The headline is a familiar one: “Central Oregon real estate man punished for cheating Social Security of disability pay”. Opponents of disability benefits will use a case like this to their advantage – cases like this spur Congressional calls for hearings and support increases in the SSA budget for searching for cheaters. But how often does this kind of thing occur?
To find out, I did a little research. Although it’s very difficult to find studies assessing the level of fraud occurring, it’s worth noting that in fiscal year 2010, the Social Security Administration’s office of Quality Performance (OQP) implemented its post-effectuation disability case review (DCR) of ALJs’ decisions. The DCR is an in-depth review conducted by disability examiners in OQP who assess the accuracy of ALJ decisions. Cases for the DCR are selected randomly from the nation-wide pool of ALJ allowance and denial decisions. OQP reviews a case to determine whether a preponderance of the evidence supports the ALJ’s decision:
• OQP agreed with the decision in the majority of the decisions it reviewed.
• For decisions issued in FYs 2009 and 2010, OQP disagreed with ALJs’ allowance decisions in14 percent of the cases reviewed and disagreed with ALJs’ denial decisions in 10 percent of the cases reviewed. Source: CONGRESSIONAL RESPONSE REPORT The Social Security Administration’s Review of Administrative Law Judges’ Decisions; A-07-12-21234; March 2012
An argument for significant fraud in the system? Hardly.