The Office of the Inspector General: 20 Years

“As we approach our 20th anniversary … we can say with confidence that we have achieved, and continue to achieve, our mission of promoting the integrity and efficiency of SSA’s programs and operations.”

- Inspector General Patrick O’Carroll, before the U.S. Senate, February 2015

 

The OIG at the Social Security Administration was created March 31, 1995, after President Clinton signed the Social Security Independence and Program Improvements Act of 1994, which re-established SSA as an independent agency (SSA previously operated under the Department of Health & Human Services). The Inspector General Act of 1978 created independent, objective units to conduct audits and investigations related to agency programs and operations; thus, SSA, again an independent agency, needed its own OIG.

(President Clinton signs the Social Security Independence and Program Improvements Act; from the Social Security Advisory Board.)

In the 20 years since, we’ve followed our mission to improve SSA by

  • ensuring the efficiency and effectiveness of Agency operations;
  • preventing and detecting Social Security program fraud, waste, and abuse; and
  • informing Agency officials and Congress about issues and weaknesses, recommending corrective actions.

Under three Social Security Inspectors General, our diverse, specialized, and dedicated staff in OIG offices across the country—some who have been here since Day 1 in 1995—has continuously provided objective, timely, and valuable information to our stakeholders, with the ultimate goals of improving public service and ensuring taxpayer funds are used appropriately.   

Office of Audit—Identifying Vulnerabilities, Recommending Solutions

One of our first reports set the stage for the high-impact work our auditors would pursue. The 1996 report, Effectiveness in Obtaining Records to Identify Prisoners, found that SSA needed timely, complete information from correctional facilities to prevent significant overpayments to prisoners, as prohibited by the Social Security Act.

Based on this report and other work, SSA reacted swiftly and effectively. The Agency increased agreements to obtain prisoner data and improved efforts to stop payments to prisoners. Also, the Ticket to Work and Work Incentives Improvement Act of 1999 eliminated SSA’s need for formal matching agreements for prisoner records, making it easier and faster for SSA to obtain data.

Today, SSA receives prisoner data from correctional facilities monthly, a process that has generated hundreds of millions of dollars in projected savings. We’ve long encouraged SSA to pursue similar data matches with other public and private entities to promote program integrity; the 1996 prisoner audit was the first of its kind and remains a significant OIG accomplishment. 

Since inception, our primary focus has been to identify and help reduce the Agency’s improper payments—a formidable task, given the large dollars involved in SSA’s benefit programs.  For example, we’ve identified millions in overpayments to SSI recipients based on their extended time outside the United States; we’ve identified millions in underpayments to disabled beneficiaries who were eligible for higher retirement benefits.  

With a long history of detecting and preventing SSA’s improper payments, we’ve taken a leadership role in government-wide efforts to reduce payment errors, as part of the Council of Inspectors General on Integrity and Efficiency. On behalf of the Inspector General community, we work with the Office of Management and Budget on agency compliance with the Improper Payments Elimination and Recovery Act of 2010 and other legislation and mandates aimed at improving Federal payment accuracy.

Our auditors have also completed comprehensive, award-winning work related to SSA’s Death Master File (DMF), the list of people on Social Security’s records reported as deceased.

Over the years, these reviews have recommended appropriate actions for SSA to address:

  • the issuance of about $100 million in overpayments to thousands of deceased individuals;
  • the incorrect publication of tens of thousands of living individuals’ on the DMF; and
  • the omission of millions of deceased individuals’ from the DMF.

Many times, the Inspector General and our auditors suggested congressional actions to mitigate these issues. Their efforts were worthwhile, as Congress responded with legislation requiring Federal agencies to match government benefit recipients against the DMF to ensure payment accuracy, and restricting DMF access—primarily by requiring those who purchase the information to be certified as having a legitimate need for the information.

These changes—prompted by our work—reduced the abuse of deceased individuals’ personal information and prevented identity theft against living individuals mistakenly listed on the DMF. In March 2015, “60 Minutes” highlighted our work in this area in a feature on the completeness and accuracy of SSA’s death records—seen by 11.5 million viewers nationwide.

(Inspector General O'Carroll, center, testifies before the U.S. Senate on SSA's improper payments, death records; from the Associated Press.)

Office of Investigations—Getting in Front of Fraud  

Early on in our investigative history, we saw a need for the public to report Social Security fraud. In 1996, we established our Fraud Hotline to receive and process fraud allegations from across the country.

Our Hotline—which now processes reports via Internet, phone, mail, and fax—is one of the most productive in the Federal Government, receiving tens of thousands of fraud allegations every year, forwarding those reports to our special agents for investigation or SSA for administrative action.  

One of our earliest investigations of a large-scale disability fraud scheme in Washington State generated millions of dollars in SSA recoveries and savings and inspired the establishment of the Cooperative Disability Investigations program, or CDI. This award-winning, multi-agency investigation revealed several facilitators recruited refugees from Cambodia and Vietnam, coached them through the disability application and approval process, and ultimately defrauded SSA.  

The case was a huge success, but also a stark notice that we and SSA needed to get in front of disability fraud and prevent these high-dollar schemes from developing. That’s when CDI came into the picture.

In 1997, we and SSA created CDI with State Disability Determination Services and State/local law enforcement agencies. The goal, from the beginning, has been to pool resources and expertise to prevent fraud in SSA’s disability programs.

Since 1997, CDI efforts have resulted in projected savings of $3 billion to SSA’s disability programs and $2 billion to non-SSA programs.  CDI launched with five units and has since expanded to 28 units in 24 states and Puerto Rico—the program is still growing today.

Over the years, our special agents have contributed to numerous other high-impact investigations:

  • Sept. 11, 2001 terrorist attacks aftermath. It quickly became apparent how instrumental fraudulent Social Security numbers (SSNs) were for the attackers, who relied on aliases and assumed identities to integrate themselves anonymously into our society. Within minutes of the attack on the World Trade Center, our Special Agent-in-Charge at the New York Field Division offered OIG support to the FBI. Our involvement in this national investigation included divulging our data and resources to the FBI, such as: our highly qualified agents—particularly in the New York/New Jersey area; members of our electronic crime team; and our computer specialists. Across the country, agents were also assigned to the Joint Terrorism Task Forces, and many worked full‑time on the terrorism investigation and responded to allegations of SSN misuse.
  • Protecting the innocent. On several occasions, our investigative researchers went above and beyond their regular call of duty, and assisted the FBI and the National Center for Missing & Exploited Children (NCMEC) in cases of suspected child abuse. We requested SSA invoke the Health or Safety exemption of The Privacy Act to use the children’s names and search SSA’s systems to identify and locate the victims and share that information with the FBI and NCMEC. For example, after the FBI requested our research assistance, authorities located and arrested a New Hampshire man for suspected abuse. In 2011, the man pleaded guilty to various crimes and was sentenced to 60 years in Federal prison.
  • Large-scale disability fraud schemes. Recently, in Puerto Rico, our efforts have led to the indictment and arrest of 114 individuals; in New York, indictments and arrests totaled 134 individuals, including former NYPD and FDNY. Both schemes involved numerous beneficiaries, several facilitators and medical providers, and even a former SSA employee. The Puerto Rico scheme involved individuals applying for disability benefits with nearly identical claims and using the same doctor and medical providers. The New York scheme involved former NYPD “recruiters” and other facilitators coaching disability applicants on how to act during exams and what to include on their applications. In each scheme, organizers collected significant “facilitator” fees from the beneficiaries. These cases are ongoing with a fraud loss estimated at over $150 million. Each has resulted in numerous guilty pleas and spurred increased anti-fraud initiatives by SSA and several anti-fraud legislative proposals from Congress. 

   

 

 

 

 

 

 

(Top: A defendant in the New York disability fraud scheme is brought to the Manhattan District Attorney's Office; from The Wall Street Journal. Right: New York Special Agent-in-Charge Edward Ryan with U.S. Rep. and Social Security Subcommittee Ranking Member Xavier Becerra.)

 

Counsel to the Inspector General—Enforcing the Social Security Act

Our attorneys, for years, have committed to administering the Civil Monetary Penalty program—imposing penalties and assessments and providing settlement and litigation against:

  • individuals who fraudulently receive or attempt to receive SSA benefits, per Section 1129, and
  • entities that use SSA's program words or logos in communications that imply such items are authorized by SSA, per Section 1140. These communications can take many forms, including mailed or televised advertisements, Internet sites, and social media accounts.

In the past three years, OCIG imposed over $47 million in penalties and assessments, making a substantial impact to remedy fraud in SSA’s programs.

We’re also committed to fighting misleading Social Security-related Internet fraud. In 2010, OCIG launched an aggressive effort to pursue more cases and deter violations of Section 1140 though enforcement and outreach.