Inspector General: CDRs and CDI Effective Disability Integrity Tools

Beyond the Numbers

Date: 
Thursday, April 17, 2014
Posted by: 
The Office of External Relations
Inspector General Patrick O'Carroll (right) with U.S. Rep. James Lankford at the April 9 congressional hearing on SSA's disability programs.

 

We know: There are countless acronyms in the government, and more are created every day, so we’ll highlight the ones we want to talk about up front: CDI and CDRs. 

At last week’s congressional hearing on SSA’s disability review process, Inspector General O’Carroll shared with the Congress a recent Cooperative Disability Investigations (or— wait for it—CDI) case of a 42-year-old man who was receiving Social Security disability for mood disorders.

CDI, as you might know, typically investigates questionable initial claims for disability—CDI investigators provide evidence to disability examiners who decide whether people are eligible to receive benefits. The case the Inspector General talked about at the hearing, though, was a man who had already been receiving benefits, for many years. A disability examiner referred the case to CDI during a review of the man’s condition to determine if he was still eligible for benefits. It’s called a continuing disability review, or—you guessed it—a CDR. 

The CDI investigation revealed the man was capable of performing work activities that are contrary to his claims of disability, and would generate enough earnings for him to no longer be eligible for benefits; in fact, he’s a touring rock musician who promotes his band’s shows and merchandise through social media. With this additional information, the disability examiner stopped his benefits in January.

“I share this example because it combines the value of two of our most effective integrity tools—CDRs and the CDI program,” Inspector General O’Carroll said to the House Oversight Subcommittee on Energy Policy, Health Care, and Entitlements.

For many years, we’ve recommended that SSA conduct as many CDRs as resources allow. The Agency has a responsibility to assist people quickly and timely when they first apply for disability benefits, but it must also maintain the integrity of the program—and save taxpayer money—by making sure that people receiving benefits are still eligible for them years later.  

Of course, we’ve also long touted CDI’s successes. We’re pleased that, earlier this year, the Acting Commissioner of Social Security approved plans to expand CDI by up to seven units by October of 2016, which would bring the total number of CDI units from 25 to 32 across the United States and Puerto Rico.

Through the first half of fiscal year 2013, CDI program efforts have contributed to more than $165 million in projected savings to SSA’s disability programs. And CDI investigations have led to 2,022 instances where suspicious disability claims were denied or ceased.

A recent case highlight from the St. Louis CDI unit is another example of an investigation of an in-pay beneficiary:

The unit investigated a 34-year-old woman who was receiving disability benefits due to an injured back that she claimed left her unable to work. A Missouri SSA office previously received an anonymous letter with photos of the woman engaging in physical activity, so it referred the case to CDI.

The investigation found the woman was participating in activities like bow hunting that contradicted statements she had previously made to SSA about her disability and activity limitations. The CDI investigation actually prompted a CDR of the woman, and SSA ultimately terminated her benefits.

The woman was later charged with making false statements to SSA and government theft. In January, a jury convicted her and she was sentenced in U.S. District Court to a year in prison and ordered to repay SSA more than $18,000.