SOCIAL SECURITY ADMINISTRATION

SPOUSES’ TO WIDOW(ER)S’ BENEFITS
WHEN GOVERNMENT PENSIONS
ARE INVOLVED

September 2009

A-13-08-28103

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: September 30, 2009 Refer To:

To: The Commissioner

From: Inspector General

Subject: Spouses’ to Widow(er)s’ Benefits When Government Pensions are Involved
(A-13-08-28103)

OBJECTIVE

Our objective was to determine whether government pension verifications and payment recalculations were completed when auxiliary beneficiaries receiving payments as spouses had their benefit status changed to widow(er)s.

BACKGROUND

The Social Security Administration (SSA) administers the Old-Age, Survivors, and Disability Insurance (OASDI) program under Title II of the Social Security Act. The program provides monthly benefits to retired or disabled workers and their families and to survivors of deceased workers. An individual may be eligible for OASDI benefits under his/her own work history as well as under a spouse’s work history. The amount of benefits is based on the work history used in the calculation and the relationship of the individuals involved. A beneficiary may be eligible for higher benefits under a spouse’s work history at the time of application. However, events, such as the death of a spouse, may cause the type and/or amount of benefits to change.

Spouses of individuals insured under the OASDI program can be eligible for OASDI auxiliary benefits, which are based on a percentage of the insured individual’s primary insurance amount (PIA). In most cases, the maximum OASDI benefit an individual can receive as a spouse is 50 percent of the PIA. However, the maximum OASDI benefit amount an individual can receive as a widow(er) is 100 percent of the decedent’s PIA.

OASDI auxiliary benefits can be subject to the Government Pension Offset (GPO). GPO reduces monthly Social Security benefits for spouses, divorced spouses, and surviving spouses who receive a pension payment based on their own work for a Federal, State, or local government that was not covered employment, and not subject to Social Security taxes, under the Federal Insurance Contributions Act (FICA). The GPO amount is two-thirds the amount of the pension. If two-thirds of the government pension is equal to or more than the OASDI benefit, spouse or widow(er) OASDI payments can be reduced to zero.

Under certain conditions, beneficiaries may be granted an exemption from GPO. SSA policy identifies various situations for granting these exemptions. SSA policy further instructs that if an exemption applies, staff should verify the exemption in accordance with policy and record, if applicable, the exemption on GPO data input screens.

SSA staff is required to initiate an action to determine whether the change from spouse to widow(er) status would increase the benefit payment amount. If staff does not make this assessment, improper payments may occur. To identify individuals who may be subject to GPO, SSA primarily relies on applicants to report whether they are receiving, or will receive in the future, a pension based on non-covered earnings (earnings not subject to FICA taxes). However, for retired Federal employees, SSA receives monthly pension data from the Office of Personnel Management.

We examined information from an electronic data extract of the Agency’s Master Beneficiary Record (MBR). The data extracted from 1 segment of the MBR identified 2,769 widow(er)s (1) who had been eligible for OASDI spousal benefits; (2) for whom SSA concluded GPO was applicable to those spousal benefits; and (3) whose OASDI benefit status changed from spouse to widow(er) between January 1, 1985 and August 18, 2008. We selected for review a random sample of 100 widow(er)s. See Appendix B for our Scope and Methodology, and Appendix C for our Sampling Methodology and Results.

RESULTS OF REVIEW

SSA did not always verify government pension information as required by the Agency’s policies and procedures. SSA determined GPO was applicable to the OASDI spousal benefits for all 100 widow(er)s selected for review. When these 100 beneficiaries’ status changed from spouse to widow(er)s, we found SSA staff did not verify 15 widow(er)s’ government pension information as required. Because the government pension information was not verified, improper payments of about $57,000 were made from January 1985 through August 2008 to six widows in our sample. Five widows were overpaid, and one was underpaid.

We also tested the sample records to determine whether the new benefit payment was accurately calculated when the spousal benefits were converted. Generally, we found payment recalculations were completed accurately when spouses’ status changed to widow(er)s. Of the 85 widow(er)s who had their government pension information verified, we identified 3 whose payments were not converted accurately. From January 1985 through August 2008, improper payments totaling about $25,000 were made to these three individuals. One widow was overpaid, and two were underpaid.

In total, we identified 9 individuals with improper payments from the 100 sampled. These nine payment errors totaled about $82,000. Estimating our sample results to the population, SSA staff made errors converting about 4,980 spousal benefits to widows resulting in about $45.5 million in improper payments between January 1985 and August 2008. If these errors are not corrected, about 4,400 individuals will have payment errors totaling about $147.8 million over their remaining expected lifetimes.
SSA Did Not Always Verify Government Pension Information, As Required

When a spouse receives a government pension and applies for OASDI widow(er) benefits, SSA takes action to verify the government pension information. SSA policy directs staff to either (a) request a spouse to answer questions about a government pension based on his/her own government employment, not covered under Social Security, that is or may be received; or (b) complete Form SSA-3885, Government Pension Offset questionnaire. SSA had determined GPO was applicable to the spousal benefits for all 100 widow(er)s we reviewed. During our review, we did not determine the accuracy of government pension information used for, or SSA’s decisions concerning, OASDI widow(er)s benefits.

For those beneficiaries eligible for OASDI spousal benefits whose benefit status changed to widow(er)s, SSA policy indicates verification of Government pension information is not required in total offset cases. In total offset cases, OASDI auxiliary benefits are reduced to zero. However, Agency policy requires that corroborating evidence be obtained if

• the report is from a source other than the employer or pension-paying agency; and
• a change in the pension or spouse's monthly benefit will result in an increase in the benefit amount payable, for example, total to partial GPO will occur; and
• the pension information of record was not previously corroborated; or
• the pension information of record is more than 2 years old.

We examined information recorded in SSA’s information systems for 100 beneficiaries who were eligible for OASDI spousal benefits and whose benefit status changed to widow(er)s. Of the 100 widow(er)s selected for review, we found actions taken by the Agency for 85 complied with SSA’s policies regarding government pension information. Of the 85, we found the government pension information of record continued to result in GPO that reduced OASDI benefits to zero for 43 widow(er)s. In compliance with policy, Agency staff did not verify the pension information for these widow(er)s. The Agency verified government pension information for 41 widow(er)s. Finally, for one widow, the application for OASDI benefits was withdrawn.

SSA did not always verify government pension information, as required by its policies and procedures. For 15 of the 100 widow(er)s we reviewed, corroborating evidence was not obtained for government pension information, as required. Since corroborating evidence was not obtained, the GPO amount used to calculate OASDI spousal benefits was also used to recalculate widow(er)s’ benefits.

Of the 15 widow(er)s for whom corroborating evidence was not obtained for their government pension information, we found 4 were granted exemption from GPO. In each instance, the applicable MBR was annotated to indicate the exemption was “previously established.” However, the MBRs did not contain information indicating the basis for the exemptions, as required.

We also learned the Agency implemented an automated alert process in July 2004. This automated alert notifies staff when a spouse becomes a widow(er) and the verification of government pension information is over 2 years old. Three of the 15 widow(er)s we identified were converted from spouses to widow(er)s after SSA implemented this alert process. The remaining 12 widow(er)s’ conversions occurred before implementation of the alert process.

In March 2009, we met with staff from SSA’s Office of Operations, Office of Public Service and Operations Support, to determine why the required government pension verifications were not completed for 15 widow(er)s. Staff agreed corroborating evidence should have been, but was not, obtained for these widow(er)s. Staff stated a “systems alert” should be automatically sent to the applicable program service center when corroborating evidence must be obtained. Further, staff was unable to explain why the 15 widow(er)s’ government pension information was not verified. Regarding the four instances where the Agency granted exemption from GPO, we were advised “it appeared” the MBRs were coded erroneously. We requested that SSA verify the 15 widow(er)s’ pension information.

From July to September 2009, SSA provided additional information about the widows we referred for further review. SSA’s verification of pension information determined that nine widow(er)s did not have payment errors, and improper payments were made to
six widows. One widow was underpaid about $2,000, and five widows were overpaid about $55,000. Because government pension information was not verified timely, improper payments of about $57,000 were made from January 1, 1985 through August 2008 to six widows in our sample.

OASDI Widow(er)s’ Benefit Recalculations Were Not Always Completed Accurately

Generally, we found payment recalculations were completed when auxiliary beneficiaries receiving payments as spouses had their benefit status changed to widow(er)s. We determined whether benefit payment recalculations were completed for the 85 widow(er)s according to SSA’s government pension verification policies. Of the 85 widow(er)s, we found benefit payments for 84 were recalculated when their benefit status changed. For the remaining widow, benefit payment recalculation was not completed. Using the government pension information recorded in SSA’s information systems at the time of our review, we recalculated this widow’s benefit payment. Our computations indicated this widow was improperly paid. We requested SSA review the widow’s information, and the Agency subsequently acknowledged the widow was underpaid about $370 in July and August 2008.

We examined the recalculated OASDI benefits of the remaining 84 widow(er)s and identified 2 instances where benefit payments were recalculated incorrectly. Our computations indicated these widows were improperly paid. We requested that SSA review the widows’ information. The Agency subsequently acknowledged one widow was underpaid and the other was overpaid. For the period January 1985 through August 2008, two widows were underpaid a total of $830, and one widow was overpaid about $24,150.

For the period January 1985 through August 2008, we identified a total of about $25,000 in payment errors on three widows’ payment records because SSA staff did not recalculate the benefit amounts accurately.

CONCLUSION AND RECOMMENDATIONS

For the widow(er)s reviewed, we found in most instances, SSA complied with its policies for verifying government pension information. Generally, we also found payment recalculations were completed when auxiliary beneficiaries receiving payments as spouses had their benefit status changed to widow(er)s. However, we believe SSA could improve its management controls over these matters.

From January 1985 through August 2008, we estimate about 8,300 widow(er)s’ government pension information was not verified as required. Further, approximately 4,980 widow(er)s received improper payments because recalculations were not completed or OASDI benefits were inaccurately recalculated. As a result of these conditions, we estimate improper payments totaling approximately $45.5 million occurred during this period.

Furthermore, we estimate about 4,400 widow(er)s will have payment errors of approximately $147.8 million over their lifetimes if SSA does not take action to verify pension information, recalculate benefits payments when auxiliary beneficiaries receiving payments as spouses have their benefit status changed to widow(er)s, and correct benefit recalculation errors. Since the total value of improper payments could be significant, we believe SSA should take action to prevent these conditions from occurring.

We recommend SSA:

1. Correct the payment errors we identified where corroborating evidence of government pension information was not obtained as required.

2. Determine whether it would be cost effective to conduct a clean-up project to identify current widow(er)s whose government pension information was not verified as required by policy, take appropriate action to verify the information, and adjust the OASDI payment amounts as needed.

3. Remind employees to follow policies and procedures to verify government pension information when required to do so.

AGENCY COMMENTS

SSA agreed with our recommendations (see Appendix D).

/s/
Patrick P. O’Carroll, Jr.

Appendices
APPENDIX A – Acronyms
APPENDIX B – Scope and Methodology
APPENDIX C – Sampling Methodology and Results
APPENDIX D – Agency Comments
APPENDIX E – OIG Contacts and Staff Acknowledgments

Appendix A
Acronyms

C.F.R. Code of Federal Regulations
FICA Federal Insurance Contributions Act
GPO Government Pension Offset
MBR Master Beneficiary Record
OASDI Old-Age, Survivors, and Disability Insurance
OIG Office of the Inspector General
PIA Primary Insurance Amount
POMS Program Operations Manual System
SSA Social Security Administration
U.S.C. United States Code

Appendix B
Scope and Methodology

To accomplish our objective, we:

• Reviewed applicable Federal laws and regulations, pertinent parts of the Social Security Administration’s (SSA) Program Operations Manual System and other criteria relevant to the Old-Age, Survivors, and Disability Insurance (OASDI) programs and Government Pension Offset (GPO).

• Identified and reviewed prior relevant audits.

• Examined information from an electronic data extract of the Agency’s Master Beneficiary Record (MBR). The data extracted from 1 segment of the MBR identified 2,769 widow(er)s (1) who had been eligible for OASDI spousal benefits; (2) for whom SSA concluded GPO was applicable to those spousal benefits; and (3) whose OASDI benefit status changed from spouse to widow(er) between January 1, 1985 through August 18, 2008.

• Selected a random sample of 100 widow(er)s from the 2,769 identified. For the widow(er)s selected, we determined whether (1) corroborating evidence was obtained when the benefit payment status changed from spouse to widow(er); (2) OASDI benefit recalculations were completed when auxiliary beneficiaries receiving payments as spouses had their benefit status changed to widow(er)s; and (3) calculation errors occurred when auxiliary beneficiaries receiving OASDI payments as spouses had their benefit status changed to widow(er)s. See Appendix C for further information on our sampling methodology and results.

• Used government pension information and the primary insurance amount recorded in SSA’s information systems at the time of our review to recalculate OASDI benefits for the 100 widow(er)s in our sample.

• Examined information recorded in the MBR and Modernized Claims System for selected widow(er)s.

We determined the computer-processed data used for this audit were sufficiently reliable for their intended use. Further, any data limitations were minor in the context of this assignment, and the use of the data should not lead to an incorrect or unintentional conclusion. The electronic data used in our audit were primarily extracted from the MBR.

The entity audited was the Office of Public Service and Operations Support under the Deputy Commissioner for Operations. We performed our review in Baltimore, Maryland, from October 2008 to July 2009. 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.

Appendix C
Sampling Methodology and Results

We examined information from an electronic data extract of the Social Security Administration’s (SSA) Master Beneficiary Record (MBR). The data extracted from 1 segment of the MBR identified 2,769 widow(er)s (1) who had been eligible for Old Age, Survivors, and Disability Insurance (OASDI) spousal benefits; (2) for whom SSA concluded Government Pension Offset was applicable to those spousal benefits; and (3) whose OASDI benefit status changed from spouse to widow(er) between January 1, 1985 and August 18, 2008.

Of the 2,769, we selected and reviewed a random sample of 100 widow(er)s.

Table 1: Sample Population from MBR
January 1, 1985 Through August 18, 2008
Population Size (1 Segment of MBR) 2,769
Sample Size 100

For the 100 widow(er)s selected, we determined whether (1) corroborating evidence was obtained when the benefit status changed from spouse to widow(er); (2) OASDI benefit recalculations were completed when auxiliary beneficiaries receiving payments as spouses had their benefit status changed to widow(er)s; and (3) calculation errors occurred when auxiliary beneficiaries receiving OASDI payments as spouses had their benefit status changed to widow(er)s.

Table 2: Number of Beneficiaries Where Government Pension Information Was Not Verified or Corroborating Evidence Was Not Obtained
January 1, 1985 Through August 18, 2008
Sample Size 100
Number of Widow(er)s Whose Government Pension Information Was Not Verified/Corroborating Evidence Not Obtained
15
Projection of Widow(er)s Whose Government Pension Information Was Not Verified or Corroborating Evidence Not Obtained
Point Estimate (1 Segment of MBR) 415
Lower Limit 265
Upper Limit 609
Total Estimate (20 Segments of MBR) 8,300
Note: All projections are at the 90-percent confidence level.

Of the 100 widow(er)s in our sample, we found recalculations of OASDI benefits for 9 widows were not accurate. Improper payments of $82,199 were made to the 9 widows. Projecting these results to all 20 segments of the MBR, we estimate improper payments of approximately $45.5 million were made to about 4,980 widow(er)s. The following tables provide the details of our sample results, statistical projections, and estimates.

Table 3: Number of OASDI Widow(er)s’ Benefits That Were Not Accurate
January 1, 1985 Through August 18, 2008
Sample Size 100
Number of Widow(er)s’ OASDI Benefits That Were Not Accurate 9
Projection of Widow(er)s’ OASDI Benefits That Were Not Accurate
Point Estimate (1 Segment of MBR) 249
Lower Limit 134
Upper Limit 417
Total Estimate (20 Segments of MBR) 4,980
Note: All projections are at the 90-percent confidence level.

Table 4: Amount of OASDI Widow(er)s’ Benefits That Were Not Accurate
January 1, 1985 Through August 18, 2008
Sample Size 100
Amount of Widow(er)s’ OASDI Benefits That Were Not Accurate $82,199
Projection of Widow(er)s’ OASDI Benefits That Were Not Accurate
Point Estimate (1 Segment of MBR) $2,276,108
Lower Limit $251,337
Upper Limit $4,300,880
Total Estimate (20 Segments of MBR) $45,522,160
Note: All projections are at the 90-percent confidence level.

We also estimated the improper payments that can occur if SSA does not take corrective action to identify and correct the amount of OASDI benefits for widow(er)s. Our estimate is based on eight widows we identified as having inaccurate OASDI benefits as of the date we completed our review. For the eight widows, we used the over or underpayment amounts as of August 2008 to calculate their future estimated improper payments.

Table 5: Future OASDI Widow(er)s’ With Payment Errors if Corrective
Actions are Not Taken
Sample Size 100
Number of Widow(er)s’ OASDI Benefits That Were Not Accurate 8
Projection of Widow(er)s’ OASDI Benefits That Were Not Accurate
Point Estimate (1 Segment of MBR) 222
Lower Limit 114
Upper Limit 383
Total Estimate (20 Segments of MBR) 4,440
Note: All projections are at the 90-percent confidence level.

Table 6: Future OASDI Widow(er)s’ Benefit Payment Errors if Corrective
Actions are Not Taken
Sample Size 100
Amount of Widow(er)s’ Monthly OASDI Benefits That Were Not Accurate
$266,855
Projection of Widow(er)s’ Monthly OASDI Benefit Errors That Will Occur if Not Corrected
Point Estimate (1 Segment of MBR) $7,389,219
Lower Limit $849,241
Upper Limit $13,929,198
Total Estimate (20 Segments of MBR) $147,784,380
Note: All projections are at the 90-percent confidence level.

Appendix D
Agency Comments

MEMORANDUM

Date: September 24, 2009 Refer Refer To: S1J-3

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

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

Subject: Office of the Inspector General (OIG) Draft Report, “Spouses’ to Widow(er)s’ Benefits When Government Pensions are Involved” (A-13-08-28103)--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 recommendations.

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 extension 54636.

Attachment

COMMENTS ON THE OFFICE OF THE INSPECTOR GENERAL (OIG) DRAFT REPORT, "SPOUSES' TO WIDOW(ER)S’ BENEFITS WHEN GOVERNMENT PENSIONS ARE INVOLVED" A-13-08-28103

Recommendation 1

Correct the payment errors identified where corroborating evidence of government pension information was not obtained as required.

Response

We agree. We have corrected the payment errors for all of the cases identified, except for one. We are currently taking action to correct this last case.

Recommendation 2

Determine whether it would be cost effective to conduct a clean-up project to identify current widow(er)s whose government pension information was not verified as required by policy, take appropriate action to verify the information, and adjust the Old-Age, Survivors, and Disability Insurance (OASDI) payment amounts as needed.

Response

We agree. We will evaluate the cost effectiveness of conducting a clean-up project.

Recommendation 3

Remind employees to follow policies and procedures to verify government pension information when required to do so.

Response

We agree. In the first quarter of fiscal year 2010, we will issue a reminder to staff to follow agency policies and procedures when verifying government pension information.

[In addition to the information listed above, SSA provided technical comments which have been addressed, where appropriate, in this report.]
Appendix E
OIG Contacts and Staff Acknowledgments
OIG Contacts

Shirley E. Todd, Director, Evaluation Division
Randy Townsley, Audit Manager

Acknowledgments

In addition to those named above:

Janet Stein-Pezza, Auditor-in-Charge
Tracey Edwards, Auditor
Nicole Gordon, Auditor
Brennan Kraje, Statistician
Charles Zaepfel, IT Specialist

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-13-08-28103.

DISTRIBUTION SCHEDULE

Commissioner of Social Security
Office of Management and Budget, Income Maintenance Branch
Chairman and Ranking Member, Committee on Ways and Means
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Majority and Minority Staff Director, Subcommittee on Social Security
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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.