A federal auditor report ‘s finds that the Security Security Administration's lack of technology allows wrongdoers to get away with fraud.
Nothing raises the ire of Americans like learning that that criminals are cheating. Even worse is the knowledge that it’s the fault of lax government oversight of its own operations.
Social Security disability payment systems are old. Not just old, but ancient. That has created opportunities for fraud to occur. According to a new inspector general report, Social Security tracks cases through handwritten records, which makes it difficult to weed out fraud.
Congress asked the federal Office of the Inspector General (OIG) to conduct a top-to-bottom review of the Social Security Disability Office to figure out how widespread fraud occurred in New York City, Puerto Rico, and West Virginia occurred. These cases involved bogus disability claims paid out to police officers and fire fighters in the case of New York. In West Virginia, a Social Security administrative law judge actually conspired with a lawyer to approve the bogus benefits.
Key solutions to fighting fraud begin with stepping into the digital age. By transitioning to electronic records, it would make it easier to identify fraud on the part of doctors and caregivers. Once electronic, the SSA can employ tools like predictive analytics to monitor disability insurance for patterns of fraud.
Social media also has role to play. Letting judges look at online social media profiles of disability applicants can help spot fraudulent cases, but currently judges are banned from doing anything other than looking at the case file. As the Washington Times reports, in the New York City case, some of the bogus applicants had posted pictures of themselves doing physical activities like flying helicopters, sport fishing or riding a Jet Ski. As you can imagine, all these are activities that investigators said were inconsistent with their disability claims.
Here are just three recommendations from the report:
· Invest in predictive analytics tools to identify claims more likely to be fraudulent. SSA should have current integrity tools in place that routinely analyze disability claims and medical records to identify and flag claims for further review…
· Invest in a comprehensive searchable system of records to identify and review trends in claims with common characteristics. To flag and investigate suspicious or questionable claims, SSA needs the ability to match and analyze claims with the same claimant representatives and doctors/medical facility; as well as to search for similar impairments, wording, and phrases in disability applications or medical records.
· Continue oversight of performance and productivity of hearing offices and Administrative Law Judges… SSA should routinely review its data to identify judges with high-allowance rates and determine if patterns exist and allowances are connected to the same claimant representatives or doctors/medical facility.
The work will not be quick, easy, or inexpensive. But it is work that has to be done to protect the disability programs, now and in the future.
This report lays out solid concrete steps that Social Security can and should take to minimize fraud and abuse. The next question is how much political will there is to enact them. Based on comments from officials, SSA doesn't seem to think fraud is a big problem or big enough that they should do more than current action.
SSA officials have touted that there's less than one percent of fraud in disability programs, but as this report indicates, that is misleading. SSA is only counting cases that were referred for prosecution for potential fraud in a 2006 sample. Some 18 percent of cases from that same sample included beneficiaries who were overpaid or had their benefits stopped because they weren’t eligible — each of which could be evidence of fraud.
In addition, massive schemes such as in New York and West Virginia may yet to be uncovered. Because they don’t see it doesn’t mean it doesn't exist. If nothing else, this report exposes just how at risk disability payments are to fraud in the future. SSA is sticking its head in the sand.
As Americans we want our tax dollars to be spent wisely, especially when it comes to our social safety net. While recommendations from OIG may be costly upfront, they can save taxpayer dollars lost to fraud and erosion of the public trust, which is priceless.