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Supplemental Security Income (SSI) Fraud Protection

SSI Fraud

The Supplemental Security Income (SSI) program provides a vital safety net for our State’s most needy, disabled, and elderly individuals. Thanks to SSI, an elderly widow has the resources to stay at home and a parent gets help in caring for a severely disabled child.

Nearly 7 million individuals receive monthly SSI benefits, totaling more than $33 billion last year. Despite such, there has been too much fraud and abuse in SSI, undermining public support for a program that is critical for so many truly needy individuals.

While the vast majority of applicants are not out to defraud the program, the designation of the SSI program as “High Risk” by the General Accounting Office (GAO) is well deserved. For several reasons the SSI disability program is more labor intensive and difficult to administer than any other disability program.

Both medical eligibility and exact payment amounts are determined by complex rules. Individuals applying for SSI disability benefits are among the most vulnerable of our population.

They are, by definition, very poor. Most have little or no ongoing medical treatment able to provide comprehensive records. Many do not speak English and/or have little background education. These individuals are strong candidates for manipulation by others for financial gain. They are often the victims themselves of others whose mission is to defraud the SSI program.

SSI Fraud Protection

  • Drug Addiction and Alcoholism Removed

  • In 1994, GAO reported that after years of rapid growth, an estimated 250,000 Americans were getting disability checks due to drug addiction or alcoholism.

    The government is literally paying people to drink themselves to death.  Hence, in 1996, SSA ended the drug addicts and alcoholics part of the program and used some of the savings for more drug treatment where it might help individuals overcome their addictions.

  • Enhance Ability to Detect Residency Violations

  • The SSI program paid about $35 million recipients in 2002. In recent years, the SSA has identified a general increase in the amount of annual overpayments made to (1) individuals who are found to have violated program residency requirements or to (2) recipients who leave the United States and live outside the country for more than 30 consecutive days without informing the SSA.

    This problem has caused concern among both program administrators and policy makers. As such, GAO was tasked to determine the extent to which SSI benefits are improperly paid to individuals who are not present in the United States and to identify any weaknesses in SSA’s processes and policies that impede the agency’s ability to detect and deter residency violations.

  • Increasing SSA Penal Authority

  • The SSA Commissioner is given the power to impose civil monetary penalty and an assessment on persons who knowingly provide false information or knowingly withhold information to obtain Social Security benefits.

    The civil monetary penalty may be up to $5,000.00 for each violation and the assessment may be up to twice the amount of benefits wrongfully paid to the individual.

  • Representative Payee

  • The SSA may also designate a representative payee to accept monthly benefit payments of SSI recipients who are considered physically or mentally incapable of managing their own funds or on behalf of children under age 18. In most cases, a family member or friend of the recipient serves as the representative payee.

    Other individuals and organizations that may serve as representative payees include members of community organizations, public agencies or non-profit institutions that have custody of the recipient, non-custodial federal institutions and private, profit organizations licensed under state law that have custody of the recipient.

    Individuals are disqualified from serving as a representative payee if they have been convicted of fraudulent conduct involving Social Security Program.

  • Claimant Representatives

  • Social Security and SSI disability claimants may choose to have an attorney or other qualified individual represent them in proceedings before the SSA.

    The representative may charge a fee for his or her services, but the fee must be authorized by the SSA under either the fee petition process or the fee agreement process.

    Despite these tremendous strides, however, GAO will testify that SSI remains on its list of programs at high risk of waste, fraud and abuse

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