over a 10 year time period 22% of drivers were caught driving drunk at some time. There isn't such a study as far as I know but let's say there was. Would it be fair and reasonable to have the lead sentence on an article about that study that reads "Nearly a quarter of all people who drove over the last ten years were found to be driving drunk, raising questions about law enforcement on our dangerous highways." I would say no. First, 22% isn't nearly a quarter, any more than 44% is nearly half. More important, if 22% of drivers have been caught driving drunk, law enforcement is doing its job in catching people driving drunk. There's no reason to question what law enforcement is doing. For the same reason, there's no reason to question the Social Security Administration's efforts to detect and prevent overpayments. Most important, the hypothetical lead sentence is misleading since it suggests that at any given time that nearly one quarter of drivers are drunk and that's not what the hypothetical study showed. By the same token, the OIG didn't show that at any given time 44% of benefits recipients are being overpaid as the AP story implies. The AP story is misleading.

OIG Report On Overpayments

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

Our review of 1,532 beneficiaries in current pay status as of October 2003 found that over a 10-year period (from October 2003 through February 2014), SSA [Social Security Administration] assessed overpayments for 44.5 percent of sampled beneficiaries. Based on the sample, we estimated

• SSA assessed overpayments totaling about $16.8 billion between October 2003 and February 2014 for approximately 4 million beneficiaries who were in current payment status in October 2003 ;

• SSA recovered about $8 .1 billion of the $16.8 billion in overpayments it assessed ; and

• SSA prevented about $8 billion in overpayments between October 2003 and February 2014 to approximately 1 million beneficiaries in current pay status in October 2003 by suspending monthly payments.

Additionally, the overpayment rate in Fiscal Year 2004 was 3.1 percent of all benefits paid that year.

     The report goes on to note that although it can take time, after ten years Social Security had been able to recover 85% of the overpayments made in 2003. Many of the overpayments were, as the report puts it, unavoidable because the individuals received interim benefits while they appealed benefit terminations.

I Think I Know Why Eric Conn Hasn't Been Prosecuted -- He's A Doofus

     I can't remember much from my law school class on criminal law but I do remember that prosecuting someone for fraud is awfully difficult. You have to prove that the defendant intended to deceive, did deceive and that the deception caused harm. That's a lot to prove beyond a reasonable doubt. Let's look at some of the problems involved in prosecuting Eric Conn for fraud.

     Was Social Security really deceived? Social Security's Administrative Law Judges (ALJs) aren't stupid. When they see the same type of odd-looking evidence submitted repeatedly they ask questions. They also tend to come to conclusions about that evidence. In my book, I advise against attorneys sending all their clients to one physician for medical examinations. Even if everything is above board, this looks bad to ALJs. They heavily discount the evidence. In Conn's case, I would hazard a guess that the ALJs who were receiving the medical "reports" that Conn is alleged to have submitted would testify that they knew the reports were bogus and paid no attention to them. If you wonder why Social Security couldn't recognize that Conn was acting fraudulently, maybe the answer is that they did realize it but thought what Conn was doing was a farce. Conn wasn't winning because of the allegedly phony reports but despite them.

     Can what Conn is alleged to have done be considered deceptive when it is little different than what Social Security does routinely? Most Social Security disability claim files at the hearing level contain "opinions" offered by physicians at the initial and reconsideration levels. These physicians never see the claimants. The opinion forms are usually filled out by a non-physician disability examiner and then routinely signed off on by the physician. Workloads are such that it is impossible for the physicians to actually review the medical evidence in most cases. The physicians or, more accurately, the disability examiners rely upon Social Security RFC (Residual Functional Capacity) guidelines in filling out the forms. In theory, the RFC guidelines don't exist. Social Security denies that they exist. Yeah, right. Does Social Security want some of these physicians on the stand testifying under oath about the RFC guidelines? Not only do the opinions of Social Security's physicians appear in the files but Social Security has told ALJs that these physicians are "experts" whose opinions must be considered and that their opinions may be entitled to more weight than that given to the opinions of treating physicians. How is what Social Security does any different than what Conn is alleged to have done, other than the fact that Conn, unlike Social Security, was in no position to demand that ALJs treat the opinions with more respect than they deserved?

     Would the decisions have been any different if Conn had not submitted the questionable opinions? Much attention has been paid to the fact that ALJ David Daugherty was approving essentially all of Conn's clients. Little attention has been paid to the fact that Daugherty was approving essentially all of every other attorney's clients as well. No one is alleging that the other attorneys were submitting the same sort of medical reports that Conn is alleged to have submitted. I think a jury would probably conclude that the questionable opinions were of no consequence; Daugherty would have approved the cases without the opinions Conn submitted.

     To me, Conn doesn't look like a criminal. He looks like a doofus whose only real skill is self-promotion. He couldn't figure out that his silly scheme was ineffective and would look criminal to a many people.

Social Security Folds

     WYMT-TV reports that "Social Security Administration officials announced Thursday disability benefits for hundreds of Appalachian residents will be restored."

Television Coverage For Kentucky Fiasco

     The local television station is covering the fiasco in Kentucky.

But We've Really Been Pressed By Republicans In Congress To Do Something!

     From the Lexington Herald-Dispatch:

The Social Security Administration has until 5 p.m. Thursday to respond to attorneys who seek an injunction to block the immediate suspension of disability benefits to more than 900 people, according to a court order entered Wednesday. ...

U.S. District Judge Amul R. Thapar scheduled a telephonic hearing on the injunction for 3 p.m. Friday.

[The attorney's] motion, filed late Tuesday, linked as many as three suicides to the suspension notices. He first learned of an Ivel, Ky., man's death, whose widow he cited in saying the client shot himself Monday. ...

U.S. Rep. Evan Jenkins, R-W.Va., and U.S. Rep. Hal Rogers, R-Ky., called upon Social Security to give each person more time to provide medical records to support their original claim, according to letters sent to Social Security's Acting Commissioner Carolyn Colvin. ...