Social Security Number Protection
Management of the Disability Process
Improper Payments
Internal Control Environment and Performance Measures
Critical Infrastructure Protection and Systems Security
Service Delivery
Alphabetical Index
Acronyms
Act Social Security Act
CDI Cooperative Disability Investigation
CDR Continuing Disability Review
DDS Disability Determination Services
DHS Department of Homeland Security
DI Disability Insurance
DoD Department of Defense
ESF Earnings Suspense File
FY Fiscal Year
GAO Government Accountability Office
MBR Master Beneficiary Record
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
OQA Office of Quality Assurance and Performance Assessment
Plan Annual Work Plan
PMA President's Management Agenda
PwC PricewaterhouseCoopers
SEI Self-employment Income
SSA Social Security Administration
SSI Supplemental Security Income
SSN Social Security Number
WC Workers' 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 the 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. Below is the status of SSA's efforts, as
reported by OMB's June 2004 Scorecard.
This Plan describes 106 reviews we intend to complete, 45 reviews we intend
to begin, and 16 performance indicator reviews we will oversee in FY 2005 in
the following issue areas.
Social Security Number Protection
Management of the Disability Process
Improper Payments
Internal Control Environment and Performance Measures
Critical Infrastructure Protection and Systems Security
Service Delivery
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.
Social Security Number Protection
In FY 2003, SSA issued over 17.6 million original and replacement SSN cards,
and SSA received approximately $533 billion in employment taxes related to earnings
under assigned SSNs. Protecting the Social Security number (SSN) and properly
posting the wages reported under SSNs are critical to ensuring eligible individuals
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 on the black market;
(4) using the SSN of a deceased individual; or
(5) creating a nine-digit number out of thin air.
To ensure SSN integrity, SSA must employ effective front-end controls in its
enumeration process. To effectively combat SSN misuse, we believe SSA should
establish a reasonable threshold for the number of replacement SSN cards an
individual may obtain during a year and over a lifetime, continue to address
identified weaknesses in its information security environment to better safeguard
SSNs, and consider revising its policies to require that field offices obtain
independent verification of the birth records for U.S. citizens under age 1
before SSN assignment.
SSA has taken steps to improve controls within its enumeration process, including
establishing the Enumeration Response Team. As a result of the Team's efforts,
SSA now performs full collateral verification of all immigration documents before
assigning SSNs to noncitizens. SSA requires mandatory interviews for all applicants
for original SSNs who are over age 12 (lowered from age 18) and requires evidence
of identity for all children, regardless of age. In addition, SSA has established
an Enumeration Center in Brooklyn, New York, that focuses exclusively on assigning
SSNs and issuing SSN cards. SSA has also created an Identity Theft Workgroup
in which we participate.
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 eligible individuals
are receiving the correct payment amounts. In addition, SSA's disability 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 2003, SSA had posted 9.6 million wage items to its
ESF for Tax Year 2001, 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 to achieve more accurate wage reporting.
SSA has taken steps to reduce the size and growth of the ESF. For example, SSA
has expanded its Employee Verification Service by piloting an on-line service
called the Social Security Number Verification Service, which allows employers
to verify the names and SSNs of employees before reporting their wages to SSA.
The Agency has also modified its automated processes to better identify the
numberholder related to suspended items. Whereas previous internal edits used
only the name and SSN related to the suspended wage, SSA stated the new processes
would use information stored on the earnings and benefits records.
The SSN and Unauthorized Work
SSA also assigns nonwork SSNs to noncitizens who are (1) in the United States
but are not authorized to work and (2) are not present in the United States,
but are entitled to a federally-financed benefit that requires an SSN. In recent
years, SSA has strictly limited the assignment of such numbers. Furthermore,
SSA monitors noncitizens who show earnings under a nonwork SSN and reports this
information to the Department of Homeland Security (DHS). Nonetheless, our audits
have noted a number of 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.
Recent legislation (Pub. L. 108-203, Social Security Protection Act of 2004)
prohibits the payment of Title II benefits based on the earnings of any individual
who is not a U.S. citizen or national and who has never been issued an SSN to
work in the United States. SSA's implementation of this new law will require
increased coordination with DHS to ensure SSA has the correct work status information
in its systems.
In FY 2005, we plan to complete 26 reviews in this area and begin 6 reviews.
We Plan to Complete the Following Reviews in FY 2005
Analysis of Undeliverable Social Security Number Cards
Assessment of the Enumeration-at-Entry Process
Congressional Response Report: Educational Institutions' Issuance of Work Authorization
Documents to Foreign Students
Incorrect Death Information for Auxiliary Beneficiaries Turning 18 Years of
Age
Military Wage Items in the Earnings Suspense File
Reported Earnings Before the Issuance of a Social Security Number
Social Security Number Cards Issued After Death
Social Security Number Misuse in the Agriculture, Services (Temporary Labor
and Cleaning), and Food Service (Bars and Restaurants) Industries (3 Reports)
Social Security Numbers Issued to Noncitizens Who Subsequently Leave the Country
or Whose Immigration Status Expires
Suspended and Nonwork Wages Among the Social Security Administration's Payroll
and Contractors (2 Reports)
The Impact of Unauthorized Employment on Social Security Benefits
The Self-Employment Income Earnings Suspense File
Universities' Use of Social Security Numbers as Student Identifiers (Regions
I Through X)
Usefulness of Employee Correspondence in Reducing the Growth of the Earnings
Suspense File
We Plan to Begin the Following Reviews in FY 2005
Disability Determination Services' Disclosure of Social Security Numbers to
Third Parties
Effectiveness of the Young Children's Earnings Records Reinstatement Process
Issuance of Replacement Social Security Number Cards to Inmates
Prisoners' Access to Social Security Numbers
The Basic Pilot Between the Social Security Administration and the Department
of Homeland Security
Top 100 Employers with Nonwork Wages
ANALYSIS OF UNDELIVERABLE SOCIAL SECURITY NUMBER CARDS
Objective
To determine why SSN cards are returned to the Agency as undeliverable and to
evaluate the physical security over these cards.
Background
SSA estimates between 250,000 and 500,000 SSN cards are returned each year.
Undeliverable cards are kept in a secure container in the mailroom and periodically
destroyed by contractors. SSA does not have a system in place to track the number
of cards that are returned to the Agency as undeliverable. Because returned
cards are not counted or logged, there is no way of determining whether there
is a pattern that would indicate potential fraudulent activity.
ASSESSMENT OF THE ENUMERATION-AT-ENTRY PROCESS
Objective
To assess the effectiveness of SSA's Enumeration-at-Entry process.
Background
SSA entered into agreements with the Department of State (State) and DHS, formerly
the Immigration and Naturalization Service, in 1996 and 2000, respectively,
to assist SSA in enumerating certain classes of immigrants. State and DHS collect
and transmit to SSA enumeration data collected as part of the immigration process.
SSA calls this process Enumeration-at-Entry.
SSA allows immigrants who are lawfully admitted as permanent residents and age
18 or older to apply for an SSN card through Enumeration-at-Entry. By electing
to participate in this program, the immigrant does not complete a Form SS-5,
Application for a Social Security Card. Instead, the immigrant applies for an
original SSN card on the State DS-230 Form, Application for Immigrant Visa and
Alien Registration, and DHS electronically transmits to SSA the data elements
collected for enumeration purposes. Using these data, SSA assigns an SSN to
the immigrant and mails the SSN card to the address the immigrant provided State
or DHS.
Enumeration-at-Entry is designed to improve the integrity of the enumeration
process because actions are based on certification by State and DHS regarding
identity and work authorization. Phase 1, which began in October 2002 consists
of State collecting enumeration information from noncitizens over age 18 who
are issued visas to become permanent resident aliens in the United States. After
Phase 1 is fully implemented, SSA, DHS and State will discuss expanding this
process to other groups of immigrants.
CONGRESSIONAL RESPONSE REPORT: EDUCATIONAL INSTITUTIONS' ISSUANCE OF WORK AUTHORIZATION
DOCUMENTS TO FOREIGN STUDENTS
Objective
To determine whether foreign students receiving work authorization letters from
schools and assigned SSNs actually enroll, attend classes, and are employed
on campus.
Background
Over 500,000 foreign students were enrolled at educational institutions in the
United States during the 2002-2003 academic year. Students coming to the United
States to pursue full-time academic or vocational studies are admitted under
three nonimmigrant classifications: (1) the F-1, which includes academic students
in colleges, universities, seminaries, conservatories, academic high schools,
other academic institutions and language training; (2) the M-1, which relates
only to vocational students; and (3) the J-1, which covers exchange visitors.
These 3 categories accounted for approximately 1 million of the 32.8 million
nonimmigrants admitted to the United States in 2001.
A recent regulation, Evidence Requirements for Assignment of SSNs; Assignment
of SSNs to Foreign Academic Students in F-1 Status, requires that F-1 students
without a DHS employment authorization document provide evidence of both work
authorization and employment before the Agency will assign them an SSN. Specifically,
the F-1 student will need to provide documentation from the school that he/she
will be engaging in authorized employment (in the form of written confirmation
from a designated school official) and written documentation that he/she is
engaged in or has secured employment (in the form of a written statement from
the student's employer).
Despite these controls, the Senate Committee on Governmental Affairs is concerned
that some educational institutions are providing students with work authorization
letters even though these institutions have no intent to hire the students for
on-campus employment. Rather, the schools may be providing these letters solely
to assist the students in obtaining SSNs. Additionally, the Committee has asked
that we examine certain schools deemed to be "diploma mills," which
are perceived to be in business mainly to assist noncitizens in gaining entrance
to the United States via student visas.
INCORRECT DEATH INFORMATION FOR AUXILIARY BENEFICIARIES TURNING 18 YEARS OF
AGE
Objective
To identify individuals who turned 18 years of age and were incorrectly identified
by SSA as deceased because they were auxiliary beneficiaries.
Background
Our January 2002 review, Disclosure of Personal Beneficiary Information to the
Public (A 01 01-01018), and our August 2002 review, Effectiveness of the Social
Security Administration's Earnings After Death Process (A-03-01-11035), identified
beneficiaries who were improperly listed as deceased on SSA's Death Master File.
At some point these individuals had been Old-Age, Survivors and Disability Insurance
(OASDI) auxiliary beneficiaries and, upon turning age 18, were no longer eligible
for benefits. In such cases, SSA places a payment status code of "T4"
(a child terminated because of attainment of age 18) on their Master Beneficiary
Records (MBR). However, those "T4" codes were mistakenly associated
with dates of death on the MBR for the same month the "T4" code was
entered on the MBR. This information was later propagated to the Death Master
File, resulting in these beneficiaries being erroneously listed as deceased.
Because SSA releases the Death Master File to the public, the personal information
for these individuals is being made available over the Internet. Further, SSA
is posting the wages for these individuals to the ESF instead of the MEF, so
they are not earning credit towards later benefits. Finally, if they are receiving
benefits, SSA will periodically alert the cases, suspend their benefits, and
request that they prove they are alive.
MILITARY WAGE ITEMS IN THE EARNINGS SUSPENSE FILE
Objective
To determine whether individuals who have public responsibilities and positions
of trust, primarily active duty military employees, have wages posted to SSA's
ESF and what actions have been taken to resolve these wage problems.
Background
Our September 2003 Profile of the Social Security Administration's Non-Work
Alien File (A 14 03-23071) found that individuals who had public responsibilities
and positions of trust, including active duty military employees, had wages
recorded in SSA's non-work alien file. Our review will determine whether an
additional condition exists among military employees where SSA could not match
the name and/or SSN on the wage report to Agency records and had to place the
wages in the ESF.
We will review suspended wages in the ESF for Tax Years 1997 to 2002 to (1)
determine the number of items submitted to the ESF by military branches and
(2) identify potential patterns of errors and irregularities in wage reporting,
or other reasons for the suspension of these wage items.
REPORTED EARNINGS BEFORE THE ISSUANCE OF A SOCIAL SECURITY NUMBER
Objective
To determine whether SSA's Master Earnings File is recording earnings for individuals
before they are issued an SSN.
Background
SSA provides OASDI benefits to individuals based on their lifetime earnings
reported under a valid SSN. These earnings determine whether an individual has
enough quarters of coverage, or work credits, for insured status. Social Security
work credits are based on an individual's total annual wages or self-employment
income. An individual can earn up to four credits each year. The amount needed
for a credit changes from year to year. In 2002, for example, an individual
earned one credit for each $870 of wages or self-employment income. When an
individual earns $3,480, he or she has earned four credits for the year.
Our March 2003 Congressional Response Report: Social Security Administration
Benefits Related to Unauthorized Work (A-03-03-23053), noted that Social Security
laws and regulations do not always differentiate between citizens and noncitizens
for determining quarters of coverage. As a result, SSA often creates a work
history for individuals with valid SSNs, even when some of the earnings belonged
to noncitizens who were in the United States illegally or were otherwise unauthorized
to work at the time of their earnings but who later obtained a valid SSN.
Earnings posted before enumeration could represent a situation where individuals
were working in the economy illegally before enumeration or it could represent
other problems, such as improper postings by SSA's edit programs or errors in
the Numident fields. Our review of a sample of such cases should help to determine
the frequency of such occurrences, their causes, and their potential impact
on the integrity of SSA's programs.
SOCIAL SECURITY NUMBER CARDS ISSUED AFTER DEATH
Objective
To assess SSA's controls over the issuance of replacement SSN cards where a
date of death is present on the Numident.
Background
Individuals applying for a replacement SSN card must complete, sign, and submit
an Application for a Social Security Card (Form SS-5) at an SSA field office
or through the mail. Because SSA must be certain the individual is who he or
she claims to be, SSA requires that each applicant present documentary evidence
of his or her identity. An identity document submitted as evidence must be recently
issued and provide information so field office personnel can compare its contents
with SS-5 data and/or the applicant's physical appearance.
Field office personnel review the SS-5 and determine the validity of supporting
evidentiary documents. They then certify and enter applicant information into
SSA's Modernized Enumeration System. Once certified, the SSN application undergoes
numerous automated edits to further validate applicant information. If the application
passes all of these edits, the Modernized Enumeration System issues a replacement
SSN card.
SSA will not issue a replacement card when the numberholder is deceased. Rather,
the Agency can provide third-party verification, an SSN verification printout,
or instructions on how to obtain a Numident. The requestor must provide proper
identification and a death certificate, if the death is not posted on the Numident.
Recent audit work has found numerous instances where it appears multiple SSN
replacement cards were issued to individuals after a date of death had been
posted to the Numident. This review will determine whether the appropriate policy
is being followed and identify instances of potential SSN misuse.
SOCIAL SECURITY NUMBER MISUSE IN THE AGRICULTURE, SERVICES (TEMPORARY LABOR
AND CLEANING), AND FOOD SERVICE (BARS AND RESTAURANTS) INDUSTRIES (3 REPORTS)
Objective
To assess the potential for SSN misuse in the agriculture, services, and food
service industries. In addition, we will determine actions SSA has taken on
the recommendations contained in our January 2001 reports regarding the agriculture
and services (temporary labor and cleaning) industries.
Background
One of SSA's most important responsibilities is to maintain records of wage
amounts employers pay individuals. To facilitate this responsibility, SSA created
SSNs to maintain individual earnings records and issued workers cards as a record
of their SSN. Because SSA calculates future benefit payments based on the earnings
an individual has accumulated over his or her lifetime, accuracy in recording
those earnings is critical. SSA's ability to do so, however, greatly depends
on employers and employees correctly reporting names and SSNs on Forms W-2 (Wage
and Tax Statement).
SSA uses over 20 automated edits to match employees' names and SSNs and properly
credit their earnings to the Master Earnings File. SSA places wage items that
fail to match name and SSN records into its ESF. As of October 2003, SSA had
posted 9.6 million wage items to the ESF for TY 2001, representing about $56
billion in wages.
SSN misuse often occurs when an individual provides an employer with an SSN
that either has (1) never been assigned or (2) already been assigned to another
person. Individuals use SSNs illegally for a variety of reasons, one of which
is to obtain employment.
SOCIAL SECURITY NUMBERS ISSUED TO NONCITIZENS WHO SUBSEQUENTLY LEAVE THE COUNTRY
OR WHOSE IMMIGRATION STATUS EXPIRES
Objective
To determine whether noncitizens legally assigned SSNs, but who leave the country
or overstay their visas, are misusing the SSNs. Additionally, we will determine
what remedies the Agency could implement to prevent such misuse.
Background
Based on work performed by our Office of Investigations, we are aware of situations
in which noncitizens legally come to the United States and obtain an SSN based
on a temporary work-authorized visa. However, once their visa expires or they
leave the country, they or someone else continue to use the SSN to work illegally
in the United States, obtain benefits, or defraud financial institutions.
SSA does not have a policy to deactivate or void SSNs. Accordingly, SSNs are
assigned to the numberholders for life-regardless of their immigration status.
SUSPENDED AND NONWORK WAGES AMONG THE SOCIAL SECURITY ADMINISTRATION'S PAYROLL
AND CONTRACTORS (2 REPORTS)
Objective
To determine whether SSA employees, or contractor employees working at SSA,
are using nonwork SSNs and/or SSNs that do not match the name/SSN combination
in SSA's records.
Background
Title II of the Act requires that SSA maintain records of wage amounts employers
pay to individuals. Employers report their employees' wages to SSA at the conclusion
of each tax year. Wages on those employer reports containing invalid names and/or
SSNs cannot be posted to an individual's earnings record in SSA's MEF. Instead,
these wages are placed in the ESF-a repository for unmatched wages. Suspended
wages can affect a worker's eligibility for and/or the amount of retirement,
disability, or survivor benefits. In addition, when wage reports cannot be matched
to the correct individual, both SSA and the employer incur additional administrative
costs in correcting unmatched wage reports.
Our September 2003 Profile of the Social Security Administration's Non-Work
Alien File (A 14 03-23071) found that individuals having public responsibilities
and positions of trust, including SSA employees, had wages recorded in SSA's
unauthorized employment file. Our review will determine whether SSA also employs
individuals and/or contractor employees using nonwork SSNs or names/SSNs that
do not match SSA's records.
THE IMPACT OF UNAUTHORIZED EMPLOYMENT ON SOCIAL SECURITY BENEFITS
Objective
To assess the accuracy of SSA's Non-Work Alien file and estimate benefit amounts
resulting from unauthorized employment.
Background
Each year, SSA informs DHS of noncitizens who are working illegally. SSA sends
DHS an electronic data file of information on individuals who have earnings
recorded under SSNs assigned for nonwork purposes. Resource priorities and data
compatibility problems have prevented the Bureau from making effective use of
the unauthorized earnings information it receives.
While SSA notifies DHS of unauthorized employment, the Agency does not routinely
tell SSA when it changes a person's employment status from unauthorized to authorized.
Unless the person informs SSA directly of such a change, SSA enumeration records
will continue to show the person as not authorized for employment and record
his or her earnings on the Non-Work Alien file. Consequently, SSA does not know
the number of workers shown on the Non-Work Alien file who are authorized for
employment and should not be reported to DHS or the amount of SSA benefits resulting
from unauthorized employment.
THE SELF-EMPLOYMENT INCOME EARNINGS SUSPENSE FILE
Objective
To identify patterns of errors and irregularities in the self-employment income
posted to the ESF.
Background
Title II of the Act requires that SSA maintain accurate records of wages reported
by employers. The 1950 Social Security Amendments extended Social Security coverage
to most self-employed individuals beginning with Tax Year 1951. Reported earnings
and self-employment income (SEI) containing invalid names and/or SSNs cannot
be posted to individual earnings records and are instead placed in the ESF and
the SEI ESF. Earnings placed in these two suspense files can affect a worker's
eligibility for and the amount of retirement, disability, and survivor benefits.
Taxpayers report SEI to the Internal Revenue Service on Schedule SE, which is
part of the individual's income tax return. The Internal Revenue Service reports
this SEI information to SSA, which maintains microfilm records of the data in
a SEI file. The SEI ESF is maintained in the Earnings Reports Branch and the
Claims Development branch for investigative purposes.
Preliminary analysis of the SEI ESF indicates that a high volume of earnings
are being reported under "900" series numbers, which appear to be
very similar to IRS Individual Taxpayer Identification Numbers.
UNIVERSITIES' USE OF SOCIAL SECURITY NUMBERS AS STUDENT IDENTIFIERS (REGIONS
I THROUGH X)
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.
USEFULNESS OF EMPLOYEE CORRESPONDENCE IN REDUCING THE GROWTH OF THE EARNINGS
SUSPENSE FILE
Objective
To determine whether trends in employer and employee addresses can assist SSA
in highlighting problem areas and focusing on employer-assistance activities.
Background
The purpose of the decentralized correspondence process is to contact individuals
to resolve SSN and/or name discrepancies on reported earnings. The correspondence
provides the wage earner with information about the reported name/SSN and wage
amount and requests that the reported information be reviewed, verified or corrected
where possible, and returned. While SSA sends most of the decentralized correspondence
notices to employees, it sends a notice to the employer when an employee's address
is unavailable. In Tax Year 2002, SSA mailed the public over 9 million decentralized
correspondence notices.
Returned notices are matched against SSA's internal records and the ESF. If
the resubmitted name/SSN information matches SSA's records, the wage item is
reinstated from the ESF to the earner's record. If the provided information
is still invalid, no further correspondence is sent, and items remain in the
ESF awaiting additional edit processes.
A review of the addresses found on these decentralized correspondence notices
could better identify those areas of the country where name/SSA mismatches are
most prevalent. These data could then be used to assist Employer Services Liaison
Officers in targeting their efforts to educate the employer community.
Management of the Disability Process
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 field offices
and State Disability Determination Services (DDS). SSA representatives in the
field offices 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 field office sends the case to a DDS to develop medical
evidence and evaluate 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/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 hold hearings and issue decisions. In FY 2003, hearing
offices processed 571,928 cases. OHA's average processing time has increased
significantly from 274 days in FY 2000 to 344 days in FY 2003. Further, the
pending workload was 591,562 cases on September 30, 2003, whereas it was 346,756
cases on September 30, 2000. 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. In September 2003, the Commissioner of
Social Security proposed a new approach to improving the disability determination
process, which includes several initiatives that emphasize timely and accurate
disability decisions. For example, a quick-decision step would initially sort
claims based on information provided by claimants to identify people who are
obviously disabled. Additionally, the Commissioner proposed an in-line quality
review process and a centralized quality control unit. The Commissioner views
her September 2003 proposal as the first step in a collaborative process eventually
leading to a final plan for disability improvements.
In addition to her long-term proposal, the Commissioner has accelerated the
Agency's transition to the electronic disability folder. The electronic disability
folder will allow for disability claims information to be stored electronically
and transmitted electronically between field offices, DDSs, and OHA.
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 18
CDI units operating in 17 States. In the first half of FY 2004, the CDI units
saved SSA almost $64 million by identifying fraud and abuse related to initial
and continuing claims within the disability program.
In FY 2005, we plan to complete 10 reviews and begin 2 reviews in this area.
We Plan to Complete the Following Reviews in FY 2005
Evaluation of the Social Security Administration's Electronic Disability Initiative
Impact of Due Process on Supplemental Security Income and Disability Insurance
Benefit Payments Made During the Appeals Process (2 Reports)
Office of Hearings and Appeals Megasite Bar-coding System
Office of Hearings and Appeals Pre-effectuation Review Process
Office of Hearings and Appeals Reversal of Disability Denial Decisions Involving
Investigative Information from Cooperative Disability Investigation Units
Supplemental Security Income Recipient Wages Reported on the Earnings Suspense
File
The Social Security Administration's Identification of Special Disability Workload
Cases
The Social Security Administration's Ticket to Work Program
The Social Security Administration's Workers' Compensation Data Match with the
State of Texas
We Plan to Begin the Following Reviews in FY 2005
Consistency of Initial Disability Determination Services Award Rates
The Social Security Administration's Ticket to Work Program-Employment Networks
EVALUATION OF THE SOCIAL SECURITY ADMINISTRATION'S ELECTRONIC DISABILITY INITIATIVE
Objective
To determine whether SSA's project management of its Electronic Disability Initiative
will enable the Agency to meet the project's expected functionality, including
systems security, while complying with laws and regulations pertaining to system
development efforts.
Background
The Electronic Disability Initiative is the Agency's technological approach
to automating the disability claims process. The Electronic Disability Initiative
is expected to assist the Agency in finding innovative ways to meet the challenge
of increasing workloads in the future. The Electronic Disability initiative
will replace the current paper claims folder with an electronic record that
can be accessed by all case processing components. Electronic Disability is
expected to eliminate the need to print, mail, store and reconstruct the paper
claims folder;
prevent keying of the same information at multiple case processing locations;
control and assign work from electronic queues rather than paper folders; and
ensure disability files are available when an appeal is filed or continuing
disability review is due.
IMPACT OF DUE PROCESS ON SUPPLEMENTAL SECURITY INCOME AND DISABILITY INSURANCE
BENEFIT PAYMENTS MADE DURING THE APPEALS PROCESS (2 REPORTS)
Objective
To determine the financial impact of SSA's appeals process on the SSI and DI
benefit payments made under Public Law 97-455.
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 DDS as well as disability specialists in the program service centers.
Public Law 97-455 gives the disabled beneficiary the option for benefit continuation
through the reconsideration and/or administrative law judge hearing process
in medical cessation determinations.
It takes approximately 322 days for initial claims and CDRs to go through the
OHA level of appeal. Benefit payments made during the OHA appeal 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 MEGASITE BAR-CODING SYSTEM
Objective
To determine whether the technological and management improvements implemented
at the Megasite effectively track case folders and safeguard folders from loss.
Background
Appeals for disability claims are handled within the Office of Appellate Operations.
Folders for denied claims are sent to the Megasite in Springfield, Virginia.
The Megasite is the central repository for all claims pending the possibility
that the claimant will request a review of the file by an Administrative Appeals
Judge. In FY 2003, we reviewed the operations of the OHA Megasite. We conducted
the review because the computer inventory system was losing data and SSA staff
could not find requested folders.
We tested the Megasite's physical and computerized inventories. The Megasite
had approximately 200,000 folders at the time of our audit. We selected a random
sample of 300 folders from the inventory system. We projected OHA could not
locate as many as 10,100 folders. OHA subsequently installed new computer and
bar coding equipment.
We made a number of recommendations regarding Megasite operations including
improving the technology in the Megasite; enhancing accountability for records
management by collecting information on the number of lost folders and costs
to replicate missing documents; and developing formal reports detailing the
results of the inventories to include the count of folders inventoried and any
discrepancies noted.
SSA claims the new bar-coding system has reduced the time to code and file cases
by 83 percent and has reduced the number of aged cases and Appeals Council decisions
that are remanded to hearing offices as a result of lost files.
OFFICE OF HEARINGS AND APPEALS PRE-EFFECTUATION REVIEW PROCESS
Objective
To determine the effectiveness of the pre-effectuation review process.
Background
As part of its continuing efforts to improve the quality of its disability determinations,
SSA has modified the review process involving disability allowance decisions
made by administrative law judges. In August 1998, the Agency began the pre-effectuation
review process of administrative law judge decisions. This process allows the
Office of Quality Assurance and Performance Assessment (OQA) to review allowance
decisions made by administrative law judges and refer them to the Appeals Council
for review. Pre-effectuation reviews focus on cases that involve problematic
issues or have a higher likelihood of error. Once referred, the Appeals Council
considers the case and OQA's reasons for believing the decision should be reviewed.
The Appeals Council has 60 days to look at those cases it decides to review.
After its review, the Council can issue its own decision on the case or remand
the case to the administrative law judge who initially decided to allow the
case.
SSA initiated the pre-effectuation review process to identify policy issues
that should be clarified through publication of regulations or rulings. Discussions
with SSA staff indicate the pre-effectuation review process has identified differences
in disability determinations between OQA policy and the administrative law judges'
decisions. Through the pre-effectuation review process, OQA has identified cases
that were initially allowed by the administrative law judges but that OQA feels
should be disallowed. Further, after referral from OQA, the Appeals Council
often agrees with OQA's position and remands such cases to the administrative
law judges for further review.
OFFICE OF HEARINGS AND APPEALS REVERSAL OF DISABILITY DENIAL DECISIONS INVOLVING
INVESTIGATIVE INFORMATION FROM COOPERATIVE DISABILITY INVESTIGATION UNITS
Objective
To determine the extent of and the reasons for OHA reversal of DDS denial decisions
when the denial was based on evidence obtained from a CDI Unit.
Background
The CDI program is managed in a cooperative effort between SSA's Office of Operations,
the OIG, and the Office of Disability Programs. SSA provides virtually all of
the funding for the CDI program while OIG maintains the daily operations. Since
FY 1998, 18 units have been opened in 17 States. 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 Units report facts
uncovered during an investigation to resolve questions of fraud in SSA's disability
programs. The CDI Unit does not make disability determinations but provides
information to the State DDSs to make timely and accurate disability determinations.
In FY 2003, CDI Units confirmed 1,640 fraud cases. As a result, SSA avoided
improper payments of approximately $102 million.
SUPPLEMENTAL SECURITY INCOME RECIPIENT WAGES REPORTED TO THE EARNINGS SUSPENSE
FILE
Objective
To determine whether existing information in SSA's systems, including correspondence
with employees, can assist the Agency in detecting suspended wages related to
SSI recipients.
Background
Title II of the Act requires that SSA maintain records of wage amounts employers
pay individuals. Employers report their employees' wages to SSA at the conclusion
of each tax year. Wages on those employer reports containing invalid names and/or
SSNs cannot be posted to an individual's earnings record in SSA's Master Earnings
File. Instead, these wages are placed in the ESF. Suspended wages can affect
a worker's eligibility for and/or the amount of retirement, disability, or survivor
benefits. In addition, when wage reports cannot be matched to the correct individual,
both SSA and the employer incur additional administrative costs correcting unmatched
wage reports.
As of July 2002, the ESF contained approximately 244 million wage items totaling
about $421 billion related to Tax Years 1937 through 2001. In Tax Year 2001
alone, 9.6 million items and $56 billion in wages were posted to the ESF. Removal
of wage items and their associated dollar value from the ESF only occurs when
the wages can be matched and posted to an individual's Master Earnings File.
SSA sends decentralized correspondence to employees to resolve SSN and/or name
discrepancies on reported earnings. The correspondence provides the wage earner
with information about the reported name/SSN and wage amount and requests that
the reported information be reviewed, verified or corrected where possible,
and returned. While SSA sends most of the decentralized correspondence notices
to employees, it sends a notice to the employer when an employee's address is
unavailable.
Wages posted to the Master Earnings File are used to identify SSI recipients
who are working. If an SSI recipient's wages are in the ESF, his or her SSI
payments could be too high. Our review will determine whether wages in the ESF
could be used to update earnings records and locate potential overpayments to
SSI recipients.
THE SOCIAL SECURITY ADMINISTRATION'S IDENTIFICATION OF SPECIAL DISABILITY WORKLOAD
CASES
Objective
To determine whether SSA has identified and taken actions to implement system
enhancements to prevent future Special Disability Workload cases and identified
the universe of Special Disability Workload cases.
Background
SSA identified individuals who were receiving SSI payments and who appear to
be insured for, but were not receiving, disability benefits under the DI program.
SSA refers to these cases as the Special Disability Workload.
Each year, SSA identifies individuals who meet insured status for DI benefits.
SSA uses a "KZ diary" to alert field office staff to those cases where
an individual receiving SSI payments is likely to be insured for disability
benefits under the OASDI program. However, SSA's systems did not always identify
all SSI applicants who were insured for disability benefits under the DI program
or gained insured status through subsequent earnings.
In 1999, SSA identified approximately 130,000 Special Disability Workload cases.
In FY 2002, this workload increased to 300,000 cases. In its FY 2003 Performance
and Accountability Report, SSA stated the Agency is reviewing approximately
476,000 Special Disability Workload cases for potential DI entitlement.
THE SOCIAL SECURITY ADMINISTRATION'S TICKET TO WORK PROGRAM
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.
Background
The Ticket to Work program was established by the Ticket to Work and Work Incentives
Improvement Act of 1999. The program provides eligible DI and SSI beneficiaries
with tickets that can be used to obtain vocational rehabilitation or employment
services through an Employment Network or State vocational rehabilitation agency.
The program is intended to increase access to, and the quality of, rehabilitation
and employment services. The Ticket to Work program was designed to provide
beneficiaries greater freedom and choice of service providers, create competition
to provide high-quality services that are responsive to beneficiary needs and
give providers incentives to deliver services in the most efficient and appropriate
manner. Daily administration of the Ticket to Work program is the responsibility
of a program manager. SSA has contracted Maximus, Inc., to perform this role.
The contract with Maximus includes 23 tasks representing the specific services
it is required to provide.
We will review the following 10 tasks identified in the contract. The remaining
tasks will be assessed in separate reviews.
Task 1 - Contractor Orientation
Task 2 - Start-up Plan
Task 3 - Toll-free Number
Task 8 - Ticket Program Training
Task 9 - Management of Ticket Process
Task 16 - Monthly Progress Reports
Task 17 - Annual Report
Task 20 - Periodic Meetings with SSA Project Officer
Task 21 - Periodic Special Studies
Task 22 - Conference Planning
THE SOCIAL SECURITY ADMINISTRATION'S WORKERS' COMPENSATION DATA MATCH WITH THE
STATE OF TEXAS
Objective
To report on the status of SSA's pilot project matching DI records with Texas
workers' compensation (WC) payment data. As part of this audit, we plan to evaluate
the procedures used to complete the matching process, summarize the impact of
unreported and incorrectly reported WC payments on DI benefits, and determine
the status of collection and payment of over/underpayments identified during
the matching process.
Background
SSA administers the OASDI program under Title II of the Act to provide benefits
to retired and disabled workers, including their dependents and survivors. Benefits
are reduced or totally offset if a disabled worker is also entitled to State
WC payments.
On August 15, 2000, SSA and the Texas Workers' Compensation Commission signed
an agreement for the Commission to provide SSA WC records for a matching operation.
SSA identified 3,463 cases for which it had no prior WC information (Type A
alerts) and 1,773 cases for which it did have WC information but for which the
amounts in SSA's records differed from the amounts in the Texas WC file (Type
B alerts).
Our April 2003 Management Advisory Report: The Social Security Administration's
Workers' Compensation Data Match with the State of Texas reported that we could
not evaluate the results of SSA's WC data match with the State of Texas because
SSA had not (1) completed its analysis of the DI cases with WC data identified
from the match, (2) conducted a match against SSI records, (3) assigned overall
accountability of the Texas match project to any particular component, (4) defined
when it will derive the results necessary to determine whether the project will
be worth expanding to other States, or (5) conducted or started the process
of conducting a cost-benefit analysis as of the time of our review.
Based on our recommendation, SSA designated the Office of Disability and Income
Security Programs to oversee, consolidate, and report the work being done by
the various SSA components involved in the project and establish time frames
for the completion of work by each component and the lead office. SSA also stated
that OQA would perform the cost-benefit analysis for the Title II portion of
the Texas data match. As of May 2004, SSA had completed its review of cases
identified from matching records from the Texas database to SSA beneficiary
records.
Improper Payments
SSA issues benefit payments under the OASDI and SSI programs. Since SSA is responsible
for issuing timely benefit payments for complex entitlement programs to about
50 million individuals, even the slightest error in the overall process can
result in millions of dollars in over- or underpayments.
Improper payments are defined as payments that should not have been made or
were made for incorrect amounts. 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.
The President and Congress have expressed interest in measuring the universe
of improper payments within the Government. In August 2001, OMB published the
FY 2002 PMA, which included a Government-wide initiative for improving financial
performance. 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 Act, agencies that administer programs where the risk of improper
payments is significant must estimate their annual amount of improper payments
and report this information in their Annual Performance and Accountability Reports.
OMB works with each agency to establish goals for reducing improper payments
for each program.
SSA and the OIG have had discussions on 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. In August 2003, OMB issued
specific guidance to SSA to only include avoidable overpayments in its improper
payment estimate because these payments could be reduced through changes in
administrative actions. Unavoidable overpayments that result from legal or policy
requirements are not included in SSA's improper payment estimate.
SSA has been working to improve its ability to prevent over- and underpayments
by obtaining beneficiary information from independent sources sooner and/or
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
identifies and prevents payments to beneficiaries who are no longer disabled.
In FY 2004, we focused on improper payments that go undetected by SSA's normal
processes. For instance, in one review of disabled beneficiaries who work, we
found that SSA had assessed about $1.78 billion in overpayments for about 117,320
individuals. However, we estimated the Agency did not detect about $1.37 billion
in overpayments to about 63,000 beneficiaries. SSA is implementing eWork, a
new initiative to strengthen controls in this area.
Working with SSA, we have made great strides in reducing benefit payments to
prisoners and SSI payments to fugitive felons, and these efforts continue. However,
our work has shown that improper payments-such as those related to WC-continue
to diminish the Social Security trust funds. Additionally, with the passage
of the Social Security Protection Act of 2004, SSA faces new challenges in preventing
and recovering improper payments-such as OASDI benefits to fugitives.
In FY 2005, we plan to complete 19 reviews and begin 12 reviews in this area.
We Plan to Complete the Following Reviews in FY 2005
Controls over Title II Replacement Checks
Controls over Unnegotiated Checks
Disabled Supplemental Security Income Recipients with Earnings on the Master
Earnings File
Follow-up: The Social Security Administration's Controls to Prevent and Detect
Direct Deposit Fraud
Implementation of the Executive Order Prohibiting Payments to Terrorists
Individuals Receiving Benefits Under Multiple Social Security Numbers at the
Same Address
Individuals Receiving Multiple Auxiliary or Survivors Benefits
Information System Controls over Workers' Compensation Payments
Manual Changes to Title II Benefits Via the Manual Adjustment Credit and Award
Data Entry System
Payroll Tax Reporting by the Social Security Administration's Contractors
Representative Payee Reports Indicating Excess Conserved Funds for Supplemental
Security Income Recipients
School Attendance by Student Beneficiaries over Age 18
The Social Security Administration's Administrative Finality Rules
The Social Security Administration's Controls over Suspending Collection Efforts
on Title XVI Overpayments
The Social Security Administration's Controls over the Old-Age, Survivors and
Disability Insurance Waiver Approval Process
The Social Security Administration's Decisions to Terminate Collection Efforts
for Old-Age, Survivors and Disability Insurance Overpayments Recorded on the
Recovery of Overpayments, Accounting and Reporting System
The Social Security Administration's Use of Deportation Data
Uncollectible Title XVI Overpayments that Exceed $200
Undetected Overpayments in the Social Security Administration's Disability Programs
We Plan to Begin the Following Reviews in FY 2005
Effectiveness of the Social Security Administration's Controls and Procedures
over Supplemental Security Income Death Alerts
Follow-up: Supplemental Security Income Overpayment Audit
Follow-up: The Social Security Administration's Controls over Withholding Taxes
and Suspending Benefits to Foreign Beneficiaries where Country of Citizenship
is Known
Follow-up: The Social Security Administration's Efforts to Improve the Management
of its Pending Workers' Compensation Workload
Follow-up: The Social Security Administration's Recovery of Medicare Premiums
Related to Title II Payments Made After Death
Management of the Treasury Reclamation Process
Match of Veterans Affairs Historical Death File Against Supplemental Security
Income and Old-Age, Survivors and Disability Insurance Beneficiaries
New Earnings Suspense File Edits and Changes in Disability Income Benefits
Office of Hearings and Appeals Attorney Fees
Payment Accuracy of the Cleaned Up Disability Insurance Cases with Workers'
Compensation/Public Disability Offset
Payments to Surviving Spouses at Retirement Age
Savings Due to the Suspension of Benefits to Prisoners
CONTROLS OVER TITLE II REPLACEMENT CHECKS
Objective
To determine the adequacy of controls over the number of double-check negotiations
issued to the same beneficiary or representative payee and the adequacy of actions
to recover double-check negotiations.
Background
A recent audit of the controls over Title XVI replacement checks found that
SSA has neither adequate controls to prevent individuals from negotiating multiple
replacement checks nor procedures to promptly recover overpayments. The number
of double-check negotiations has continued to increase in recent years, and
SSA needs to take further actions to address this problem. Based on our audit
results, we recommended additional training, automation enhancements, increased
use of administrative sanctions and direct deposit, and assistance to field
offices with high numbers of double-check negotiations.
Our review of the data of Title II double-check negotiations showed there were
over 200 cases of beneficiaries with 5 or more double-check negotiations in
a 2.5 year time frame.
CONTROLS OVER UNNEGOTIATED CHECKS
Objective
To assess the effectiveness of controls over unnegotiated checks.
Background
SSA initiated the Unnegotiated Check Project to identify Title II beneficiaries
who have not cashed 10 or more checks within the last 5 years. SSA attempted
to contact beneficiaries by mail and telephone. In some cases, field representatives
also went to beneficiaries' addresses. In cases where SSA was ultimately unable
to locate beneficiaries, it suspended benefits with the current operating month
pending any further clarification of the claimant's status.
At the end of this process, SSA examined each case and concluded checks had
not been cashed because the beneficiary had died, was incapacitated, or had
moved. In a number of cases, claimants were aware they had not cashed the checks
but were unaware the checks became void after a certain number of days. In other
cases, SSA could not locate the claimant or fraud was involved in some way.
For example, some individuals were deceased, but someone was cashing their checks.
In New York, SSA found 368 claimants who had 10 or more unnegotiated checks
in the 5-year period ended December 2002. SSA referred these cases to our Office
of Investigations.
DISABLED SUPPLEMENTAL SECURITY INCOME RECIPIENTS WITH EARNINGS ON THE MASTER
EARNINGS FILE
Objective
To determine whether SSA considered the earnings of disabled individuals when
determining SSI eligibility and payment amounts.
Background
SSA considers individuals to be disabled if they cannot engage in any substantial
gainful work activity because of a physical or mental impairment. This inability
to work must have lasted (or be expected to last) for 12 continuous months or
end in death.
SSI program rules require that SSA consider disabled recipients' earnings when
determining eligibility and payment amounts. To identify unreported or underreported
earnings, SSA conducts various computer data matches. For example, it compares
earnings reported to the Master Earnings File with its SSI payment records.
FOLLOW-UP: THE SOCIAL SECURITY ADMINISTRATION'S CONTROLS TO PREVENT AND DETECT
DIRECT DEPOSIT FRAUD
Objective
To follow-up on prior recommendations and determine the effectiveness of SSA's
controls over the prevention and detection of direct deposit fraud and irregularities.
Background
One of SSA's strategic goals is to deliver citizen-centered, high-quality service.
One way SSA plans to achieve this goal is by expanding the use of Internet and
toll-free telephone services. While expanding the use of electronic services
will improve SSA's responsiveness, it will also increase the risk of unauthorized
access to SSA records and beneficiary payments.
SSA offers many services to customers through its 1-800 number telephone service,
including change of direct deposit information. SSA is also affiliated with
the QuickStart direct deposit program. QuickStart allows beneficiaries to have
their benefit payments deposited electronically in their checking or savings
account without direct interaction or contact with SSA staff.
We issued an early alert memorandum in 1999 and a management advisory report
in 2001. Our early alert stated SSA needed to train all service representative
and teleservice representatives on the proper detection and reporting procedures
for potential direct deposit fraud incidents and establish an automated trail
to track electronic transactions originating outside the Agency.
Our management advisory report stated People can circumvent controls designed
to prevent direct deposit fraud in situations where SSA has no face-to-face
contact with the customer or beneficiary.
SSA has insufficient controls in place to prevent or detect fraud, or the assignment
of future benefits to third parties, when depository financial institutions
initiate direct deposit transactions.
Transactions initiated by depository financial institutions can be used to bypass
SSA's representative payee process.
IMPLEMENTATION OF THE EXECUTIVE ORDER PROHIBITING PAYMENTS TO TERRORISTS
Objective
To assess SSA's internal controls over the implementation of Executive Order
13224 prohibiting payments to terrorists.
Background
On September 23, 2001, the President signed Executive Order 13224, Blocking
Property and Prohibiting Transactions with Persons who Commit, Threaten to Commit,
or Support Terrorism. On December 18, 2002, the Department of the Treasury (Treasury)
issued Treasury Financial Manual, Bulletin No. 2003-04 notifying Federal agencies
that they must not make payments to any individual or organization listed on
Treasury's Office of Foreign Assets Control website, which contains a list of
persons who commit, threaten to commit, or support terrorism. The Bulletin requires
that agencies consult the website before making payments.
The 89-page list of organizations and individuals is posted on the Office of
Foreign Assets Control website: http://www.ustreas.gov/offices/enforcement/ofac/sanctions/terrorism.html.
The individuals and organizations are listed by name and alias, and the individual
data vary as far as detail. In some cases, a date of birth or partial date of
birth is provided, and, in rare cases, an SSN is listed.
To comply with the Executive Order, SSA needs to ensure that none of the individuals
or organizations is receiving benefits or any type of payments from SSA.
INDIVIDUALS RECEIVING BENEFITS UNDER MULTIPLE SOCIAL SECURITY NUMBERS AT THE
SAME ADDRESS
Objective
To identify individuals who are inappropriately receiving Social Security benefits
and SSI payments under multiple SSNs at the same mailing address.
Background
When an individual applies for OASDI benefits or SSI payments, SSA staff asks
the person about any prior applications for benefits. They do this to ensure
individuals who may be entitled on more than one record receive the correct
amount, as the total benefits payable should not exceed the largest benefit
payable on any one record. In addition, SSA runs a Master File Duplicate Detection
Operation semiannually to identify OASDI records that appear to be duplicates
based on name, date of birth, and ZIP Code. SSA personnel review the records
to determine whether they relate to the same beneficiary, correct the benefit
amounts (if necessary), and assess any overpayments.
Although SSA has controls in place to identify and prevent multiple benefit
payments to the same person, we were alerted to three cases in January 2004
where the beneficiary inappropriately received benefits under multiple SSNs
at the same address. To identify the extent of this situation, we analyzed a
data extract of approximately 47 million OASDI beneficiaries and 7 million SSI
recipients receiving payments in March 2004. Based on our analysis of these
SSNs, address information and benefit records, we initially identified 381 beneficiaries
who may have received benefits inappropriately under at least 2 different SSNs
at the same address.
INDIVIDUALS RECEIVING MULTIPLE AUXILIARY OR SURVIVORS BENEFITS
Objective
To determine whether individuals who receive multiple auxiliary or survivors
benefits are entitled to the benefit payments.
Background
In February 2004, during our audit of Individuals Receiving Multiple Childhood
Disability Benefits, we identified a new population of 1,514 individuals who
appeared to be receiving multiple auxiliary or survivor benefits inappropriately.
The OASDI program provides auxiliary benefits to the eligible spouses and children
of retired or disabled workers. In addition, benefits may be payable to the
survivors of deceased workers. Individuals may be entitled to auxiliary or survivor
benefits based on several workers' earnings (for example, based on the earnings
of both parents) but generally may only be paid the higher of the two.
We referred the 1,514 cases to SSA, and we are working with the Agency to ensure
corrective action is taken.
INFORMATION SYSTEM CONTROLS OVER WORKERS' COMPENSATION PAYMENTS
Objective
To assess the effectiveness of the application controls governing the correct
calculation of WC offset amounts in the Title II Disability System. Also, we
will determine whether the changes made for the Title II redesign have corrected
the rejection of certain WC cases.
Background
Since 2002, disability claims involving WC offset can be processed in SSA field
offices. However, the Title II Disability System is rejecting certain WC cases.
A systems error or a claims representative improperly processing the case could
be causing the rejection of certain cases. Furthermore, rejected cases tend
to be more time-consuming and costly to process because both the field offices
and the program service centers have to work them.
The Social Security Act requires that SSA offset disability benefits for individuals
who receive Federal, State or locally administered WC benefits in most States.
However, 14 States are required by State law to offset WC benefits with Title
II disability benefits.
When an individual applies for Title II disability benefits, field office personnel
determine whether WC may be involved. If SSA approves disability benefits and
the applicant's WC claim is pending, SSA requires that beneficiaries report
receipt of subsequent WC payments. SSA policies and procedures require that
personnel follow up on WC issues until resolved. SSA's Modernized Claims System
generates a one-time diary alert after benefit approval. This diary alert reminds
personnel to follow up on pending WC issues. Program service center personnel
must manually establish additional diaries to continue developing WC issues.
MANUAL CHANGES TO TITLE II BENEFITS VIA THE MANUAL ADJUSTMENT CREDIT AND AWARD
DATA ENTRY SYSTEM
Objective
To determine whether SSA's procedure for manually changing Title II benefit
payments via the Manual Adjustment Credit and Award Data Entry system results
in payment errors.
Background
A Manual Adjustment Credit and Award Process action establishes a new record
and/or changes any or all previously established MBR data.
When a beneficiary receives payment on more than one record, the underpayment
or overpayment is usually manually calculated; therefore, there is the potential
for human error using the Manual Adjustment Credit and Award Process/Manual
Adjustment and Award Data Entry system.
We believe the potential for error, based on prior OIG work, warrants reviewing
this area. In
FY 2002, SSA assessed about $1.6 billion in new Title II overpayments-a portion
of which was manually calculated.
PAYROLL TAX REPORTING BY THE SOCIAL SECURITY ADMINISTRATION'S CONTRACTORS
Objective
To determine whether SSA's contractors are appropriately paying payroll taxes
on their employees.
Background
In the February 2004 audit, Some DoD Contractors Abuse the Federal Tax System
with Little Consequence, GAO reported that Department of Defense (DoD) and Internal
Revenue Service records showed that over 27,000 DoD contractors owed about $3
billion in unpaid Federal taxes as of September 30, 2002. Of these contractors,
GAO found that over 25,600 contractors owed payroll taxes, with some dating
back to the early 1990s. These payroll taxes included amounts withheld from
employee wages for Social Security, Medicare, Federal individual income taxes
and the employer's related matching contributions for Social Security and Medicare.
As of May 2004, SSA had about 2,600 active contracts totaling over $1.3 billion.
These contracts relate to a variety of SSA operations, including medical services,
worker rehabilitation, consulting/auditing, and verification services. We will
review the earnings records of SSA's contractors to verify that Social Security
and Medicare payroll taxes are being collected and reported accurately.
REPRESENTATIVE PAYEE REPORTS INDICATING EXCESS CONSERVED FUNDS FOR SUPPLEMENTAL
SECURITY INCOME RECIPIENTS
Objective
To evaluate SSA's policies and procedures for processing Representative Payee
Reports indicating excess conserved funds for SSI recipients. Specifically,
we will evaluate SSA's controls to ensure excess conserved funds information
is forwarded to the appropriate SSA field office for review and compliance with
policies for resolving reported excess conserved funds.
Background
Under the SSI program, to be eligible for benefits, a recipient is limited to
$2,000 in resources (or $3,000 for recipients with a spouse who is also eligible
for benefits). If the resource limits are exceeded, benefit payments to the
recipient are usually suspended. Benefits are resumed if the recipient's resources
subsequently fall below the limit.
Representative payees are required to provide SSA an annual Representative Payee
Report accounting for how benefits were spent and how much in benefits were
conserved. When a representative payee reports conserved funds over $2,000,
SSI eligibility is questionable. Therefore, SSA must contact the representative
payee to determine continued eligibility. In addition, a large amount of conserved
SSI payments may also indicate the representative payee is not spending enough
to meet the recipient's needs.
Recent audits found that SSA has not always taken appropriate actions when representative
payees report excess conserved funds for SSI recipients. For example, in one
case, a representative payee reported $12,562 in conserved funds. However, SSA
did not perform the required review, and, as a result, benefits continued uninterrupted.
SCHOOL ATTENDANCE BY STUDENT BENEFICIARIES OVER AGE 18
Objective
To determine the adequacy of SSA's procedures for ensuring student beneficiaries
over age 18 are entitled to receive student benefits in accordance with the
Social Security Act.
Background
Title II of the Act provides benefits to children of insured workers upon the
worker's retirement, death, or disability. Generally, child beneficiaries may
continue to receive benefits until they marry or reach age 18. Amendments to
the Act provide for extended benefits beyond age 18 to enable child beneficiaries
who are full-time students at an elementary or secondary school to complete
their education.
SSA relies on student beneficiaries to voluntarily report events that may affect
their continuing entitlement to benefits. For example, students who attend school
part-time or have graduated or dropped out are no longer eligible for benefits.
In addition, students who are married, convicted of a crime, or paid by their
employer to attend school are no longer eligible for benefits.
Our prior audit work disclosed that student beneficiaries received incorrect
and unsupported payments of $73.9 and $140.4 million, respectively. In response
to our audit, in March 2001, SSA revised its forms and reporting requirements,
obtained school certification before awarding student benefits, shifted the
workload from processing centers to field offices, and provided its employees
additional training and guidance.
THE SOCIAL SECURITY ADMINISTRATION'S ADMINISTRATIVE FINALITY RULES
Objective
To assess the impact of SSA's administrative finality rules on the assessment
of overpayments.
Background
Once SSA makes determinations regarding SSI or OASDI eligibility or payment
amounts, those determinations may be reopened and revised under certain conditions.
The rules SSA uses to reopen and revise determinations are known as the rules
of administrative finality.
SSA regulations allow a determination to be reopened and revised under the rules
of administrative finality under the following conditions:
within 1 year of the date of notice of an initial determination for any reason;
after 1 year, but within 2 years for SSI or 4 years for OASDI determinations,
upon a finding of "good cause"; or
at any time, if the determination or decision was procured by fraud or "similar
fault."
SSA does not consider SSI or OASDI benefit payments issued for any months before
the administrative finality time limits to be overpayments, and recovery is
not pursued.
THE SOCIAL SECURITY ADMINISTRATION'S CONTROLS OVER SUSPENDING COLLECTION EFFORTS
ON TITLE XVI OVERPAYMENTS
Objective
To (1) evaluate SSA's controls over suspending collection efforts on Title XVI
overpayments because recipients are unable or unwilling to pay, cannot be located,
or are out of the country and (2) determine whether the decisions to suspend
collection efforts on these overpayments were in accordance with SSA's policies
and procedures.
Background
Title XVI of the Social Security Act established the SSI program in 1972, effective
January 1, 1974, to provide income to financially needy individuals who are
aged, blind or disabled. SSA relies heavily on beneficiary self-disclosure of
all income sources, earned or unearned, as well as computer matching from other
Federal and State agencies to verify that information, such as the beneficiary's
marital status and/or living arrangements, is correct. The information is used
to determine initial eligibility, benefit amounts and periodic benefit redeterminations.
Because a beneficiary's SSI determination factors, such as financial status,
marital status and living arrangements, may vary over time, SSI payments are
error-prone and may result in overpayments.
Recovery of SSI debt is more likely to occur with debtors still eligible for
an SSA monthly benefit and typically withheld from a portion of the monthly
benefit until the overpayment is repaid. For debtors no longer receiving a monthly
benefit, collection efforts are more difficult. The end result is often a decision
to write off the debt. Debt write-offs include debts that are waived, which
are not subject to future recovery, and debts where the Agency terminates debt
collection efforts, which may be subject to future recovery. However, if the
write off is deemed suspended from further collection, such as unable or unwilling
to pay, unable to locate, or out of the country, the overpayment may be recovered.
This suspension allows the Agency to stop unproductive collection efforts while
continuing to keep collection options open to a change of events that may lead
to collection of the overpayment. These overpayments are left indefinitely in
suspended collection status so the Agency may use various collection tools at
a future date.
THE SOCIAL SECURITY ADMINISTRATION'S CONTROLS OVER THE OLD-AGE, SURVIVORS AND
DISABILITY INSURANCE WAIVER APPROVAL PROCESS
Objective
To determine whether SSA's waiver approval process ensures administrative waivers
of $500 or less adequately protect the OASDI program's integrity and 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 because of
retirement, disability and death. For the fiscal year ended September 30, 2003,
the OASDI program provided total benefit payments of $467.5 billion to 46.9
million beneficiaries.
Payments in an amount greater than the amount to which an individual is entitled
are considered overpayments. When overpayments occur, Agency policies indicate
various actions should be taken to collect the amount overpaid. 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."
For Fiscal Year 2003, SSA reported in its Report on Receivables Due from the
Public approximately $276.8 million in overpayment waivers. Overpayment waivers
totaled approximately $67 million for the Old-Age and Survivors Insurance program
and $209.8 million for the Disability Insurance program.
THE SOCIAL SECURITY ADMINISTRATION'S DECISIONS TO TERMINATE COLLECTION EFFORTS
FOR OLD-AGE, SURVIVORS AND DISABILITY INSURANCE OVERPAYMENTS RECORDED ON THE
RECOVERY OF OVERPAYMENTS, ACCOUNTING AND REPORTING SYSTEM
Objective
To determine whether SSA's decisions to terminate collection efforts for OASDI
overpayments recorded on the Recovery of Overpayments Accounting and Reporting
System were in accordance with its policies and procedures.
Background
SSA administers the OASDI program under Title II of the Social Security Act.
The OASDI program provides protection against the loss of earnings due to retirement,
disability and death.
Overpayments consist of legally defined and non-legally defined overpayments.
Legally defined overpayments are payments of more than the correct amount. For
example, a payment is improperly certified to the address of an individual who
has the same or similar name as the intended beneficiary. Non-legally defined
overpayments are payments not due or received by the beneficiary or were not
correctly used for the beneficiary. Non-legally defined overpayments are incorrect
or erroneous payments. For example, beneficiary's funds misused by a representative
payee.
Agency policies prescribe various actions to be taken to recover overpayments.
It is SSA's responsibility to identify the overpayments and pursue recovery
of the debt.
SSA may decide to terminate collection efforts after all appropriate collection
tools have been used and the debt is considered uncollectible. Although active
collection efforts cease, the overpayments are maintained on SSA's Recovery
of Overpayments Accounting and Reporting System as inactive debts that may be
recovered sometime in the future.
THE SOCIAL SECURITY ADMINISTRATION'S USE OF DEPORTATION DATA
Objective
To determine how effectively SSA identifies beneficiaries and other individuals
who have been deported from the United States.
Background
Each month, the United States Citizenship and Immigration Services, a component
of DHS, notifies SSA of individuals who have been deported from the United States.
This notification is required by section 202(n)(2) of the Act and applies to
individuals deported under section 241(a) of the 1990 Immigration and Nationality
Act.
SSA's Division of Annual Withholding Report receives the United States Citizenship
and Immigration Services deportation listing each month, verifies SSNs on the
list, and records deportation information on SSA's Disability, Railroad, Alien
and Military Service database. As of June 23, 2003, this database contained
207,391 deportation records.
Section 202(n) of the Act prohibits SSA from paying Social Security benefits
to certain individuals deported from the United States. In addition, SSA cannot
make SSI payments to deportees. The law requires that SSA stop both OASDI and
SSI payments in the month that United States Citizenship and Immigration Services
notifies SSA of the deportation.
UNCOLLECTIBLE TITLE XVI OVERPAYMENTS THAT EXCEED $200
Objective
To determine whether SSA properly classified Title XVI overpayments as uncollectible.
Background
Title XVI of the Act established the SSI program to provide income to financially
needy individuals who are aged, blind or disabled. SSA relies heavily on beneficiary
self-disclosure of all financial resources as well as computer matching from
other Federal and State agencies. Since an individual's financial resources
can vary, SSI payments are error-prone and may result in overpayments.
Under limited circumstances, SSA may deem an overpayment uncollectible. For
example, if the beneficiary has filed for bankruptcy or has been declared bankrupt,
SSA will deem the overpayments uncollectible. If the beneficiary is deceased
and has no surviving spouse or estate, SSA deems any overpayments on this beneficiary's
record uncollectible. Also, when specific conditions are met, the Act requires
that SSA deem overpayments relating to presumptive disability as uncollectible.
Title XVI program funds may be lost if overpayments are incorrectly classified
as uncollectible. From FY 1998 through 2001, overpayments deemed uncollectible
increased from $99 to $150 million, a 51-percent increase.
UNDETECTED OVERPAYMENTS IN THE SOCIAL SECURITY ADMINISTRATION'S DISABILITY PROGRAMS
Objective
To quantify the amount of undetected overpayments in SSA's disability programs.
Background
On September 4, 2003, we received a request from Senator Charles Grassley to
further analyze the improper payment prevalence in SSA's disability programs.
SSA pays disability benefits under Titles II and XVI of the Social Security
Act. In FY 2002, SSA paid approximately $97.2 billion in benefits under the
DI and SSI programs and assessed about $2.9 billion in overpayments. However,
based on our prior studies of SSA, other Federal agencies, and private disability
insurers, we believe about 10 percent of SSA's disability benefit payments could
be at-risk for undetected overpayments.
Internal Control Environment and Performance Measures
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 disability
claims under the DI and SSI programs. Disability determinations under both DI
and SSI are performed by DDSs in each State in accordance with Federal regulations.
In carrying out its obligation, each DDS is responsible for determining claimants'
disabilities and ensuring adequate evidence is available to support its determinations.
To assist in making proper disability 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 located 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 2003, SSA allocated
over $1.6 billion to fund DDS operations.
During FYs 2000 through 2003, we conducted 15 DDS administrative cost audits.
In 13 of the 15 audits, internal control weaknesses were identified. 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 6 of the 15 DDS administrative cost audits, we reported unallowable indirect costs totaling about $12.3 million. 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 through the indirect cost process benefited SSA's disability programs and the costs were equitably distributed to its programs.z
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 the 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 the
performance of programs, and begin integrating this presentation with associated
cost.
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 conduct audits to assess the internal control environment
over SSA's performance measures. The objective of this work is to assess the
reliability of SSA's performance data and evaluate the extent to which SSA's
performance measures describe its planned and actual performance meaningfully.
Assessing the control environment over DDSs and SSA's performance measures helps
to ensure that the Agency is properly managing its resources to meet it mission.
In FY 2005, we plan to complete 19 reviews and begin 11 reviews in this area.
We also plan to oversee the reviews of 16 performance measures.
We Plan to Complete the Following Reviews in FY 2005Administrative Costs Claimed
by State Disability Determinations Services: 11 reviews to be conducted in Alaska,
Arkansas, Delaware, District of Columbia, Iowa, New Hampshire, North Carolina,
Ohio, Pennsylvania, South Dakota, and Wisconsin
Costs Incurred by Maximus, Inc., on Contract Number 0600-00-60020
Fiscal Year 2004 Financial Statement Audit Oversight
Fiscal Year 2004 Inspector General Statement on the Social Security Administration's
Major
Management Challenges
Independent Living Resource Center of North East Florida
Indirect Costs Claimed by the Arizona, New Jersey, and Oregon Disability Determination
Services
Westat Contract Closeout on Contract Number 0600-99-36200
We Plan to Begin the Following Reviews in FY 2005
Administrative Costs Claimed by the Indiana, Louisiana, Maine, Maryland, Missouri,
New York, Oklahoma, and Virginia Disability Determination Services
Credit Evaluations on Social Security Administration Employees Before the Issuance
of Government Charge Cards
Fiscal Year 2005 Financial Statement Audit Oversight
The Social Security Administration's Oversight of the Financial Reporting of
the Disability Determination Services
We plan to Oversee Reviews of the Following Performance Indicators
Performance Indicator Audits: Audits of the Social Security Administration's
Performance Data
Number of appellate actions processed
Number of initial disability claims pending
Number of SSA hearings pending
Hearings decision accuracy rate
Retirement and Survivor Insurance claims processed
Percent of people who do business with SSA rating the overall service as "excellent,"
"very good," or "good"
SSI nondisability redeterminations
Periodic continuing disability reviews processed
Percent of outstanding SSI debt in a collection arrangement
Percent of outstanding OASDI debt in a collection arrangement
SSN requests processed
Percent of SSNs issued that are free of critical error
Annual earnings items processed
Number of job enrichment opportunities (includes Headquarters component and
regional development programs)
Number of SSA hearings cases processed per workyear
Percent of SSI Aged claims processed by the time the first payment is due or
within 14 days of the effective filing date
ADMINISTRATIVE COSTS CLAIMED BY STATE DISABILITY DETERMINATION SERVICES
We will be conducting reviews in the following State DDSs
Alaska
Arkansas
Delaware
District of Columbia
Iowa
New Hampshire
North Carolina
Ohio
Pennsylvania
South Dakota
Wisconsin
Objective
The objectives of the DDS administrative cost audits are to evaluate the DDS'
internal controls over the accounting and reporting of administrative costs,
determine whether costs claimed by the DDSs were allowable and properly allocated
and funds were properly drawn, and assess the general security controls environment.
Background
The DI program was established in 1956 under Title II of the Act. The program
is designed to provide benefits to wage earners and their families in the event
the wage earner becomes disabled. In 1972, the Congress enacted the SSI program
(Public Law 92-603). The SSI program provides a nationally uniform program of
income to financially needy individuals who are aged, blind or disabled. Disability
determinations under both DI and SSI are performed by a DDS in each State or
other responsible jurisdiction in accordance with Federal regulations. In carrying
out its obligation, each DDS is responsible for determining the claimants' disabilities
and ensuring adequate evidence is available to support its determinations. SSA
reimburses DDSs for their allowable administrative costs.
COSTS INCURRED BY MAXIMUS, INC., ON CONTRACT NUMBER 0600-00-60020
Objective
To review the direct and indirect costs charged by Maximus on this contract.
Background
The Ticket to Work and Work Incentives Improvement Act of 1999 was enacted to
enable disabled beneficiaries to receive a ticket 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 to work.
Maximus, Inc., was selected as the Program Manager and is responsible for administering
most aspects of the ticket program, including recruiting and managing Employment
Networks and managing the ticket process. During the initial 24-month period
a beneficiary is using his/her ticket, there is no requirement for work. However,
the beneficiary must be participating in an employment plan. At the conclusion
of the initial 24-month period, the Program Manager will conduct a progress
review to determine whether the beneficiary is meeting the guidelines and still
using a ticket. The Program Manager will then conduct annual progress reviews
at the end of each 12-month period.
FISCAL YEAR 2004 FINANCIAL STATEMENT AUDIT OVERSIGHT
Objective
To fulfill our responsibilities under the Chief Financial Officers Act and related
legislation for ensuring the quality of the audit work performed, we will monitor
PricewaterhouseCoopers' (PwC) audit of SSA's FY 2004 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. PwC will perform the audit work to support this opinion
of SSA's financial statements. We will monitor the contract to ensure the reliability
of PwC's work to meet our statutory requirements for auditing the Agency's financial
statements.
FISCAL YEAR 2004 INSPECTOR GENERAL STATEMENT ON THE SOCIAL SECURITY ADMINISTRATION'S
MAJOR MANAGEMENT CHALLENGES
Objective
To summarize and assess SSA's progress in addressing the most serious management
and performance challenges.
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 in FY 2004.
Social Security Number Integrity and Protection
Management of the Disability Process
Improper Payments
Budget and Performance Integration
Critical Infrastructure Protection/Systems Security
Service Delivery
We will summarize each challenge and document actions SSA has taken to address
it.
INDEPENDENT LIVING RESOURCE CENTER OF NORTH EAST FLORIDA
Objective
To determine whether SSA's funds are being used in accordance with the terms
of the grant.
Background
The Ticket to Work and Work Incentives Improvement Act of 1999 (Ticket program)
improves access to employment training and placement services for people with
disabilities who want to work. Under the Ticket program, eligible beneficiaries
can receive employment services, vocational services, or other support services
to help them return to work. The Ticket program provides the beneficiary the
opportunity to choose from a variety of employment networks. The employment
networks may be public or private organizations that contract with SSA to provide
employment services to eligible beneficiaries.
In addition, SSA's Office of Employment Support Programs' Benefits Planning,
Assistance and Outreach Program approves and allocates grant money to public
and private organizations to assist eligible beneficiaries in making informed
choices about returning to work. In July 2001, the Benefits Planning, Assistance
and Outreach program awarded a cooperative agreement to the Independent Living
Resource Center of Northeast Florida, which covers five counties in Florida:
Nassau, Baker, Clay, Duval, and St. Johns. Over the first 3 years of the grant,
the Center received $236,304.
Our audit will focus on reviewing the direct and indirect costs claimed on this
grant.
INDIRECT COSTS CLAIMED BY STATE DISABILITY DETERMINATION SERVICES
We will conduct indirect cost reviews in the following States.
Arizona
New Jersey
Oregon
Objective
To review the State DDS' indirect costs to determine whether the costs claimed
on the SSA financial reports (State Agency Report of Obligations for SSA Disability
Programs, Form SSA-4513) are allowable and properly allocated.
Background
The DI program was established in 1956 under Title II of the Act. The DI program
provides benefits to wage earners and their families in the event the wage earner
becomes disabled. In 1972, Congress enacted the SSI program (Public Law 92-603).
The SSI program provides a nationally uniform program of income to financially
needy individuals who are aged, blind, or disabled. Disability determinations
under the DI and SSI programs 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 that
adequate evidence is available to support its determinations. SSA reimburses
State DDSs for allowable expenditures.
WESTAT CONTRACT CLOSEOUT ON CONTRACT NUMBER 0600-99-36200
Objective
To determine the allowability of the direct costs and apply the final indirect
rates to compute the total allowable contract costs submitted.
Background
Westat was awarded contract 0600-99-36200 on December 21, 1998. This $23.4 million
cost-plus-fixed-fee contract was awarded to conduct a Disability Evaluation
Study/National Study of Health and Activity. The Disability Evaluation Study
is a major research effort to understand the prevalence of disability and the
potential for growth in SSA's disability rolls and to understand what enables
"disabled" individuals to remain in the workplace. Through the Disability
Evaluation Study, SSA would estimate how many adults in the U.S. population
would meet eligibility criteria for Social Security disability benefits, how
many of them work despite their impairments, and which factors enable them to
work. Through three additional funding modifications, as of August 9, 2001,
the contract value was increased to $39.3 million.
However, on October 22, 2002, the contract was terminated because of a shift
in SSA's budget and project management prioritization goals. On February 28,
2003, SSA deobligated the excess funds and modified the contract value to $19.9
million. On January 16, 2004, Westat submitted its settlement proposal. On March
30, 2004, Westat submitted its final completion voucher. The final completion
voucher included all costs claimed from December 21, 1998 through March 25,
2003.
PERFORMANCE INDICATOR AUDITS: AUDITS OF 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 2003-2008. The Agency's most recent annual performance
plan presents 4 strategic goals in its strategic plan and 47 Government Performance
and Results Act performance measures.
The success of SSA's performance measurement initiatives hinges on the quality
of the data used to measure and report program performance. Consequently, it
is important that SSA have assurance that the data reported are reliable and
meaningful and that its performance report will be useful to Congress and Agency
management.
During FY 2005, we will review the following performance indicators.
Number of appellate actions processed
Number of initial disability claims pending
Number of SSA hearings pending
Hearings decision accuracy rate
Retirement and Survivor Insurance claims processed
Percent of people who do business with SSA rating the overall service as "excellent,"
"very good," or "good"
SSI nondisability redeterminations
Periodic continuing disability reviews processed
Percent of outstanding SSI debt in a collection arrangement
Percent of outstanding OASDI debt in a collection arrangement
SSN requests processed
Percent of SSNs issued that are free of critical error
Annual earnings items processed
Number of job enrichment opportunities (includes Headquarters component and
regional development programs)
Number of SSA hearings cases processed per workyear
Percent of SSI Aged claims processed by the time the first payment is due or
within 14 days of the effective filing date
Critical Infrastructure Protection and Systems Security
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. Protection of these systems is essential
to telecommunications, energy, financial services, manufacturing, water, transportation,
health care, and emergency services.
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 and the Federal Information Security Management Act
of 2002. SSA has several other components throughout the organization that handle
systems security, including the Office of Information Technology Security Policy
within the Office of the Chief Information Officer.
Homeland Security Presidential Directive 7 requires that all Federal departments
and agency heads identify, prioritize, assess, remediate, and protect their
respective critical infrastructure and key resources. OMB provided guidance
to Federal departments and agencies on how to prepare plans to protect physical
and cyber critical infrastructure and key resources and to complete these plans
by July 31, 2004. We have worked closely 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.
One important issue in systems security is restricting 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. However, because our observations were limited
to only a few offices, we do not know how pervasive these security breaches
may be. We plan to better assess OHA's vulnerabilities in this area.
In addition, under the Federal Information Security Management Act, we independently
evaluate SSA's security program. We also monitor the Agency's efforts and progress
on the Expanded Electronic Government initiative of the PMA. Systems security
is a key component of this initiative, and we are working with the Agency to
resolve outstanding issues so it can get to green on the Electronic Government
Scorecard.
In FY 2005, we plan to complete 14 reviews and begin 6 reviews in this area.
We Plan to Complete the Following Reviews in FY 2005
Access to Secured Areas in Hearing Offices-Regions I Through X
Assessing the Social Security Administration's Disability Control File Application
Controls
Disability Determination Services Procedures for Removing Sensitive Information
from Excess Computers
Federal Information Security Management Act
The Social Security Administration's Patch Management Process
We Plan to Begin the Following Review in FY 2005
Death Alert Control and Update System-Release 3.2
Follow-up of Information System Controls of the Social Security Administration's
Representative Payee System
Follow-up of the Agency's Disability Determination Services General Control
Requirements
General Controls Review of the Maryland Disability Determination Services
Software Development Through the Social Security Administration's Shared Hosting
Environment
Use of Click and Sign as a Signature Alternative for Internet Applications
ACCESS TO SECURED AREAS IN HEARING OFFICES-REGIONS I THROUGH X
Objective
To assess controls over physical security in hearing offices.
Background
OHA is one of the largest administrative adjudicative systems in the world.
At the hearing level, the Chief Administrative Law Judge manages 10 regional
offices and 140 hearing offices. In FY 2003, approximately 1,000 administrative
law judges rendered about 500,000 decisions at the hearing level. Claims folders
containing sensitive information about claimants, such as SSNs and private medical
information, are stored, reviewed and moved through the hearing offices.
OHA must ensure its employees, facilities, and records are safeguarded against
security threats. OHA has policies and procedures for physical security to safeguard
hearing office access, protect Government property, and protect on-site personnel
and sensitive data. In March 2004, we issued an early alert to the Commissioner
concerning problems we observed involving security issues in six hearing offices
while conducting other audits. Based on our previous audit findings, we are
concerned about the physical security at hearing offices. As a result, we will
review the physical security at 20 hearing offices-2 in each of SSA's 10 Regions.
ASSESSING THE SOCIAL SECURITY ADMINISTRATION'S DISABILITY CONTROL FILE APPLICATION
CONTROLS
Objective
To assess the application controls of the Disability Control File. This audit
will encompass the three phases of the processing cycle (input, processing,
and output) to ensure that Disability Control File transactions are authorized,
complete and accurate. The audit will include the determination of whether (1)
requests for data and use of data are authorized, (2) data are accurate and
valid; (3) data are properly processed; and (4) output data are accurate, valid
and distributed to authorized users.
Background
The Ticket to Work and Work Incentives Improvement Act of 1999 provides for
support of those disabled beneficiaries who want to return to work and subsequently
leave the disability benefit rolls. Nearly all of the data that describe the
activity for those beneficiaries that attempt to work will be controlled in
the Disability Control File. These data and related software are commonly referred
to as the Ticket to Work program functions.
The Disability Control File replaces the CDR Control File as the disability
database for both Title II and Title XVI records and will be expanded to house
records for all disabled individuals, including claim information by SSN. In
addition to information available on the CDR Control File for records selected
for a medical CDR, or records selected for eligibility for the Ticket to Work
program, the new Disability Control File will allow technicians to add both
medical and work CDRs initiated in the field office or processing center.
The Disability Control File will consolidate all data needed to control and
process all types of disabled beneficiary medical and work CDRs. The Disability
Control File allows for the processing of all aspects of a CDR from initiation
to disposition using data from a single source. The Disability Control File
will also control any subsequent reviews for those individuals who are determined
to still be disabled after the CDR is complete.
Establishment of the Disability Control File is a major step in SSA's effort
to perform required CDRs timely and accurately. As of July 2004, about 10.6
million Americans were receiving DI/SSI-related disability benefits.
DISABILITY DETERMINATION SERVICES PROCEDURES FOR REMOVING SENSITIVE INFORMATION
FROM EXCESS COMPUTERS
Objective
To examine the policies and procedures the State DDSs follow when excessing
computer equipment to ensure sensitive information is removed.
Background
The DDSs are State agencies responsible for developing medical evidence and
rendering the initial determination on whether an SSA disability claimant is
legally disabled or blind. As such, computer equipment within the DDSs store
such sensitive information as a claimant's SSN, medical and other personal information.
The North Carolina State Auditors reviewed a sample of machines that had been
excessed by a variety of state agencies and found files on those machines were
accessible, including password files and other sensitive information. Some of
these machines were from the Department of Health and Human Services, which
is the parent agency for the North Carolina DDS.
The DDS Security Document directs DDSs to run the SSA WipeDisk utility on equipment
used for the storage of sensitive information (servers, personal computers,
laptops, etc.) before its disposal or donation to another entity.
FEDERAL INFORMATION SECURITY MANAGEMENT ACT
Objective
To determine whether SSA is in compliance with the Federal Information Security
Management Act for FY 2005.
Background
The Federal Information Security Management Act of 2002 requires an Agency-wide
information security program and annual reviews of the security program performed
by the Agency and by the OIG, separately. Each year, OMB issues questions to
be answered concerning agencies' compliance with the Federal Information Security
Management Act.
THE SOCIAL SECURITY ADMINISTRATION'S PATCH MANAGEMENT PROCESS
Objective
To determine whether SSA implements and performs effective patch management
practices and whether the necessary steps are taken to mitigate the risks created
by software vulnerabilities.
Background
Vulnerabilities are weaknesses in software that can be exploited by a malicious
entity to gain greater access and/or permission than it is authorized to have
on the computer. A patch is a piece of software code that is inserted into a
program to temporarily fix a defect. Patches are developed and released by software
vendors when vulnerabilities are discovered. Timely patching is critical to
maintain the operational availability, confidentiality, and integrity of information
technology systems. However, failure to keep operating system and application
software patched can create a weakness.
A recent GAO report noted that agencies generally are implementing important
common practices for effective patch management, such as performing systems
inventories and providing information security training. However, they are not
consistently performing others, such as risk assessments and testing all patches
before deployment. According to this report, agencies face several challenges
to implement effective patch management practices, including (1) quickly installing
patches while implementing effective patch management practices, (2) patching
heterogeneous systems, (3) ensuring that mobile systems receive the latest patches,
(4) avoiding unacceptable downtime when patching high-availability systems,
and (5) dedicating sufficient resources to patch management.
Service Delivery
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 two of the greatest challenges in the area are the
representative payee process and managing human capital.
Representative Payee Challenges
When SSA determines a beneficiary cannot manage his/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 6.8 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.
Human Capital Challenges
SSA, like many other Federal agencies, is being challenged to address its human
capital shortfalls. In January 2001, GAO added strategic human capital management
to its list of high-risk Federal programs and operations. 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. At the
same time, 59 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.
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.
SSA continues to score "green" in "Progress in Implementing the
President's Management Agenda" on the OMB Scorecard and, in July 2004,
improved its rating in "Status" from "yellow" to "green."
In FY 2005, we plan to complete 18 reviews and begin 11 reviews in this area.
We Plan to Complete the Following Reviews in FY 2005
Controls for Concurrently Entitled Social Security Administration Beneficiaries
with Representative Payees
Effects of Staffing on Hearing Office Performance
Nation-wide Survey of Individual Representative Payees for the Social Security
Administration and Regions I Through X
Representative Payees Receiving Benefit Payments for Beneficiaries They do not
Serve as the Official Payee
The Social Security Administration's Office of Systems' Training Program
The Social Security Administration's Procedures for Addressing Employee-Related
Allegations-Regions I, VII, and X
We Plan to Begin the Following Reviews in FY 2005Assessing the Agency's Controls
in the Protection of Application Software
Beneficiaries in Suspended Payment Status Pending the Selection of a Representative
Payee
Concurrent Beneficiaries Receiving Representative Payee and Direct Payments
Under Separate Programs
Controls over Representative Accounting of Social Security Funds (Public Law
108-203)
Controls to Ensure Benefits are Re-issued if Funds are Misused by Organizational
Representative Payees (Public Law 108-203)
Death Alert Control and Update System - Release 3.2
Public Law 108-203, Section 104, Fee Forfeiture in Case of Benefit Misuse by
Representative Payee
Public Law 108-203, Section 105, Liability of Representative Payees for Misused
Funds
Public Law 108-203, Section 210, Authority for Cross-Program Recovery of Benefit
Overpayment
Qualifications for Non-Attorney Representatives (Public Law 108-203)
Representatives Barred From Practicing Before the Social Security Administration
(Public Law
108-203)
CONTROLS FOR CONCURRENTLY ENTITLED SOCIAL SECURITY ADMINISTRATION BENEFICIARIES
WITH REPRESENTATIVE PAYEES
Objective
To determine the effectiveness of SSA's controls to prevent concurrently entitled
SSA beneficiaries from having different payees under separate programs.
Background
SSA pays benefits under the Title II and XVI programs. Most beneficiaries receive
benefits from only one program. Concurrently entitled beneficiaries, however,
receive benefits from both programs.
Under either program, when a beneficiary cannot manage or direct the management
of his/her benefits, a representative payee is appointed. SSA's policy requires
that one payee be appointed for all benefits to which the individual is entitled,
unless there is some compelling reason to do otherwise. Also, personnel must
document each claims file with the reason for naming different payees in rare
instances where different payees are appointed. Where different payees are appointed,
field offices should prepare a diary for a manual accounting report to be obtained
on the Title II claim, when appropriate, because the system only sends an accounting
report to the Title XVI payee.
In a prior review, we found differing payee arrangements, incomplete accounting,
and inaccuracies in SSA's data.
EFFECTS OF STAFFING ON HEARING OFFICE PERFORMANCE
Objective
To examine how staffing affects hearing office performance in the areas of productivity
and timeliness.
Background
OHA makes decisions on appealed determinations involving retirement, survivors,
disability, and SSI payments. OHA is headquartered in Falls Church, Virginia.
Within OHA, the Office of the Chief Administrative Law Judge administers the
nationwide hearings organization and the Chief Administrative Law Judge is the
principal consultant and advisor to the Associate Commissioner on all matters
concerning the administrative law judge hearing process.
In our report, Best Practices in the Highest Producing Hearing Offices, we highlighted
the best practices used by OHA's most productive hearing offices. In this report,
we will discuss our findings on how staffing affects hearing office performance
in terms of productivity and timeliness.
NATION-WIDE SURVEY OF INDIVIDUAL REPRESENTATIVE PAYEES FOR THE SOCIAL SECURITY
ADMINISTRATION AND REGIONS I THROUGH X
Objective
To determine whether individual representative payees used Social Security benefits
received for the care and well being of the beneficiaries they serve.
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'
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.
This is a nation-wide review of individual representative payees serving fewer
than 15 beneficiaries. In addition, we will issue separate reports to each Regional
Commissioner summarizing the results of our review in their respective regions.
REPRESENTATIVE PAYEES RECEIVING BENEFIT PAYMENTS FOR BENEFICIARIES THEY DO NOT
SERVE AS THE OFFICIAL PAYEE
Objective
To determine the extent of representative payees who are managing beneficiary
payments for whom they are not the representative payee.
Background
In three prior audits, we determined that representative payees endorsed and
deposited benefit payment checks of beneficiaries for whom they were not the
representative payee.
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'
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.
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. Specifically, we will review the allocation of training
opportunities, types, and cost of training provided to current Office of Systems
staff and new hires to enhance skills/competencies needed to meet future workloads.
Background
Technology is the foundation of the Agency's current and future ability to provide
quality service in the face of a significant increase in workloads and the loss
of experienced staff.
For SSA to meet its customers' future needs, it must restructure its systems'
processes to make effective use of new technologies and ensure it has staff
trained on the application of 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.
In January 2003, GAO issued a report on the Major Management Challenges and
Program Risks: Social Security Administration. That report 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, or outsourcing considerations…"
The Office of Systems guides and manages the development, acquisition, and use
of SSA's information technology resources. These resources support the Agency's
programmatic 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.
THE SOCIAL SECURITY ADMINISTRATION'S PROCEDURES FOR ADDRESSING EMPLOYEE-RELATED
ALLEGATIONS-REGIONS I, VII, AND X
Objective
To evaluate the adequacy of SSA's policies and procedures for addressing employee-related
allegations, determine how well SSA complied with those policies and procedures,
and determine whether SSA actually referred all employee-related allegations
that should have been referred to the OIG.
Background
Every year, SSA receives various types of allegations related to its programs
and the misuse of Social Security numbers. While SSA may receive allegations
directly, we also refer allegations to SSA that we receive through our Hotline.
For FYs 2000 through 2002, we referred 876 employee-related allegations to SSA.
Of this number, 665 were sent to SSA's regional offices.
Allegations concerning employees are significant because of the potential losses
to SSA's programs and the corresponding negative public impact such issues can
cause SSA. Our review will focus on the development and resolution of our referrals
of employee-related allegations sent to the Boston, Kansas City, and Seattle
Regional Offices during FYs 2000 through 2002 and on allegations or instances
of employee misconduct brought to the attention of the Regional Offices through
other sources.
Alphabetical Index
A
Access to Secured Areas in Hearing Offices-Regions I Through X 5- 1
Administrative Costs Claimed by State Disability Determination Services 4-1
Analysis of Undeliverable Social Security Number Cards 1-1
Assessing the Social Security Administration's Disability Control File Application
Controls 5-2
Assessment of the Enumeration-at-Entry Process 1-2
C
Congressional Response Report: Educational Institutions' Issuance of Work Authorization
Documents to Foreign Students 1-3
Controls for Concurrently Entitled Social Security Administration Beneficiaries
with Representative Payees 6-1
Controls over Title II Replacement
Checks 3-1
Controls over Unnegotiated Checks 3-2
Costs Incurred by Maximus, Inc., on Contract Number 0600-00-60020 4-2
D
Disability Determination Services Procedures for Removing Sensitive Information
from Excess Computers 5-3
Disabled Supplemental Security Income Recipients with Earnings on the Master
Earnings File 3-3
E
Effects of Staffing on Hearing Office Performance 6-2
Evaluation of the Social Security Administration's Electronic Disability Initiative
2-1
F
Federal Information Security
Management Act Audit 5-4
Fiscal Year 2004 Financial Statement Audit Oversight 4-3
Fiscal Year 2004 Inspector General Statement on the Social Security Administration's
Major Management Challenges 4-4
Follow-up: The Social Security Administration's Controls to Prevent and Detect
Direct Deposit Fraud 3-4
I
Impact of Due Process on Supplemental Security Income and Disability Insurance
Benefit Payments Made During the Appeals Process (2 Reports) 2-2
Implementation of the Executive Order Prohibiting Payments to Terrorists 3-5
Incorrect Death Information for Auxiliary Beneficiaries Turning 18
Years of Age 1-4
Independent Living Resource Center of North East Florida 4-5
Indirect Costs Claimed by State Disability Determination Services 4-6
Individuals Receiving Benefits Under Multiple Social Security Numbers at the
Same Address 3-6
Individuals Receiving Multiple Auxiliary or Survivors Benefits 3-7
Information System Controls over Workers' Compensation Payments 3-8
M
Manual Changes to Title II Benefits via the Manual Adjustment Credit and Award
Data Entry System 3-9
Military Wage Items in the Earnings Suspense File 1-5
N
Nation-wide Survey of Individual Representative Payees for the Social Security
Administration and Regions I Through X 6-3
O
Office of Hearings and Appeals Megasite Bar-coding System 2-3
Office of Hearings and Appeals Pre-effectuation Review Process 2-4
Office of Hearings and Appeals Reversal of Disability Denial Decisions Involving
Investigative Information from Cooperative Disability Investigation Units 2-5
P
Payroll Tax Reporting by the Social Security Administration's Contractors 3-10
Performance Indicator Audits: Audits of the Social Security Administration's
Performance Data 4-8
R
Reported Earnings Before the Issuance of a Social Security Number 1-6
Representative Payee Reports Indicating Excess Conserved Funds for Supplemental
Security Income Recipients 3-11
Representative Payees Receiving Benefit Payments for Beneficiaries They do not
Serve as the Official Payee 6-4
S
School Attendance by Student Beneficiaries over Age 18 3-12
Social Security Number Cards Issued After Death 1-7
Social Security Number Misuse in the Agriculture, Services (Temporary Labor
and Cleaning), and Food
Service (Bars and Restaurants) Industries (3 Reports) 1-8
Social Security Numbers Issued to Noncitizens Who Subsequently Leave the Country
or Whose Immigration
Status Expires 1-9
Supplemental Security Income Recipient Wages Reported to the Earnings Suspense
File 2-6
Suspended and Nonwork Wages Among the Social Security Administration's Payroll
and Contractors (2 Reports) 1-10
T
The Impact of Unauthorized Employment on Social Security Benefits 1-11
The Self-Employment Income Earnings Suspense File 1-12
The Social Security Administration's Administrative Finality Rules 3-13
The Social Security Administration's Controls over Suspending Collection Efforts
on Title XVI Overpayments 3-14
The Social Security Administration's Controls over the Old-Age, Survivors and
Disability Insurance Waiver Approval Process 3-15
The Social Security Administration's Decisions to Terminate Collection Efforts
for Old-Age, Survivors and Disability Insurance Overpayments Recorded on the
Recovery of Overpayments, Accounting and Reporting System 3-16
The Social Security Administration's Identification of Special Disability Workload
Cases 2-7
The Social Security Administration's Office of Systems' Training Program 6-5
The Social Security Administration's Patch Management Process 5-5
The Social Security Administration's Procedures for Addressing Employee-Related
Allegations-Regions I, VII,
and X 6-6
The Social Security Administration's Ticket to Work Program 2-8
The Social Security Adminitration's Use of Deportation Data 3-17
The Social Security Administration's Workers' Compensation Data Match with the
State of Texas 2-9
U
Uncollectible Title XVI Overpayments
that Exceed $200 3-18
Undetected Overpayments in the Social Security Administration's Disability Programs
3-19
Universities' Use of Social Security Numbers as Student Identifiers (Regions
I Through X) 1-13
Usefulness of Employee Correspondence in Reducing the Growth of the Earnings
Suspense File 1-14
W
Westat Contract Closeout on Contract Number 0600-99-36200 4-7