OFFICE OF
THE INSPECTOR GENERAL
SOCIAL SECURITY ADMINISTRATION
FEDERAL EMPLOYEES RECEIVING BOTH
FEDERAL EMPLOYEES' COMPENSATION ACT
AND DISABILITY INSURANCE PAYMENTS
October 2010
A-15-09-19008
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.
SOCIAL SECURITY
MEMORANDUM
Date: October 14, 2010
To: The Commissioner
From: Inspector General
Subject: Federal Employees Receiving Both Federal Employees' Compensation Act
and Disability Insurance Payments (A-15-09-19008)
OBJECTIVE
Our objective was to determine the extent to which improper payments resulted
when Federal employees received both Social Security disability payments and Federal
Employees' Compensation Act (FECA) payments.
We conducted our review for research and statistical purposes only. Our office
will not be taking any action that might affect the rights, benefits, or privileges
of specific
individuals identified during this review.
BACKGROUND
FECA provides Federal employees injured while performing their duties with workers'
compensation (WC) benefits, which include wage-loss benefits for total or partial
disability, monetary benefits for permanent loss of use of a schedule member,2
medical benefits, and vocational rehabilitation. FECA also provides survivor benefits
to eligible
dependents if the injury causes the employee's death. The Department of Labor
(DoL) Office of Workers' Compensation Programs (OWCP) administers FECA.
The Social Security Administration's (SSA) Disability Insurance (DI) program,
established under Title II of the Social Security Act (Act),3 provides benefits
to
individuals who become disabled.
The Act states, when a DI beneficiary under age 65 also receives public disability
benefits, which includes WC,4 a reduction of the DI benefit may occur.5 The Act
requires that disability benefits be reduced when the worker is also eligible
for periodic or lump sum WC payments, so the combined amount of WC and Social
Security disability benefits does not exceed 80 percent of the workers' average
current earnings.6 The combined payments after the reduction, however, will never
be less than the amount of Social Security disability benefits before the
reduction.
The Supplemental Security Income (SSI) program, established under Title XVI of
the Act,8 provides payments to financially needy individuals who are aged, blind,
and/or
disabled. Generally, for SSI payments, the more income an individual has, the
lower his or her payment will be. An individual whose income exceeds a certain
amount in a
particular month is not eligible for SSI in that month. Overpayments result when
the recipient¡¦s total amount of compensation received for any period
exceeds the total
amount the individual should have received in SSI for that period.
In September 2000, DoL provided SSA with a file of FECA recipients for a one-time
match against SSA¡¦s Master Beneficiary (MBR) and Supplemental Security
Record
(SSR) to identify possible DI and SSI recipients who did not report, or incorrectly
reported, their FECA benefit payments to SSA. SSA initiated a match in July 2001
that
concluded in September 2001. The MBR match resulted in 2,732 DI output alerts
where the FECA benefit amount and/or the effective date of that benefit amount
did not
match the WC offset information on the MBR. The SSR match resulted in 483 alerted
cases.
RESULTS OF REVIEW
We confirmed with SSA that improper payments resulted when recipients' FECA compensation
was not recorded or accounted for in the calculation of their DI benefits.
In addition, we estimated improper payments that resulted when SSA did not take
into account recipients¡¦ FECA compensation in calculating their
SSI payments.
We randomly selected and examined 100 FECA recipients: 50 DI beneficiaries and
50 SSI recipients. We re-calculated the recipients¡¦ Social Security
disability benefits,
4 WC is a temporary or permanent payment made under a Federal or State law to
a worker because of a work related injury, illness, or disease. Sources of WC
payments include Insurance Carrier, State WC Board, Self-insured employer, and
DoL and other Federal WC programs.
Taking into account their FECA compensation received in any years from June 2002
to April 2010.10 It was our goal to determine whether SSA considered FECA in calculating
Social Security benefits or whether overpayments occurred. See Appendix B for
our scope and methodology and Appendix C for our sampling methodology.
DI Beneficiaries
Of the 50 FECA recipients in our review, 32 had estimated overpayments of DI benefits
because their FECA compensation was not considered in the calculation of their
DI
benefits. Five recipients did not have their FECA compensation recorded and accounted
for on their MBR; however, no estimated overpayment resulted. Seven
recipients received FECA compensation before becoming entitled to DI benefits;
therefore, they did not have to report their FECA compensation since they did
not
receive FECA compensation while receiving DI benefits. The MBRs of the remaining
six recipients indicated the calculation of their DI benefits included the FECA
compensation they received. See Table 1.
Table 1: DI Beneficiaries
Result
Number of DI
Recipients
Recipients Without FECA Compensation Reported
on Their MBR, Resulting in an Estimated Overpayment 32
Recipients Without FECA Compensation Reported on Their MBR with No Resulting Overpayment
5
Recipients Who Received FECA Compensation But Not While Receiving DI Benefits;
Therefore, They
Did Not Have to Report Their FECA Compensation 7
Recipients Whose FECA Compensation Was Reported 6
Total Sample Size 50
As shown above, 44 of the 50 recipients did not have FECA compensation reported
on their MBR. However, 37 of the 50 recipients should have had their FECA compensation
reported on their MBR. Projecting to our population of 1,502 recipients, we estimate
there were approximately 1,111 recipients who received FECA compensation and DI
benefits with no indicator on their MBR of recording, accounting for, and/or possibly
offsetting DI benefits because of their FECA compensation. Based on our re-calculation
of DI benefits, we determined there were overpayments for 32 of these 37 recipients.
Based on these findings, we project approximately $43 million in estimated overpayments
were paid to about 961 beneficiaries for whom SSA did not consider
FECA compensation in the initial calculation of their DI benefits. As of the date
of this report, 36 of the 37 recipients continue to receive DI benefits. One recipient's
benefits
terminated due to death. See Appendix C for our sampling methodology.
We performed our re-calculations using SSA¡¦s Interactive Compensation
Facility for DI cases and eComputations for SSI cases.
SSI Recipients
Of the 50 SSI recipients in our review, 21 had estimated overpayments because
SSA did not take into account their FECA compensation when calculating the recipients¡¦
SSI
payments. In addition, for two recipients, SSA did not take into account their
compensation; however, no estimated overpayment resulted. Further, 12 recipients
did
not have to report their FECA compensation because they received it before receiving
SSI payments. The SSR of the remaining 13 recipients indicated that the calculation
of
their SSI payments included the FECA compensation they received. Finally, DoL
Agency Query System (AQS)11 records for two recipients were not available; therefore,
we did not perform a re-calculation. See Table 2.
Table 2: SSI Recipients
Result
Number of SSI
Recipients
Recipients Without FECA Compensation Reported on Their SSR, Resulting in an Estimated
Overpayment 21
Recipients Without FECA Compensation Reported on Their SSR with No Resulting Overpayment
2
Recipients Who Received FECA Compensation But Not While Receiving SSI Payments'
They Did Not Have to Report Their FECA Compensation 12
Recipients Whose FECA Compensation Was Reported on Their SSR 13
Recipients Whose FECA Compensation Was Not Available in DoL AQS 2
Total Sample Size 50
As shown above, 35 of the 50 recipients did not have FECA compensation reported
on their SSR. However, 23 of the 50 recipients should have had their FECA compensation
reported on their SSR. Using a straight-line estimation methodology to our population
of 190, we estimate there were about 87 recipients who received FECA compensation
and SSI payments with no indicator on their SSR that SSA took into account the
FECA compensation for a possible offset against their SSI payments. Based on our
recalculation
of SSI payments, we determined 21 of the 23 recipients were overpaid.
Based on these findings, using a straight-line estimation methodology, we estimate
approximately $603,140 in overpayments was paid to about 80 recipients whose FECA
compensation was not initially accounted for in the calculation of their SSI payments.
As of the date of this report, 20 of the 23 recipients continued to receive SSI
payments.
See Appendix C for our sampling methodology.
AQS displays detailed information on FECA cases for injured workers from Federal
agencies. It includes demographic data, up-to-date case status information, and
links to the cases¡¦ complete compensation payment history.
CONCLUSION AND RECOMMENDATIONS
Based on the results of our analyses, the potential exists for additional overpayments
to occur and continue if SSA does not implement corrective action to improve its
oversight
and monitoring of FECA payments received by DI and SSI beneficiaries. Unfortunately,
because of restrictions of the Computer Matching and Privacy Protection Act of
1988,12
we cannot communicate the identities of the individuals noted in our comparisons.
We recommend SSA develop a computer matching agreement with DoL to identify
possible DI and SSI claimants whose benefits do not reflect the FECA compensation
they received. A matching agreement will allow SSA to perform matching activities
similar to what we performed in this review, and take appropriate action for recipients
who have overpayments that result from SSA not taking FECA compensation into
account.
AGENCY COMMENTS
SSA agreed with our recommendation. The Agency¡¦s comments are included
in Appendix D.
Patrick P. O'Carroll, Jr.
The Computer Matching and Privacy Protection Act of 1988 amended the Privacy Act
by describing the manner in which computer matching involving Federal agencies
could be performed and by adding certain protections for individuals applying
for and receiving Federal benefits.
Appendices
APPENDIX A - V Acronyms
APPENDIX B - V Scope and Methodology
APPENDIX C - V Sampling Methodology
APPENDIX D - V Agency Comments
APPENDIX E - V OIG Contacts and Staff Acknowledgments
Appendix A
Acronyms
Act Social Security Act
AQS Agency Query System
C.F.R. Code of Federal Regulations
DI Disability Insurance
DoL Department of Labor
FECA Federal Employees' Compensation Act
FY Fiscal Year
ICF Interactive Compensation Facility
MBR Master Beneficiary Record
OIG Office of the Inspector General
OWCP Office of Workers¡¦ Compensation Programs
PCOM Personal Communications
SSA Social Security Administration
SSI Supplemental Security Income
SSN Social Security Number
SSR Supplemental Security Record
U.S.C. United States Code
WC Workers' Compensation
B-1
Appendix B
Scope and Methodology
The Department of Labor (DoL), Office of Inspector General, assisted us by providing
data files from DoL¡¦s Office of Workers¡¦ Compensation
Programs (OWCP). Those files
contained Federal Employees¡¦ Compensation Act (FECA) recipient data.
DoL also provided us access to its Agency Query System (AQS),1 which allowed us
to determine
the amount of FECA payments made to recipients from June 2002 to April 2010. The
data files included case management2 and 2002 through 2007 benefit payment
information.3 We combined these files to obtain a complete FECA record for each
recipient. We compared the recipients to the Social Security Administration¡¦s
(SSA)
Master Beneficiary (MBR)4 and Supplemental Security Records (SSR).5 Descriptions
of the matches, extractions, and re-calculation methodologies used in this audit
follow.
SSA, MBR, and SSR Matches
We matched the DoL FECA recipient data to SSA¡¦s MBR and SSR to determine
whether the recipients had an SSA record. This resulted in 206,432 DI matches
and
54,599 SSI matches. These matches represented cases where FECA recipients who
had an MBR or SSR received FECA compensation in any year from 2002 to 2007. We
summarized these matches by Social Security number (SSN) to determine unique recipients,
resulting in 54,856 DI recipients and 1906 SSI recipients.
1 AQS displays detailed information on FECA cases for injured workers from Federal
agencies. It includes demographic data, up-to-date case status information, and
links to access the case's complete compensation payment history.
2 This case information is from DoL¡¦s National Case Management File.
The types of information included are the recipient's name, address, SSN, type
of injury, date of injury, etc.
3 This compensation information is from DoL¡¦s Automated Compensation
Payment System. These files contain 2002 through 2007 compensation payment data.
4 The MBR contains information about each claimant who has applied for retirement,
survivors, or disability benefits or a claimant who enrolled in the Hospital Insurance
or Supplementary Medical Insurance program. For example, the MBR contains the
claimant's name, date of birth, gender, etc.
5 The SSR contains a record for each individual who has applied for Supplemental
Security Income (SSI).
6 Because the SSR reports all benefit activity from a claim¡¦s inception
to its present status, it was difficult to determine the extent of reporting of
beneficiaries with workers¡¦ compensation based solely on an extraction
of unearned income fields. Therefore, we applied specific extractions to the population
of FECA recipients to determine whether they were entitled to SSI benefits. This
resulted in 462 recipients.
We summarized the 462 by SSN to determine unique recipients. This yielded 190
recipients. From this population we reviewed a sample of 50 recipient SSRs to
determine whether SSA took into account their FECA compensation in the calculation
of their SSI benefits.
B-2 Extractions
After the match to the MBR and SSR, we performed extractions to determine the
recipients whose FECA compensation SSA did not take into account in the initial
calculation of their Social Security disability benefits.
DI Recipient Extractions
From the population of 54,856 FECA recipients who received DI benefits as primary
beneficiaries,7 we excluded recipients who were not in current pay status8 and
had
workers' compensation (WC) indicators on their MBR.9 We also excluded recipients
who had WC information posted to their WC/PDB Datasheet/Query.
SSI Recipient Extractions
From the population of 54,599 SSR matches, we excluded recipients who applied
for SSI payments, but never received them, and recipients denied payments. We
also
excluded recipients who were not primary beneficiaries in current pay status.
The results of the DI and SSI extractions yielded approximately 1,502 beneficiaries
and
190 recipients, respectively, who received FECA compensation in any 1 year, or
all years from 2002 to 2007, and appeared not to have WC indicators on their MBR
or
SSR. Although these extractions were effective, further certainty required a review
of each recipient¡¦s MBR and SSR. We accomplished this certainty
by reviewing a
statistical sample of 50 beneficiary MBRs and SSRs. If we determined that recipients
FECA compensation was not included in the calculation of their Social Security
disability
benefits, we re-calculated the benefits to determine an estimated DI or SSI overpayment.
7 SSA, POMS, GN 03301.002 B. A primary beneficiary¡¨ is a Social Security
numberholder entitled to benefits on his/her own work record. An ¡uxiliary
beneficiary is someone entitled to benefits based on someone else's work record,
by virtue of relationship to the numberholder.
8 For the purposes of this review, we selected beneficiaries with Ledger Account
File code ¡§C,¡¨ which indicates a beneficiary is in insured
current payment status, that is, one who is receiving monthly benefits.
9 When FECA recipients report their compensation, their MBR should be populated
with the following WC fields: WC type, WC/ Public Disability (WC/PDB) Benefit:
Start Date, Offset Type, Offset start date, Average Current Earnings effective
date, and indicators that a beneficiary received periodic WC payments.
B-3 Re-calculation of Social Security Disability Benefits
Based on our review of a sample of FECA recipients¡¦ MBRs and SSRs,
we confirmed with SSA what recipients¡¦ FECA compensation the Agency
did not take into account in
the calculation of their Social Security disability benefits. Based on instructions
provided by SSA, we re-calculated the Social Security disability benefits as if
the FECA
compensation was included in the calculation of their DI and SSI payments. We
performed these re-calculations by entering FECA compensation amounts the recipient
received in any 1 year, or all years, from June 2002 to April 2010, into the Interactive
Compensation Facility (ICF) of SSA¡¦s Personal Communications (PCOM)
application for
DI cases and SSI eComputations for SSI cases. The difference between what the
beneficiary received and what we re-calculated was the estimated overpayment.
Re-calculation Steps
Re-calculations of DI and SSI payments entailed the following steps.
1. Reviewed copies of the MBR, WC/PDB Datasheet/Queries, and SSR to determine
whether they reflected WC data.
2. Reviewed DoL¡¦s AQS to determine the monthly amount of FECA compensation
paid to the recipient from June 2002 to April 2010.
3. Determined the amount of DI and SSI payments paid to the recipient in the period
they received FECA compensation.
4. Entered the FECA compensation the recipient received into ICF for DI or SSI
eComputations for SSI to re-calculate benefits.
5. Determined whether there was an overpayment of DI or SSI benefits.
An Operations Analyst and Program Expert from SSA's Office of Disability Operations
provided instructions and assisted us in re-calculating the DI benefits. For the
sample
of 50 beneficiaries we tested who received DI benefits, they confirmed instances
where improper payments resulted because SSA did not take into account the recipients¡¦
FECA compensation in the calculation of their DI benefits. They also reviewed
20 percent of the re-calculated DI benefits we performed to ensure accuracy.
In addition, an analyst from SSA¡¦s Office of Applications and Supplemental
Security Income Systems provided us instructions of how to re-calculate SSI payments
that
include WC. Based on the analyst¡¦s instructions, we performed re-calculations
for the sample of 50 recipients who received SSI payments to estimate improper
payments that
resulted when SSA did not take into account the recipients' FECA compensation
in the calculation of their SSI payments.
B-4 The Privacy Act
The Privacy Act of 1974, as amended, places limitations on the use of records.
According to the Privacy Act, ¡§¡Kno record which is contained
in a system of records
may be disclosed to a recipient agency or non-Federal agency for use in a computer
matching program except pursuant to a written agreement between the source agency
and the recipient agency or non-Federal agency....¡¨10 However, the
term matching program¡¨ does not include ¡§¡Kmatches
performed to support any research or statistical
project; the specific data of which may not be used to make decisions concerning
the rights, benefits, or privileges of specific individuals.¡¨11 This
applies to our computerized
comparison of data, which we performed for research and statistical purposes only.
Data Reliability
We determined that the data used in this report were sufficiently reliable given
the audit objective and intended use of the data. We did not review DoL recipient
case files to
determine whether any additional FECA data provided by DoL¡¦s OIG
were accurate, complete, and valid. Furthermore, we did not assess SSA¡¦s
internal controls used to
administer its FECA program. We performed our fieldwork from February to June
2010.
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 that
the evidence
obtained provides a reasonable basis for our findings and conclusions based on
our audit objectives.
Appendix C
Sampling Methodology
The Department of Labor provided us access to its Agency Query System, which allowed
us to ascertain the amounts of Federal Employees¡¦ Compensation Act
(FECA)
compensation paid to recipients from 2002 to 2010. We determined there were 54,856
Disability Insurance (DI) beneficiaries and 190 Supplemental Security Income
(SSI) recipients who had a Master Beneficiary (MBR) or Supplemental Security Record
(SSR), respectively. Based on our extractions, we determined that 1,502 FECA
recipients possibly received DI benefits without the Social Security Administration
(SSA) taking into account their FECA compensation in the initial calculation of
their Social
Security disability benefits. We also determined that 190 recipients received
SSI payments that may or may not have been calculated taking into account the
FECA
compensation received. Although our extractions were effective, further certainty
required a review of the recipients¡¦ MBRs and SSRs. We accomplished
this by
randomly selecting samples of 50 DI beneficiaries and 50 SSI recipients to determine
whether SSA took into account their FECA compensation or whether overpayments
occurred.
We identified two sampling frames, DI and SSI. The DI sample included FECA recipients
who received DI benefits as primary beneficiaries,1 were in current pay status,
and whose FECA compensation was not included in the calculation of their DI benefits
on their MBR. The SSI sample included FECA recipients who received SSI payments,
who were in current pay status, and whose FECA compensation was not included in
the calculation of their SSI payments on their SSR.
DI
We projected our results based on our review of 50 FECA recipients who received
DI benefits. We projected FECA recipients who received DI benefits with no indicator
that
SSA took into account their FECA compensation in the calculation of their benefits.
The following table provides the details of our sample results and statistical
projection.
1 SSA, Program Operations Manual System, GN 03301.002 B. A primary beneficiary¡¨
is a Social Security numberholder entitled to benefits on his/her own work record.
An ¡§auxiliary beneficiary is someone entitled to benefits based on
someone else¡¦s work record, by virtue of relationship to the numberholder.
C-2
Sample Results and Attribute Projection for FECA Recipients Who Received DI Benefits
with No Indicator That Their FECA
Compensation Was Recorded and Accounted for Population Size 1,502
Sample Size 50
Number of Instances Where DI Beneficiaries Received SSA Disability Benefits with
No Indicator That FECA Compensation Was Recorded and Accounted for 37
Point Estimate 1,111
Lower Limit 933
Upper Limit 1,257
Note: Projections are at the 90-percent confidence level.
We developed attribute and variable projections based on the 50 FECA recipients
who received DI benefits with no indicator that FECA compensation was recorded
and
accounted for that resulted in an estimated overpayment. The following table provides
the details of our sample results and statistical projections.
Sample Results Where FECA Recipients Received DI Benefits with No Indicator That
Their FECA Compensation Was Recorded and Accounted for That Resulted in an Overpayment
Population Size 1,502
Sample Size 50
Number of Instances Where DI Beneficiaries Received SSA Disability Benefits with
No Indicator That FECA Compensation Was Recorded and Accounted for that Resulted
in an Overpayment 32
Resulting Overpayments for DI Beneficiaries Whose FECA
Compensation Was Not Recorded and Accounted for $1,444,351
Attribute Projection
Point Estimate 961
Lower Limit 776
Upper Limit 1,128
Variable Projection
Point Estimate $43,388,304
Lower Limit $29,746,908
Upper Limit $57,029,700
Note: Projections are at the 90-percent confidence level.
C-3 SSI
We performed a straight-line estimate for the FECA recipients who received SSI
payments with no indicator that SSA took into account their FECA compensation.
From
our sample of 50 recipients, we determined that 23 (46 percent) received SSI payments
with no indicator that SSA took into account their FECA compensation. Therefore,
we
estimate 87 of the 190 displayed this characteristic.
Sample Results Where FECA Recipients Received SSI with No Indicator Their FECA
Compensation Was Recorded and Accounted for
Population Size 190
Sample Size 50
Number of Instances Where Recipients Received
SSI with No Indicator That FECA Compensation
Was Recorded and Accounted for 23
Percentage 46
Straight Line Estimate of Recipients 87
Further, 21 of the 50 (42 percent) recipients received SSI payments with no indicator
on their SSR that SSA took into account their FECA compensation, resulting in
overpayments of $158,721. A straight-line estimate2 resulted in a total estimated
overpayment of $603,140 for 80 recipients. The following table provides the details
of
our sample results and estimate.
Sample Results Where FECA Recipients Received SSI Payments with No Indicator That
Their FECA Compensation Was Recorded and Accounted for That Resulted in an Overpayment
Population Size 190
Sample Size 50
Number of Instances Where Recipients Received
SSI with No Indicator That FECA Compensation
Was Recorded and Accounted for 21
Percentage 42
Straight-Line Estimate of Recipients 80
Amount Overpaid $158,721
Straight-Line Estimate of Overpayments2 $603,140
2 We based our straight-line estimate on the following equation: $158,721/50 X
190. We used a similar calculation for the estimate of recipients.
Appendix D
Agency Comments
SOCIAL SECURITY
D-1
MEMORANDUM
Date: September 16, 2010
To: Patrick P. O'Carroll, Jr.
Inspector General
From: James A. Winn /s/ Executive Counselor to the Commissioner
Subject: Office of the Inspector General (OIG) Draft Report, ¡§Federal
Employees Receiving Both Federal Employees¡¦ Compensation Act and
Disability Insurance Payments¡¨ (A-15-09-19008) --
INFORMATION
Thank you for the opportunity to review the subject draft report. Please see our
attached comments.
Please let me know if we can be of further assistance. You may direct staff inquiries
to Rebecca Tothero, Acting Director, Audit Management and Liaison Staff, at (410)
966-6975.
D-2
COMMENTS ON THE OFFICE OF THE INSPECTOR GENERAL (OIG) DRAFT REPORT, FEDERAL EMPLOYEES
RECEIVING BOTH FEDERAL EMPLOYEES¡¦
COMPENSATION ACT AND DISABILITY INSURANCE PAYMENTS¡¨ (A-15-09-19008)
Thank you for the opportunity to review the subject report. We offer the following
comments and a response to your recommendation.
GENERAL COMMENTS
Your report focuses on the entire population of persons receiving Federal Employees
Compensation Act (FECA) payments who may also be improperly receiving Disability
Insurance
(DI) or Supplemental Security Income (SSI) disability payments. On September 14,
2006, you issued a report titled, ¡§Federal Employees¡¦
Compensation Act ¡V Social Security Administration Employees (A-15-06-26123).¡¨
As the title suggests, your 2006 study focused more narrowly on only former Social
Security Administration (SSA) employees. You reached similar conclusions in both
reports that some FECA beneficiaries may also be receiving DI and SSI payments
improperly.
In the first report, you recommended that ¡§SSA coordinate with the
OIG to develop a computer matching agreement with [Department of Labor (DoL)]
to acquire FECA recipient data to match on a periodic basis with data contained
in SSA¡¦s systems.¡¨ We agreed with your September 2006
recommendation, and, in fact, had already begun negotiations some months prior
to establish such a match with the DoL. We drafted an agreement, and by May 2006,
two of our executives had signed it. There is no indication, however, that DoL
ever signed the agreement.
We were unsuccessful in determining why the agreement was not concluded with DoL.
The executives who signed it left the agency more than two years ago, and no one
remains who can
recall any specifics about the situation. Some recollect that there may have been
some resistance on the part of DoL, but we cannot definitively say that was the
case. All this notwithstanding, we plan to pursue establishing a matching agreement
with DoL as you recommend.
RESPONSE TO RECOMMENDATION
Recommendation
Develop a computer matching agreement with DoL to identify possible DI and SSI
claimants whose benefits do not reflect the FECA compensation they received. A
matching agreement will allow SSA to perform matching activities similar to what
we performed in this review and take appropriate action for recipients who have
overpayments that result from SSA not taking into account FECA compensation.
D-3
Response
We agree.
We are currently drafting a computer matching agreement for this purpose and have
started discussions with the DoL. Under the agreement, we will ask DOL¡¦s
Office of Workers¡¦
Compensation Programs to:
disclose Federal employee compensation benefit data to the Social Security Administration
(SSA). The disclosure will provide SSA with information necessary to verify the
accuracy of
payment eligibility factors for the Supplemental Security Income (SSI) program
K and the Title II disability insurance program .We have determined that the legal
authority to perform this computer match is included in Sections 224(h)(1) and
1636(f) of the Social Security Act which require Federal agencies to furnish us
with information necessary to verify eligibility for the SSI and DI programs.
This agreement will also be governed by the Computer Matching Privacy Protection
Act of 1998 (CMPPA). Under CMPPA, we are required to have both agencies Data Integrity
Boards approve the agreement, publish a Federal Register Notice, and in addition,
send notification to OMB and Congress.
Appendix E
OIG Contacts and Staff Acknowledgments
OIG Contacts
Victoria Vetter, Director, Financial Audit Division
Deborah Kinsey, Audit Manager
Acknowledgments
In addition to those named above:
Ronald Anderson, Auditor-In-Charge
For additional copies of this report, please visit our Website 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-15-09-19008.
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.