Supplemental Security Income
Disability Program Vulnerable to Applicant Fraud When Middlemen Are Used Gao ID: HEHS-95-116 August 31, 1995Some ineligible applicants who cannot speak English have obtained Social Security Income (SSI) benefits illegally by using middlemen. These middlemen, who provide translation services, have allegedly coached SSI claimants on how to appear mentally disabled, used dishonest health care providers to submit false medical evidence for those seeking benefits, and provided false information on claimants' medical and family histories. By 1990, the Social Security Administration (SSA) had become aware of the middleman problem. For example, a Washington State middleman arrested for fraud had helped at least 240 immigrants obtain $7 million in SSI benefits by coaching them on which medical symptoms to claim and providing false information on their medical conditions and family histories. This report describes factors that contribute to the SSI program's vulnerability to fraudulent applications and describes federal and state initiatives to combat such fraudulent activities.
GAO found that: (1) although the Social Security Administration (SSA) has been aware of allegations of SSI fraud related to the use of middlemen since 1990, the number of applicants who have obtained SSI benefits illegally through the use of middlemen is unknown; (2) the number of immigrants receiving SSI disability benefits rose from 45,000 in 1983 to 267,000 in 1993; (3) in California, about 6,000 potentially fraudulent applications have been identified, of which about 30 percent represent SSI claims being paid; (4) ineligible SSI recipients can receive about $113,000 in SSI, Medicaid, and Food Stamp benefits by the time they are 65 years old; and (5) SSA has established a task force in California to combat fraudulent applications involving middlemen and has terminated benefits for 207 recipients, as of April 1995. In addition, GAO found that SSI is vulnerable to fraudulent applications involving middlemen because SSA: (1) management practices and bilingual staff shortages enable applicants to use middlemen; (2) performs only limited monitoring of middlemen; (3) has limited funds for investigations; (4) has not coordinated its efforts to monitor middlemen with state Medicaid agencies; and (5) needs a better strategy to keep ineligible applicants from ever being accepted on SSI rolls.
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