OFFICE OF
THE INSPECTOR GENERAL

SOCIAL SECURITY ADMINISTRATION

SUPPLEMENTAL SECURITY INCOME
RECIPIENTS ELIGIBLE FOR
VETERANS BENEFITS

January 2010

A-01-09-19031

AUDIT REPORT

Mission

By conducting independent and objective audits, evaluations and investigations, we inspire public confidence in the integrity and security of SSA’s programs and operations and protect them against fraud, waste and abuse. We provide timely, useful and reliable information and advice to Administration officials, Congress and the public.

Authority

The Inspector General Act created independent audit and investigative units, called the Office of Inspector General (OIG). The mission of the OIG, as spelled out in the Act, is to:

 Conduct and supervise independent and objective audits and investigations relating to agency programs and operations.
 Promote economy, effectiveness, and efficiency within the agency.
 Prevent and detect fraud, waste, and abuse in agency programs and operations.
 Review and make recommendations regarding existing and proposed legislation and regulations relating to agency programs and operations.
 Keep the agency head and the Congress fully and currently informed of problems in agency programs and operations.

To ensure objectivity, the IG Act empowers the IG with:

 Independence to determine what reviews to perform.
 Access to all information necessary for the reviews.
 Authority to publish findings and recommendations based on the reviews.

Vision

We strive for continual improvement in SSA’s programs, operations and management by proactively seeking new ways to prevent and deter fraud, waste and abuse. We commit to integrity and excellence by supporting an environment that provides a valuable public service while encouraging employee development and retention and fostering diversity and innovation.

MEMORANDUM

Date: January 6, 2010 Refer To:

To: The Commissioner

From: Inspector General

Subject: Supplemental Security Income Recipients Eligible for Veterans Benefits (A 01 09 19031)

OBJECTIVE

Our objective was to identify Supplemental Security Income (SSI) recipients who were potentially eligible for Department of Veterans Affairs (VA) benefits instead of SSI payments.

BACKGROUND

The SSI program is a national Federal cash assistance program administered by the Social Security Administration (SSA) that provides a minimum level of income to financially needy individuals who are aged, blind, or disabled. Since the SSI program is intended to be a program of last resort, individuals must apply for all other benefits for which they are potentially eligible. Generally, individuals are not eligible for SSI if they fail to take all the appropriate steps to apply for all other benefits for which they may be eligible—including VA benefits.

VA administers a pension program that provides benefits to financially needy veterans who are aged or have disabilities unrelated to their military service. VA considers individuals disabled if they have been determined disabled by SSA. Veterans must also meet eligibility requirements related to their military service to qualify for VA pension benefits. Generally, VA monthly benefits are more than SSI payments, so it is usually more advantageous for someone to receive benefits from VA instead of SSI payments. See Table 1 for a comparison of SSI and VA benefit eligibility requirements.

Table 1: Comparison of SSI and VA Benefit Eligibility Requirements
Benefit Eligibility Requirements SSI
Payments VA Pension Benefits
Aged (65 or older) or disabled  
Limited income or resources  
Discharged from military service under conditions other than dishonorable 
Served at least 90 days of active military service with 1 day during a wartime period. After September 7, 1980, generally served at least 24 months (or the full period for which called or ordered to active duty) 

As shown in Table 1, eligibility requirements for SSI payments and VA benefits are similar since individuals must be aged or disabled and have limited income/resources to qualify for benefits. Therefore, veterans may, in fact, be eligible for VA benefits instead of SSI payments if they also meet VA’s requirements related to military service. As a result, if individuals indicate they served at least 90 days of active military service (with 1 day during a wartime period) while applying for SSI payments, SSA field office staff refers the individuals to VA to apply for benefits. If individuals do not take all necessary steps to obtain any VA benefits, the individuals may not be eligible for SSI payments.

To perform our review, we identified 2,390 SSI recipients as of March 2009 (from 1 of 20 Social Security number segments) with military earnings during certain wartime periods who appeared to meet VA’s requirements for benefits. We randomly selected 100 cases from this population for detailed analysis. (See Appendix B for more details on our scope, methodology, and sample results.)

RESULTS OF REVIEW

We found that some SSI recipients appeared potentially eligible for VA benefits instead of SSI payments. Based on our review, we estimate SSA paid about $1.3 billion to approximately 22,000 SSI recipients who appeared to meet VA requirements for benefits. In addition, we estimate that SSA will continue to pay about $126 million in SSI payments over the next 12 months to individuals who appeared eligible for VA benefits instead of SSI payments.

Of the 100 cases in our sample,

• 45 appeared potentially eligible for VA benefits;
• 45 did not appear eligible for VA benefits; and
• 10 had military earnings, but we were unable to determine potential VA benefit eligibility.

SSI RECIPIENTS POTENTIALLY ELIGIBLE FOR VA BENEFITS

In total, 45 SSI recipients in our sample appeared potentially eligible for VA benefits instead of SSI and had received approximately $2.7 million in SSI as of June 2009. These recipients had received SSI payments for an average of 134 months—or 11 years—as of June 2009. Of the 45 individuals, 44 served during the Vietnam era and 1 during the Persian Gulf War.

For example, in one case, a disabled SSI recipient had military earnings during the Vietnam era. This recipient served in the Army from October 1968 to July 1970 for approximately 640 days—with at least 1 day during wartime—and received an honorable discharge from the military. Therefore, he appeared to meet VA’s requirements for benefits and received about $104,000 in SSI payments from January 1993 to June 2009. According to SSA’s systems, there was no indication this individual had applied for VA benefits.

In another example, a disabled SSI recipient had military earnings during the Persian Gulf War. This recipient served in the Navy from June 1988 to May 1992 for about 1,427 days and received an honorable discharge from the military. Therefore, he appeared to meet VA’s requirements for benefits and received about $36,000 in SSI payments from January 2003 to June 2009. According to SSA’s systems, there was no indication this individual had applied for VA benefits.

VA benefits are generally of greater monetary value than SSI payments—so it is usually more advantageous for individuals to receive VA benefits. Specifically, in Fiscal Year 2007, the average monthly VA benefit was $709, whereas the average monthly SSI payment was $468. In addition, the greatest Federal monthly SSI payment an individual could receive in 2007 was $623. Therefore, if these individuals are, in fact, eligible for VA benefits, they could receive higher monthly benefit payments.

Although individuals in our sample appeared potentially eligible for VA benefits, only VA—not SSA—can make that determination. As of August 2009, VA had a backlog of approximately 400,000 pending cases—and it could create an additional workload for VA if all potentially eligible individuals file for benefits. Although VA had a backlog, it was committed to reducing the processing times of disability claims and was trying to improve its technologies to process the claims faster and more efficiently.

SSA’s EFFORTS TO WORK WITH VA

At the time of our audit, SSA’s Office of Quality Performance was working with VA to determine whether SSI recipients were actually eligible for VA benefits. Specifically, in September 2009, SSA provided VA information on approximately 62,000 SSI recipients so VA could determine whether these individuals were, in fact, eligible for benefits. As of November 2009, VA was still analyzing these cases.

CONCLUSION AND RECOMMENDATION

We found that some SSI recipients appeared potentially eligible for VA benefits instead of SSI payments. Generally, it is more advantageous for an individual to receive VA benefits instead of SSI since those monthly benefits tend to be higher. We estimate SSA paid about $1.3 billion to approximately 22,000 SSI recipients who appeared to meet VA requirements for benefits—however, only VA can determine whether these individuals are, in fact, eligible for VA benefits. At the time of our review, SSA was working with VA to address this issue. However, VA had a backlog of pending cases, and this could create an additional workload if all SSI recipients potentially eligible filed for VA benefits.

In addition, we estimate that SSA will continue to pay about $126 million in SSI payments over the next 12 months to individuals who appeared eligible for VA benefits instead of SSI payments. Therefore, we recommend SSA continue its efforts to work with VA to ensure individuals who should be receiving VA benefits instead of SSI payments are, in fact, receiving VA benefits.

AGENCY COMMENTS

SSA agreed with our recommendation. See Appendix C.

/s/
Patrick P. O’Carroll, Jr.

Appendices
APPENDIX A – Acronyms

APPENDIX B – Scope, Methodology, and Sample Results

APPENDIX C – Agency Comments

APPENDIX D – OIG Contacts and Staff Acknowledgments

Appendix A
Acronyms

C.F.R. Code of Federal Regulations
GAO Government Accountability Office
Pub. L. No. Public Law Number
SSA Social Security Administration
SSI Supplemental Security Income
U.S.C. United States Code
VA Department of Veterans Affairs

Appendix B
Scope, Methodology, and Sample Results

To accomplish our objective, we:

• Reviewed applicable sections of the Social Security Act and other relevant legislation as well as the Social Security Administration’s (SSA) regulations, rules, policies, and procedures.
• Identified 2,390 Supplement Security Income (SSI) recipients as of March 2009 (from 1 of 20 Social Security number segments) with military earnings during certain wartime periods who appeared to meet the Department of Veterans Affairs (VA) requirements for benefits. Specifically, it appeared these individuals
 were discharged from military service under conditions other than dishonorable and
 served at least 90 days of active military service with 1 day during a wartime period; or after September 7, 1980, generally served at least 24 months (or the full period for which called or ordered to active duty).
• From this population, we selected a random sample of 100 cases for detailed analysis. Our sample included 98 disabled SSI recipients and 2 aged SSI recipients. We analyzed each case to determine whether the SSI recipient appeared potentially eligible for VA benefits. Specifically, we:
 Reviewed available information on the following SSA systems: Supplemental Security Record, Modernized Claims System, Modernized SSI Claims System, Master Earnings File, and VA Benefits Query.
 Researched information related to the individuals’ military service available on the National Archives and Records Administration database.
 Calculated the amount of SSI received by recipients who appeared potentially eligible for VA benefits as of June 2009.
• Obtained information from SSA’s Office of Quality Performance on the Agency’s efforts to work with VA.

We performed our audit between June and October 2009 in Boston, Massachusetts. We tested the data obtained for our audit and determined them to be sufficiently reliable to meet our objective. The entities audited were SSA’s field offices under the Deputy Commissioner for Operations. We conducted this performance audit in accordance with generally accepted government auditing standards. Those standards require that we plan and perform the audit to obtain sufficient, appropriate evidence to provide a reasonable basis for our findings and conclusions based on our audit objectives. We believe the evidence obtained provides a reasonable basis for our findings and conclusions based on our audit objectives.

SAMPLE RESULTS

Table B-1: Population and Sample Size
Population (one segment) 2,390
Sample Size 100
Estimated Number of Recipients in the Universe (Population of audited segment multiplied by 20) 47,800

Table B-2: SSI Payments to Recipients Potentially Eligible for VA Benefits Number of Recipients Dollars
Sample Results 45 $2,683,550
Point Estimate 1,076 $64,136,848
Projection Lower Limit 877 $47,046,785
Projection Upper Limit 1,279 $81,226,911
Estimate in 20 Segments (Point estimate multiplied by 20) 21,520 $1,282,736,960
Note: All projections are at the 90-percent confidence level.

Table B-3: SSI Payments SSA Will Continue to Pay over the Next 12 Months to Recipients Potentially Eligible for VA Benefits Number of Recipients Dollars
Sample Results 45 $262,717
Point Estimate 1,076 $6,278,953
Projection Lower Limit 877 $4,816,134
Projection Upper Limit 1,279 $7,741,771
Estimate in 20 Segments (Point estimate multiplied by 20) 21,520 $125,579,060
Note: All projections are at the 90-percent confidence level.

Appendix C
Agency Comments

MEMORANDUM

Date: December 28, 2009 Refer
Refer To: S1J-3

To: Patrick P. O'Carroll, Jr.
Inspector General

From: Margaret J. Tittel /s/ Dean Landis for
Acting Chief of Staff

Subject: Office of the Inspector General (OIG) Draft Report, “Supplemental Security Income Recipients Eligible for Veterans Benefits” (A-01-09-19031)—INFORMATION

Thank you for the opportunity to review and comment on the draft report. We appreciate OIG’s efforts in conducting this review. Attached is our response to the report findings and recommendation.

Please let me know if we can be of further assistance. You may direct staff inquiries to
Candace Skurnik, Director, Audit Management and Liaison Staff, at (410) 965-4636.

Attachment

COMMENTS ON THE OFFICE OF THE INSPECTOR GENERAL (OIG) DRAFT REPORT, “SUPPLEMENTAL SECURITY INCOME RECIPIENTS ELIGIBLE FOR VETERANS BENEFITS” (A-01-09-19031)

Recommendation

Continue the efforts to work with the Department of Veterans Affairs (VA) to ensure individuals who should be receiving VA benefits instead of Supplement Security Income (SSI) payments are, in fact, receiving VA benefits.

Comment

We agree. We will continue to work with the VA to identify SSI recipients who may be eligible for VA benefits. In addition, we will ensure that those SSI recipients who are eligible for VA benefits take the necessary actions to apply and receive VA benefits.

Appendix D
OIG Contacts and Staff Acknowledgments
OIG Contacts

Judith Oliveira, Director, Boston Audit Division

Acknowledgments

In addition to those named above:

Kevin Joyce, IT Specialist

Melinda Padeiro, Senior Auditor

Katie Toli, Auditor

For additional copies of this report, please visit our web site at www.socialsecurity.gov/oig or contact the Office of the Inspector General’s Public Affairs Staff Assistant at (410) 965-4518. Refer to Common Identification Number A 01 09 19031.

DISTRIBUTION SCHEDULE

Commissioner of Social Security
Office of Management and Budget, Income Maintenance Branch
Chairman and Ranking Member, Committee on Ways and Means
Chief of Staff, Committee on Ways and Means
Chairman and Ranking Minority Member, Subcommittee on Social Security
Majority and Minority Staff Director, Subcommittee on Social Security
Chairman and Ranking Minority Member, Committee on the Budget, House of Representatives
Chairman and Ranking Minority Member, Committee on Oversight and Government Reform
Chairman and Ranking Minority Member, Committee on Appropriations, House of Representatives
Chairman and Ranking Minority, Subcommittee on Labor, Health and Human Services, Education and Related Agencies, Committee on Appropriations,
House of Representatives
Chairman and Ranking Minority Member, Committee on Appropriations, U.S. Senate
Chairman and Ranking Minority Member, Subcommittee on Labor, Health and Human Services, Education and Related Agencies, Committee on Appropriations, U.S. Senate
Chairman and Ranking Minority Member, Committee on Finance
Chairman and Ranking Minority Member, Subcommittee on Social Security Pensions and Family Policy
Chairman and Ranking Minority Member, Senate Special Committee on Aging
Social Security Advisory Board

Overview of the Office of the Inspector General
The Office of the Inspector General (OIG) is comprised of an Office of Audit (OA), Office of Investigations (OI), Office of the Counsel to the Inspector General (OCIG), Office of External Relations (OER), and Office of Technology and Resource Management (OTRM). To ensure compliance with policies and procedures, internal controls, and professional standards, the OIG also has a comprehensive Professional Responsibility and Quality Assurance program.
Office of Audit
OA conducts financial and performance audits of the Social Security Administration’s (SSA) programs and operations and makes recommendations to ensure program objectives are achieved effectively and efficiently. Financial audits assess whether SSA’s financial statements fairly present SSA’s financial position, results of operations, and cash flow. Performance audits review the economy, efficiency, and effectiveness of SSA’s programs and operations. OA also conducts short-term management reviews and program evaluations on issues of concern to SSA, Congress, and the general public.
Office of Investigations
OI conducts investigations related to fraud, waste, abuse, and mismanagement in SSA programs and operations. This includes wrongdoing by applicants, beneficiaries, contractors, third parties, or SSA employees performing their official duties. This office serves as liaison to the Department of Justice on all matters relating to the investigation of SSA programs and personnel. OI also conducts joint investigations with other Federal, State, and local law enforcement agencies.
Office of the Counsel to the Inspector General
OCIG provides independent legal advice and counsel to the IG on various matters, including statutes, regulations, legislation, and policy directives. OCIG also advises the IG on investigative procedures and techniques, as well as on legal implications and conclusions to be drawn from audit and investigative material. Also, OCIG administers the Civil Monetary Penalty program.
Office of External Relations
OER manages OIG’s external and public affairs programs, and serves as the principal advisor on news releases and in providing information to the various news reporting services. OER develops OIG’s media and public information policies, directs OIG’s external and public affairs programs, and serves as the primary contact for those seeking information about OIG. OER prepares OIG publications, speeches, and presentations to internal and external organizations, and responds to Congressional correspondence.
Office of Technology and Resource Management
OTRM supports OIG by providing information management and systems security. OTRM also coordinates OIG’s budget, procurement, telecommunications, facilities, and human resources. In addition, OTRM is the focal point for OIG’s strategic planning function, and the development and monitoring of performance measures. In addition, OTRM receives and assigns for action allegations of criminal and administrative violations of Social Security laws, identifies fugitives receiving benefit payments from SSA, and provides technological assistance to investigations.