OFFICE OF
THE INSPECTOR GENERAL

SOCIAL SECURITY ADMINISTRATION

MILITARY SERVICE
CASUALTY CASES

December 2009

A-01-09-29056

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: December 17, 2009 Refer To:

To: The Commissioner

From: Inspector General

Subject: Military Service Casualty Cases (A-01-09-29056)

OBJECTIVE

The objective of this review was to assess the Social Security Administration's (SSA) efforts to streamline the disability claims process for Military Service Casualty Cases (MSCC).

BACKGROUND

The Military Service Casualty initiative is a commitment by SSA to provide expedited disability claim services to wounded service members and their families. SSA established procedures to expedite disability claims for any military service personnel injured October 1, 2001 or later, provided that injury occurred while they were on active duty.

To receive disability benefits, an individual must first file an application with SSA. An SSA field office then determines whether the individual meets the non-disability criteria for benefits, and if so, generally forwards the claim to the disability determination services (DDS) in the State or other responsible jurisdiction in accordance with the Social Security Act and Federal regulations for a disability determination. Once the DDS makes a determination, it sends the claim back to the SSA field office for final processing or to the Disability Quality Branch (DQB) for review before final processing.
The Department of Defense (DoD) identifies military casualties and provides SSA with their Social Security numbers (SSN). SSA verifies and stores these SSNs until the individual contacts the Agency. As of March 2008, when one of these individuals contacts the Agency to file for disability benefits, SSA’s system will alert the field office and add an MSCC flag to the disability claim folder to alert the adjudicator to expedite the claim.

The Agency processes MSCCs under the terminal illness (TERI) procedures, which instruct SSA and DDS staffs to handle MSCCs expeditiously because of their sensitivity. Additionally, staff inputs coding in SSA’s systems to identify, track, and enable reporting of the case as an MSCC.

In June 2007, SSA’s Office of Process Policy formed the Military Casualty workgroup with representatives from several Agency components from its Headquarters and regions. The workgroup meets regularly to discuss policy and procedures, identify and develop training, and share lessons learned and best practices when processing claims for military service members.

To perform our review, we obtained a file of individuals who received a disability determination from a DDS in Calendar Year 2008. From this file, we identified 3,712 claims with an MSCC code in the “List” field and 3,415 claims with an MSCC code in the “Litigation” field but not the “List” field (7,127 claims in total). We randomly selected 100 cases from each of these populations for detailed analysis.

Additionally, we identified 19,050 individuals whose disability claims were not coded as MSCC but who had military wages between 2001 and 2007. We randomly selected 250 cases from this population for detailed analysis. (See Appendix B for additional information on our scope, methodology, and sample results. Also, see Appendices C and D for a breakout of all sample cases by region and State.)

RESULTS OF REVIEW

Generally, we found that SSA’s efforts to streamline the disability process for MSCCs were successful. Overall, SSA processed most cases identified as MSCC in fewer days than the national average. However, based on our sample results, the Agency may not have identified all cases that qualified as MSCCs and may not have coded all claims that received expedited processing as MSCCs. As a result, we estimate that SSA may have
 failed to expedite 5,182 cases that met the criteria for MSCC processing and
 underreported the number of claims processed as MSCC by 3,277 cases, so that the Agency processed about 10,404 claims expeditiously (rather than just the 7,127 claims coded as MSCC in SSA’s systems).

SAMPLE RESULTS FOR CASES CODED AS MSCC

In our sample of 200 cases coded as MSCCs, we found that SSA and the DDS appropriately identified and coded 195 cases. The Agency processed these 195 cases at the initial level in an average of 88 days, below SSA’s national average processing time. The following timeline shows the average processing time for initial disability claims by component.

SSA added the MSCC flag before sending the case to the DDS in 175 of the 195 cases. These 175 cases were assigned to a DDS examiner in an average of 3 days from the date the DDS received the claim, 5 days earlier than cases that did not contain an MSCC flag.

By properly identifying and coding claims as MSCC, SSA was able to expedite processing. For example, a man from Michigan filed for disability benefits on September 4, 2008. The Agency identified his claim as an MSCC because he alleged he was injured by a roadside bomb in Iraq. The DDS received the claim the next day and allowed it in 15 days. The claimant received his first disability benefit on September 25, 2008—3 weeks after filing for benefits.

Of the 200 sample cases coded as MSCC,
• 116 were allowed for disability benefits at the initial level,
• 79 were not allowed for disability benefits at the initial level, and
• 5 were miscoded and did not meet the criteria for an MSCC.

Of the 79 cases not allowed for disability benefits at the initial level, 49 claimants did not appeal. Of the 30 cases appealed, 7 were allowed at the reconsideration level, and 5 were allowed at the hearings level. As shown in Table 1, three individuals were still waiting for a decision on a hearing at the time of our review.

Table 1: Status of Pending Hearing Decisions for Sample Cases Coded as MSCC
Date Hearing was Filed Status as of December 2009 Was an MSCC Flag Present on the Hearing System?
October 2008 Hearing held – waiting for decision No
December 2008 Hearing held – waiting for decision Yes
January 2009 Hearing not yet scheduled No

SAMPLE RESULTS FOR CASES WITH MILITARY EARNINGS PRESENT BUT NOT CODED IN SSA’S SYSTEMS AS MSCC

We reviewed a sample of 250 cases with military earnings between 2001 and 2007 but not coded in SSA’s systems as MSCC. Of these 250 cases, we determined

• 68 appeared to meet MSCC criteria but were not expedited;
• 43 had an MSCC flag on the disability claim folder;
• 136 were appropriately not identified as MSCC; and
• 3 were for family members filing for benefits on military service members’ records.

Possible MSCC Cases

Of the 250 sample cases not coded as MSCC, 68 appeared to meet MSCC criteria. The Agency processed these 68 initial claims in an average of 103 days, ranging from 19 to 319 days. The following timeline shows the average processing time for these 68 initial disability claims by component.

By not identifying claims as MSCC, SSA may not have expedited claims that qualified under MSCC criteria. For example, a man from Texas applied for disability benefits in December 2007. He alleged his disability began in July 2006 when he was discharged from the military. He stated his disability was due to post-traumatic stress disorder; nerve damage in his arms, legs, and left foot; and scarring of the bone. His claim was not identified as an MSCC. SSA sent his claim to the DDS in February 2008 and it was allowed in June 2008, 172 days after he filed the claim. Had SSA flagged and coded the claim as an MSCC, the claimant might have received his benefits sooner.

Of the 68 cases that were not identified as MSCC but may have met the criteria,
• 14 were allowed for disability benefits at the initial level, and
• 54 were not allowed for disability benefits at the initial level.

Of the 54 cases not initially allowed, 36 were not appealed. Of the 18 cases that were appealed, 3 were allowed at the reconsideration level, and 5 were allowed at the hearings level. As of August 2009, seven claimants were waiting for decisions on their appeals.

Flagged as MSCC but Not Coded in SSA’s Systems

Of the 250 sample cases not coded as MSCCs in SSA’s systems, 43 had an MSCC flag on the disability folder. Although these claims received expedited processing, SSA was not able to track them for reporting purposes or for potential research on MSCC issues. The Agency processed these 43 cases at the initial level in an average of 86 days, ranging from 12 to 218 days. The following timeline shows the average processing time for these 43 initial disability claims by component.

Of the 43 sample cases that were flagged as MSCC but not coded in SSA’s systems,
• 22 were allowed for disability benefits at the initial level, and
• 21 were not allowed for disability benefits at the initial level.

Of the 21 claimants not initially allowed, 9 did not appeal. Of the 12 claimants who appealed, 3 were allowed at the reconsideration level, and 4 were allowed at the hearings level. As of August 2009, three claimants were waiting for decisions on their appeals.

SSA’s EFFORTS TO IMPROVE THE MSCC PROCESS

SSA has made efforts to improve the MSCC process. As of August 2009, SSA’s MSCC workgroup had met 19 times to discuss the initiative and address issues related to these claims. Additionally, on February 12, 2009, the Office of Disability Adjudication and Review updated its procedures regarding processing MSCCs at the hearing level. Furthermore, the Office of Disability Programs
• prepared resource kits with a wide-ranging collection of internal and external publications pertaining to Wounded Warriors, including contacts, articles, instructions, check sheets, and training materials;
• issued an administrative message on October 30, 2009 to provide consolidated information on the processing of claims for the MSCC workload; and
• conducted a Wounded Warrior Webinar on November 4, 2009 to reach out to service members, their family and friends, and military advocates and organizations.

CONCLUSION AND RECOMMENDATION

Generally, we found that SSA’s efforts to streamline the disability process for MSCC were successful. SSA processed cases identified as MSCC in an average of 88 days, 18 days faster than the national average. However, the Agency may not have identified all cases that qualified as MSCC and may not have coded all claims that received expedited processing as MSCCs.

To improve the effectiveness of MSCCs, we recommend that SSA ensure that all claimants who qualify for expedited processing under MSCC criteria are identified and coded properly.

AGENCY COMMENT

SSA agreed with the recommendation (see Appendix E).

/s/
Patrick P. O’Carroll, Jr.

Appendices
APPENDIX A – Acronyms

APPENDIX B – Scope, Methodology, and Sample Results

APPENDIX C – Cases Coded as Military Service Casualty Cases by Region and State

APPENDIX D – Cases with Military Earnings but Not Coded as Military Service Casualty Cases by Region and State

APPENDIX E – Agency Comments

APPENDIX F – OIG Contacts and Staff Acknowledgments

Appendix A
Acronyms

DDS Disability Determination Services
DoD Department of Defense
DQB Disability Quality Branch
MSCC Military Service Casualty Case
SSA Social Security Administration
SSN Social Security Number
TERI Terminal Illness

Appendix B
Scope, Methodology, and Sample Results

To accomplish our objective, we:

 Reviewed applicable sections of the Social Security Act and Social Security Administration (SSA) regulations, rules, policies, and procedures.

 Obtained a file of all disability claims with an initial or reconsideration level determination in Calendar Year 2008. From this file, we:

o Identified 3,712 disability applicants whose claims were processed as Military Service Casualty Cases (MSCC) in Calendar Year 2008. We identified these cases based on coding in the “List” field on SSA’s records.

o Identified 3,415 disability applicants whose claims were processed as MSCCs in Calendar Year 2008. We identified these cases based on coding in the “Litigation” field on SSA’s records and removed any cases already in the population based on the “List” field.

o Selected a sample of 100 cases from each population. For each claim, we:

(a) Reviewed SSA’s systems, including the Disability Determination Services Query, Master Beneficiary Record, Supplemental Security Record, Modernized Claims System, Modernized Supplemental Security Income Claims System, and electronic disability folder.

(b) Determined whether the case was properly coded.

(c) Calculated the number of days it took the Agency to complete the claim.

o Matched the file against SSA’s Master Earnings File to identify 19,050 individuals whose disability claims were not coded as MSCC but had military earnings between 2001 and 2007.

o Selected a sample of 250 cases from this population. For each case, we:

(a) Reviewed SSA’s systems, including the Disability Determination Services Query, Master Beneficiary Record, Supplemental Security Record, Modernized Claims System, Modernized Supplemental Security Income Claims System, and electronic disability folder.

(b) Determined whether the claim (1) may have met MSCC criteria, (2) was flagged as an MSCC, (3) was appropriately not identified as an MSCC, or (4) was the claim of a family member filing for benefits on the military service members record.

(c) Calculated the number of days it took the Agency to complete the claim if it appeared to have met the criteria of an MSCC or was flagged as an MSCC.

o Projected the results to the population for (1) cases that were not expedited but appeared to meet MSCC criteria and (2) cases that had an MSCC flag on the disability claim folder but were not coded in SSA’s systems.

o Compared the Social Security numbers for cases coded as MSCC to the list of Wounded Military Personnel provided to SSA by the Department of Defense to determine how many claims were identified as MSCC because of the automated match.

We conducted our audit between May and August 2009 in Boston, Massachusetts. The entities audited were the Offices of Disability Programs under the Deputy Commissioner for Retirement and Disability Policy and Disability Determinations 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 tested the data obtained for our audit and determined them to be sufficiently reliable to meet our objective. We believe the evidence obtained provides a reasonable basis for our findings and conclusions based on our audit objectives.

SAMPLE RESULTS

Table B-1: Cases with Military Earnings but Not Coded As MSCC
Population 19,050
Sample Size 250
Applicants Whose Claims Possibly
Met the MSCC Criteria
Sample Results 68
Point Estimate 5,182
Projection Lower Limit 4,310
Projection Upper Limit 6,131
Applicants Whose Claims Were Flagged
but Not Coded as MSCC
Sample Results 43
Point Estimate 3,277
Projection Lower Limit 2,554
Projection Upper Limit 4,111
Note: All Projections are at the 90-percent confidence level.

Appendix C
Cases Coded as Military Service Casualty Cases by Region and State

Tables C-1 through C-10 show our 200 sample cases coded in the Social Security Administration’s systems as Military Service Casualty Cases (MSCC) by Region and State.

Table C-1: Summary of Sample MSCCs
Region 1: Boston
State Number of Cases Proportion of 200 Sample Cases
Connecticut 0 0.0%
Maine 1 0.5%
Massachusetts 1 0.5%
New Hampshire 0 0.0%
Rhode Island 0 0.0%
Vermont 0 0.0%

Total 2 1.0%

Table C-2: Summary of Sample MSCCs
Region 2: New York
State Number of Cases Proportion of 200 Sample Cases
New Jersey 1 0.5%
New York 11 5.5%
Puerto Rico 5 2.5%

Total 17 8.5%

Table C-3: Summary of Sample MSCCs
Region 3: Philadelphia
State Number of Cases Proportion of 200 Sample Cases
Delaware 0 0.0%
District of Columbia 5 2.5%
Maryland 3 1.5%
Pennsylvania 1 0.5%
Virginia 2 1.0%
West Virginia 2 1.0%

Total 13 6.5%

Table C-4: Summary of Sample MSCCs
Region 4: Atlanta
State Number of Cases Proportion of 200 Sample Cases
Alabama 1 0.5%
Florida 2 1.0%
Georgia 5 2.5%
Kentucky 6 3.0%
Mississippi 2 1.0%
North Carolina 21 10.5%
South Carolina 1 0.5%
Tennessee 0 0.0%

Total 38 19.0%

Table C-5: Summary of Sample MSCCs
Region 5: Chicago
State Number of Cases Proportion of 200 Sample Cases
Ohio 4 2.0%
Illinois 6 3.0%
Indiana 5 2.5%
Michigan 4 2.0%
Minnesota 1 0.5%
Wisconsin 1 0.5%

Total 21 10.5%

Table C-6: Summary of Sample MSCCs
Region 6: Dallas
State Number of Cases Proportion of 200 Sample Cases
Arkansas 5 2.5%
Louisiana 3 1.5%
New Mexico 0 0.0%
Oklahoma 2 1.0%
Texas 45 22.5%

Total 55 27.5%

Table C-7: Summary of Sample MSCCs
Region 7: Kansas City
State Number of Cases Proportion of 200 Sample Cases
Iowa 0 0.0%
Kansas 4 2.0%
Missouri 5 2.5%
Nebraska 0 0.0%

Total 9 4.5%

Table C-8: Summary of Sample MSCCs
Region 8: Denver
State Number of Cases Proportion of 200 Sample Cases
Colorado 13 6.5%
Montana 0 0.0%
North Dakota 0 0.0%
South Dakota 0 0.0%
Utah 0 0.0%
Wyoming 0 0.0%

Total 13 6.5%

Table C-9: Summary of Sample MSCCs
Region 9: San Francisco
State Number of Cases Proportion of 200 Sample Cases
Arizona 2 1.0%
California 7 3.5%
Hawaii 4 2.0%
Nevada 0 0.0%

Total 13 6.5%

Table C-10: Summary of Sample MSCCs
Region 10: Seattle
State Number of Cases Proportion of 200 Sample Cases
Alaska 2 1.0%
Idaho 5 2.5%
Oregon 0 0.0%
Washington 12 6.0%

Total 19 9.5%

Appendix D
Cases with Military Earnings but Not Coded as Military Service Casualty Cases by Region and State

We reviewed a sample of 250 individuals whose disability claims were not coded as Military Service Casualty Cases (MSCC) in the Social Security Administration’s systems but who had military earnings between 2001 and 2007 (as shown in Appendix B). Of these 250 cases, we determined
• 68 may have met MSCC criteria but were not expedited;
• 43 had an MSCC flag on the disability claim folder;
• 136 were appropriately not identified as MSCC; and
• 3 were family members filing for benefits on military service members’ records.

Tables D-1 through D-10 show these 250 cases by region and State.

Table D-1: Summary of Sample MSCCs
Region 1: Boston
State Possibly met MSCC Criteria Flagged as MSCC Appropriately Not Identified as MSCC Total by State
Number Proportion of 68 Cases Number Proportion of 43 Cases Number Proportion of 136 Cases
Connecticut 0 0.0% 0 0.0% 0 0.0% 0
Maine 0 0.0% 0 0.0% 0 0.0% 0
Massachusetts 1 1.5% 0 0.0% 1 0.7% 2
New Hampshire 0 0.0% 1 2.3% 0 0.0% 1
Rhode Island 0 0.0% 0 0.0% 0 0.0% 0
Vermont 0 0.0% 1 2.3% 1 0.7% 2

TOTAL 1 1.5% 2 4.6% 2 1.4% 5

Table D-2: Summary of Sample MSCCs
Region 2: New York
State Possibly met MSCC Criteria Flagged as MSCC Appropriately Not Identified as MSCC Total by State
Number Proportion of 68 Cases Number Proportion of 43 Cases Number Proportion of 136 Cases
New Jersey 0 0.0% 0 0.0% 4 2.9% 4
New York 2 2.9% 2 4.7% 6 4.4% 10
Puerto Rico 0 0.0% 1 2.3% 2 1.5% 3

TOTAL 2 2.9% 3 7.0% 12 8.8% 17

Table D-3: Summary of Sample MSCCs
Region 3: Philadelphia
State Possibly met MSCC Criteria Flagged as MSCC Appropriately Not Identified as MSCC Total by State
Number Proportion of 68 Cases Number Proportion of 43 Cases Number Proportion of 136 Cases
Delaware 0 0.0% 0 0.0% 0 0.0% 0
District of Columbia 0 0.0% 1 2.3% 0 0.0% 1
Maryland 0 0.0% 0 0.0% 4 2.9% 4
Pennsylvania 5 7.4% 2 4.7% 4 2.9% 11
Virginia 1 1.5% 0 0.0% 6 4.4% 7
West Virginia 3 4.4% 0 0.0% 1 0.7% 4

TOTAL 9 13.3% 3 7.0% 15 10.9% 27

Table D-4: Summary of Sample MSCCs
Region 4: Atlanta
State Possibly met MSCC Criteria Flagged as MSCC Appropriately Not Identified as MSCC Total by State
Number Proportion of 68 Cases Number Proportion of 43 Cases Number Proportion of 136 Cases
Alabama 5 7.4% 0 0.0% 4 2.9% 9
Florida 7 10.3% 2 4.7% 7 5.1% 16
Georgia 3 4.4% 4 9.3% 6 4.4% 13
Kentucky 3 4.4% 1 2.3% 2 1.5% 6
Mississippi 1 1.5% 0 0.0% 4 2.9% 5
North Carolina 3 4.4% 0 0.0% 9 6.6% 12
South Carolina 1 1.5% 0 0.0% 4 2.9% 5
Tennessee 1 1.5% 2 4.7% 3 2.2% 6

TOTAL 24 35.4% 9 21.0% 39 28.5% 72

Table D-5: Summary of Sample MSCCs
Region 5: Chicago
State Possibly met MSCC Criteria Flagged as MSCC Appropriately Not Identified as MSCC Total by State
Number Proportion of 68 Cases Number Proportion of 43 Cases Number Proportion of 136 Cases
Illinois 0 0.0% 1 2.3% 3 2.2% 4
Indiana 1 1.5% 0 0.0% 1 0.7% 2
Michigan 0 0.0% 0 0.0% 1 0.7% 1
Minnesota 0 0.0% 1 2.3% 4 2.9% 5
Ohio 2 2.9% 1 2.3% 8 5.9% 11
Wisconsin 0 0.0% 0 0.0% 1 0.7% 1

TOTAL 3 4.4% 3 6.9% 18 13.1% 24

Table D-6: Summary of Sample MSCCs
Region 6: Dallas
State Possibly met MSCC Criteria Flagged as MSCC Appropriately Not Identified as MSCC Total by State
Number Proportion of 68 Cases Number Proportion of 43 Cases Number Proportion of 136 Cases
Arkansas 0 0.0% 0 0.0% 5 3.7% 5
Louisiana 1 1.5% 0 0.0% 3 2.2% 4
New Mexico 1 1.5% 1 2.3% 0 0.0% 2
Oklahoma 1 1.5% 2 4.7% 1 0.7% 4
Texas 12 17.6% 1 2.3% 14 10.3% 27

TOTAL 15 22.1% 4 9.3% 23 16.9% 42

Table D-7: Summary of Sample MSCCs
Region 7: Kansas City
State Possibly met MSCC Criteria Flagged as MSCC Appropriately Not Identified as MSCC Total by State
Number Proportion of 68 Cases Number Proportion of 43 Cases Number Proportion of 136 Cases
Iowa 0 0.0% 0 0.0% 0 0.0% 0
Kansas 0 0.0% 1 2.3% 3 2.2% 4
Missouri 4 5.9% 2 4.7% 4 2.9% 10
Nebraska 2 2.9% 1 2.3% 0 0.0% 3

TOTAL 6 8.8% 4 9.3% 7 5.1% 17

Table D-8: Summary of Sample MSCCs
Region 8: Denver
State Possibly met MSCC Criteria Flagged as MSCC Appropriately Not Identified as MSCC Total by State
Number Proportion of 68 Cases Number Proportion of 43 Cases Number Proportion of 136 Cases
Colorado 0 0.0% 2 4.7% 0 0.0% 2
Montana 0 0.0% 0 0.0% 1 0.7% 1
North Dakota 0 0.0% 0 0.0% 1 0.7% 1
South Dakota 0 0.0% 0 0.0% 0 0.0% 0
Utah 0 0.0% 1 2.3% 1 0.7% 2
Wyoming 0 0.0% 0 0.0% 0 0.0% 0

TOTAL 0 0.0% 3 7.0% 3 2.1% 6

Table D-9: Summary of Sample MSCCs
Region 9: San Francisco
State Possibly met MSCC Criteria Flagged as MSCC Appropriately Not Identified as MSCC Total by State
Number Proportion of 68 Cases Number Proportion of 43 Cases Number Proportion of 136 Cases
Arizona 1 1.5% 2 4.7% 0 0.0% 3
California 4 5.9% 8 18.6% 13 9.6% 25
Hawaii 1 1.5% 0 0.0% 0 0.0% 1
Nevada 0 0.0% 0 0.0% 1 0.7% 1

TOTAL 6 8.9% 10 23.3% 14 10.3% 30

Table D-10: Summary of Sample MSCCs
Region 10: Seattle
State Possibly met MSCC Criteria Flagged as MSCC Appropriately Not Identified as MSCC Total by State
Number Proportion of 68 Cases Number Proportion of 43 Cases Number Proportion of 136 Cases
Alaska 0 0.0% 1 2.3% 0 0.0% 1
Idaho 1 1.5% 0 0.0% 0 0.0% 1
Oregon 0 0.0% 1 2.3% 1 0.7% 2
Washington 1 1.5% 0 0.0% 2 1.5% 3

TOTAL 2 3.0% 2 4.6% 3 2.2% 7

Appendix E
Agency Comments

MEMORANDUM

Date: December 4, 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, “Military Service Casualty Cases”
(A-01-09-29056)—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 recommendation.

Please let me know if we can be of further assistance. Please 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 DRAFT REPORT, “MILITARY SERVICE CASUALTY CASES” (A-01-09-29056)

Your review revealed we succeeded in streamlining the disability process for Military Service Casualty Cases (MSCC). We processed cases identified as MSCC faster than the average processing time for initial disability claims. However, your review also revealed we do not always properly identify those cases qualified as MSCC. As a result, we failed to expedite all the MSCCs. As indicated in our comments below, we have taken steps to continue improving the processing of these cases.

Recommendation

In order to improve the effectiveness of MSCCs, the Social Security Administration (SSA) should ensure that all claimants who qualify for expedited processing under MSCC criteria are identified and coded properly.

Comment

We agree.

• We will continue to work on improving communications with our front line employees to ensure they understand and comply with the special handling requirements for these cases. We have reminded our direct public contact employees of the importance of identifying wounded warriors, not only during the initial claims application but also throughout the entire claims process. This will help to ensure the wounded warriors receive the special services to which they are entitled.

• For cases processed in our Office of Disability Adjudication and Review, we updated the governing Hearings, Appeals, and Litigation Law Manual (HALLEX) section (I 2 1 40 – Critical Cases). We issued the updated HALLEX transmittal on February 12, 2009.

• On October 31, 2009, we reissued an administrative message (AM-07056REV), providing consolidated information on the processing of claims for the military casualty workload.

• In 2009, we worked closely with various military centers to identify wounded warriors. In addition, we recently held a wounded warrior webinar, which 2000 wounded warriors and their families viewed. These outreach efforts inform individuals about the services we provide and help us to identify wounded warriors who applied for benefits.

[SSA also provided technical comments, which were incorporated into the report where appropriate.]

Appendix F
OIG Contacts and Staff Acknowledgments
OIG Contacts

Judith Oliveira, Director, Boston Audit Division

Phillip Hanvy, Acting Audit Manager

Acknowledgments

In addition to those named above:

Katie Greenwood, Auditor

Kevin Joyce, IT Specialist

Brennan Kraje, Statistician

David Mazzola, Audit Manager

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 29056.

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.