OFFICE OF
THE INSPECTOR GENERAL

SOCIAL SECURITY ADMINISTRATION

The Good Cause Provision Under the Fugitive Felon Program

March 2010

A-01-10-21052

CONGRESSIONAL RESPONSE
REPORT

March 2010

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.

Background
OBJECTIVE
Our objective was to evaluate the Social Security Administration’s (SSA) use of the good cause provision for fugitive felons and probation or parole violators.

BACKGROUND

On October 22, 2009, Sam Johnson, Ranking Member, Committee on Ways and Means, Social Security Subcommittee; John Linder, Ranking Member, Committee on Ways and Means, Income Security and Family Support Subcommittee; and Wally Herger, Member, Committee on Ways and Means, asked us to review SSA’s application of the good cause provision in the Agency’s fugitive felon program.

Specifically, the Members requested the following.

(1) The step-by-step procedures by which the Agency determines whether good cause exists.
(2) How often the Agency found good cause in the fugitive felon program.
(3) Fugitive cases where good cause was not found and whether it appeared the person met the good cause criteria (for example, the offense was non-violent and not drug-related).
(4) Based on this preliminary review, whether the Agency is effectively administering the good cause provisions in the fugitive felon program.
The Social Security Act prohibits the payment of Title II and XVI benefits to a beneficiary who is fleeing to avoid prosecution, custody, or confinement for a felony—and to a beneficiary who is violating a condition of probation or parole—unless the Agency determines that good cause exists for paying such benefits.

Before SSA takes action to suspend benefit payments, it sends the beneficiary a notice about the warrant information the Agency has received and the impact it may have on benefit payments. The notice also advises the beneficiary of his or her rights to file an appeal or request a waiver. Finally, the letter informs the beneficiary of the conditions that must be met for the Agency to find there is good cause to continue the benefit payments.

See Appendix B for additional background information on SSA’s fugitive felon program and Appendix C for our scope, methodology, and sample results.

Results of Review
Generally, SSA administered the good cause provision effectively when individuals requested exemption under the good cause provision. SSA informs beneficiaries of the good cause provision, but the Agency only reviews cases for possible good cause exemptions when requested by the beneficiary. Responses to the specific information Congress requested are below.

Step-by-Step Procedures by which the Agency Determines Whether Good Cause Exists

SSA obtains the names, dates of birth, and Social Security numbers of individuals with outstanding warrants from law enforcement agencies. SSA verifies the individuals’ identities through its Enumeration Verification System, and the Office of the Inspector General (OIG) confirms the warrants are still valid. The information is then recorded in the Agency’s Fugitive Felon SSA Control File (FFSCF).

Before SSA takes action to suspend benefit payments, it sends the beneficiary a letter about the warrant information it has received and the impact the unsatisfied warrant(s) may have on benefit payments. The notice explains how benefits could continue under the good cause provisions of the fugitive program. (If an individual is not receiving benefits, a notice of suspension is not sent. However, if benefits that should have been withheld because of fugitive status were paid before benefits were suspended or terminated, SSA sends an overpayment notice that tells the beneficiary he or she can appeal the overpayment.) The burden to establish good cause is on the beneficiary.

The Agency will determine that good cause exists and continue benefit payments if a court of competent jurisdiction found the person not guilty, dismissed the charges, vacated the warrant for arrest, or issued any similar exonerating order. SSA will also find good cause to continue or repay benefits if the beneficiary was erroneously implicated in the criminal offense because of identity fraud. Beneficiaries may request good cause for these reasons at any time.

Additionally, the Agency can determine that good cause exists and continue benefit payments if the criminal offense – or in the case of probation or parole violators, both the violation and the underlying offense – was non-violent and not drug related, and

certain mitigating factors exist. Beneficiaries may request good cause for these reasons up to 12 months from the date of SSA’s letter, and they have 90 days after requesting good cause to provide sufficient evidence.

The mitigating factors SSA considers are as follows.

 The beneficiary had not been convicted of any subsequent felony crimes since the warrant was issued, and the law enforcement agency that issued the warrant will not extradite the fugitive felon or is unwilling to act on the warrant.
 The beneficiary had not been convicted of any subsequent felony crimes since the warrant was issued; the warrant is/was the only existing warrant and was issued 10 or more years before the date SSA processed the current warrant information; and the beneficiary is incapable of managing payments, resides in a long-term care facility, is legally incompetent, or lacks the mental capacity to resolve a warrant.

If sufficient evidence is not provided to SSA, it will not find good cause.

How Often the Agency Found Good Cause in the Fugitive Felon Program

SSA made good cause determinations for 21,542 beneficiaries from a population of more than 400,000 individuals with warrants. As shown in Table 1, the Agency found good cause in 20,174 cases and did not find good cause in 1,368 cases.

Table 1: Good Cause Decisions Number of Beneficiaries Portion
SSA found good cause 20,174 93.6%
SSA did not find good cause 1,368 6.4%
TOTAL 21,542 100%

Fugitive Cases Where Good Cause Was Not Found and Whether the Person Appeared to Meet the Good Cause Criteria

Based on our sample, in most of the 1,368 cases where good cause was not found, the beneficiary did not meet the good cause criteria. We estimate the Agency properly did not find good cause for about 1,040 individuals. However, we could not determine whether the good cause denial decision was proper in about 301 cases.

Specifically, we analyzed a random sample of 50 of the 1,368 individuals to whom SSA did not find good cause. We determined in
• 38 cases (76 percent), the final determination made by SSA appeared to be proper;
• 11 cases (22 percent), we could not determine whether the denial was appropriate based on the documentation and information available in SSA’s systems; and
• 1 case (2 percent), the denial appeared to be improper. In this case, the individual’s offense was non-violent and not drug-related, the individual had not been convicted of any subsequent felonies, no other warrants existed, and the warrant was issued more than 10 years before it was matched to the beneficiary’s SSA record. Additionally, SSA’s records indicated the individual lacked the mental capacity to resolve the warrant—one of the mitigating good cause criteria. Therefore, it appeared good cause criteria had been met.

Whether the Agency Is Effectively Administering the Good Cause Provision in the Fugitive Felon Program

We found the Agency generally administered the good cause provision in the fugitive felon program effectively.

We analyzed a sample of 275 individuals from a population of 454,756 individuals with warrants as of October 2009. We reviewed records on SSA’s system and found in

• 154 cases (56 percent), no evidence that a good cause exemption was requested. In 20 of these cases, SSA’s records indicated the individual lacked the capacity to resolve a warrant, yet the individual did not have a representative payee. We sent cases needing action to SSA.
• 104 cases (38 percent), good cause did not apply; and
• 17 cases (6 percent), good cause was determined. SSA properly did not find good cause in 2 cases and the Agency found good cause in15 cases. Good cause appeared to be properly found in 13 of these cases and not properly found in 2 cases.

Conclusion
Generally, SSA administered the fugitive good cause provision effectively when individuals requested exemption under the good cause provision. SSA informs beneficiaries of the good cause provision, but the Agency only reviews cases for possible good cause exemptions when requested by the beneficiary.

The burden is on the beneficiary to request a good cause exemption and provide evidence to support the good cause determination.

Appendices
APPENDIX A – Acronyms
APPENDIX B – Additional Background
APPENDIX C – Scope, Methodology, and Sample Results

Appendix A
Acronyms

FFSCF Fugitive Felon SSA Control File
NICMS National Investigative Case Management System
OIG Office of the Inspector General
POMS Program Operations Manual System
Pub. L. No. Public Law Number
SSA Social Security Administration
U.S.C. United States Code

Appendix B
Additional Background

GOOD CAUSE PROVISION

The Social Security Act prohibits payment of benefits to individuals fleeing to avoid prosecution, custody, or confinement for felonies or violating a condition of probation or parole under Federal or State law. It also provides for the Social Security Administration (SSA) to continue payments to beneficiaries who have unsatisfied warrants if there is good cause to do so.

Before SSA takes action to suspend benefit payments, it sends the beneficiary a notice about the warrant information the Agency has received and the impact it may have on benefit payments. The notice also advises the beneficiary of his or her rights to file an appeal or request a waiver. Finally, the letter informs the beneficiary of the conditions that must be met for the Agency to find that there is good cause to continue the benefit payments. The burden for good cause is on the beneficiary.

THE GOOD CAUSE PROCESS

The Agency will determine that good cause exists and continue benefit payments if

 a court of competent jurisdiction found the person not guilty of the criminal offense or probation or parole violation, dismissed the charges relating to the criminal offense or probation or parole violation on the unsatisfied warrant, vacated the warrant for arrest for the criminal offense or probation or parole violation, or issued any similar exonerating order or has taken similar exonerating action or
 the individual was erroneously implicated in the criminal offense or a probation or parole violation based on identity fraud.

If neither of these conditions apply, Agency policy indicates it will give the beneficiary the opportunity to establish good cause based on mitigating circumstances if (1) the criminal offense or probation/parole violation on which the beneficiary was charged or convicted was non-violent and not drug-related, and, in the case of probation or parole violators, the original offense was also non-violent and not drug related; (2) the beneficiary was not convicted of any subsequent felony crimes since the warrant was

issued; and (3) other mitigating factors exist, as set forth below under Option A or Option B. For a finding of good cause in these circumstances, all the factors in either Option A or Option B must be met.

Additionally to Meet Option A

 The law enforcement agency that issued the warrant reports it will not extradite the fugitive felon or is unwilling to act on the warrant.

Additionally to Meet Option B

 The warrant is/was the only existing warrant and was issued 10 or more years before the date the Fugitive Felon Match processed the current warrant information and
 The beneficiary
 lacks the mental capacity to resolve a warrant as evidenced by one of the diagnosis codes listed in a specific Agency policy,
 is incapable of managing payments,
 is legally incompetent,
 has a representative payee appointed by SSA to handle payments, or
 is residing in a long-term care facility, such as a nursing home or mental treatment/care facility.

Figure 1 illustrates the fugitive good cause process.

Appendix C
Scope, Methodology, and Sample Results

To accomplish our objective, we:

 Researched the Social Security Act, the Social Security Protection Act of 2004, and the Social Security Administration’s (SSA) regulations, policies, and procedures related to good cause in the fugitive felon program.

 Reviewed Office of the Inspector General reports related to fugitive felons and probation or parole violators. Specifically, we reviewed the following reports.
 Title II Benefits to Fugitive Felons and Probation or Parole Violators (A 01 07 17039), July 2008.
 The Social Security Administration’s Fugitive Felon Program and the Martinez Settlement Agreement (A-01-09-29177), October 2009
 Semiannual Report to Congress, October 1, 2008 – March 31, 2009.

 Obtained a data file of 454,756 fugitives and probation or parole violators in the Office of the Inspector General’s National Investigative Case Management System (NICMS) as of October 2009. We analyzed a random sample of 275 cases from this file to determine whether good cause had been requested and assess SSA’s good cause determinations.

 Obtained a data file of 483,966 individuals with warrants in the Fugitive Felon SSA Control File (FFSCF) as of December 2009. We analyzed these data and identified 21,542 individuals whose records indicated SSA found or did not find good cause. The Agency found good cause in 20,174 cases and did not find good cause in 1,368 cases. We analyzed a random sample of 50 of 1,368 cases in which SSA did not find good cause to determine whether this was proper.

We performed our review October 2009 through January 2010 in Boston, Massachusetts. We tested the data used and determined them to be sufficiently reliable to meet our objective. The entities reviewed were the Deputy Commissioner for Systems and SSA field offices and program service centers under the Deputy Commissioner for Operations. We conducted our review in accordance with the President’s Council on Integrity and Efficiency’s Quality Standards for Inspections.

SAMPLE RESULTS FOR INDIVIDUALS IN THE FFSCF FOR WHOM SSA DID NOT FIND GOOD CAUSE

Table C-1: Population and Sample Size
Population size 1,368
Sample size 50
Note: All Projections are at the 90-percent confidence level.

Table C-2: Good Cause Properly Not Found Number of Beneficiaries
Sample Results 38
Point Estimate 1,040
Projection Lower Limit 879
Projection Upper Limit 1,168

Table C-3: Unable to Determine Whether Good Cause Was Properly Not Found Number of Beneficiaries
Sample Results 11
Point Estimate 301
Projection Lower Limit 178
Projection Upper Limit 459

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.