Fraud/Similar Fault/Potential Fraud
OIG determined John has been receiving disability since 2016 and started working in 2018 and did not report his earnings to SSA.
Fraud
OIG
The Office of Inspector General
Fraud referral are submitted through FITS
What is Unrestricted Reopening for Determination or Decisions Obtained by Fraud or Similar Fault
GN 04020.010
Sarah and her three kids are getting disability. Their dad Ben takes Sarah to court and the kids are no longer in her custody, but Sarah continues to receive benefits for her three kids and never informs SSA of the new payee for her kids
Potential Fraud
Fraud Information Tracking Sytem
Report of Investigation
OGC gets fraud referrals
False OIG receives them
What is Fraud?
DI 28075.001
Tiffany is receiving Worker's Compensation and failed to provide us with proof because she did not want to contact the WC carrier to obtain the proof because he did not think it was important, therefore OIG determined not to pursue this case
Similar Fault
ARIS
Allegation Referral Intake System
TWP
Trial Work Period
What is Overpayment Fraud Referral?
GN 02201.050
Tony was hurt while working on his job and started receiving WC in 2010. Tony completed an application for DIB in 2012 and stated on the application he was not receiving WC when he was still receiving WC benefits.
Potential fraud
CDR
Continuing Disability Review
CDI
Cooperative Disability Investigation
False FITS is updated every Monday
What is Fraud or Similar Fault Framework
GN 04107.000
Jim passed away in 2019 and his daughter Emily continued to received his payments and withdraw from his bank account. OIG sends SSA COR documents.
Fraud
COR
Court Ordered Restitution
You have won a 10 min recess for you and the rest of the class when you see fit.
Potential fraud is when Sue grandma sends a letter to SSA stating Sue is working two jobs and receiving benefits
true
What is How the PC Reports Program Violations
GN 04111.025