Last week the Social Security Administration Office of the Inspector General (“OIG”) issued their Semiannual Report to Congress. It summarizes their auditing activities within the last six months and provides statistics on their investigations.
Does it seem like there are a lot of Continuing Disability Reviews in California? It is because there are. The OIG has a unit called Cooperative Disability Investigations (“CDI”) in which they work with State Disability Determination Services (“DDS”) and local law enforcement to identify and resolve issues of fraud and abuse in continuing disability claims. The OIG received 570 allegations in California alone, more than in any other state. Of those cases, 183 of them were denied. I.e., benefits were terminated. The OIG estimated that this resulted in a $12,505,334 savings to SSA. So interestingly, less than half of them resulted in benefits being terminated but would explain why it seems we are seeing many continuing disability reviews. (See p. 21 of the report.) (It should be noted that these statistics reflect only those allegations that the OIG acted upon. SSA conducts more that are not initiated by OIG.) There are other interesting facts and figures in this report that warrant review. For instance, the OIG receives a large number of allegations of fraud and abuse. Within the six month period between October 1, 2013 and March 31, 2014, they received over 58,000 allegations. Most of these came from SSA employees themselves. Their agents closed more than 3,700 criminal investigations resulting in 230 arrests, over 630 indictments and informations, over 580 criminal convictions and 170 civil judgments/civil monetary assessments.
The report summarizes cases of fraud and abuse and misuse of SSNs that the OIG has investigated. It covers fraud on the part of claimants as well as fraud by SSA employees. Reports of fraud and corruption seem to occur in all states. In California, the OIG highlighted the case of a woman who failed to report her marriage and assets and was collecting SSI. She had allegedly been collecting SSI from 2002 – 2013 but had neglected to tell SSA that she married in 2002 and purchased a home with her husband in 2008. According to OIG, she had also made other false statements and misrepresentations to SSA about her marital status and who was living in her household. The OIG imposed a penalty of $71,000 and a $62,717 assessment for a total civil monetary penalty of $133,717. (See p. 25)
As a result of their investigations the OIG placed $6 million in funds to better use and helped SSA to save $165,340,379.