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.

Abolish The Marriage Penalties

      Should marriage be discouraged? There may be a few who have had sad experiences with marriage who would answer that question “yes” but I think that most would say, to the contrary, that marriage should be encouraged. So, why does Social Security have provisions that punish people for getting married? Why do I as an attorney who represents Social Security clients have to warn people about the negative consequences of marriage? Social Security may not be the sole reason but disabled people are much less likely to marry than healthy people. That’s not a good thing for the disabled people or society in general.

     Here are those punitive provisions:

• In most cases people drawing disabled adult child benefits lose all benefits if they marry.
• Two disabled people drawing SSI get less money as a married couple than if they just “live in sin.”
• A disabled person drawing SSI can continue to receive SSI if they “live in sin” with a person who is working full time but loses benefits if they get married.

Where It Started

 

Sounds Trumpy

      From a POMS Transmittal Sheet:

... The Social Security Administration (SSA) disbanded the Office of International Programs, which was responsible for negotiating and implementing bilateral Social Security agreements, and merged the office into various components throughout SSA Headquarters. SSA transferred the certificate of coverage workload to the Office of Central Operations, Office of Earnings and International Operations. The Office of Data Exchange and Policy Publication absorbed the totalization negotiation and implementation workloads and was renamed the Office of Data Exchange, Policy Publications, and International Negotiations (ODEPPIN). ...

     Many people have work careers that span more than one country. Preventing situations where such people end up without social security benefits in any country is important to all nations. Many American companies have employees overseas. Many overseas companies have employees in the United States.  Avoiding double taxation of wages for social security is important to all nations. All of this will become more and more important as time goes along. "America First" only gets you so far. We need more bilateral social security agreements. We're lacking agreements with Mexico, India, Argentina, the Philippines and Israel, to name just a few countries. This isn't about giving anyone, especially foreign nationals, special benefits. It's basic equity for Americans who spend part of their employment careers working outside the U.S. and for American companies who do business overseas.

Today's Congressional Hearing

      Here's info on today's hearing before the House Social Security Subcommittee:

What:	Social Security Subcommittee Hearing entitled   “Save Our Social Security Now”
When:	1:00 p.m. on Thursday, September 24, 2020
Where:	This hearing will take place remotely via Cisco Webex  video conferencing.
Watch:	Livestream of the hearing can be viewed via live webcast accessible  at the Ways and Means Committee’s website. The webcast will not  be available until the hearing begins.

 Witnesses:

PANEL 1

• The Honorable Ron Wyden (D-OR)

PANEL 2

• The Honorable Danny K. Davis (D-IL)
• The Honorable Linda Sánchez (D-CA)
• The Honorable Judy Chu (D-CA)
• The Honorable Don Beyer (D-VA)

PANEL 3

• Nancy J. Altman, President of Social Security Works
• Will Goodwin, U.S. Army Veteran and the Director of Government Relations for VoteVets 
• Amy Matsui, Director of Income Security and Senior Counsel at the National Women’s Law Center
• Janice Dean, New York, New York
• Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare
• Robert Roach, President of the Alliance for Retired Americans

Chiropractors Charged In Disability Fraud Scheme

      From a press release:

Dr. Thomas Hobbs and Dr. Vivian Carbone-Hobbs of Jefferson County were indicted with two members of their office staff, a former union representative of Anheuser-Busch In Bev, and five patients with conspiring to fraudulently obtain disability benefits from the Social Security Administration...

 According to the indictment, the defendants exaggerated the patients’ medical conditions and ability to care for themselves in order to qualify for the government disability benefits and the private insurance disability payments. The chiropractors also required their patients to undergo excessive medical treatments and diagnostic evaluations beyond what was medically necessary to pad their medical records....

Beginning as early as 2011, AB In-Bev employees sought the chiropractors’ assistance because it permitted them to fraudulently obtain Social Security disability insurance benefit payments, a long-term disability insurance payment of $100,000.00 from Prudential Insurance Companies, and long-term and short-term disability benefits through Met-Life. In exchange, his patients paid him as much as $3,000.00 for each of the types of disability payments they were seeking in addition to insurance payments he collected from Blue Cross Blue Shield and United Health Care and payment for unreimbursed services from the patients.

The losses resulting from the false and fraudulent statements to the Social Security Administration and the private insurance disability providers exceeded $12,000,000. ...

Another Report On Rep Payees

     The Social Security Advisory Board (SSAB) has released a study it commissioned on representative payees at Social Security. Rep payees handle money for beneficiaries who are unable to handle it for themselves. Most often a rep payee is a grown child or other close relative who handles the money responsibly but improper or illegal conduct by rep payees isn't as rare as anyone would like. The study is fine although its first recommendation, more studies, is part of the tradition of scholars making such self-serving recommendations when they do research for the federal government.

     Unfortunately, there are three underlying problems with rep payees that no one seems to be able to do anything about:

• There are some claimants who don't have anyone close to them who is willing to be rep payee. If some stranger is going to have to do it and do it right, it's going to cost real money but taking more than a nominal sum out of the benefits will leave some claimants without enough money to live on.
  
• There are temptations for rep payees. Some will give in to the temptation and steal from the person whose money they're supposed to be handling. There's no way to completely prevent this. There's not even a clear path to reducing it. Detecting it after it happens is difficult.
  
• Overseeing rep payees is a difficult job. Even with adequate staffing at Social Security there will always be problems but Social Security lacks the manpower to do a lot of things, including effectively overseeing rep payees. That's because agency appropriations are too low, like, maybe, two billion dollars a year too low. One political party tries hard to keep the Social Security Administration underfunded for reasons that go well beyond rep payees.
  

Am I Spoiling The Soft Rollout?

      A friend just stumbled upon the fact that Social Security's ERE online system for attorneys and others representing claimants now allows access to their clients' files pending at the initial and reconsideration levels. Who know how long this may have been available but no one knew? I guess they were planning to make an announcement eventually.

     Unlike at the hearing and Appeals Council levels, there's no way yet of accessing a list of cases pending at initial and reconsideration but this is still a step forward.