ALJ Administrative Law Judge
CDI Cooperative Disability Investigation
CDR Continuing Disability Review
CPMS Case Processing and Management System
DDS Disability Determination Services
DI Disability Insurance
DoJ Department of Justice
ESF Earnings Suspense File
FECA Federal Employees' Compensation Act
FO Field Office
FY Fiscal Year
GAO Government Accountability Office
HSPD Homeland Security Presidential Directive
IRS Internal Revenue Service
MADCAP Manual Adjustment, Credit and Award Processes
NWALIEN Non-Work Alien File
OASDI Old-Age, Survivors and Disability Insurance
OHA Office of Hearings and Appeals
OIG Office of the Inspector General
OMB Office of Management and Budget
PMA President's Management Agenda
SEI Self-Employment Income
SSA Social Security Administration
SSI Supplemental Security Income
SSN Social Security Number
SSNVS Social Security Number Verification System
USCIS U.S. Citizenship and Immigration Services
VA Veteran's Affairs
WC Worker's Compensation
Executive Overview
Annual Work Plan
Our Annual Work Plan (Plan) outlines our perspective of the top management challenges
facing the Social Security Administration (SSA) and serves as a tool for communicating
our priorities to SSA, the Congress, the Office of Management and Budget (OMB),
and other interested parties. The activities described address the fundamental
goals related to SSA's mission to administer Social Security programs and operations
effectively and efficiently. Our work is prioritized to focus our resources
on those areas that are most vulnerable to fraud, waste and abuse. To ensure
we provide a coordinated effort, we work closely with the Offices of Investigations,
Chief Counsel to the Inspector General, and Executive Operations.
Our Plan is categorized to mirror the top management challenges that cut across
the Government, as outlined in the President's Management Agenda (PMA) and rated
by OMB's Scorecard.
The PMA was designed to coordinate agency efforts to "address the most
apparent deficiencies and focus resources where the opportunity to improve performance
is the greatest." The PMA's goal is to establish a more responsible and
responsive Government that is citizen-centered, results-oriented, and market-based.
OMB provides each Federal agency a scorecard rating their performance. The scorecard
is designed around a simple grading system: green for success, yellow for mixed
results, and red for unsatisfactory. Following is the status of SSA's efforts,
as reported by OMB's June 2005 Scorecard.
This Plan describes 102 reviews we intend to complete, 73 reviews we intend
to begin, and 16 performance indicator reviews we will oversee in FY 2006 in
the following issue areas.
Social Security Number Protection
Management of the Disability Process
Improper Payments and Recovery of Overpayments
Internal Control Environment and Performance Measures
Systems Security and Critical Infrastructure Protection
Service Delivery and Electronic Government
To assist us in this analysis, we crosswalked the PMA, Commissioner Priorities,
Social Security Advisory Board, and Government Accountability Office (GAO) high-risk
areas to those identified by our prior and ongoing work. The following table
demonstrates that our perspective is congruent with other key decisionmakers.
In preparing this Plan, we solicited suggestions from the Agency. We received
a number of suggestions for inclusion in our Plan, and we have incorporated
as many of them as possible.
We recognize this Plan is dynamic, so we encourage continuous feedback and additional
suggestions. This flexibility enables us to meet emerging and critical issues
evolving throughout the upcoming year.
For more information on this Plan, please contact the Office of Audit at (410)
965-9700.
In FY 2004, SSA issued over 17.8 million original and replacement Social Security
number (SSN) cards, and SSA received approximately $545 billion in employment
taxes related to earnings under assigned SSNs. Protecting the SSN and properly
posting the earnings reported under SSNs are critical to ensure individuals
entitled to benefits receive the full benefits due them.
Efforts to Protect the SSN
The SSN has become a key to social, legal, and financial assimilation in this
country. Because the SSN is so heavily relied on as an identifier, it is also
valuable as an illegal commodity. Criminals improperly obtain SSNs by (1) presenting
false documentation; (2) stealing another person's SSN; (3) purchasing an SSN;
(4) using the SSN of a deceased individual; or
(5) contriving an SSN by selecting any nine digits.
SSA has taken steps to improve controls in its enumeration process. SSA verifies
all immigration documents before assigning SSNs to noncitizens. Additionally,
SSA requires
(1) mandatory interviews for all applicants for original SSNs who are age 12
or older (lowered from age 18) and (2) evidence of identity for all children,
regardless of age. In addition, SSA has established Enumeration Centers in Brooklyn,
New York, and Las Vegas, Nevada, that focus exclusively on assigning SSNs and
issuing SSN cards. Also, in FY 2005, SSA implemented new systems enhancements
that simplified the interpretation of, and compliance with, SSA's complex enumeration
policies. Furthermore, the Agency enhanced its Modernized Enumeration System
to interrupt the issuance of SSN cards when a parent claims to have an improbably
large number of children and add an alert to an individual's record when the
SSN has been used to establish a fictitious identity.
In addition to these improvements, SSA is planning to implement several other
enhancements that will better ensure SSN protection. These endeavors were required
by the Intelligence Reform and Terrorism Prevention Act of 2004. The plans include
the following:
Restricting the issuance of multiple replacement SSN cards to 3 per year and
10 in a lifetime.
Requiring independent verification of any birth record submitted by an individual
to establish eligibility for an SSN, other than for purposes of enumeration
at birth.
Coordinating with the Department of Homeland Security (DHS) and other agencies
to further improve the security of Social Security cards and numbers.
Working with the Department of Health and Human Services to promulgate standards
to increase the integrity and consistency of birth certificates.
We applaud the Agency for these efforts and believe, over the past several years,
SSA has made significant strides in providing greater protection for the SSN.
Nevertheless, throughout society, incidences of SSN misuse continue to rise.
Accordingly, to further protect SSN integrity, we believe SSA should:
Encourage public and private entities to limit use of the SSN as an individual
identifier.
Continue to address identified weaknesses in its information security environment
to better safeguard SSNs.
Continue to coordinate with partner agencies to pursue any data sharing agreements
that would increase data integrity.
The SSN and Reported Earnings
Properly posting earnings ensures eligible individuals receive the full retirement,
survivor and/or disability benefits due them. If earnings information is reported
incorrectly or not reported at all, SSA cannot ensure all individuals entitled
to benefits are receiving the correct payment amounts. In addition, SSA's programs
depend on earnings information to determine whether an individual is eligible
for benefits and to calculate the amount of benefit payments.
SSA spends scarce resources correcting earnings data when incorrect information
is reported. The Earnings Suspense File (ESF) is the Agency's record of annual
wage reports for which wage earners' names and SSNs fail to match SSA's records.
As of October 2004, SSA had posted approximately 9 million wage items to its
ESF for Tax Year 2002, representing about $56 billion in wages. This was before
some planned edits, which may have further reduced this number.
While SSA has limited control over the factors that cause the volume of erroneous
wage reports submitted each year, there are still areas where the Agency can
improve its processes. SSA can improve wage reporting by educating employers
on reporting criteria, identifying and resolving employer reporting problems,
and encouraging greater use of the Agency's SSN verification programs. SSA also
needs to coordinate with other Federal agencies with separate, yet related,
mandates. For example, the Agency now collaborates with the Internal Revenue
Service (IRS) to achieve more accurate wage reporting.
SSA has taken steps to reduce the size and growth of the ESF. For example, in
June 2005, SSA expanded its voluntary Social Security Number Verification Service
(SSNVS) to all interested employers nationwide. SSNVS allows employers to verify
the names and SSNs of employees before reporting their wages to SSA. SSA also
participates in a joint program with DHS, called the Basic Pilot, which verifies
the names and SSNs of employees as well as their citizenship and authorization
to work in the U.S. economy. In December 2004, the Basic Pilot program was made
available to employers nationwide.
The Agency is also modifying the information it shares with employers. Under
the Intelligence Reform and Terrorism Prevention Act of 2004, SSA is required
to add both death and fraud indicators to the SSN verification systems for employers,
State agencies issuing drivers' licenses and identity cards, and other verification
routines, as determined appropriate by the Commissioner of Social Security.
The SSN and Unauthorized Work
SSA assigns nonwork SSNs to noncitizens who are (1) in the United States but
are not authorized to work and (2) are applying for, or are recipients of, a
federally financed benefit that requires an SSN. Recently, SSA strictly limited
the assignment of such numbers. Furthermore, SSA tracks earnings reported under
a nonwork SSN and reports this information to DHS. Nonetheless, our audits have
noted several issues related to nonwork SSNs, including (1) the type of evidence
provided to obtain a nonwork SSN, (2) the reliability of nonwork SSN information
in SSA's records, (3) the significant volume of wages reported under nonwork
SSNs, and (4) the payment of benefits to noncitizens who qualified for their
benefits while working in the country without proper authorization.
In March 2004, Congress placed new restrictions on the receipt of SSA benefits
by noncitizens who are not authorized to work in the United States. Under the
Social Security Protection Act of 2004, if a noncitizen worker was first assigned
an SSN on or after January 1, 2004, Title II benefits are precluded based on
his/her earnings unless the noncitizen was ever assigned an SSN for work purposes
or admitted to the United States as a visitor for business (B-1) or as an allied
crewman (D-1/D-2).
SSA's implementation of this new law will require increased coordination with
DHS to ensure SSA has the correct work status information in its records.
In FY 2006, we plan to complete 19 reviews and begin 13 reviews in this area.
We Plan to Complete the Following Reviews in FY 2006
Assessment of the Validity of Earnings Posted to the Social Security Administration's
Master Earnings File for Children Ages 7 Through 13
Basic Pilot Between the Social Security Administration and the Department of
Homeland Security
Congressional Response Report: Enumeration of F-1 Students
Disposal of Sensitive Documents at the Social Security Administration
Effectiveness of the Young Children's Earnings Records Reinstatement Process
Employers with the Most Wage Items in the Nonwork Alien File
Follow-up: Controls over Nonwork Social Security Numbers
Follow-up: Enumeration at Birth Program
Follow-up: Issues Identified During the Internal Control Review over the Processing
of Social Security Number Cards
Hospitals' Use and Protection of Social Security Numbers
Impact of Employer Wage Corrections on the Earnings Suspense File
Individuals Receiving Benefits Under Multiple Social Security Numbers at Different
Addresses
Issuance of Replacement Social Security Number Cards to Prisoners
Prisoners' Access to Social Security Numbers
Self-Employment Income Earnings Suspense File
Suspended and Nonwork Wages Among the Social Security Administration's Contractors
Suspended and Nonwork Wages in the Social Security Administration's Payroll
The Impact of Unauthorized Employment on Social Security Benefits
Universities' Use of Social Security Numbers as Student Identifiers in Region
IX
We Plan to Begin the Following Reviews in FY 2006
Controls over Manual Wage Adjustments
Effectiveness of the Large Employer Reinstatement Facility
Evaluation of the Social Security Number Verification Service Pilot
Follow-up: Assessment of the Enumeration at Entry Process
Follow-up: The Social Security Administration's Processing of Requests for Social
Security Numbers in Emergency Situations
Individuals Working in the Economy with Special Indicators on their Numident
Record
New Social Security Numbers Issued to Individuals over Age 16
Separation of Duties Relating to the Enumeration and Claim Taking Processes
Social Security Administration Verification Feedback to Divisions of Motor Vehicles
Special Indicator Codes on the Numident and the Effect on Title II and Title
XVI Claims
The Social Security Administration's Compliance with SS-5 Assistant Policies
and Procedures
The Social Security Administration/Internal Revenue Service Reconciliation Process
The Social Security Administration's Las Vegas Social Security Card Center
Assessment of the Validity of Earnings Posted to the Social Security Administration's
Master Earnings File for Children Ages 7 Through 13
Objective
To determine whether individuals are inappropriately claiming earnings on children's
SSNs.
Background
The Office of Earnings, Enumeration and Administrative Systems has ESF alerts
for multiple/unusual postings for children under age 7. Effective Tax Year 1991,
the Annual Wage Reporting process checks the Numerical Identification (Numident)
for the reported SSN and date of birth. If the date of birth indicates the numberholder
is age 6 or younger, the earnings are identified as a Young Children's Earnings
Record item and placed in the ESF. When the Annual Wage Reporting process is
complete, a Young Children's Earnings Record investigate file is generated to
determine whether the earnings belong to the reported SSN. There is no alert
process in place for earnings on the records of children ages 7 through 13.
Basic Pilot Between the Social Security Administration and the Department of
Homeland Security
Objective
To assess the controls over data sharing and verification in SSA's joint pilot
with DHS to verify employment eligibility.
Background
The Illegal Immigration Reform and Immigration Responsibility Act of 1996 established
the Basic Pilot, a voluntary employee verification program for employers.
The program involves verifying the employment authorization of all newly hired
employees against SSA and DHS databases.
The President signed the Basic Pilot Extension and Expansion Act of 2003 on
December 3, 2003. This new law extends the pilot program for 5 more years (11
years total) and expands it to all 50 States as of December 2004.
Congressional Response Report: Enumeration of F-1 Students
Objective
To determine whether foreign students receiving SSNs based on work authorization
letters from schools and documentation of promised or actual employment attend
classes and are employed on-campus.
Background
In October 2004, SSA implemented the regulation, Evidence Requirements for Assignment
of Social Security Numbers; Assignment of SSNs to Foreign Academic Students
in F 1 Status. The regulation requires that F-1 students who do not have a DHS
Employment Authorization Document or authorization for curricular practical
training must provide an on-campus work authorization and evidence they have
secured employment or a promise of employment.
The Senate Committee on Governmental Affairs is concerned that some educational
institutions are providing students with work authorization letters and documentation
of promised employment when they do not intend to hire the students for on-campus
employment. Rather, the schools may be providing this documentation solely to
assist the students in obtaining SSNs.
Disposal of Sensitive Documents at the Social Security Administration
Objective
To determine whether employees are disposing of sensitive documents in accordance
with SSA's policy.
Background
As a part of SSA's financial statement audit, we accompanied PricewaterhouseCoopers'
staff during site visits to various SSA facilities nationwide. During several
site visits, we observed conditions regarding the disposal of sensitive documents
that warranted management's attention.
We have issued memorandums to the Deputy Commissioner for Operations and the
Regional Commissioner for Seattle identifying several instances of improper
disposal of sensitive documents in various SSA offices. These documents contained
SSNs and other identifying information, such as names, addresses, earnings,
and bank account numbers.
Effectiveness of the Young Children's Earnings Records Reinstatement Process
Objective
To assess the effectiveness of the Young Children's Earnings Record reinstatement
process in resolving suspended wages, reducing the size of the ESF, and detecting
potential fraud.
Background
As part of the annual earnings reporting process, SSA reviews the Numident to
determine whether the individual is a minor. If the date of birth indicates
the individual is under age 7, the earnings are placed in the ESF and transmitted
to a Young Children's Earnings Record investigate file so notices can be printed
and mailed to employers and/or employees. These notices request that the addressee
confirm or update the employee's information.
The suspended earnings are reinstated if the employer confirms the information
SSA received is correct. If the information is incorrect, SSA contacts the employee
and instructs him or her to visit an SSA field office (FO) to update his or
her information. Unresolved earnings remain in the ESF.
Employers with the Most Wage Items in the Nonwork Alien File
Objective
To (1) identify and profile the 100 employers responsible for sending the most
wage items to the Nonwork Alien (NWALIEN) file for Tax Years 2001 through 2003
and (2) determine the accuracy of the data in this file.
Background
SSA assigns SSNs to noncitizens who do not have DHS' permission to work in the
United States under very limited circumstances. These reasons include (1) a
Federal statute or regulation requiring that a noncitizen provide his or her
SSN to get a particular benefit or service to which he or she has otherwise
established entitlement or (2) a State or local law requiring that a noncitizen
who is legally in the United States provide his or her SSN to get public assistance
benefits to which he or she has otherwise established entitlement and for which
all other requirements have been met. SSA issues these individuals SSN cards
that are annotated with a "not valid for employment" legend. Each
year, SSA informs DHS of noncitizens who are potentially working illegally using
nonwork SSNs.
Follow-up: Controls over Nonwork Social Security Numbers
Objective
To review SSA's efforts to resolve nonwork SSN issues reported by our earlier
audit, which (1) analyzed Social Security benefits being paid to individuals
under nonwork SSNs, (2) analyzed earnings reported for nonwork SSNs, and (3)
determined whether SSA had adequate controls over the issuance of nonwork SSNs.
Background
SSA regulations regarding the assignment of nonwork SSNs were published in March
1974 during the Agency's implementation of the Social Security Amendments of
1972. SSA's policies implementing these regulations required that applicants
for nonwork SSNs document a valid reason for needing an SSN, but it was not
until January 1996 that SSA officially defined what constituted a valid reason.
Before this time, SSA issued nonwork SSNs for a variety of reasons including
tax, banking, school, insurance, driver's license, and Government benefit purposes.
As of August 1997, SSA had issued approximately 7 million nonwork SSNs. Recently,
the number of nonwork SSNs issued has declined because SSA has limited the circumstances
under which it will issue these numbers.
Based on our prior audit results, we believed there was a need for legislation
prohibiting the crediting of SSN accounts with earnings and related quarters
of coverage for periods of unauthorized work. The amount of benefit payments
resulting from the credits is significant. We estimate that about $63 million
in benefits would be paid under the accounts of SSN holders who were age 62
and older as of August 7, 1997, for the 12-month period ended May 1999. In addition,
we estimated $1.7 billion would have been paid under these accounts by 2019
as a result of the credits. We recommended that SSA (1) propose legislation
to prohibit the crediting of nonwork earnings and related quarters of coverage
for purposes of benefit entitlement; (2) perform its own actuarial calculations
of the effects of the nonwork quarters of coverage on benefit payments, if deemed
necessary, to support changes in legislation; (3) conduct periodic quality reviews
of processed SSN applications and provide timely feedback to field office personnel;
and (4) review the 452 unrestricted SSNs processed by the California field offices
temporary Service Representatives to identify other coding errors that resulted
in the incorrect issuance of SSN cards containing work authorization.
In its response, SSA stated it had long been concerned about the use of nonwork
SSNs in the employment sector. However, the Agency believed the issue of unauthorized
work could be dealt with more effectively through pilot projects for determining
work eligibility than through a legislative proposal. SSA asserted that the
legislative proposal we recommended would be difficult to administer because
the Agency's records would not allow the determination of when an individual
may or may not be allowed to work.
Follow-up: Enumeration at Birth Program
Objective
To determine the status of corrective actions SSA has taken to address recommendations
resulting from our September 2001 report, Audit of the Enumeration at Birth
Program. We will also determine whether SSA's internal controls adequately protect
the integrity of the Enumeration at Birth process.
Background
Implemented in 1990, the Enumeration at Birth program assigns SSNs to newborns,
with parental approval, as part of States' birth registration process. In FY
2004, SSA assigned about 4 million original SSNs to newborns through Enumeration
at Birth.
Our prior review of the procedures and related controls employed by the hospitals,
cognizant Bureaus of Vital Statistics, and SSA disclosed the need for SSA to
establish additional controls to reduce the Enumeration at Birth program's vulnerability
to error and misuse and to enhance program efficiency. For example, we recommended
that SSA enhance its duplicate record detection and prior SSN detection routines
to provide greater protection against the assignment of multiple SSNs.
Follow-up: Issues Identified During the Internal Control Review over the Processing
of Social Security Number Cards
Objective
To determine whether the proposed recommendations from the previous review have
been implemented.
Background
In January 2004, we issued a report on the internal controls over the processing
of SSN cards at SSA's National Computer Center. This report identified significant
internal control weaknesses. We made several recommendations to strengthen the
internal control structure.
Hospitals' Use and Protection of Social Security Numbers
Objective
To assess hospitals' use and protection of SSNs and the potential risks associated
with such use.
Background
Millions of individuals seek medical care each year. To assist in this process,
many hospitals use individuals' SSNs as unique identifiers. The potential for
identity theft increases each time an individual divulges his or her SSN. Recent
incidents of identity theft at hospitals have led some hospitals to reconsider
the practice of using SSNs as identifiers. However, at many hospitals, individuals
continue to be identified primarily by their SSN, even when another identifier
would suffice.
Impact of Employer Wage Corrections on the Earnings Suspense File
Objective
To assess the effect of corrected wage postings on the size of the ESF.
Background
Each year, employers send SSA over 230 million Forms W-2, Wage and Tax Statement.
Periodically, an employer will report an incorrect amount for an employee and
send SSA a corrected W-2.
Earnings reported under a name/SSN that do not match SSA's records go into the
ESF. If the suspended wage report is later corrected, the original and corrected
W-2s remain in the ESF until they are reinstated to the Master Earnings File.
However, if the employer corrects a wage amount but does not correct the name/SSN,
the ESF will continue to show original and corrected wages, which could lead
to an over/underestimate of the ESF's true size.
Individuals Receiving Benefits Under Multiple Social Security Numbers at Different
Addresses
Objective
To identify improper payments made to Title II and/or Title XVI beneficiaries
who are receiving payments under multiple SSNs at different addresses.
Background
In FY 2005, we issued a report on individuals who received benefits under multiple
SSNs at the same address. This report identified over $9.1 million in overpayments
and $1.4 million in savings.
Our initial computer analysis of Title II and XVI recipient records on the date
of birth, first five characters of the individual's first name, mother's maiden
name, father's last name, and place of birth resulted in numerous matches where
it appears to be the same person with a different SSN and address.
Issuance of Replacement Social Security Number Cards to Prisoners
Objective
To assess the effectiveness of SSA's controls for issuing replacement SSN cards
under prison agreements.
Background
Correctional institutions often assist inmates in obtaining a replacement SSN
card before their release to facilitate their return to society. In some cases,
the only proof of identity the inmates provide is a prison record. At least
three cases have been identified in which individuals were incarcerated in a
State prison under someone else's identity. In two of those cases, the individuals
attempted to obtain replacement SSN cards under aliases and were only caught
because the individuals were dead.
Prisoners' Access to Social Security Numbers
Objective
To determine the extent to which prisoners have access to SSNs and how this
could increase incidences of identity theft.
Background
There is no legal prohibition on inmates working in prison industries from having
access to customers' SSNs. The Social Security Number Privacy and Identity Theft
Prevention Act of 2005 seeks to prohibit government entities from employing
inmates in any type of prison industry that would allow prisoners access to
the SSNs of other individuals. GAO found that, as of 1998, about 1.2 million
inmates had access to personal information through correctional industry work
programs.
Self-Employment Income Earnings Suspense File
Objective
To identify patterns of errors and irregularities in self-employment income
(SEI) posted to the ESF.
Background
Section 1401 of the Internal Revenue Code requires that the IRS impose the Self-Employment
Contributions Act tax on self-employment earnings. This tax is equivalent to
the Federal Insurance Contributions Act tax and includes contributions for the
Social Security and Medicare programs. IRS shares SEI information with SSA so
it can be posted to the appropriate earner's record.
SSA matches this reported SEI with its Numident file to verify an individual's
name and SSN to record the earnings in the individual's Master Earnings File.
Income reports with invalid name/SSN combinations are placed in the SEI ESF.
Suspended and Nonwork Wages Among the Social Security Administration's Contractors
Objective
To determine whether contractors providing goods and services to SSA have employees
with (1) SSNs that do not match the name/SSN combination in SSA's records or
(2) nonwork SSNs.
Background
SSA does business with thousands of contractors who provide a variety of goods
and services including medical, worker rehabilitation, consulting, auditing,
and verification services. SSA information and facilities could be exposed to
unnecessary risks if these contractors are employing individuals who provided
incorrect name/SSN combinations and/or are not authorized to work in the United
States.
Suspended and Nonwork Wages in the Social Security Administration's Payroll
Objective
To determine whether SSA employees are working under (1) SSNs that do not match
the name/SSN in SSA's records or (2) nonwork SSNs.
Background
SSA employees should (1) provide SSA with a correct name/SSN combination so
their wages can be properly posted to their earnings record and (2) be authorized
to work in the United States. SSA employees who do not meet these criteria could
expose SSA's information and facilities to unnecessary risks.
Our September 2003 report, Profile of the Social Security Administration's Non-Work
Alien File, stated that individuals who have public responsibilities and positions
of trust, including SSA employees, have wages recorded in SSA's unauthorized
employment file.
The Impact of Unauthorized Employment on Social Security Benefits
Objective
To assess the impact of unauthorized employment on Social Security benefits
and the accuracy of employment authorization information as recorded on SSA's
Numident.
Background
Each year, SSA informs the U.S. Citizenship and Immigration Services (USCIS)
about earnings reported on nonwork SSNs. SSA sends the notification in the NWALIEN
file. Resource priorities and data compatibility problems have prevented USCIS
from effectively using this information.
While SSA notifies USCIS of earnings reported under nonwork SSNs, USCIS does
not routinely tell SSA when it changes a person's employment status from unauthorized
to authorized. Unless the person informs SSA of such a change, the person's
earnings will continue to be reported in the NWALIEN file. Consequently, SSA
does not know the number of workers shown on the NWALIEN file who are authorized
for employment, or the amount of SSA benefits resulting from unauthorized employment.
Universities' Use of Social Security Numbers as Student Identifiers in Region
IX
Objective
To assess universities' use of SSNs as student identifiers and the potential
risks associated with such use.
Background
Millions of students enroll in educational institutions each year. To assist
in this process, many colleges and universities use students' SSNs as personal
identifiers. The American Association of Collegiate Registrars and Admissions
Officers found that almost half (1,036) of member institutions that responded
to a 2002 survey used SSNs as the primary student identifier.
The potential for identity theft increases each time an individual divulges
his or her SSN. Recent incidents of identity theft at universities have led
some schools to reconsider the practice of using SSNs as the primary student
identifier. However, at many colleges and universities, students continue to
be identified primarily by their SSN, even when another identifier would suffice.
SSA administers the Disability Insurance (DI) and Supplemental Security Income
(SSI) programs, which provide benefits based on disability. Most disability
claims are initially processed through a network of Social Security FOs and
State Disability Determination Services (DDS). SSA representatives in the FOs
are responsible for obtaining applications for disability benefits, disability
report forms and authorization for disclosure of information forms as well as
verifying non-medical eligibility requirements, which may include age, employment,
marital status, or Social Security coverage information. After initial processing,
the FO sends the case to a DDS to develop medical evidence and evaluate the
disability.
Once SSA establishes an individual is eligible for disability benefits under
either the DI or SSI program, the Agency turns its efforts toward ensuring the
individual continues to receive benefits only as long as SSA's eligibility criteria
are met. For example, a continuing disability review (CDR) may show the individual
no longer meets SSA's disability criteria or has demonstrated medical improvement.
If an individual disagrees with the Agency's decision on his or her claim or
CDR, the claimant can appeal to SSA's Office of Hearings and Appeals (OHA).
OHA's field structure consists of 10 regional offices and 140 hearing offices.
OHA's administrative law judges (ALJ) hold hearings and issue decisions. In
FY 2004, hearing offices processed 497,379 cases. OHA's average processing time
has increased significantly from 308 days in FY 2001 to 391 days in FY 2004.
Further, the pending workload was 635,601 cases on September 30, 2004, whereas
it was 392,387 cases on September 30, 2001. We have focused our attention on
weaknesses within OHA-such as the backlog of cases, safeguards for sensitive
information in case files, and shredding documents.
GAO added modernizing Federal disability programs-including SSA's-to its 2003
high-risk list due, in part, to outmoded concepts of disability, lengthy processing
times, and decisional inconsistencies. To address improvements needed in SSA's
disability programs, the Commissioner of Social Security presented to Congress,
on September 25, 2003, her proposed plan for the disability determination process.
On July 26, 2005, the Commissioner announced proposed regulations in the Federal
Register, which outlines her plan. The proposed regulations would:
establish a Quick Disability Determination process through which State agencies
will expedite initial determinations for claimants who are clearly disabled;
create a Federal Expert Unit to augment and strengthen medical and vocational
expertise for disability adjudicators at all levels of the disability determination
process;
eliminate the State agency reconsideration step and terminate the disability
prototype that SSA is conducting in 10 States;
establish Federal reviewing officials to review State agency initial determinations
upon the claimants' request;
preserve the claimants' right to request and be provided a de novo hearing,
which will be conducted by an ALJ;
close the record after the ALJ issues a decision, but allow for the consideration
of new and material evidence under certain circumstances;
gradually shift certain Appeals Council functions to a newly established Decision
Review Board; and
strengthen in-line and end-of-line quality review mechanisms at the State agency,
reviewing official, hearing, and Decision Review Board levels of the disability
determination process.
In addition to the Commissioner's proposed improvements to the disability process,
the Agency is transitioning to the electronic disability folder. The electronic
disability folder will allow for disability claims information to be stored
and transmitted electronically between FOs, DDSs, and OHA.
SSA is working to ensure that individuals with disabilities who want to work
have the opportunity to do so. The Comprehensive Work Opportunity Initiative
represents the Agency's overarching strategy to assist individuals with disabilities
in attaining economic self-sufficiency and breaking through potential barriers
to employment. The Ticket to Work program, which provides beneficiaries with
disabilities expanded options for access to employment, vocational rehabilitation,
and other support services to help them work, is one element of SSA's Comprehensive
Work Opportunity Initiative.
Disability Fraud
Fraud is an inherent risk in SSA's disability programs. Some unscrupulous people
view SSA's disability benefits as money waiting to be taken. A key risk factor
in the disability program is individuals who feign or exaggerate symptoms to
become eligible for disability benefits. Another key risk factor is the monitoring
of medical improvements for disabled individuals to ensure those individuals
who are no longer disabled are removed from the disability rolls.
We are working with SSA to address the integrity of the disability programs
through the Cooperative Disability Investigation (CDI) program. The CDI program's
mission is to obtain evidence that can resolve questions of fraud in SSA's disability
programs. The CDI program is managed in a cooperative effort between SSA's Office
of Operations, the OIG, and the Office of Disability Programs. There are 19
CDI units operating in 17 States. During FY 2004, the CDI units saved SSA almost
$133 million by identifying fraud and abuse related to initial and continuing
claims in the disability program.
In FY 2006, we plan to complete 13 reviews and begin 7 reviews in this area.
We Plan to Complete the Following Reviews in FY 2006
Assessing the Application Controls for the Social Security Administration's
Integrated Disability Management System
Case Management Procedures at the Hearing Office in Creve Coeur, Missouri
Case Processing and Management System and Workload Management
Controls over Payments to Attorneys
Demonstration Project: Qualifications for Non-Attorney Representatives
Digital Recording Acquisition Project at the Office of Hearings and Appeals
Disability Determinations Made for Beneficiaries Convicted of Disability Insurance
Fraud
Impact of Statutory Benefit Continuation on Disability Insurance and Supplemental
Security Income Benefit Payments Made During the Appeals Process (2 Reports)
Office of Hearings and Appeals Reversal of Disability Denial Decisions Involving
Investigative Information from Cooperative Disability Investigation Units
The Social Security Administration's Independence Day Assessment
The Social Security Administration's Ticket to Work Program-Employment Networks
The Social Security Administration's Ticket to Work Program-Ticket Assignments
We Plan to Begin the Following Reviews in FY 2006
Aged Cases at the Hearing Level
Diagnosis Codes for Favorable Office of Hearings and Appeals Disability Decisions
Duplicative Use of Vocational Expert Evidence by the Office of Hearings and
Appeals
Office of Hearings and Appeals Video Hearings
Representatives Barred from Practicing Before the Social Security Administration
(Public Law 108-203)
The Office of Hearings and Appeals' Cap on Attorney Assessments Under Public
Law 108-203
The Social Security Administration's Oversight of Manual Adjustment, Credit
and Award Processes Payments
Assessing the Application Controls for the Social Security Administration's
Integrated Disability Management System
Objective
To assess the application controls for SSA's Integrated Disability Management
System.
Background
The Integrated Disability Management System was established as the central repository
for disability information for all Title II and XVI beneficiaries to enhance
management of post-entitlement disability-related actions and determinations.
The Integrated Disability Management System houses most of the disability-related
data that were previously contained in SSA's Master Beneficiary Record, including
claims information by individual SSN.
The Integrated Disability Management System integrates several disability-related
systems and databases, including the Disability Control File, Ticket Payment
File, Earnings File, and Employment Network payment system. The integration
of these systems and databases helps SSA monitor all disability-related information
for a beneficiary, including work and earnings, Ticket to Work status, pending
and processed CDRs, and expedited reinstatement actions. The Integrated Disability
Management System processes Employment Network payments and helps ensure SSA
periodically reviews the medical condition of all individuals receiving disability
benefits to determine whether beneficiaries and recipients continue to be disabled.
Case Management Procedures at the Hearing Office in Creve Coeur, Missouri
Objective
To determine whether evidence exists to substantiate allegations related to
inefficient case management procedures at the Creve Coeur Hearing Office.
Background
OHA is responsible for holding hearings and issuing decisions as part of SSA's
process for determining whether a person may receive benefits. OHA directs a
nation-wide field organization staffed with more than 1,150 ALJs who conduct
impartial "de novo" hearings and make decisions on appealed determinations
involving SSA's retirement, survivors, disability, and supplemental security
income programs.
We received an allegation related to the Creve Coeur Hearing Office's case management
procedures. Specifically, it was alleged that (1) the hearing office delays
the issuance of decisions once its monthly quota has been met and (2) ALJs process
an inequitable number of cases, which has resulted in a backlog of thousands
of cases.
To address the allegations, we will interview staff at the Creve Coeur Hearing
Office and analyze OHA case processing statistics. If our analysis of these
statistics discloses that these alleged practices are occurring at other hearing
offices, we will extend our work to hearing offices nationwide.
Case Processing and Management System and Workload Management
Objective
To assess the Case Processing and Management System's (CPMS) ability to improve
workload management at hearing offices in OHA.
Background
SSA designed and developed CPMS to enhance and improve the efficiency of its
hearings case management system in its hearing offices. CPMS is one part of
SSA's Electronic Disability initiative.
OHA completed its installation of CPMS in 2004. CPMS replaces the Hearing Office
Tracking System for all cases, with the exception of cases pertaining to Medicare
claims. CPMS implementation began in pilot sites in December 2003, and, by August
2004, it was operational in all 140 hearing offices.
CPMS contains significant enhancements for OHA, including improved development
tools, case controls, notice tools, and management information. In addition,
CPMS will provide extensive data propagation, new automated scheduling techniques,
an automated knowledge base, interactive screens, a secure and centralized repository
of data, hyperlinks to reference material and interfaces with other SSA systems,
including the electronic folder. It will also eliminate a number of manual processes.
Controls over Payments to Attorneys
Objective
To determine whether SSA has adequate controls over fees paid to attorneys.
Background
OHA holds hearings as part of SSA's process for determining whether a person
is eligible for benefits. The first step in the appeals process is called reconsideration.
If the claimant disagrees with that decision, the claimant may request a hearing
before an ALJ. The claimant may appoint either an attorney or other qualified
individual to represent him or her at the hearing. Claimant representatives
charge and receive a fee for their services.
Attorney fee payments are processed at program service centers using the Single
Payment System. The Single Payment System replaced the manual One Check Only
payment system in May 2002. The Single Payment System is a national system used
to automate attorney fee payments and other Title II payments that cannot be
made through the Title II system. It was created to ensure timeliness of attorney
fee payments, stop duplicate and erroneous payments, reduce the number of inputs,
and document management information.
Our August 2001 report, Approval of Claimant Representatives and Fees Paid to
Attorneys, stated that SSA made duplicate payments to attorneys, staff did not
follow procedures, and attorney fee payments with invalid or incorrect SSNs
were not detected. Also, the One Check Only Payment System was used to process
payments to attorneys. We made several recommendations, and SSA agreed with
most of them. For those recommendations with which SSA disagreed, SSA stated
that the Single Payment System should resolve these issues.
Demonstration Project: Qualifications for Non-Attorney Representatives
Objective
To assess the implementation of SSA's demonstration project.
Background
In March 2004, Congress enacted the Social Security Protection Act. Under section
303 of the Social Security Protection Act, the Commissioner of Social Security
is required to develop and implement a 5-year, nation-wide demonstration project
that gives certain non-attorney representatives the option of having approved
representatives' fees withheld and paid directly from the beneficiary's past
due benefits. Non-attorney representatives who participate in the demonstration
project must: hold a bachelor's degree, pass a written examination, secure professional
liability insurance, undergo a criminal background check, and complete continuing
education courses. OHA is required to report to Congress within 1 year on the
demonstration project.
Digital Recording Acquisition Project at the Office of Hearings and Appeals
Objective
To assess the implementation of digital recording equipment in OHA.
Background
In FY 2003, as part of SSA's electronic disability initiative, the Agency started
the Digital Recording Acquisition Project. The Digital Recording Acquisition
Project's mission entails replacing all of OHA's aging analog, four-track tape
recorders with digital equipment to provide an electronic recording that is
compatible with the electronic disability initiative.
Digital recording equipment, and the associated recordable compact discs, are
less bulky than the analog equipment and audiocassettes and therefore take less
storage space in both the claims folder and SSA's Payment Centers and the Federal
Records center.
In FY 2004, SSA entered into a contract for the installation and maintenance
of digital recording equipment. The contractor is to install and fully integrate
1,470 systems at OHA's hearing offices, regions and remote sites. SSA anticipates
all hearings will be digitally recorded by February 2006.
Disability Determinations Made for Beneficiaries Convicted of Disability Insurance
Fraud
Objective
To examine the sufficiency of disability determinations made for DI beneficiaries
subsequently convicted of DI fraud. Specifically, we will identify trends related
to fraud cases identified by the Office of Investigations.
Background
The State DDSs are responsible for determining whether individuals who applied
for disability benefits are disabled. When the DDS determines the individual
is not disabled, the decision can be appealed to OHA, which can, and often does,
rule in favor of the applicant with a finding that the individual was disabled.
All approved disability claims are then subject to CDRs. If a beneficiary's
condition has substantially improved, the individual may be found to be no longer
disabled and disability payments are stopped. We received a complaint alleging
that DDSs are hard pressed to document substantial improvement when they initially
found the individual was not disabled but OHA later ruled in favor of the individual.
Consequently, without a determination of substantial improvement in cases where
the disabling condition was originally questionable, the individual is not likely
to have benefits stopped as a result of the CDR process.
Impact of Statutory Benefit Continuation on Disability Insurance and Supplemental
Security Income Benefit Payments Made During the Appeals Process (2 Reports)
Objective
To evaluate the financial impact of DI and SSI benefit payments made during
the SSA appeals process on the trust fund and the effectiveness of the Public
Law allowing benefits to continue.
Background
A determination of benefit cessation is made when a CDR reveals the beneficiary
no longer meets the requirements for disability benefits. Benefit cessation
decisions are made by disability examiners in the Office of Central Operations
and the DDSs, as well as by disability specialists in the program service centers.
Public Law 97-455, as extended by Public Law 101-508, provides the disabled
beneficiary the option for DI benefit continuation through the reconsideration
and/or ALJ hearing process in medical cessation determinations. Public Law 98-460
provides the same payment continuation option to SSI recipients.
The average OHA processing time for hearings is approximately 370 days for the
DI program and 420 days for the SSI program. Benefit payments made during the
OHA appeals process are considered overpayments if the cessation decision is
upheld. SSA waives the overpayment when the claimant is found to be without
fault in causing the overpayment, and recovery or adjustment would defeat the
purpose of the disability program.
Office of Hearings and Appeals Reversal of Disability Denial Decisions Involving
Investigative Information from Cooperative Disability Investigation Units
Objective
To identify the circumstances that may have resulted in the allowance of benefits
at the hearings level when a prior investigation conducted by a CDI unit contributed
to a denial decision.
Background
CDI units support SSA's strategic goal of establishing zero tolerance for fraud,
thus ensuring public confidence in the integrity of SSA's programs and operations.
The CDI unit reports facts uncovered during an investigation to resolve questions
of fraud in SSA's disability programs. The CDI unit does not make disability
determinations; it provides information to the DDSs for their use in making
timely and accurate disability determinations. SSA provides most of the funding
for the CDI program, while the OIG maintains the day-to-day operations. Together,
these agencies have dedicated over 100 full-time staff to the initiative.
During the period July 1999 through April 2004, CDI investigative results were
used to support over 4,700 DDS decisions to deny SSA disability benefits. This
allowed SSA to avoid improper payments of approximately $278 million. However,
906 decisions were appealed to OHA, of which, 526 were overturned.
The Social Security Administration's Independence Day Assessment
Objective
To determine whether Independence Day Assessment procedures are effective for
deciding when DDSs are ready to implement the electronic folder system.
Background
To certify that a DDS can operate in a paperless environment, SSA created the
Independence Day Assessment. SSA's four-step process is to (1) conduct assessment
visits to identify impediments to moving to a fully electronic environment;
(2) provide necessary instructions and training for SSA and DDS employees; (3)
certify that National Archives and Records Administration recordkeeping requirements
are met; and (4) conduct validation visits to certify the DDS is ready to transition
to a fully electronic environment.
Before a DDS can be certified to operate in a fully electronic environment,
all "critical" or "adjudicatively significant" discrepancies
must be resolved. A "critical" or an "adjudicatively significant"
discrepancy is an error that can alter the outcome of the disability determination.
After certification of the DDS, the appropriate Regional Commissioner will work
with the DDS administrator and appropriate SSA officials to decide when the
DDS can discard paper source documents.
The Social Security Administration's Ticket to Work Program-Employment Networks
Objective
To conduct a performance review of SSA and its contractor MAXIMUS, Inc., to
ensure contract objectives are being met and are in accordance with the Ticket
to Work and Work Incentives Improvement Act of 1999.
Background
The Ticket to Work and Work Incentives Act of 1999 was enacted to enable eligible
Social Security and SSI recipients with disabilities to receive a ticket they
can use to obtain employment services, vocational rehabilitation services, or
other support services from an approved provider of their choice, called an
Employment Network. The Employment Network can be a private organization or
public agency that agrees to work with SSA to provide Vocational Rehabilitation,
employment, and other support services to assist beneficiaries in going to work
and remaining on the job. The Employment Network designs a signed agreement
to help the disabled beneficiary return to work. As of July 25, 2005, SSA had
enrolled 1,347 Employment Networks and 79 Vocational Rehabilitation Agencies.
To date, SSA has issued over 10 million tickets.
The Social Security Administration's Ticket to Work Program-Ticket Assignments
Objective
To determine whether vocational rehabilitation agencies completed Agency Ticket
Assignment Forms (Form SSA-1365) in accordance with the Ticket to Work and Work
Incentives Improvement Act of 1999 and related SSA policies.
Background
Advocates of disabled individuals have charged that State vocational rehabilitation
agencies have taken advantage of the Ticket to Work program at the expense of
the ticket holders. They charge that State vocational rehabilitation agencies
are sending the Ticket to Work program manager Forms SSA-1365, State Agency
Ticket Assignment Form - Ticket to Work and Self-Sufficiency Program, that are
unsigned by the disabled beneficiary. The State vocational rehabilitation agencies
attach an Individual Plan for Employment to the Form. The Individual Plans for
Employment were developed by the State vocational rehabilitation agencies and
the disabled beneficiaries. By doing this, State vocational rehabilitation agencies
have been able to assign tickets without the ticket holders' knowledge.
As of May 20, 2004, 44,850 tickets have been assigned to State vocational rehabilitation
agencies and 4,522 had been assigned to Employment Networks.
Improper payments are defined as any payment that should not have been made
or that was in an incorrect amount. Examples of improper payments include inadvertent
errors, payments for unsupported or inadequately supported claims, or payments
to ineligible beneficiaries. Furthermore, the risk of improper payments increases
in programs with a significant volume of transactions, complex criteria for
computing payments, and an overemphasis on expediting payments.
SSA and the OIG have discussed such issues as detected versus undetected improper
payments and avoidable versus unavoidable overpayments that are outside the
Agency's control and a cost of doing business. OMB issued specific guidance
to SSA to only include avoidable overpayments in its improper payment estimate
because those payments can be reduced through changes in administrative actions.
Unavoidable overpayments that result from legal or policy requirements are not
to be included in SSA's improper payment estimate.
The President and Congress have expressed interest in measuring the universe
of improper payments in the Government. In August 2001, OMB published the PMA,
which included a Government-wide initiative for improving financial performance,
including reducing improper payments. In November 2002, the Improper Payments
Information Act of 2002 was enacted, and OMB issued guidance in May 2003 on
implementing this law. Under the Social Security Act, SSA must estimate its
annual amount of improper payments and report this information in the Agency's
annual Performance and Accountability Report. OMB will then work with SSA to
establish goals for reducing improper payments in its programs.
SSA issues billions of dollars in benefit payments under the Old-Age, Survivors
and Disability Insurance (OASDI) and SSI programs-and some improper payments
are unavoidable. In FY 2004, SSA issued about $522 billion in benefit payments
to about 52 million people. Since SSA is responsible for issuing timely benefit
payments for complex entitlement programs to millions of people, even the slightest
error in the overall process can result in millions of dollars in over- or underpayments.
In FY 2005 (through June), SSA reported that it detected over $3 billion in
overpayments. SSA also noted in its Performance and Accountability report for
FY 2004 that the Agency recovered almost $2 billion in overpayments.
In January 2005, OMB issued a report Improving the Accuracy and Integrity of
Federal Payments that noted that seven Federal programs-including SSA's OASDI
and SSI programs-accounted for approximately 95 percent of the improper payments
in FY 2004. However, this report also noted that SSA had reduced the amount
of SSI improper payments by over
$100 million since levels reported in FY 2003.
SSA has been working to improve its ability to prevent over- and underpayments
by obtaining beneficiary information from independent sources sooner and using
technology more effectively. For example, the Agency is continuing its efforts
to prevent improper payments after a beneficiary dies through the use of Electronic
Death Registration information. Also, the Agency's CDR process is in place to
identify and prevent beneficiaries who are no longer disabled from receiving
payments. Additionally, in FY 2005, SSA implemented eWork-a new automated system
to control and process work related CDRs-which should strengthen SSA's ability
to identify and prevent improper payments to disabled beneficiaries.
SSA is also taking action to prevent and recover improper payments.
Working with us in FY 2005 on an OIG audit of Individuals Receiving Benefits
Under Multiple Social Security Numbers at the Same Address, SSA identified about
$9.2 million in overpayments.
In another FY 2005 review-School Attendance by Student Beneficiaries over Age
18-we estimated that SSA disbursed about $70 million in incorrect payments to
32,839 students. SSA agreed with our recommendation to ensure the overpayments
are established and collection activities initiated for the incorrect payments
identified in this audit.
We have helped the Agency reduce improper payments to prisoners and improper
SSI payments to fugitive felons. However, our work has shown that improper payments-such
as those related to workers' compensation (WC)-continue to occur. Additionally,
with the passage of the Social Security Protection Act of 2004, SSA has new
opportunities and faces new challenges in preventing and recovering improper
payments-such as OASDI benefits to fugitives.
In FY 2006, we plan to complete 20 reviews and begin 18 reviews in this area.
We Plan to Complete the Following Reviews in FY 2006
Controls over Miscellaneous Payments Made Using the Social Security Administration's
Single Payment System
Controls over Old-Age, Survivors and Disability Insurance Replacement Checks
Controls over Payments to Auxiliary Beneficiaries Enumerated After the Primary's
Death
Controls over Survivor's Benefits When Indications Exist a Wage Earner is Alive
Controls over the Social Security Administration's Death Resurrection Process
Cross-program Recovery of Benefit Overpayments
Federal Employees' Compensation Act-Nation-wide Review of Federal Employees
with Wages on the Master Earnings File
Follow-up: Controls over Supplemental Security Income Replacement Checks
Improper Benefits Paid to Dually Entitled Title II Beneficiaries
Improperly Paid Lump Sum Death Payments
Match of Veteran's Affairs Historical Death File Against Social Security Administration
Payment Files
Nursing Home Residents Receiving Supplemental Security Income
Overstated Earnings and Their Effect on Social Security Administration Programs
Payment Accuracy of Disability Insurance Benefits with a Workers' Compensation
Offset
Payments Resulting from Disability Insurance Actions Processed via the Social
Security Administration's Manual Adjustment, Credit and Award Processes
Payments to Surviving Spouses at Retirement Age
The Social Security Administration's Collection of Court-ordered Restitutions
The Social Security Administration's Controls over the Old-Age, Survivors and
Disability Insurance Waiver Approval Process
The Social Security Administration's Controls over the Write-off of Uncollectible
Title XVI Overpayments
The Social Security Administration's Decisions to Terminate Collection Efforts
for Old-Age, Survivors and Disability Insurance Overpayments
We Plan to Begin the Following Reviews in FY 2006
Accuracy of the Social Security Administration's Second Clean-up of Title II
Disability Insurance Cases with a Workers' Compensation Offset
Analysis of the Supplemental Security Income Financial Account Verification
Process
Beneficiaries Who Refuse Part B Medicare Coverage
Disabled Adult Children Not Receiving Old-Age, Survivors and Disability Insurance
Benefits
Effectiveness of Social Security Administration Field Offices' Use of On-line
Access to Detect Wages When Processing Supplemental Security Income Claims
Follow-up: Supplemental Security Income Overpayments
Follow-up: The Social Security Administration's Management of its Federal Employees'
Compensation Act Program
Improper Retirement and Survivor Payments Resulting from the Annual Earnings
Test
Multiple Direct Deposits for Individual Title XVI Payments into the Same Bank
Account
Payments to Spouses and Surviving Spouses over Age 70
Procedures and Circumstances that Result in the Issuance of Supplemental Security
Income Replacement Checks in the Regions with the Greatest Number of Double-check
Negotiations
Supplemental Security Income Recipients' Dedicated Accounts
Suspension of Supplemental Security Income Eligibility for Failure to Provide
Information
The Social Security Administration's Automated Cross-recovery of Supplemental
Security Income Overpayments from Monthly Title II Benefits
The Social Security Administration's Oversight of the Clean-up of Title II Disability
Insurance Cases Involving a Workers' Compensation Offset
Title II Beneficiaries Living in Canada
Title II Benefits with Unearned Income on the Supplemental Security Record
Underpayments on Prior Supplemental Security Records not Recognized on Current
Records
Controls over Miscellaneous Payments Made Using the Social Security Administration's
Single Payment System
Objective
To determine whether SSA has established adequate controls to ensure miscellaneous
payments made through the Single Payment System are valid.
Background
SSA uses the Single Payment System to issue payments for attorney fees and OASDI
payments that cannot be made through the current Title II system. The Single
Payment System was created to ensure the timeliness of payments, stop duplicate
and erroneous payments and document management information.
The Single Payment System is used to make miscellaneous payments:
when payments due for a prior period (such as prior year earnings) and the continuing
status of the case is deferred,
when the computed net amount due exceeds $29,999.99,
to pay a death underpayment to a nonbeneficiary,
to issue an excess refund to a nonbeneficiary or financial institution,
to pay a limited payability check replacement to a terminated beneficiary and
to nonbeneficiaries.
Controls over Old-Age, Survivors and Disability Insurance Replacement Checks
Objective
To determine (1) whether SSA FO and teleservice center employees are following
procedures for nonreceipt of OASDI payments; (2) the effectiveness of controls
over the number of double-check negotiations issued to the same beneficiary
or payee; and (3) the effectiveness of actions to recover double-check negotiations.
Background
When SSA receives a report of nonreceipt of a benefit check, the interviewer
reviews the Master Beneficiary Record, the Payment History Update System, the
Supplemental Security Record, or Inquiry Response queries to determine whether
the nonreceipt report is appropriate. If appropriate, and the required delivery
time has elapsed, the nonreceipt report is transmitted with a B- or C-stop,
as appropriate, via direct input to the central office.
In certain situations, a replacement check should not be issued to a beneficiary
until SSA receives a reply from Treasury on the status of the original check
if the MBR contains a special message alerting that the claimant has previously
misused the non-receipt reporting process. SSA staff can annotate the Master
Beneficiary Record with a special message if a claimant negotiated both an original
and a replacement check within the 2 years immediately preceding a claim of
non-receipt.
Controls over Payments to Auxiliary Beneficiaries Enumerated After the Primary's
Death
Objective
To determine whether controls over payments to auxiliary beneficiaries enumerated
after a wage earner's death were effective.
Background
Children, widows, spouses, and parents who receive Social Security benefits
based on a primary wage earner's Social Security record are referred to as auxiliary
beneficiaries. Each auxiliary beneficiary must have an assigned SSN to receive
benefits. If an auxiliary or survivor claimant does not have an SSN, an Application
for a Social Security Card (Form SS-5) must be completed.
The primary wage earner's SSN is used to track the auxiliary beneficiary's benefit
payments. SSA commonly refers to the auxiliary beneficiary's SSN as the Beneficiary's
Own Account Number and maintains this information on the Master Beneficiary
Record.
In the Dallas Region, the Office of Investigations found an SSA employee was
committing fraud by enumerating nonexistent children for deceased wage earners.
The "false" children applied for survivor's benefits, and the benefits
were deposited into bank accounts that were accessible by the SSA employee.
The fraudulently obtained funds were then used at the employee's discretion.
In all these cases, the fictitious children were enumerated after the primary's
date of death.
Controls over Survivor's Benefits When Indications Exist a Wage Earner is Alive
Objective
To determine the appropriateness of continued survivor's benefits when SSA records
indicate the wage earner is alive.
Background
SSA accepts and posts death reports for nonbeneficiaries received from a relative,
friend, neighbor, or others. The reporter must provide the name, date of birth,
and SSN before SSA can add the death to the Numident. These reports can be made
by mail, telephone, or in person. Although SSA may accept death reports for
nonbeneficiaries from third parties, proof of death is required when a claimant
applies for benefits based on the earnings of a deceased person or when a claimant's
eligibility is dependent on another person's death. If the death report is posted
in error, SSA deletes the death data from its Numident.
During our audit of Social Security Number Cards Issued After Death, we found
survivor's benefits paid without proof of death. We also identified 15 cases
in which the primary account holder personally applied for a replacement card
while survivor's payments were being made to the numberholder's auxiliary beneficiaries.
During our review of the SSN application, we determined that SSA verified the
individuals' identities to issue the SSN cards. Even after the individuals'
identities were verified, the survivor's benefits continued.
Controls over the Social Security Administration's Death Resurrection Process
Objective
To assess SSA's procedures and internal controls for its Death Resurrection
Process.
Background
On March 18, 2003, SSA changed the death resurrection process; however, it appears
that vulnerabilities remain under the new procedures. Unless the death input
is an obvious administrative error, a face-to-face interview is required with
the individual. Proof of identity is documented electronically and annotated
to show the names of two SSA employees: an initiator and an approver. The approver
then takes action to resume benefit payments. If the reinstatement action results
in an exception, the matter is referred to the Payment Service Center for resumption
of benefits.
Cross-Program Recovery of Benefit Overpayments
Objective
To review the Agency's actions pertaining to cross-program recovery of benefit
overpayments as authorized by the Social Security Protection Act of 2004.
Background
The Social Security Protection Act of 2004, section 210, authorizes SSA to recover
overpayments paid under one program from the benefit payments of another program.
The provision allows the Agency to withhold up to 100 percent of any underpayment
and 10 percent of ongoing monthly benefit payments.
Federal Employees' Compensation Act-Nation-wide Review of Federal Employees
with Wages on the Master Earnings File
Objective
To determine whether Federal employees are receiving Federal Employees' Compensation
Act (FECA) payments for periods in which wages were reported on SSA's Master
Earnings File.
Background
FECA provides income and medical cost protection to covered Federal civilian
employees injured on the job, employees who have incurred a work-related injury
or occupational disease and beneficiaries of employees whose death is attributable
to a job-related injury or occupational disease. It provides payment as compensation
for lost wages, monetary awards for bodily impairment or disfigurement, medical
care, vocational rehabilitation, and survivor's compensation.
FECA is administered by the Office of Workers' Compensation Programs, Department
of Labor. Benefits are paid from the Employees' Compensation Fund, which is
principally funded by the Federal agency that employs the injured worker.
Follow-up: Controls over Supplemental Security Income Replacement Checks
Objective
To determine whether SSA has addressed the recommendations made in our prior
audit, Controls over Supplemental Security Income Replacement Checks.
Background
SSA generally issues an immediate replacement for missing checks. If SSA has
reason to believe an individual is misusing policy of immediate replacement,
it can request that Treasury determine the status of the original check before
issuing a replacement payment. In addition, if an individual is unsure whether
a benefit check was received, SSA will direct Treasury to determine the status
of the original check before issuing a replacement.
Improper Benefits Paid to Dually Entitled Title II Beneficiaries
Objective
To assess SSA's controls to prevent improper payments to dually entitled Title
II beneficiaries.
Background
Individuals may be entitled to Title II benefits based on several workers' earnings
simultaneously (for example, the earnings of both parents) but may generally
only be paid on the higher benefit. When a beneficiary becomes entitled to another,
higher benefit, SSA stops issuing the lower benefit payments, thus preventing
an overpayment.
In March 2005, an SSA employee alerted us to a group of cases where it appeared
dually entitled Title II beneficiaries were being overpaid. Based on our analysis
and discussions with SSA program staff, SSA's controls over dual-entitlement
cases could be strengthened.
Improperly Paid Lump Sum Death Payments
Objective
To determine whether SSA is incurring losses due to Lump Sum Death Payments
erroneously paid when an outstanding overpayment remains on the numberholder's
record.
Background
A lump-sum death benefit of $255 may be paid upon the death of a person who
has enough quarters of coverage. This payment is limited to a spouse or a minor
child who, in the month of death, is eligible for certain Social Security benefits
based on the worker's record. If no spouse or child meeting these requirements
exists, the Lump Sum Death Payment is not paid.
SSA policy states that, when there is a recoverable overpayment to any person
on a record, the Lump Sum Death Payment must be withheld. However, Lump Sum
Death Payments are routinely paid through SSA FOs via the Modernized Claims
System. FOs are responsible for recognizing that an overpayment exists on the
record and sending the case to be manually processed in an SSA program service
center. If the FO does not recognize the overpayment on the record, the Modernized
Claims System will erroneously pay the Lump Sum Death Payment rather than reduce
the overpayment.
Match of Veteran's Affairs Historical Death File Against Social Security Administration
Payment Files
Objective
To determine whether SSA has identified all beneficiaries reported by Veteran's
Affairs (VA) as deceased.
Background
In a 2001 audit, we found that SSA had not been matching death records received
from VA for at least 2 years. SSA began matching these records again after our
audit, but this would only ensure future deaths are identified. To identify
all deaths, SSA needs to obtain a historical death file from VA to match against
SSA program data. Follow-up with SSA in 2003 found the Agency had not pursued
this issue.
We obtained a death file from VA and matched it against Title II and XVI payment
records. We identified 1,691 records with a date of death on VA's file but that
were in current pay status on SSA's records as of June 2005.
Nursing Home Residents Receiving Supplemental Security Income
Objective
To determine whether SSA is obtaining nursing home residential data timely and
effectively processing the data to avoid overpayments.
Background
SSI payments are available under Title XVI of the Social Security Act to people
who are aged, blind, or disabled and have limited resources. Residence in a
nursing home or other long-term care facility may affect an SSI recipient's
eligibility and/or payment amount.
The Social Security Domestic Employment Reform Act of 1994 requires that nursing
homes and other long-term care administrators report the admission of any SSI
recipient to SSA within 2 weeks of admission. SSA requires that FO liaisons
work closely with the administrators and staff of these institutions to facilitate
the flow of information regarding SSA recipients. Further, SSA conducts a monthly
match of records maintained by the Centers for Medicare and Medicaid Services
to identify recipients whose admission to a nursing home has not been reported.
This match produces diary alerts that are sent to field offices for further
processing and verification.
SSA attempts to prevent overpayments to nursing home residents by relying on
recipient self-reporting and maintaining contact with nursing homes to obtain
admissions information. When SSA does not receive timely notification of an
SSI recipient's admission, it may continue to issue benefit payments for months,
or even years, after the month of admission.
Overstated Earnings and Their Effect on Social Security Administration Programs
Objective
To determine whether Title II and XVI recipients are overstating SEI on their
Federal income tax returns and, if so, the effect on SSA programs.
Background
SSA regional offices have reported that disabled Title II and XVI recipients
are overstating SEI on their Federal income tax returns. The overstated SEI
makes the individuals eligible for the Federal Earned Income Tax Credit and
potentially
(1) increases their monthly Title II benefits and (2) allows them to acquire
quarters of coverage for Title II and Medicare benefits.
We have reviewed a number of cases where individuals receiving Title II and/or
XVI disability benefits reported SEI for Tax Years 2000 to 2003 on their Federal
income tax returns. When questioned by SSA, the individuals disclaimed the earnings
and stated their tax preparer instructed them to report the earnings to become
eligible for the Earned Income Tax Credit. SSA removed the SEI from individual
earnings records in most of these cases and was still investigating the other
cases.
We plan to review SSA records to determine whether other SSA regions have experienced
these problems, what efforts have been taken to remove these earnings, what
information has been shared with the IRS, and whether the overstated earnings
have led to improper payments.
Payment Accuracy of Disability Insurance Benefits with a Workers' Compensation
Offset
Objective
To determine the accuracy of DI payments with a WC offset that began between
January 1, 1998 and December 31, 2004.
Background
SSA acknowledged the complexity of administering the WC offset provision related
to DI claims and that these claims have a relatively high rate of payment errors.
As a result, SSA
1. Conducted a nation-wide WC refresher training course.
2. Revised the WC chapter in the Program Operations Manual System.
3. Implemented a revised process to
re-verify WC information every 3 years.
4. Released a Title II software redesign to improve payment accuracy by automating
computations.
Payments Resulting from Disability Insurance Actions Processed via the Social
Security Administration's Manual Adjustment, Credit and Award Processes
Objective
To determine the accuracy of DI payments resulting from actions completed through
the Manual Adjustment, Credit and Award Processes (MADCAP).
Background
SSA administers the OASDI program under Title II of the Social Security Act.
MADCAP is a system used to manually establish, change or correct information
maintained on a Title II claimant's Master Beneficiary Record. When SSA's direct
input systems cannot automatically process certain actions, SSA's program service
center staff manually processes the actions. Certain manual actions can result
in MADCAP payments. Between July 1, 2004 and September 30, 2004, SSA made over
$773.8 million in MADCAP payments, of which $578.4 million (74.7 percent) was
to DI beneficiaries.
Payments to Surviving Spouses at Retirement Age
Objective
To determine whether surviving spouses are receiving the highest benefit due
them at retirement age and SSA properly identified and notified eligible survivors
about those higher benefits.
Background
Title II of the Social Security Act provides retirement and disability benefits
to surviving spouses who are over age 60 based on their deceased spouse's earnings.
The Act also provides reduced retirement benefits to individuals with sufficient
earnings who are age 62 or older.
When a surviving spouse under age 62 applies for Title II benefits, the spouse
is limited to survivor benefits because they are not eligible for retirement
benefits. If the spouses are age 62 but under full retirement age, they may
be eligible to receive reduced retirement benefits based on their own earnings.
Surviving spouses who elect not to receive reduced retirement benefits must
reapply to obtain retirement benefits, when they reach full retirement age.
The Social Security Administration's Collection of Court-ordered Restitutions
Objective
To determine the effectiveness of SSA's efforts to collect court-ordered restitutions.
Background
The Department of Justice (DoJ) has responsibility for collecting payment of
Federal debts through its Financial Litigation Unit. The Financial Litigation
Unit enforces collection of civil debts on behalf of Federal agencies in litigation
that most often involves Federal loan programs, civil penalties assessed by
Federal agencies, and civil fraud actions litigated by the U.S. Attorney's Office.
DoJ may impose collection efforts, such as property liens and garnishment of
wages. DoJ does not, however, discourage the Agency's collection efforts.
SSA's Program Operations Manual System contains procedures for the collection
of court-ordered restitutions. It specifically states that regular adjustment
and recovery policies apply and cites the actions staff must take to ensure
recovery of court-ordered restitutions.
The Social Security Administration's Controls over the Old-Age, Survivors and
Disability Insurance Waiver Approval Process
Objective
To determine (1) whether SSA's waiver approval process for administrative waivers
of $500 or less safeguard program integrity for the OASDI program and (2) if
waiver decisions exceeding $500 are in accordance with Title II of the Social
Security Act.
Background
The OASDI program provides protection against the loss of earnings due to retirement,
disability or death.
Payments in an amount greater than the amount to which an individual is entitled
are considered overpayments. When an overpayment occurs, it is SSA's responsibility
to identify the overpayment and pursue recovery of the debt. Beneficiaries can
seek relief from repaying an overpayment by requesting a waiver. Generally,
SSA policy allows field office personnel to waive recovery of an overpayment
if the beneficiary is without fault and recovery would "defeat the purpose
of Title II" or is "against equity and good conscience."
The Social Security Administration's Controls over the Write-off of Uncollectible
Title XVI Overpayments
Objective
To determine whether SSA properly classified Title XVI overpayments as uncollectible.
Background
To determine whether an individual qualifies for SSI payments, SSA relies on
beneficiary self-disclosure of their financial position and computer matching
of financial data from other Federal and State agencies. SSI recipients' income
and living expenses may vary over time. If this financial information is not
reported to SSA promptly, SSI payments could be made in error and may result
in overpayments. In certain situations, SSA determines the overpayment is uncollectible
and elects to write the debt off. Generally, SSA writes off uncollectible overpayments
when the debt is discharged in a Bankruptcy Court decision,
an ALJ declared the overpayment uncollectible, the overpaid beneficiary is dead
and all proper efforts to collect the overpayment have proved fruitless, there
was an early delivery of an SSI check in the month of the recipient's death,
SSA's system erroneously computed an overpayment, and presumptive disability
payments were paid in an earlier month when a later date of onset was established.
In FY 2004, SSA wrote off about $84 million in overpayments designated with
an "N" Transaction code and a "blank" Recovery Transaction
Code.
The Social Security Administration's Decisions to Terminate Collection Efforts
for Old-Age, Survivors and Disability Insurance Overpayments
Objective
To determine whether SSA's decisions to terminate collection efforts for OASDI
overpayments were in accordance with its policies and procedures.
Background
SSA may decide to terminate collection efforts after all collection tools have
been used and an overpayment is considered uncollectible. Although collection
efforts cease, the overpayments are maintained on SSA's Recovery of Overpayments
Accounting and Reporting System as inactive debts that may be recovered in the
future. Our August 2004 data extract from SSA's Recovery of Overpayments Accounting
and Reporting System identified 64,753 decisions to terminate collection efforts
for overpayments totaling approximately $312.8 million in FY 2003.
Internal control comprises the plans, methods, and procedures used to meet
missions, goals, and objectives. Internal controls help safeguard assets and
prevent and detect errors and fraud. Assessing the internal control environment
is important since internal control is a critical part of performance-based
management. SSA's internal control environment helps its managers achieve desired
results through effective stewardship of public resources.
SSA is responsible for implementing policies for the development of claims under
the DI and SSI programs. Disability determinations under DI and SSI are performed
by DDSs in each State in accordance with Federal regulations. Each DDS is responsible
for determining claimants' disabilities and ensuring adequate evidence is available
to support its determinations. Each DDS is authorized to purchase medical examinations,
x-rays, and laboratory tests on a consultative basis to supplement evidence
obtained from the claimants' physicians or other treating sources. There are
52 DDSs: 1 in each of the 50 States, the District of Columbia, and Puerto Rico.
SSA reimburses the DDS for 100 percent of allowable expenditures up to its approved
funding authorization. In FY 2005, SSA allocated over $1.7 billion to fund DDS
operations.
During FY 2000 through July 2005, we conducted 39 DDS administrative cost audits.
In 20 of the 39 audits, we identified internal control weaknesses. For example,
we reported that improvements were needed to ensure Federal funds were properly
drawn and payments to medical providers were in accordance with Federal regulations.
The lack of effective internal controls can result in the mismanagement of Federal
resources and increase the risk of fraud.
In 15 of the 39 DDS administrative cost audits, we reported about $21.2 million
in unallowable indirect costs. As a result, we initiated a separate review of
SSA's oversight of indirect costs. We reported that SSA needed to improve its
oversight of indirect costs claimed by DDSs to ensure SSA funds obligated by
DDSs benefited SSA and were equitably distributed to its programs.
Congress, external interested parties, and the general public need sound data
to monitor and evaluate SSA's performance. SSA relies primarily on internally
generated data to manage the information it uses to administer its programs
and report to Congress and the public. The necessity for good internal data
Government-wide has resulted in the passage of several laws, including the Government
Performance and Results Act. In addition to legislation calling for greater
accountability within the Government, the PMA has focused on the integration
of the budget and performance measurement processes. The PMA calls for agencies
to, over time, identify high quality outcome measures, accurately monitor programs'
performance, and integrate this presentation with associated costs.
SSA sets forth its mission and strategic goals in strategic plans, establishes
yearly targets in its annual performance plan, and reports on its performance
annually. Each year, we assess the reliability of SSA's performance data and
evaluate the extent to which SSA's performance measures describe its planned
and actual performance. Assessing the control environment over DDSs and SSA's
performance measures helps ensure the Agency is managing its resources to meet
its mission.
In FY 2006, we plan to complete 20 reviews, begin 19 reviews, and oversee the
reviews of
16 performance measures in this area.
We Plan to Complete the Following Reviews in FY 2006
Administrative Costs Claimed by State Disability Determination Services: Indiana,
Louisiana, Maine, Maryland, New Jersey, North Carolina, Oklahoma, Tennessee,
Texas, Virginia, Washington D.C., and Wisconsin
Controls over Representative Payee Accounting of Social Security Funds (Public
Law 108-203)
Costs Claimed by the Virginia Commonwealth University on Contract Number 600-99-38679
Disclosure Statement for MAXIMUS Human Services Operations
Fiscal Year 2005 Financial Statement Audit Oversight
Fiscal Year 2005 Inspector General Statement on the Social Security Administration's
Major Management Challenges
Indirect Cost Rates for MAXIMUS, Inc.
Indirect Costs for the Connecticut Disability Determination Services for the
Period July 1, 2003 -September 30, 2005
The Social Security Administration's Compliance with Employee Tax Requirements
We Plan to Begin the Following Reviews in FY 2006
Administrative Costs Claimed by the California, Florida, Idaho, Illinois, Mississippi,
Missouri, New York, Puerto Rico, Rhode Island, Utah, Vermont, and West Virginia
Disability Determination Services
Contract Audit of Contract Number 300-01-60127-AAU AP
Costs Incurred by MAXIMUS, Inc., on Contract Number 0600-00-60020
Credit Evaluations on Social Security Administration Employees Before the Issuance
of Government Charge Cards
Fiscal Year 2006 Financial Statement Audit Oversight
Fiscal Year 2006 Inspector General Statement on the Social Security Administration's
Major Management Challenges
Indirect Costs Claimed by the Kansas Disability Determination Services
The Social Security Administration's Oversight of Contracts
We Plan to Oversee Reviews of 16 Performance Indicators
Administrative Costs Claimed by State Disability Determination Services
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Objective
We will be conducting reviews in the following State DDSs: Indiana, Louisiana,
Maine, Maryland, New Jersey, North Carolina, Oklahoma, Tennessee, Texas, Virginia,
Washington D.C., and Wisconsin to:
1. Evaluate the DDS' internal controls over the accounting and reporting of
administrative costs,
2. Determine whether costs claimed by the DDS were allowable and funds were
properly drawn, and
3. Assess limited areas of the general security controls environment.
Background
The DI program was established in 1956 under Title II of the Social Security
Act. The program is designed to provide benefits to wage earners and their families
in the event the wage earner becomes disabled. In 1972, Congress enacted the
SSI program under Title XVI of the Social Security Act. The SSI program provides
a nationally uniform program of income to financially needy individuals who
are aged, blind or disabled. Disability determinations under DI and SSI are
performed by an agency in each State in accordance with Federal regulations.
In carrying out its obligation, each State agency is responsible for determining
the claimants' disabilities and ensuring adequate evidence is available to support
its determinations. DDSs are authorized to purchase consultative examinations
to supplement evidence obtained from the claimants' physicians or other treating
sources. SSA pays the DDS for 100 percent of allowable expenditures.
Controls over Representative Payee Accounting of Social Security Funds (Public
Law 108-203)
Objective
To ensure annual representative payee accounting is done timely and accurately
and that, when the accounting is not completed, SSA takes appropriate action.
Background
The Social Security Protection Act of 2004 was signed into law on March 2, 2004.
It gives SSA the authority to redirect delivery of benefit payments when a representative
payee fails to provide a required accounting report. The provision was effective
September 2004.
Costs Claimed by the Virginia Commonwealth University on Contract Number 600-99-38679
Objective
To determine whether costs claimed by the Virginia Commonwealth University were
allowable, allocable and reasonable according to applicable Federal regulations
and the terms of the contract.
Background
SSA's Office of Acquisition and Grants requested an audit of costs Virginia
Commonwealth University incurred for Contract Number 600-99-38679. This contract
was awarded to Virginia Commonwealth University to continue its development
of a prototype software decision tool that would let SSA determine the net benefit
effects for beneficiaries considering returning to work. Virginia Commonwealth
University claimed $2.1 million for the contracted service period from September
30, 1999 through March 29, 2005.
Disclosure Statement for MAXIMUS Human Services Operations
Objective
To ensure the adequacy of the disclosure statement submitted by MAXIMUS for
its Human Services segment, effective
October 1, 2003. Specifically, we will determine whether the disclosure statement:
is current, accurate, complete and adequately describes the contractor's cost
accounting practices.
In addition, we will determine whether the disclosed practices comply with Federal
cost accounting standards.
Background
SSA contracted with MAXIMUS to manage the Ticket to Work program. Because of
the proportion of contract funding provided to MAXIMUS, SSA has been designated
with audit oversight for FYs 2000 through 2003. As the cognizant agency, SSA
is required to review, negotiate, and approve MAXIMUS' cost allocation plans
or indirect cost proposals on behalf of all Federal agencies. After FY 2003,
SSA is cognizant for those contracts under the MAXIMUS Human Services Operations
segment. During FY 2005, MAXIMUS submitted to SSA's Office of Acquisition and
Grants a disclosure statement, effective October 1, 2003, for the Human Services
Operations segment. The disclosure statement indicates cost accounting practices
and changes since the prior submission. As the cognizant agency, SSA has requested
we conduct an adequacy determination of the disclosure statement.
Fiscal Year 2005 Financial Statement Audit Oversight
Objective
To fulfill our responsibilities under the Chief Financial Officers Act of 1990
and related legislation for ensuring the quality of the audit work performed,
we will monitor PricewaterhouseCoopers' audit of SSA's FY 2005 financial statements.
Background
The Chief Financial Officers Act of 1990 requires that agencies annually prepare
audited financial statements. Each agency's Inspector General is responsible
for auditing these financial statements to determine whether they provide a
fair representation of the entity's financial position. This annual audit also
includes an assessment of the Agency's internal control structure and its compliance
with laws and regulations. PricewaterhouseCoopers will perform the audit work
to support this opinion of SSA's financial statement. We will monitor the contract
to ensure the reliability of PricewaterhouseCoopers' work to meet our statutory
requirements for auditing the Agency's financial statements.
Fiscal Year 2005 Inspector General Statement on the Social Security Administration's
Major Management Challenges
Objective
To summarize and assess SSA's progress in addressing its most serious management
and performance challenges as identified by the OIG.
Background
In November 2000, the President signed the Reports Consolidation Act of 2000,
which requires that Inspectors General provide a summary and assessment of the
most serious management and performance challenges facing the agencies and the
agencies' progress in addressing these challenges.
We identified the following management challenges for FY 2005.
Social Security Number Protection
Management of the Disability Process
Improper Payments
Internal Control Environment and Performance Measures
Systems Security and Critical Infrastructure Protection
Service Delivery
We will summarize each challenge and document actions SSA has taken to address
them.
Indirect Cost Rates for MAXIMUS, Inc.
Objective
To review the indirect cost rates used by MAXIMUS and recommend adjustments
to those rates, as necessary, for FYs 2000 through 2003.
Background
MAXIMUS offers various services to Federal clients and has worked with over
100 agencies and offices over its 28-year history. Some of the services provided
are financial management and consulting, research and evaluation studies, education,
health care, and human resource management consulting.
MAXIMUS must submit indirect cost proposals to the cognizant Federal agency
for approval. For the 4 years of our audit, SSA was the cognizant agency.
Indirect Costs for the Connecticut Disability Determination Services for the
Period July 1, 2003 - September 30, 2005
Objective
To assess the indirect costs for the Connecticut DDS for the period
July 1, 2003 - September 30, 2005 and follow up on prior recommendations.
Background
Disability determinations are performed by DDSs in each State or other responsible
jurisdictions according to Federal regulations. Each DDS is responsible for
determining claimants' disabilities and ensuring adequate evidence is available
to support its determinations. SSA reimburses the DDS for 100 percent of the
allowable expenditures, including direct and indirect costs.
SSA requested this audit in response to a prior Audit of the Administrative
Costs Claimed by the Connecticut Disability Determination Services. Specifically,
SSA raised the issue of rising indirect costs resulting from the State of Connecticut's
change in methodology for determining indirect costs from an indirect cost rate
agreement to a Public Assistance Cost Allocation Plan.
The Social Security Administration's Compliance with Employee Tax Requirements
Objective
To determine whether SSA is (1) appropriately paying employment taxes on wages
and (2) reporting required wage information and other payments on the designated
IRS forms.
Background
Federal agencies are subject to the same requirements as all employers. The
Internal Revenue Code requires that employers pay employment taxes on wages
and report wages and certain other payments on various IRS forms. Federal employment
taxes include Federal income tax withholdings, social security, and Medicare
taxes. Employers are required to deposit employment taxes on a daily, weekly,
or semi-weekly schedule depending on the amount of tax they accumulate for deposits.
Performance Indicator Audits: The Social Security Administration's Performance
Data
Objective
To determine the reliability of the performance data SSA uses to measure selected
performance indicators
Background
Congress passed the Government Performance and Results Act of 1993 to bring
greater accountability to Federal agencies. The Government Performance and Results
Act established a system for strategic and annual performance planning and reporting
to set goals for program performance and to measure results. The law requires
that each agency create
(1) 5-year strategic plans, (2) annual performance plans, and (3) annual performance
reports. SSA released its latest strategic plan in 2003, which covers FYs 2003
through 2008. The Agency's latest annual performance plan was released in March
2005. It presents the annual performance indicators and goals for FY 2006. SSA
established 4 strategic goals, and 44 Government Performance and Results Act
performance measures, and an additional 9 Program Assessment Rating Tool performance
measures.
The success of SSA's performance measurement initiatives hinges on the quality
of the data used to measure and report upon program performance. Consequently,
it is important that SSA have assurance the data reported are reliable and meaningful
and its performance report will be useful to the Congress and Agency management.
As a result, we will award a contract to test SSA's performance data and the
systems from which they are generated to gain assurance that the data reported
in the performance plan are reliable and meaningful. We will oversee the contractor,
who will assess the reliability of the performance data used with the following
performance measures.
Agency Decisional Accuracy Rate
Align Employee Performance with Agency Mission and Strategic Goals
Average Processing Time for Hearings
Average Processing Time for Initial Disability Claims
DDS Cases Processed Per Workyear
Enhance Efforts to Improve Financial Performance Using Management Cost Accountability
Systems
Improve Workload Information Using Social Security Unified Measurement System
Increase the Percent of Employee Reports (W-2 Forms) Filed Electronically
Increase the Usage of Electronic Entitlement and Supporting Actions
Maintain Zero Outside Infiltrations of SSA's Programmatic Mainframes
Minimize Skill and Knowledge Gaps in Mission-Critical Positions
Number of DI and SSI Beneficiaries, with Tickets Assigned, Who Work (over Calendar
Year 2003 Baseline of 2,726)
Number of Initial Disability Claims Processed by the Disability Determination
Services
Optimize the 800-Number Agent Busy Rate
Optimize the Speed in Answering 800-Number Calls
Reduce the Average Number of Days Needed to Process Hearings Appeals
The information technology revolution has changed the way governments and
businesses operate. Today, the growth in computer interconnectivity brings a
heightened risk of disrupting or sabotaging critical operations, reading or
copying sensitive data, and tampering with critical processes. Those who wish
to disrupt or sabotage critical operations have more tools than ever. The United
States works to protect the people, economy, essential services, and national
security by ensuring that any disruptions are infrequent, manageable, of minimal
duration, and cause the least damage possible. The Government must continually
strive to secure information systems for critical infrastructures.
SSA's information security challenge is to understand and mitigate system vulnerabilities.
At SSA, this means ensuring the security of its critical information infrastructure,
such as access to the Internet and its networks. By improving systems security
and controls, SSA will be able to use current and future technology more effectively
to fulfill the public's needs. The public will not use electronic access to
SSA services if it does not believe those systems are secure. SSA addresses
critical information infrastructure and systems security in a variety of ways.
For example, it has created a Critical Infrastructure Protection work group
that works toward compliance with various directives, such as the Homeland Security
Presidential Directives (HSPD) and the Federal Information Security Management
Act of 2002. Additionally, SSA created the Office of Information Technology
Security Policy within the Office of the Chief Information Officer.
HSPD 7 requires that all Federal department and agency heads identify, prioritize,
assess, remediate, and protect their respective critical infrastructure and
key resources. To comply with HSPD 7, SSA submitted its Critical Federal Infrastructure
Protection Plan to OMB in 2004. SSA continues to work with OMB to resolve any
outstanding issues regarding its plan. We have worked with SSA to help meet
these requirements. The Agency plans must address identification, prioritization,
protection, and contingency planning, including the recovery and reconstitution
of essential capabilities.
HSPD 12 mandates the development of a common identification Standard for all
Federal employees and contractors. The Agency recently created a work group
that coordinates with other Agencies and OMB to address HSPD 12. We plan to
evaluate SSA's efforts to comply with HSPD 12, as required by Federal Information
Processing Standards 201.
Another important systems security issue is the restriction of physical access
to the Agency's systems and data. We reported on physical security problems
at several hearing offices and noted that non-SSA employees were allowed inappropriate
access to secured areas. Though the managers at these sites took prompt action
to remedy the security breaches, we believe the same security concerns may be
present at other hearing offices. Because of our findings at several hearing
offices, we plan to expand our reviews to determine whether OHA has established
adequate physical security controls at its numerous remote hearing sites.
In addition, under the Federal Information Security Management Act, we independently
evaluate SSA's security program. Systems security is a key component of this
initiative, and we will continue to work with the Agency to resolve outstanding
issues so it can reach green on the Electronic Government Scorecard.
In FY 2006, we plan to complete 16 reviews and begin 7 reviews in this area.
We Plan to Complete the Following Reviews in FY 2006
Compliance with Homeland Security Presidential Directive 12 Personal Identification
Verification Guidelines in Federal Information Processing Standards 201
Fiscal Year 2006 Federal Information Security Management Act
Physical Security at Remote Hearing Sites (10 reviews conducted)
Physical Security at the Great Lakes, Northeastern and Southeastern Program
Service Centers (3 reviews conducted)
The Social Security Administration's E-mail Security
We Plan to Begin the Following Reviews in FY 2006
Death Alert Control and Update System
Follow-up: Information System Controls for the Social Security Administration's
Representative Payee System
General Controls Review of the Florida Disability Determination Service Administration
Office
Monitoring the Social Security Administration's Development of a Second Data
Center
Physical Security at the Mid-America Program Service Center
The Social Security Administration's Implementation of Active Directory
The Social Security Administration's Patch Management Process
Compliance with Homeland Security Presidential Directive 12 Personal Identification
Verification Guidelines in Federal Information Processing Standards 201
Objective
To evaluate SSA's compliance with HSPD 12, as required by Federal Information
Processing Standards 201.
Background
HSPD 12 mandates the development of a common identification "Standard"
for all Federal employees and contractors and establishes milestones for adoption
of the new identification Standard. HSPD 12 requires that the heads of executive
departments and agencies, require the use of identification by Federal employees
and contractors that meets the Standard in gaining physical access to federally
controlled facilities and logical access to federally controlled information
systems. HSPD 12 requires that agencies identify and validate that every Federal
employee and contractor have at least a National Agency Check and Inquiry or
higher security investigation on file.
In response to HSPD 12, National Institute of Standards and Technology published
Federal Information Processing Standards 201. Federal Information Processing
Standards 201 sets the "Standard" for Government-wide reliable Personal
Identification Verification for Federal employees and contractors. Federal Information
Processing Standards 201 addresses the fundamental control and security objectives
of HSPD 12.
Fiscal Year 2006 Federal Information Security Management Act
Objective
To determine whether SSA is in compliance with the Federal Information Security
Management Act for FY 2006.
Background
The Federal Information Security Management Act requires that Agencies maintain
an agency-wide information security program. Annual reviews of the security
program are performed by the agency and the OIG. Each year, OMB issues questions
to be answered concerning agencies' compliance with the Federal Information
Security Management Act.
Physical Security at Remote Hearing Sites (10 Reviews Conducted)
Objective
To review controls over physical security in OHA's remote hearing sites.
Background
OHA conducts work at remote sites to accommodate the hearing requests of individuals
who do not live near a hearing office. OHA conducts about 40 percent of its
hearings in remote sites.
OHA establishes temporary or permanent remote sites based on case receipts,
service to the claimant, and cost factors. Employees who work at these remote
sites (1) may operate in locations not under Government control, (2) perform
their duties alone or in teams of 2 or 3 employees, and/or (3) are normally
not accompanied by management officials.
Employees who work at remote hearing sites may need additional security measures
because of their isolation from other OHA offices.
Physical Security at the Great Lakes, Northeastern and Southeastern Program
Service Centers
Objective
To determine (1) what actions SSA has taken to address physical security vulnerabilities
identified in prior reviews and (2) whether physical security standards used
by other Federal agencies, such as the Department of Defense and VA, can be
applied to SSA facilities.
Background
Following the 1994 Oklahoma City bombing, a DoJ study created minimum physical
security standards for Federal buildings. The President directed Federal agencies
to upgrade the physical security of their facilities based on DoJ's recommendations.
SSA placed its version of the DoJ standards into its Administrative Instructions
Manual System.
Recently, several Federal agencies have published physical security guidelines
that go beyond the DoJ minimum standards. In 2002, the Department of Defense
issued a report entitled, DoD Minimum Antiterrorism Standards for Buildings,
and made it available to the general public. A VA Task Group recently recommended
that all VA facilities adopt the Department of Defense standards. The Federal
Emergency Management Administration published considerable scientific research
to support that buildings not meeting Department of Defense standards are vulnerable
to catastrophic consequences if subjected to a terrorist attack.
The Social Security Administration's E-mail Security
Objective
To evaluate the adequacy of SSA's electronic mail (e-mail) services security
controls designed to ensure confidentiality, availability, and integrity of
sensitive information. As part of the audit, we will evaluate SSA's management,
operational, and technical controls related to e-mail security for consistency
with Federal standards and guidelines and industry best practices.
Background
E-mail is used extensively within SSA for operational and business communications.
Sensitive data are often sent via e-mail within, as well as outside, SSA. In
today's network environment, e-mail is also a preferred path by hackers to distribute
viruses, worms, and spam. It is critical to protect information sent or received
via e-mail from unauthorized use, disclosure, modification, destruction, or
exploitation.
SSA's e-mail system is based on the Microsoft Outlook Exchange 2003 software
product. Employees can access their e-mail either from within SSA or remotely
via a workstation (desktop or laptop). SSA employees can also use e-mail when
communicating with individuals outside the Agency.
One of SSA's goals is to deliver high-quality, "citizen-centered"
service. This goal encompasses traditional and electronic services to applicants
for benefits, beneficiaries and the general public. It includes services to
and from States, other agencies, third parties, employers, and other organizations,
including financial institutions and medical providers. This area includes basic
operational services, and three of the greatest challenges in the area are the
representative payee process, managing human capital and electronic Government.
Representative Payee Process
When SSA determines a beneficiary cannot manage his or her benefits, SSA selects
a representative payee who must use the payments for the beneficiary's needs.
There are about 5.4 million representative payees who manage benefit payments
for 6.9 million beneficiaries. While representative payees provide a valuable
service for beneficiaries, SSA must provide appropriate safeguards to ensure
they meet their responsibilities to the beneficiaries they serve.
We have completed several audits of representative payees. Our audits have identified
deficiencies with the accounting for benefit receipts and disbursements, vulnerabilities
in the safeguarding of beneficiary payments, poor monitoring and reporting to
SSA of changes in beneficiary circumstances, inappropriate handling of beneficiary-conserved
funds, and
improper charging of fees.
In March 2004, the President signed into law the Social Security Protection
Act of 2004. This Act provides several new safeguards for those individuals
who need a representative payee. In addition, it presents significant challenges
to SSA to ensure representative payees meet beneficiaries' needs. For example,
it requires that SSA conduct periodic on-site reviews of representative payees
and a statistically valid survey to determine how payments made to representative
payees are being used. It also authorizes SSA to impose civil monetary penalties
for offenses involving misuse of benefits received by a representative payee.
In FY 2006, we plan to conduct reviews that focus on SSA's efforts to implement
the provisions of the Social Security Protection Act of 2004.
Managing Human Capital
SSA, like many other Federal agencies, is being challenged to address its human
capital shortfalls. As of January 2005, GAO has continued to identify strategic
human capital management on its list of high-risk Federal programs and operations.
GAO initially identified human capital management as high-risk in January 2001.
In addition, Strategic Management of Human Capital is one of five Government-wide
initiatives contained in the PMA.
By the end of 2012, SSA projects its DI and Old-Age and Survivors Insurance
benefit rolls will increase by 35 percent and 18 percent, respectively. Further,
by FY 2014, SSA projects 56 percent of SSA's employees will be eligible to retire.
This retirement wave will result in a loss of institutional knowledge that will
affect SSA's ability to deliver quality service to the public.
Along with the workload increase, the incredible pace of technological change
will have a profound impact on both the public's expectations and SSA's ability
to meet those expectations. In the face of these challenges, technology is essential
to achieving efficiencies and enabling employees to deliver the kind of service
that every claimant, beneficiary and citizen needs and deserves.
SSA's Office of Systems is responsible for guiding and managing the development,
acquisition, and use of the information technology resources that support the
Agency's program and business functions. The Office of Systems estimates 66
percent of its FY 2003 Information Technology workforce will be eligible for
retirement over the next 10 years.
The critical loss of institutional skills and knowledge, combined with greatly
increased workloads at a time when the baby-boom generation will require its
services must be addressed by succession planning, strong recruitment efforts,
and the effective use of technology. As of June 30, 2005, SSA continued to score
"green" in "Progress in Implementing the President's Management
Agenda" on the OMB Scorecard.
Electronic Government
The Expanded Electronic Government, or "e-Government," initiative
of the PMA directs the expanded use of the Internet to provide faster and better
access to Government services and information. Specifically, e-Government instructs
SSA to help citizens find information and obtain services organized according
to their needs.
According to SSA, its e-Government strategy is based on the deployment of high-volume,
high-payoff applications, for both the public and the Agency's business partners.
To meet increasing public demands, SSA has pursued a portfolio of services that
enable on-line transactions and increase opportunities for the public to conduct
SSA business electronically in a private and secure environment.
Over the past 6 years, SSA has launched the Internet Social Security Benefit
Application and created on-line requests for Social Security Statements, replacement
Medicare cards, proof of income letters and change of address. The Agency also
added more on-line reports, such as the Adult Disability and Work History Report,
the Childhood Disability Report and the Appeals Disability Report.
In FY 2006, we plan to complete 14 reviews and begin 9 reviews in this area.
We Plan to Complete the Following Reviews in FY 2006
Assessment of the Adequacy of the Social Security Administration's Controls
over the Use of Signature Proxies on Applications for Benefits
Assessment of the Implementation of Workers' Compensation Offset in Title II
Redesign Release 3
Beneficiaries in Suspended Payment Status Pending the Selection of a Representative
Payee
Concurrent Beneficiaries Receiving Representative Payee and Direct Payments
Follow-up: The Social Security Administration's Management of Congressional
Inquiries
Follow-up: The Social Security Administration's Procedures to Identify Representative
Payees Who Are Deceased
New System to Provide Disabled Beneficiaries Receipts for Work Activity
Referral of Information from the Telephone Service Centers to the Responsible
Field Offices
Representative Payee On-site Reviews of State Institutions
Representative Payees Receiving Benefits for Children in Foster Care
Restitution of Misused Funds to Beneficiaries Under Public Law 108-203
Scott County Community Services-A Fee-for-Service Representative Payee for the
Social Security Administration
The Social Security Administration's Nation-wide Asbestos Program
The Social Security Administration's Office of Systems' Training Program
We Plan to Begin the Following Reviews in FY 2006
Assessment of Advanced Aged Beneficiaries' Need for a Representative Payee
Beneficiaries Who Previously Had Representative Payees Receiving Benefit Payments
Directly
Medicare Modernization Act-Part D Subsidy Income Verification
Organizations Serving as Representative Payees Who Are Not Registered with the
Social Security Administration
Organizational Payees Who Do Not Promptly Notify the Social Security Administration
When a Beneficiary in Their Care Dies
Public Law 108-203, Section 105, Liability of Representative Payees for Misused
Funds
The Accuracy of Addresses on Social Security Statements
The Social Security Administration's Competitive Sourcing Efforts
The Social Security Administration's Electronic Disability Training Program
Assessment of the Adequacy of the Social Security Administration's Controls
over the Use of Signature Proxies on Applications for Benefits
Objective
To assess the adequacy of controls over the use of signature proxies as alternatives
to the pen-and-ink or "wet" signatures on applications for benefits.
Background
SSA is evolving its claims-taking process to an electronic environment. To eliminate
the need for retaining paper applications, SSA implemented three signature proxy
alternatives to the pen-and-ink or "wet" signatures required on applications
for Title II and XVI benefit payments. The signature alternatives apply to cases
processed on or after June 21, 2004 in SSA's Modernized Claims and the Modernized
Supplemental Security Income Systems. The three types of signature proxies implemented
by SSA are: (1) Attestation; (2) Witnessed Signature; and (3) Click and Sign.
Assessment of the Implementation of Workers' Compensation Offset in Title II
Redesign Release 3
Objective
To assess changes to the WC portion of the Title II Initial Claim and Post Entitlement
System made with the Title II Redesign Release 3 project.
Background
Section 223 of the Social Security Act requires that SSA provide monthly DI
benefits to individuals who meet specific disability requirements. Workers injured
on the job may qualify for DI benefits in addition to benefits under Federal
and State WC programs. However, combined DI and WC benefits could result in
workers receiving more in disability payments than they earned before they became
disabled. To prevent this, Congress enacted the WC offset provision under section
224 of the Social Security Act, which requires that SSA reduce DI benefits by
the amount of any other disability benefit paid under any law or plan of the
United States, a State, or a political subdivision. In each instance, SSA reduces
the DI benefit unless the other disability payment originates in a State with
a "reverse offset" law. For States with a recognized "reverse
offset" law, the WC benefit would be reduced.
In July 2004, SSA implemented Title II Redesign Release 3 to reduce manual tasks,
improve the quality of the data stored on the master records, and reduce the
number of actions that result in exceptions that have to be worked by processing
center technicians by 50 percent. As a result of the Redesign, new data collected
and stored on the Master Beneficiary Record captures additional historical information
and aids field personnel in claims development and post-entitlement actions.
Beneficiaries in Suspended Payment Status Pending the Selection of a Representative
Payee
Objective
To determine whether SSA has adequate controls to ensure payments to beneficiaries
are not improperly withheld pending the selection of a representative payee.
Background
SSA selects representative payees for OASDI beneficiaries and SSI recipients
when representative payments would serve the individual's interests.
SSA policy states that benefits should not be suspended when a beneficiary requires
a representative payee and none is immediately available. Instead, benefits
must be paid directly to the beneficiary while SSA searches for an individual
or organization to serve as a representative payee. However, direct payment
is prohibited to beneficiaries who are legally incompetent and beneficiaries
who are under age 15. Finally, benefits can be suspended for a maximum of 1
month, if SSA determines direct payments to the beneficiary would cause "substantial
harm."
Concurrent Beneficiaries Receiving Representative Payee and Direct Payments
Objective
Determine whether SSA has adequate controls to prevent the direct payment of
concurrent OASDI and SSI benefit payments to individuals who have been appointed
a representative payee.
Background
Some individuals cannot manage or direct the management of their finances because
of their youth or mental and/or physical impairments. Congress granted SSA the
authority to appoint representative payees to receive and manage these beneficiaries'
and recipients' benefit payments. SSA selects representative payees for OASDI
beneficiaries or SSI recipients when representative payments would serve the
individual's interest.
About 6.9 million individuals have representative payees. Of these, approximately
800,000 are concurrently entitled under the OASDI and SSI programs. Generally,
if SSA has made a determination that an individual is incapable of receiving
direct payment under one of its programs, a similar decision would be warranted
under the other program.
Follow-up: The Social Security Administration's Management of Congressional
Inquiries
Objective
To determine the extent to which SSA implemented recommendations from our September
2002 evaluation report concerning its management of congressional inquiries.
Background
Our September 2002 report stated SSA lacked an adequate national system of internal
controls related to its management of congressional inquiries. We found no Agency-wide
automated system for controlling, monitoring, and tracking inquiries. SSA could
not identify the total number of congressional inquiries it received; no component
was designated the responsibility of managing congressional inquiries nationwide;
and multiple components were not complying with Agency-wide policies and procedures
when responding to congressional inquiries.
The Agency agreed with two of our three recommendations. In addition, the Agency
stated "In the spring of 2000, the Office of the Commissioner began efforts
to replace the Commissioner's Correspondence System (CCS) with more current
technology, which would enhance the Agency's ability to track correspondence
processing as well as to facilitate document management. This commercial document
management and workflow software product will form the core of our nationwide
Assignment and Correspondence Tracking (ACT) application."
Follow-up: The Social Security Administration's Procedures to Identify Representative
Payees Who Are Deceased
Objective
To follow up on the recommendations in our September 1999 report.
Background
Our FY 1999 report stated that about 2,091 deceased representative payees received
about $17.3 million in OASDI and SSI benefit payments from the date of the payee's
death through June 1998. Since SSA was not aware that payments had been made
to these deceased payees, the Agency could not be sure the funds had been used
for the sole benefit of the intended beneficiaries.
We also found several conditions that affected the completeness and accuracy
of SSA's payee data files and adversely affected our ability to match these
files with the Agency's Death Master File. We recommended that SSA (1) routinely
match the Death Master File against the Master Representative Payee File, (2)
emphasize the correct procedures to be performed to ensure funds paid to deceased
payees are accounted for and transferred to the new payee, (3) correct instances
where erroneous dates of death are contained on Master Beneficiary Records,
(4) correct instances where the payee's SSN on the Master Beneficiary and Supplemental
Security Records were erroneous, (5) implement an edit to ensure the payee's
SSN is updated on the Master Beneficiary Record whenever a new payee is added,
and (6) identify representative payees for SSI recipients who are not included
in the Master Representative Payee File.
New System to Provide Disabled Beneficiaries Receipts for Work Activity
Objective
To assess SSA's development of a new system to provide receipts to disabled
beneficiaries when they report work and earnings and assess SSA's integration
of the new system into its current architecture.
Background
The Social Security Protection Act of 2004 contains a provision that requires
that SSA issue a receipt to disabled beneficiaries each time they report their
work and earnings. This provision is effective as soon as possible but no later
than 1 year after enactment and until such time as SSA implements a centralized
computer file.
Referral of Information from the Telephone Service Centers to the Responsible
Field Offices
Objective
To determine whether calls received on SSA's 800-number that require FO involvement
are being routed to the FO timely and the FO is timely resolving the pending
issues.
Background
SSA customers frequently contact SSA using the national 800-number to report
changes that affect SSI eligibility and payment amounts (such as changes in
address/living arrangements, income, and resources). SSA operating instructions
require that teleservice representatives make any appropriate changes to the
pending SSI event and, in some circumstances, transfer ownership of the event
to the FO for further development and resolution.
Representative Payee On-site Reviews of State Institutions
Objective
To evaluate the adequacy of SSA's Representative Payee Onsite Review Program
for State hospitals and developmental centers.
Background
The Social Security Disability Benefits Reform Act of 1984 requires that State
hospitals and developmental centers be reviewed once every 3 years. The purpose
of the on-site reviews is to:
explore how SSA and State institutions can improve mutual understanding and
work toward resolving common problems applicable to the beneficiaries for whom
the institution serves as representative payee,
determine whether a State institution's performance as representative payee
conforms with SSA's policies regarding use of benefits and reporting of significant
events, and
determine the extent to which recommendations made in prior reviews have been
implemented and take appropriate action to ensure compliance with SSA's policies.
Representative Payees Receiving Benefits for Children in Foster Care
Objective
To determine whether beneficiaries and recipients in the Baltimore City Department
of Social Services' foster care program had their benefit payments managed by
representative payees who were not their foster care parents and whether these
funds were at-risk.
Background
Some individuals cannot manage or direct the management of their finances because
of their youth or mental and/or physical impairments. Congress granted SSA the
authority to appoint representative payees to receive and manage these beneficiaries'
and recipients' benefit payments. A representative payee may be an individual
or an organization. SSA selects representative payees for OASDI beneficiaries
and SSI recipients when representative payments would serve the individual's
interests. Parents or relatives often serve as representative payees for children
receiving benefit payments from these SSA-administered programs.
The Social Services Administration of the State of Maryland, Department of Human
Resources, administers social services in each of Maryland's 23 counties and
Baltimore City through local departments of social services. The local department
of social services provides adoption, protective and foster care services to
children and families with children.
Restitution of Misused Funds to Beneficiaries Under Public Law 108-203
Objective
To assess SSA's implementation of section 101 of the Social Security Protection
Act of 2004.
Background
The Social Security Protection Act of 2004 requires that SSA reissue benefits
to beneficiaries when such benefits were misused by organizational representative
payees or individual payees serving 15 or more beneficiaries. This provision
applies to misuse decisions made January 1, 1995 and later.
Before this law, SSA was liable to the affected beneficiary for repayment of
the amount of misused benefits only if SSA's negligence in its failure to investigate
or monitor a representative payee resulted in the misuse of benefits.
SSA identified 185 representative payees and 2,674 beneficiaries who met the
requirements of section 101 of the Social Security Protection Act of 2004. SSA
established the Misuse Restitution Control System to manage the completion of
these cases. SSA's FOs processed the Title XVI cases and Title II/XVI concurrent
cases, while both the FOs and program service centers processed the Title II
cases.
Scott County Community Services-A Fee-for-Service Representative Payee for the
Social Security Administration
Objective
To determine whether Scott County Community Services as a representative payee
for SSA (1) has effective safeguards over the receipt and disbursement of Social
Security benefits and (2) uses and accounts for Social Security benefits in
accordance with SSA's policies and procedures.
Background
SSA provides benefits to the most vulnerable members of society - the young,
the elderly, and disabled. Congress granted SSA the authority to appoint representative
payees for those beneficiaries judged incapable of managing or directing the
management of their benefits. Representative payees (organizations or individuals)
receive and manage payments on behalf of these beneficiaries. Given the vulnerability
of the beneficiaries and the risk a representative payee may misuse beneficiaries'
funds, it is imperative that SSA have appropriate safeguards to ensure representative
payees meet their responsibilities.
The Social Security Administration's Nation-wide Asbestos Program
Objective
To determine the validity of allegations of mismanagement regarding SSA's asbestos
program.
Background
SSA has a nation-wide asbestos management program, which was established in
accordance with the Asbestos Hazard Emergency Reauthorization Act. The program
includes the assessment, management, operations and maintenance, and abatement
of asbestos.
In November 1999, we issued a report, Selected Procedures Used in the Social
Security Administration's Asbestos Management Program for its Main Complex.
We reported that SSA work sites were not monitored to ensure compliance with
standard operating procedures for asbestos containment, and work order approvals
were appropriate but lacked quality assurance review. SSA concurred with our
findings and reported that action was underway to implement our recommendations.
However, several of the allegations raised concerns about SSA's management of
its Nation-wide Asbestos Program. Some of these concerns are similar to issues
identified during our prior review.
The Social Security Administration's Office of Systems' Training Program
Objective
To evaluate the Office of Systems' process for providing training to current
staff and new hires. We will review training opportunities, types of training
provided, and cost of training for current Office of Systems staff and new hires
to enhance skills/competencies needed to meet future workloads.
Background
For SSA to meet its customers' future needs, it must restructure its systems'
processes to effectively use new technologies and ensure it has staff trained
to apply those technologies. Technologies expected to be commonplace in 2010
include a rapidly evolving Internet, advances involving speech and video, and
a wide range of wireless, portable, connective devices.
A January 2003 GAO report, Major Management Challenges and Program Risks: Social
Security Administration, stated "As SSA places increased emphasis on using
information technology to support new ways of delivering service, it must also
ensure that it effectively manages its human capital to anticipate, plan for,
and support its requirements
Doing so is necessary to ensure that SSA's
plans project workforce needs far enough in advance to allow adequate time for
staff recruitment and hiring, skills refreshment and training. . . ."
The Office of Systems guides and manages the development, acquisition, and use
of SSA's information technology resources. These resources support the Agency's
program and business functions. Within the Division of Process Engineering,
Project, and Customer Service, the Systems Training and Communications Branch
manages and administers the Office of Systems' Technical Training Program.
A
Administrative Costs Claimed by State Disability Determination Services 4-1
Assessing the Application Controls for the Social Security Administration's
Integrated Disability Management System 2-1
Assessment of the Adequacy of the Social Security Administration's Controls
over
the Use of Signature Proxies on
Applications for Benefits 6-1
Assessment of the Implementation of
Workers' Compensation Offset in
Title II Redesign Release 3 6-1
Assessment of the Validity of Earnings
Posted to the Social Security Administration's Master Earnings File
for Children Ages 7 Through 13 1-1
B
Basic Pilot Between the Social Security Administration and the Department of
Homeland Security 1-1
Beneficiaries in Suspended Payment
Status Pending the Selection of a Representative Payee 6-2
C
Case Management Procedures at the
Hearing Office in Creve Coeur,
Missouri 2-1
Case Processing and Management System
and Workload Management 2-2
Compliance with Homeland Security Presidential Directive 12 Personal Identification
Verification Guidelines in Federal Information Processing
Standards 201 5-1
Concurrent Beneficiaries Receiving Representative Payee and Direct
Payments 6-2
Congressional Response Report:
Enumeration of F-1 Students 1-1
Controls over Miscellaneous Payments
Made Using the Social Security Administration's Single Payment System 3-1
Controls over Old-Age, Survivors and
Disability Insurance Replacement Checks 3-1
Controls over Payments to Attorneys 2-2
Controls over Payments to Auxiliary Beneficiaries Enumerated After the
Primary's Death 3-2
Controls over Representative Payee
Accounting of Social Security Funds
(Public Law 108-203) 4-1
Controls over Survivor's Benefits When Indications Exist a Wage Earner is Alive
3-2
Controls over the Social Security Administration's Death Resurrection
Process 3-3
Costs Claimed by the Virginia
Commonwealth University on Contract Number 600-99-38679 4-1
Cross-Program Recovery of Benefit Overpayments 3-3
D
Demonstration Project: Qualifications for
Non-Attorney Representatives 2-3
Digital Recording Acquisition Project at
the Office of Hearings and Appeals 2-3
Disability Determinations Made for Beneficiaries Convicted of Disability Insurance
Fraud 2-4
Disclosure Statement for MAXIMUS
Human Services Operations 4-2
Disposal of Sensitive Documents at the
Social Security Administration 1-2
E
Effectiveness of the Young Children's
Earnings Records Reinstatement Process 1-2
Employers with the Most Wage Items in the Nonwork Alien File 1-2
F
Federal Employees' Compensation Act-Nation-wide Review of Federal Employees
with Wages on the Master Earnings File 3-3
Fiscal Year 2005 Financial Statement Audit Oversight 4-2
Fiscal Year 2005 Inspector General Statement on the Social Security Administration's
Major Management Challenges 4-3
Fiscal Year 2006 Federal Information
Security Management Act 5-1
Follow-up: Controls over Nonwork Social Security Numbers 1-3
Follow-up: Controls over Supplemental Security Income Replacement Checks 3-4
Follow-up: Enumeration at Birth Program 1-4
Follow-up: Issues Identified During the
Internal Control Review over the
Processing of Social Security Number
Cards 1-4
Follow-up: The Social Security Administration's Management of Congressional
Inquiries 6-3
Follow-up: The Social Security Administration's Procedures to
Identify Representative Payees Who
Are Deceased 6-3
H
Hospitals' Use and Protection of Social
Security Numbers 1-4
I
Impact of Employer Wage Corrections on
the Earnings Suspense File 1-5
Impact of Statutory Benefit Continuation on Disability Insurance and Supplemental
Security Income Benefit Payments Made During the Appeals Process (2 Reports)
2-4
Improper Benefits Paid to Dually Entitled
Title II Beneficiaries 3-4
Improperly Paid Lump Sum Death Payments 3 -4
Indirect Cost Rates for MAXIMUS, Inc. 4-3
Indirect Costs for the Connecticut Disability Determination Services for the
Period
July 1, 2003 - September 30, 2005 4-4
Individuals Receiving Benefits Under
Multiple Social Security Numbers at Different Addresses 1-5
Issuance of Replacement Social Security Number Cards to Prisoners 1-5
M
Match of Veteran's Affairs Historical Death
File Against Social Security
Administration Payment Files 3-5
N
New System to Provide Disabled
Beneficiaries Receipts for Work Activity 6-4
Nursing Home Residents Receiving Supplemental Security Income 3-5
O
Office of Hearings and Appeals Reversal
of Disability Denial Decisions Involving Investigative Information from
Cooperative Disability Investigation Units 2-5
Overstated Earnings and Their Effect on
Social Security Administration Programs 3-6
P
Payment Accuracy of Disability
Insurance Benefits with a Workers' Compensation Offset 3-6
Payments Resulting from Disability
Insurance Actions Processed via the
Social Security Administration's Manual Adjustment, Credit and Award Processes
3-7
Payments to Surviving Spouses at
Retirement Age 3-7
Performance Indicator Audits: The Social Security Administration's Performance
Data 4-5
Physical Security at Remote Hearing Sites
(10 Reviews Conducted) 5-1
Physical Security at the Great Lakes, Northeastern and Southeastern Program
Service Centers 5-2
Prisoners' Access to Social Security
Numbers 1-5
R
Referral of Information from the Telephone Service Centers to the Responsible
Field Offices 6-4
Representative Payee On-site Reviews of
State Institutions 6-4
Representative Payees Receiving Benefits
for Children in Foster Care 6-5
Restitution of Misused Funds to Beneficiaries Under Public Law (108-203) 6-5
S
Scott County Community Services-A
Fee-for-Service Representative Payee
for the Social Security Administration 6-6
Self-Employment Income Earnings Suspense File 1-6
Suspended and Nonwork Wages Among
the Social Security Administration's Contractors 1-6
Suspended and Nonwork Wages in the
Social Security Administration's Payroll 1-6
T
The Impact of Unauthorized Employment
on Social Security Benefits 1-7
The Social Security Administration's
Collection of Court-ordered Restitutions 3-8
The Social Security Administration's Compliance with Employee Tax Requirements
4-4
The Social Security Administration's Controls over the Old-Age, Survivors and
Disability Insurance Waiver Approval Process 3-8
The Social Security Administration's
Controls over the Write-off of
Uncollectible Title XVI Overpayments 3-9
The Social Security Administration's
Decisions to Terminate Collection Efforts
for Old-Age, Survivors and Disability Insurance Overpayments 3-9
The Social Security Administration's E-mail Security 5-2
The Social Security Administration's Independence Day Assessment 2-5
The Social Security Administration's Nation-wide Asbestos Program 6-6
The Social Security Administration's Office
of Systems' Training Program 6-7
The Social Security Administration's Ticket
to Work Program-Employment
Networks 2-6
The Social Security Administration's Ticket
to Work Program-Ticket Assignments 2-6
U
Universities' Use of Social Security Numbers
as Student Identifiers in Region IX 1-7