fbpx

18 Activities That Social Security Uses to Stop Fraud

At Social Security, we take fraud seriously.  People often wonder what we are doing to stop fraud.  Here are 18 activities that the Social Security Administration uses to detect, deter and stop fraud.

  1.  Increase Continuing Disability Reviews   While the primary purpose of a Continuing Disability Review is to determine if a beneficiary is still entitled to benefits because of his or her medical condition, the ability to perform additional CDRs may allow SSA to detect potentially fraudulent or suspicious activities.
  2. Expand Cooperative Disability Investigation (CDI) Units   CDI units obtain evidence of material fact to resolve questions of fraud in our programs.  According to the Office of the Inspector General (OIG).  CDI units contributed more than #1 billion to agency savings over the last three fiscal years.
  3. Anti-Fraud Training  SSA requires mandatory anti-fraud training for all agency and disability determination services (DDS) employees.  Our employees remain the best and first line of defense in detecting and preventing fraud, and we remain committed to improving our training.
  4. Data Analytics   Data analytics enhance fraud detection and help develop analytical tools to determine common characteristics and patterns.  We apply these tools to help us uncover potential fraud or other suspicious behavior when we review applications or existing data on beneficiaries.  OIG is participating in this initiative.
  5. Fraud Prevention Units (FPU)  FPUs are specialized fraud units comprised of examiners dedicated to redetermine and act on probable fraud cases, as well as compile data from the cases to help us further develop analytical tools to identify potential fraud.
  6. National Anti-Fraud Committee (NAFC)  The NAFC’s mission is to support national and regional strategies to combat fraud, waste, and abuse.  The NAFC supports our goal to balance our service and stewardship work and promotes accountability to taxpayers by ensuring superior financial performance, budget management, and integrity in all payments, records and processes.
  7. Submission of Evidence Regulation   We revised our regulations to require claimants to inform us about, or submit all evidence known to them that relates to their disability claim—both favorable and unfavorable.
  8. Fraud Prosecution Project   The goal of this project is to increase the number of prosecutions for crimes involving Social Security matters.
  9. Symptom Evaluation Research Effort    Our objective in entering into a contract with the Administrative Conference of the United States (ACUS) was to commission a study of the Social Security Act.  We reviewed their findings and drafted a Social Security Ruling to make the changes they suggested.
  10. Psychological Testing Research Effort   We asked the Institute of Medicine (IOM) to perform a comprehensive review of psychological testing, including symptom validity testing.  The committee verified that, where appropriate, there is value in standardized psychological testing, including both non-cognitive measures and cognitive tests.  In their recommendation, the committee emphasized useful testing as administered, interpreted, and validated by qualified providers.
  11. Office of Anti-Fraud Programs (OAFP)  We established OAFP in November 2014 to serve as a centralized anti-fraud office within our agency.  OAFP has the lead for developing and implementing our agency’s comprehensive anti-fraud initiatives in consultation and collaboration with OIG and other internal agency components
  12. Administrative Sanctions  Effective September 23, 2013, we implemented a new, streamlined process for imposing administrative sanctions that facilitates national attention and focuses agency resources on cases that OIG investigated but declined for criminal prosecution or civil monetary penalty (CMP).
  13. Anti-Fraud Communications Campaign (AFCC)  AFCC is a multi-year campaign to convey the agency’s anti-fraud messaging and promote the agency’s continued expansion of our anti-fraud capabilities.
  14. Anti-Fraud Language on Notices   To help communicate our anti-fraud message, we are adding new Anti-Fraud and reporting responsibility language to our notices.
  15. Disability Case Review  We continue to complete disability fraud redeterminations for a number of beneficiaries.  In addition, the agency is also handling appeals and updating guidance for technicians.
  16. Impose Civil Monetary Penalties (CMP)  Section 1129 of the Social Security Act authorizes imposition of a CMP against anyone who makes false statements, misrepresentations, or material withholding in connection with obtaining or retaining benefits or payments under Titles II, VIII, or XVI of the Act.  In addition, under section 1129A of the Act, OIG may impose CMPs against representative payees for wrongful conversion of payments to their own use, or a failure to notify SSA of a material change in the beneficiary’s living arrangements or work activity.
  17. Quality Review – Field Office Adjudication   In order to strengthen the quality of field office adjudications, we established a new review process to ensure the accuracy of work completed by field office technicians.  One of the primary areas we review is the disability case processing accuracy in field offices, with a concentration on the accuracy of how we determine the applicant’s disability onset date.
  18. eServices Fraud Prevention   To improve fraud prevention and detection, we develop and use tools to identify and track suspicious or potentially fraudulent eService transactions and take appropriate preventive and corrective actions to contact the beneficiary and revert records to their pre-fraud state.

Mickie

Mickie has worked for the Social Security Administration for over 35 years. As a Public Affairs Specialist, her goal is to make Social Security easy to understand.

You May Also Like

Leave a Reply