CDI Program Thrives with Expansion, Additional Casework

Beyond the Numbers

Wednesday, June 28, 2017
Posted by: 
The Communications Division

The Cooperative Disability Investigations (CDI) program continues to serve as a strong integrity tool for Social Security’s disability programs.

The CDI program launched with five units in 1997, but it has expanded to 39 units covering 33 states, Puerto Rico, and the District of Columbia. Twelve units have opened since August 2014—in locations like Birmingham, Alabama; Charleston, West Virginia; Milwaukee; Raleigh; Washington D.C.; Baltimore; Des Moines; Little Rock; Miami; and Providence.

CDI brings together personnel from the OIG, SSA, state Disability Determination Services (DDS), and state and local law enforcement agencies, to detect and prevent suspected disability fraud.

The units that have opened in the last two-and-a-half years are performing well, notably the unit in Charleston, where we have partnered with the West Virginia Office of the Attorney General. The Charleston CDI Unit has generated $4.4 million in projected savings for state and Federal benefit programs since it launched in December 2015.

CDI program expansion should continue in the coming years, as the Bispartisan Budget Act of 2015 mandated that CDI provide investigative coverage for all 50 states by the year 2022.

Fighting Disability Fraud

CDI, for many years a front-end integrity initiative that reviews initial disability claims, is now pursuing more in-pay disability fraud cases. For example, the St. Louis CDI Unit investigated a 56-year-old man receiving disability benefits due to back disorders. Missouri disability examiners referred an allegation to the unit, suggesting the claimant was working in construction and performing strenuous physical labor.

The CDI investigation determined the man worked at a construction site installing ceiling tiles, and the construction company paid the man as an independent contractor. The man was responsible for reporting his earnings to SSA, and he failed to do so.

Because of the investigation, in May, the man was sentenced to three years’ probation and was ordered to repay about $13,000 to SSA as the result of his guilty plea to Theft of Government Funds. Consequently, the Missouri DDS stopped the man’s disability benefits, resulting in projected SSA savings of about $47,000.

In another case, the Seattle CDI Unit investigated of a 36-year-old woman who was receiving disability benefits for terminal cancer. The Washington DDS referred this case to the unit because of inconsistencies in the woman’s medical records and questions about her claims.  

The investigation confirmed the DDS suspicions—the medical evidence did not support the woman’s diagnosis, she was working, and she never had cancer. The woman previously worked in the medical field and used her knowledge of medical terminology to carry out this scheme. The woman admitted she made up the cancer story to obtain prescription narcotics from her doctors. In addition to fraudulently receiving Social Security disability benefits, the woman was married to a member of the U.S. Army, and through her husband’s military benefits, she received medical care on several military bases, leading to a $20,000 overpayment from the Army.

Because of the investigation, the DDS stopped the woman’s Social Security benefits, resulting in an overpayment of about $83,000, and projected SSA savings of about $96,000.

The woman pleaded guilty to Theft of Public Funds. In March, she was sentenced to 60 days’ home monitoring, 100 hours’ community service, and five years’ probation. She was also ordered to pay $83,000 restitution to SSA and $20,000 to the Army.

From the program’s inception in 1997 through May 2017, CDI efforts nationwide have contributed to $3.7 billion in projected savings to SSA’s disability programs and $2.6 billion in non-SSA programs like Medicaid and state benefits.

For more information, please visit the CDI page.