Articles from prior issues of The Advocate

January/February 2001

Combating Fraud: A Joint Effort
by Russ Mojcher, Conneticut DDS

The recent government task forces set up to combat fraud were established to restore confidence and integrity in the system. Their investigations serve as a check and balance in a system that has been abused, according to Senior Special Agent Juan Riberas, of the Office of Inspector General. Last year alone, the three agents assigned to the local task force uncovered fraud cases saving the government four million dollars in current payments. Projected savings of these cases if left undiscovered totalled $50 million. When three agents can save the government a total of $54 million in one year, Congress takes notice. There will be more task forces and more agents assigned to this type of work in the near future.

Special Agent Riberas apologized for not having any more specific information, but he was asked to fill in at our conference at the last minute. Special Agent In Charge Edward Ryan, was injured that morning and unavailable to attend our seminar. Agent Riberas explained that there had always been a history of complaints and tips about people who were receiving disability while not being disabled. The task forces now serve as a clearing house for these tips from other government agencies, state, federal and local, private groups such as insurance agencies and private individuals.

Most of their cases involved individuals rather that organized, group efforts to obtain benefits. In one category involving residency, they found 62 of 63 individuals investigated last year to be not eligible for payments by living outside the U. S. Other categories of cases investigated involved people using other person’s social security numbers, people cashing the checks of deceased relatives, and people no longer medically eligible.

For them to proceed from a tip to an investigation, certain criteria must be met. Is the information current? Can the allegations be proven? What resources would be required to obtain the necessary information? Their investigative techniques include research, interview, and videotaping.

Currently, those found guilty of fraud are not, prohibited from reapplying for disability benefits. However, Congress now has legislation being prepared on a fast track to prohibit them from applying for a yet-to-be-determined period of time.

All in all, the Fraud Unit has been successful in identifying and stopping fraud in the Disability Program. And, as Special Agent Riberas pointed out, if the tips they have received in the past are any indication, their work has just begun.