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Fraud

2013 September 21
tags: ,
by Steve Perrigo

Everyone would probably agree that there has always been and will always be fraud in the SSDI program.  Claimants often conceal their work either by not reporting it to SSA, working “under the table,” or working under someone else’s Social Security Number.  And then you have the recent news out of Puerto Rico where doctors were paid to falsify medical reports to help claimants get approved for disability benefits.

The real question is do we (the American taxpayers) want to adequately fund the SSA to detect, investigate, and prosecute these individuals.  It has been proven that money spent on medical reviews (CDRs) and fraud have a very high return on investment.  In addition, the SSA has some effective tools at their disposal that I have personally seen (e.g. computer wage matching programs with Federal and State taxation agencies) and established investigative programs (Office of the Inspector General (OIG) and Cooperative Disability Investigtive (CDI) units).

Unfortunately, as confirmed by a recent U.S. Government Accountability Office (GAO) Report on SSDI entitled “Work Activity Indicates Certain Social Security Disability Insurance Payments Were Potentially Improper”, it appears SSA is still lacking resources in the fight against fraud.  It is clear the Agency needs additional staffing and overtime to process CDRs, fund additional CDI units, and invest in additional technology to detect wage discrepancies faster.  An excerpt from the GAO report:

During this review, SSA officials told us that limited resources and competing workloads may have constrained the agency’s ability to act promptly when it received earnings alerts or self-reported earnings for beneficiaries from our nongeneralizable examples described above. We also reported in April 2013 that budget decisions and the way SSA prioritizes competing demands, such as processing initial claims, contribute to challenges SSA faces in maintaining the integrity of the disability program.

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