Hearing on Social Security Disability Fraud Scheme in New York
Thursday, January 16, 2014
U.S. House of Representatives,
Committee on Ways and Means,
The subcommittee met, pursuant to notice, at 9:00 a.m., in Room B‑318, Rayburn House Office Building, Hon. Sam Johnson [chairman of the subcommittee] presiding.
[The advisory of the hearing follows:]
*Chairman Johnson. The meeting will come to order. Let me begin by saying to all my colleagues on this Subcommittee that it is with deep regret that we had to call this hearing today.
Last week we were greeted with shocking headlines. The New York Times led with, “Charges for 106 in a Huge Fraud Over Disability.” And ABC News led with the “New York cops, firefighters, in massive 9/11 fraud, the indictment says.” I am outraged. But, more importantly, the American people are outraged. Law‑abiding Americans woke up to learn that the taxes they paid to Social Security had been stolen.
Today’s hearing follows September’s hearing on the scandal in Puerto Rico, which, according to the Inspector General, who is with us today, was at that time the largest fraud in the history of Social Security. Now, less than six months later, we have another even more shocking scandal in New York, where 106 people have been arrested. Not only the size of the fraud that is shocking, but those who committed it: former policemen, firemen, and a former FBI employee.
Worse, some of the defendants falsely claim that their disability was caused as a result of the 9/11 terrorist attacks, while many had never even worked at Ground Zero. It is truly a sad day in America when people who once held positions of public trust betray the public confidence. These individuals are accused of stealing from a vital program that serves those who can no longer work, due to disability.
In Fiscal Year 2013, Social Security paid out $139 billion in disability benefits to 11 million beneficiaries. Also in that same year, Social Security paid out retirement benefits to 57 million beneficiaries. This Subcommittee has held 11 hearings on the disability program, and three of them focused specifically on disability fraud because preventing fraud is essential to maintaining public confidence in the program.
The public is fast losing faith in Social Security, and I don’t blame them, because we all are. While I fully recognize there will always be bad apples, what is going on these days is very different. This is a program plagued by fraud conspiracy.
First, there was West Virginia. In October of 2013, the Senate Homeland Security and Governmental Affairs Committee released the results of their bipartisan investigation detailing collusion between a West Virginia law firm, a Social Security administrator, Administrative Law Judge, and some local doctors in approving benefits. Then there was Puerto Rico. And now, New York.
The initial cost to the system in New York is $22 million initial cost. In Puerto Rico, the scandal initially alleged to cost taxpayers $2.1 million. Amounts resulting from the corruption in West Virginia are still under investigation. Moreover, a total 181 individuals have been arrested in the New York and Puerto Rico scandals.
I know that crooks don’t care about the people who really need their benefits, but I do. According to the Trustees, it is only two years before Social Security can only pay reduced benefits, unless Congress acts. The program can’t afford more fraud. It is only a matter of time when Congress may be asked to bail out this program with the retirement side having to come to the rescue. And, if that is the case, then all taxpayers and beneficiaries will should the burden of a crime wave.
What is more troubling is that the cases are just the ones we know about so far. As we will hear from the Inspector General today, other similar investigations are underway. Like organized crime, these recent scandals reveal fraud committed by a network of professional crooks made up of doctors, lawyers, and judges. It is the new get‑rich‑quick scheme worth tens of thousands of dollars for every person who illegally gets on the rolls. It is appalling. And in New York, it went on for 25 years, starting in 1988.
With the shocking news of the disability scandal in New York, Puerto Rico, and West Virginia, Americans and this Subcommittee deserve answers, and we need them now. On behalf of my colleagues and the taxpayers, I am asking how can this happen time after time after time. Why is Social Security failing to prevent these fraud conspiracies in the first place?
But it is more than answers that are needed. To restore trust in the disability program, Social Security must be held fully accountable for failing to prevent widespread fraud. Accountability must be accompanied by action to prevent this from happening ever again. I think the time for excuses is over.
Let me make myself clear. I expect accountability at Social Security for these crimes. It is time for real leadership. It has been nearly a year to the day since Social Security had a Commissioner. With the greatest respect to Mrs. Colvin, she has been appointed on a temporary basis. These scandals send a clear warning to the President that we need a Social Security commissioner who will make it his or her six‑year mission to fight fraud and restore to the public confidence in this program.
Further, not once has any Commissioner personally asked for our help to fight fraud. The next Commissioner must set a bold, new course, and be unafraid to reach out to us here in the Congress.
Mr. O’Carroll, I am demanding a full investigation by your office of Social Security’s entire management and their failure to prevent fraud and conspiracy. And it must be a full, top‑to‑bottom investigation of Social Security. Leave no stone unturned. Find out how this could happen, and what Social Security can do to stop it in the future. You must make this investigation your top priority. I want the investigation with recommendations quickly. The rip‑off of taxpayers by professional fraudsters has to end, and it needs to end now.
I also would like a full report from you, Acting Commissioner Colvin, telling Congress the immediate actions you are taking to prevent these crimes from occurring again and again, as well as any recommendations for legislation that might help you. I want this report within 30 days.
Lastly, preventing fraud should not be and is not a partisan issue. Ranking Member Becerra, I would like to work with you on whatever legislative is needed.
Today we will hear from Acting Commissioner Carolyn Colvin and the Social Security Inspector General Pat O’Carroll. Don’t just tell us about the facts of the scandal; we can read that in the news. And don’t just tell us about what you did; it is clearly not enough. And don’t just say you need more money, when the fact is Social Security has utterly failed to protect taxpayer dollars in the first place. Social Security must first regain the trust of the American taxpayer before it can credibly argue for more money.
Hard‑working taxpayers want, need, and deserve answers and action now to restore their confidence in Social Security. I thank you all for being here today
*Chairman Johnson. I now recognize the Ranking Member, Mr. Becerra, for his opening statement.
*Mr. Becerra. Mr. Chairman, thank you very much. And let me join with you in saying that we must ask Social Security to do everything possible, and certainly the Inspector General, to give us the best sense of how to go about going after that conspiracy, that fraud that does occur.
But let me differ a bit, Mr. Chairman, from the way you have described it. The conspiracies in Puerto Rico, New York, were not uncovered by some intrepid consumer or some truth‑seeking American or some law enforcement officer outside of Social Security. It was uncovered by front‑line Social Security staff. And they are working day in and day out. In fact, they have units, some fraud‑busting units, that are doing exactly what we want them to do.
So, it is more a matter of how do we work with the people there busting fraud today within Social Security, whether in the inspector general’s office, or just the front‑line staff of Social Security, that we must work with. Because when you have former police officers, former firefighters, when you have doctors who are colluding, these are all people of trust.
And so, when a front‑line Social Security representative sees a report from a doctor, and sees in front of her or him a former police officer who may have been involved in 9/11, or a former firefighter who had saved people’s lives saying, “I am disabled, and here is my documentation from a doctor saying I deserve now to receive the disability insurance benefits that I pay for,” you could only do so much, unless you are going to say we are not going to not trust people like former firefighters, former police officers, and our doctors who care for us every day.
And so, this is deep, because the collusion was heavy and the conspiracy was dark. And so we have to get to the bottom of this. But to say that this is the fault of Social Security is to blame the wrong people who are working every day, and whose trust we have put in for decades to make sure that Social Security serves those who paid for it.
Remember, American workers pay for Social Security and Social Security Disability Insurance. Over its lifetime of some 78 years, Social Security has received from American workers some $14.5 trillion in taxes, Social Security contributions. Because we haven’t used that all up, and because some of that money has earned interest by being stored away in bonds, we now have more than $2.5 trillion in the Social Security trust fund available for Americans who have paid for Social Security and Social Security Disability Insurance.
Social Security Administration workers have diligently, day in and day out, worked to protect Americans’ Social Security. And I believe we see that in the conspiracy that was uncovered in Puerto Rico and in New York. Social Security provides a lifeline to 58 million Americans each month, 58 million Americans each month. Yet it has an overpayment rate of less than one‑half percent. Let me repeat that: less than half‑a‑percent overpayment, meaning whether it was due to fraud or due to error overpayment.
In fact, that error rate, if you compare it to the private sector, is quite low. Private sector payrolls, which calculate the paychecks that millions of Americans get every day, that ‑‑ the rate of error for the private sector payroll offices in these companies, is probably about four times higher than Social Security’s. One out of every five consumers has an error in their credit report that could keep them from getting a loan, or force them to pay higher rates in interest than they should.
Do I need to talk about Target and the recent privacy‑hacking there, or Neiman Marcus, or you name it? It happens, because there are some bad people out there, and they are after our money. And it shouldn’t surprise people that they are after Social Security’s money, as well. So we have to work very hard, Mr. Chairman. And I want to join you in calling forth this investigation. But let’s make sure we aim our fire at the bad guys, not the front‑line workers who are detecting the fraud, not the front‑line workers who are working so diligently to try to protect Americans’ money.
One of the most powerful fraud‑busting teams that SSA has is the cooperative disability investigations unit. It is ‑‑ it links with the inspector general, with local law enforcement, and front‑line SSA staff. They are highly effective. In 2012 alone, these fraud busters prevented $340 million in fraudulent Social Security payments. Most importantly, fraud prevention is built in to Social Security’s day‑to‑day operations.
As I said ‑‑ I ask again. Who was it that uncovered the fraud conspiracy in New York? SSA front‑line staff. Who was it that uncovered the conspiracy in Puerto Rico? SSA front‑line staff. Day in, day out, Social Security workers are standing guard.
The recent fraud cases were sophisticated conspiracies, involved recruiters who sought out individuals to willingly falsify applications for benefits, colluding doctors willing to provide fraudulent medical evidence. Defrauding the disability insurance program, as in these conspiracies, requires criminal collusion, criminal collusion from doctors and other persons in positions of trust.
The New York City conspiracy, if you can believe it, again, required former police officers who recruited others to lie, an attorney willing to submit false claims, doctors willing to provide fake evidence, and applicants willing to undergo fake treatment for a year to make it look like they were genuinely disabled.
Social Security’s front‑line employees are trained to spot and prevent fraud. Every employee, from the newest hire to the long‑term veteran, attends fraud referral training every year, and is alerted to potential fraud tip‑offs via a monthly bulletin. The vast majority of disability insurance beneficiaries, let’s remember, are honest, hard‑working Americans who earned their benefits through hard work, and now they need them to live on.
To put it in perspective, last year, about 11 million people received Social Security disability insurance, and about 1.8 million applied for disability benefits. That same year, Social Security Administration front‑line staff made over 22,500 referrals for suspected disability fraud. The IG opened formal investigations on 5,300 cases, and referred 100 to the attorney ‑‑ a U.S. Attorney’s office for prosecution. As you can see from these statistics, the vast majority, 99.9 percent of disability beneficiaries, are hard‑working Americans who earned their benefits.
So, Mr. Chairman, let me begin to close by saying this. We know that the number of disability insurance recipients has increased. But everyone who has looked at this has told us it is not so much because of fraud, it is because the Baby Boomers, we are retiring, and we are beginning to use our Social Security or our Social Security disability benefits. Women, over the last decades, have begun to join the workforce, and now they are becoming Social Security recipients or disability insurance recipients. So the chief actuary has told us that you don’t even calculate, in the reason for the growth in the disability insurance population, the issue of fraud.
So, let’s go full steam ahead to investigate fraud, but let’s not say that that is what is driving the fact that honest, hard‑working Americans are now using their disability benefits. Let’s go after the frauds, let’s go after those who are willing to take away the taxpayer dollar. But let’s not deprive those who have earned it, and now should receive it.
And finally, Mr. Chairman, as we go about deciding how to go out there and detect this fraud before it can ever happen, let’s not under‑staff the very people at the front lines who detect it first. Let’s not tie the hands of Social Security to find the fraud by continuing to cut their budget over $1 billion in the last year or two. That New York City office that detected the fraud, today they have fewer people on the front lines working than they did back in 2008, when they detected the fraud.
If we don’t want to see fraud, we can’t take the fraud busters off the front line. And so, let us work together to detect the fraud, but give Social Security the resources and personnel it needs to continue to be the defenders of a good working program for all Americans.
*Mr. Becerra. And, with that, Mr. Chairman, I yield back.
*Chairman Johnson. Thank you, Mr. Becerra. As is customary, any Member is welcome to submit a statement for the hearing record. And, before we move on to our testimony today, I want to remind our witnesses to please limit your oral statements to five minutes. However, without objection, all of the written testimony will be made part of the hearing record.
And before I introduce our witnesses, I want to recognize two important people who are in our audience today from the Manhattan District Attorney’s office: Cyrus Vance, Jr., a District Attorney; and David Szuchman, Executive Assistant, District Attorney, and Chief of the Investigation. Thank you all for being here.
On behalf of all Americans, I want to thank you and your staffs, along with the federal agents from the Social Security Inspector General’s staff, the detectives from the New York Police Department, the New York State Attorney General’s office, other state and local law enforcement agencies that have assisted in the arrests, and the employees of the New York State Disability Determination Services, and the Social Security Administration. Thank you for your tireless work in bringing these defendants to justice.
We will now return to our hearing. And I am suspending our usual witness order protocol by asking the Honorable Patrick O’Carroll, Jr., Inspector General, Social Security Administration, to testify first, given the hearing’s focus on the New York fraud scheme, and the primary role of the Inspector General and federal agents in this investigation. Mr. O’Carroll is accompanied by Edward Ryan, Special Agent in Charge, New York field division, Office of the Inspector General, Social Security Administration. And next is ‑‑ next to him is Honorable Carolyn Colvin, Acting Commissioner of Social Security Administration.
Mr. O’Carroll, welcome, and thanks for being here again. Please go ahead.
STATEMENT OF PATRICK P. O’CARROLL JR., INSPECTOR GENERAL, SOCIAL SECURITY ADMINISTRATION, ACCOMPANIED BY EDWARD RYAN, SPECIAL AGENT‑IN‑CHARGE, NEW YORK FIELD DIVISION, OFFICE OF THE INSPECTOR GENERAL, SOCIAL SECURITY ADMINISTRATION
*Mr. O’Carroll. Good morning, Chairman Johnson, Ranking Member Becerra, and members of the committee. Thank you for the invitation to testify today. I am joined by Special Agent in Charge Edward Ryan from our New York field division. I am also joined here today with the district attorney for Manhattan, Cyrus Vance, Jr., without whom this case may never fully have come to light.
The man you see on the TV screen is Louis Hurtado. Mr. Hurtado was an NYPD officer until 1988, when he left the force on a disability pension. In 1990, he applied for Social Security disability benefits, using a man named Raymond Lavallee as his attorney. In 1991, he was awarded benefits, including a lump sum retroactive payment of almost $19,000. He continued to receive as much as $1,700 in benefits every month, until they were suspended this week. In all, he received about $475,000 from SSA. For much of this time, he owned and operated the VIP Black Belt Champions Training Center. He taught and performed martial arts, and you can see him in his activities in this video.
While we have more evidence than this clip, I am sure you will agree that running a business like this is inconsistent with his claim that he can’t perform any work in the national economy. He is just one of 102 disability beneficiaries in this case. You will see pictures of some of them appear as I talk, who were recently indicted for fraud, and all but one has been arrested.
It is alleged that these 102 beneficiaries, most of them retired New York City public safety officials, were able to fraudulently obtain disability with the help of four men: Raymond Lavallee, an attorney; Thomas Hale, a disability consultant; Joseph Esposito and John Minerva, who are retired NYPD officers who acted as facilitators and recruiters.
The alleged scheme worked like this. A public employee on disability pension would contact Esposito or Minerva, who explained what the applicant needed to do to get SSDI for mental impairment, including coaching them on dealing with doctors, and then referred them to Hale. Hale further coached the applicant on how to appear mentally disabled, how to act, and what to say. About half of the applicants alleged stress from their work on 9/11, which caused the impairment, then referred them one of the two doctors and to Lavallee.
After a year of mental health treatment, Lavallee would submit the disability application, and the person would be awarded SSDI, including a large lump‑sum check for the year they were undergoing the treatment. Although the law generally limits attorneys to a fee of no more than $6,000, Lavallee and the other conspirators charged a fee equal to 14 months’ worth of benefits, often more than $40,000, and accepted only cash as a payment. Esposito would instruct the clients to withdraw cash from their banks in amounts under $10,000 to avoid IRS detection, and then have them bring the cash to him. He would then split the cash with his partners.
It was a lucrative business. When we executed search warrants on these four men, we found large amounts of cash in their homes and in their safety deposit boxes. For example, one safety box alone ‑‑ safety deposit box alone held $650,000. Another one held $42,000 in cash, 28 gold coins, and 5 silver platinum bars.
We began this investigation in 2008, after our New York CDI unit received a number of allegations from the New York DDS. It was a complex and lengthy investigation, but after a successful undercover operation, court‑ordered wire taps, search warrants that I mentioned earlier, and working closely with the NYPD and the Manhattan district attorney’s office, we were able to obtain all 106 indictments. This investigation is ongoing and very active; there will be likely more arrests to come.
The SSDI program relies to some extent on honesty and integrity of the applicant. When that fails, it relies on the integrity of attorneys and doctors. When all those fails, fraud becomes a real possibility. Luckily, there are lines of defense, including the talented employees of SSA and the DDSs, anti‑fraud measures like the CDI program, which led to this investigation, and law enforcement agents like the ones who put countless ‑‑ hundreds of hours into this investigation.
I can’t say enough about them or the unflagging cooperation and support of the Manhattan DA’s office and the NYPD. It was gratifying to sit in the courtroom in Lower Manhattan last week and see those who defrauded SSA brought before a judge in the first step of the judicial process. This is obviously a very short version of a long and successful story.
SAC Ryan and I are happy to answer any questions that you have. I thank you for this hearing.
[The statement of Mr. O’Carroll follows:]
*Chairman Johnson. Thank you. We appreciate your testimony.
Commissioner Colvin, I appreciate you being here. And I didn’t introduce your associate, Bea Disman; thank you for being here, as well. You are recognized.
STATEMENT OF CAROLYN COLVIN, ACTING COMMISSIONER, SOCIAL SECURITY ADMINISTRATION, ACCOMPANIED BY BEATRICE M. DISMAN, REGIONAL COMMISSIONER, NEW YORK REGION, SOCIAL SECURITY ADMINISTRATION
*Ms. Colvin. Chairman Johnson, Ranking Member Becerra, members of the subcommittee, thank you so much for this opportunity to discuss our front‑line employees’ role in uncovering the disability fraud conspiracy in New York. My name is Carolyn Colvin, and I am Social Security’s Acting Commissioner. I have served in this position since February of 2013. I am joined by Beatrice Disman, our Regional Commissioner for the New York Region. Ms. Disman is available to answer questions you may have about the case.
Like you, I am offended whenever anyone attempts to defraud the government. I am especially outraged by the details of the fraud conspiracy in New York. In this case, an attorney and several others fabricated medical history to defraud the government of millions of dollars in disability benefits. Most of the false claims involved former firefighters and police officers. Some even alleged disabilities that they said arose from the tragic events of 9/11. Frankly, I am disgusted by this betrayal of the public trust, and I applaud the Chairman for shining a light on our work to root out fraud.
On behalf of every employee at SSA, I am putting the criminals on notice. We will find you, we will prosecute you, we will seek the maximum punishment allowable under the law, and we will fight to recover the money that you have stolen.
Social Security has zero tolerance for fraud. Moreover, this case in New York touches a very special nerve. As you can imagine, criminals invoking the memory of 9/11 to masquerade as disabled is deeply personal for our employees in the New York Region. Not only are the New York Regional Office and the New York DDS located within blocks of Ground Zero, but many of our employees were working at the time of the attack, and were fortunate to escape with their lives. Many of those same employees also returned to work in emergency outposts throughout the city to accept survivor claims from the families of the deceased.
As the investigation unfolds, I could not be prouder of our employees at SSA, the New York DDS, and the office of Inspector General. They worked cooperatively to flag the fraudulent cases, connect them to a criminal conspiracy, and build the cases for prosecution. Partnership with state and federal law enforcement has likewise been essential. We owe a special debt of gratitude to the diligent employees of the New York DDS, who are funded and trained by SSA to make disability determinations and to identify fraud.
These employees originally referred fraudulent cases involved in the conspiracy to the OIG. Over time, the OIG began to notice patterns in the referrals. The New York Cooperative Disability Investigation unit, one of the original five CDI units established in 1998, was critical to connecting the individual cases to a criminal conspiracy. To date, the Manhattan District Attorney has indicted 106 individuals for their crimes.
According to our estimates, the fraudulent payments totaled $23.2 million to 102 disability beneficiaries and their auxiliaries. We have already suspended these individuals’ benefits, and we will move aggressively to recover any overpayments.
While our data show that the level of fraud in the disability program is less than one percent, even one case of fraud is too many. The best way to ensure we continue stopping fraud is to invest in our employees. Last year, they made over 22,500 disability fraud referrals to OIG. Regrettably, Congress has not fully funded our employees’ good work. In fact, since Fiscal Year 2012, Congress has appropriated $421 million less for program integrity reviews than what it authorized for us in the Budget Control Act.
Recent news that Congress may fully fund our program integrity budget in 2014 is a step in the right direction. These resources would help to ensure that only those persons eligible for benefits receive them. However, I must caution that eliminating the CDR backlog and reversing the negative effects of past years of under‑funding require a multi‑year commitment. The net effect of budget cuts over the past three years has been the loss of about 11,000 employees. That means drastically fewer people standing watch for the next attempted theft, and drastically fewer people available to serve those who truly need us. Fewer people to handle mounting workloads also jeopardizes our exceptionally high payment accuracy, which is 99 percent or better in the Social Security disability program.
We are proud of these results, and we will continue delivering them with your support. Thank you. Ms. Disman and I will do our best to answer any questions you have, with the understanding that the fraud case is an active investigation.
[The statement of Ms. Colvin follows:]
*Chairman Johnson. Thank you for your testimony. We will turn to questions now. And I have one for Mr. O’Carroll.
The New York case is the latest of three disability fraud cases in less than two years. Can the American people expect more like this? Yes or no?
*Mr. O’Carroll. Chairman Johnson, we have got a number of investigations going on now involving ‑‑
*Chairman Johnson. The reason I ask is can we expect more like this to surface, yes or no?
*Mr. O’Carroll. Probably.
*Chairman Johnson. Okay. You are refusing to give me a yes or ‑‑
*Mr. O’Carroll. If you want a yes on it, yes. We have other investigations of ‑‑
*Chairman Johnson. Okay.
*Mr. O’Carroll. ‑‑ magnitude.
*Chairman Johnson. Thank you. Ms. Colvin, has anyone at your agency been held accountable for fraud conspiracy in West Virginia, Puerto Rico, or New York cases?
*Ms. Colvin. All of those cases are still open and active.
*Chairman Johnson. You didn’t answer my question, either. Are you holding anybody in your agency accountable, yes or no?
*Ms. Colvin. I think that my answer has to be that those are still open cases. We can certainly ‑‑
*Chairman Johnson. So the answer is no. Has anyone been fired or disciplined for these fraud schemes?
*Ms. Colvin. There have been significant organizational changes in our West Virginia office. But, as I said before, those ‑‑
*Chairman Johnson. Well, you got West Virginia, Puerto Rico, and New York now. Are you taking care of those areas, as well?
*Ms. Colvin. I think we need to let the investigation continue.
*Chairman Johnson. You are not making any changes in the Administration. Is that true or false?
*Ms. Colvin. We are not making any changes in the Administration at all. There is no suggestion in my understanding that we need to do that at this time. I would prefer to see the investigation concluded, and we will make our decisions at that point.
*Chairman Johnson. Well, you know it has been a long time coming. Those investigations have been going on for many years. It is not just something brand new.
*Ms. Colvin. We make the referral, Mr. Chairman. We don’t determine the fraud or do the investigation. We simply make the referrals. And we make considerable referrals each year.
*Chairman Johnson. Yes, but you are running the agency right now. And you note on page two of your testimony, “The continued success” of the fraud detection and referral process ‑‑ you call success three scandals in two years, with the last two within six months of the same region?
*Ms. Colvin. Yes, I would call it success, because I think that anti‑fraud activities have been very successful. Remember that it was our staff who uncovered those cases, and it was the Inspector General who was able to note patterns in those individual referrals that suggested conspiracy.
I still contend that the first line of defense are our well‑trained employees, the DDS as well as the field office. They are trained to identify potential fraud, and they are doing just that. And, clearly, the reduction in the number of staff we have to watch the alert to potential fraud is a concern for us, because the numbers have substantially decreased.
*Chairman Johnson. Well, it seems like it took an awful long time to uncover this last one.
On page two you state you will move to recover any overpayments from the New York fraudsters. You call these overpayments, but aren’t they illegal payments? Yes or no?
*Ms. Colvin. I am sorry, you ‑‑
*Chairman Johnson. The payments you made to those people in New York during all this, you call them overpayments. Weren’t they illegal payments?
*Ms. Colvin. Bea?
*Ms. Disman. Chairman, as in Puerto Rico, we can’t make that determination now. I am actually waiting to get a release from the Manhattan District Attorney to start the re‑review on the cases. As a result of the re‑review, we will be able to make that determination. As I told you in Puerto Rico, in some of the cases that were involved, there is other medical evidence and other disabilities.
So, yes, we will be taking the same process as Puerto Rico. But right now you have the indictments and we have not been able to do that re‑review of the cases.
*Chairman Johnson. But it has been going on for years. It seems to me you should have been more aware of it.
Mr. O’Carroll, according to your testimony, U.S. Attorney for the southern district of New York ultimately declined to pursue the case. Thankfully, Manhattan’s District Attorney agreed to take it. Why aren’t federal prosecutors going after these crime rings?
*Mr. O’Carroll. Well, Chairman Johnson, we have taken a review of presentations on our investigations to U.S. Attorney’s office. And I would say more than half of the time that we present to them, they do accept. Many times, the U.S. Attorney’s offices have thresholds for the amount of fraud that is involved before they will authorize on a prosecution. And often times, with our cases, especially in the infancy of a case, it isn’t that much, in terms of the dollar amount, to attract the prosecution of it.
And also, too, is that, with a lot of these things, it is cooperation. In terms of if we are using undercover agents or using other agencies to help us on an investigation, we will then have somewhat of an obligation to stay with the organization. In this case, here, it was a partnership with the district attorney’s office. They were working in one direction, we were working another. We partnered, and we came up with a result. And we did keep the southern district of New York informed on it as we went along.
*Chairman Johnson. Well, I appreciate that, and I thank you all for helping us in those instances.
Why don’t federal prosecutors want to go after these kinds of crime rings?
*Mr. O’Carroll. Well, in terms of the ‑‑ it is usually ‑‑ it is a long, involved, complex investigation, would be the example of these, and ‑‑
*Chairman Johnson. Too small a ‑‑
*Mr. O’Carroll. And the small ones, they are not interested in ‑‑ usually, on it. What they will do is, if we can package them together, and make a presentation with a half‑a‑dozen or a dozen of these investigations, they will go. But ‑‑ and often times, I guess when they are making a determination on, you know, charging someone with bank robbery or a disability fraud, it goes in ‑‑ you know, they have their priorities.
And we ‑‑ but I got to also tell you, Chairman Johnson, I go out personally and interview or meet with U.S. Attorneys across the country, discuss with them investigations that we have, explain to them the advantage of ‑‑ the deterrent factor of doing it. And often times, it is just by talking to them we end up with prosecutions. So I am personally out there, talking to U.S. Attorneys, trying to get our prosecutions.
*Chairman Johnson. Well, thank you for that. I think if we don’t go after these crime rings, you know, the federal prosecutors are sending a message to professional crooks and the phony disabled that committing fraud pays off. Thank you for your testimony. I think we need to change that.
Mr. Becerra, do you have questions?
*Mr. Becerra. Thank you, Mr. Chairman. And thank you all for your testimony. And may I just say congratulations on the work you have done to uncover this fraud, the conspiracies? And especially, Ms. Disman, to you, can you please express to all your front‑line workers a sincere thank‑you for stopping what had been a conspiracy that had run for quite some time? Very much appreciated. Very much appreciative of the fact that they are the ones, your staff are the ones that discovered this. They are the ones that moved forward.
And, Mr. O’Carroll, to the inspector general, I say thank you to you and your folks, working with New York City’s district attorney and the local law enforcement authorities there in New York, for doing everything possible to follow up on the detection of the fraud, and now go after these folks. And, as the commissioner just said, now to go out and get back the money that taxpayers paid. That is very, very important.
I want to clarify something, as well. Ms. Disman, when the chairman asked you questions about have you taken back the money that some of these corrupt individuals got, and you are saying that is under investigation, I think you are essentially saying what we all know, is that, in America, you are presumed innocent until proven guilty. And not that we want any of these despicable people who held a position of trust, having been former police officers or former firefighters, that we want them to keep the money they don’t deserve, it is just that, like any other American, before you can say, “You are a bad guy,” we have got to prove it in court.
*Ms. Disman. I absolutely agree with you in two respects. Number one, let me assure all of you, this is even more despicable to me, because of my role in September 11th. Let me also assure you that my people started to identify these cases right after we set up the continuing disability investigations unit in 1998. So, we were identifying individual cases in 1999, and referring them to the Office of the Inspector General. That is how they were able to put together the trail and the patterns that actually came together in 2008.
But having said that, we have ‑‑ are abided by due process, we intend to do it. But make no mistake. As in Puerto Rico, we will get the money back. Once we review and determine the amount of the overpayment ‑‑ and I also hope that, with the Manhattan District Attorney present, that part of sentencing after the trial will be to recover the money.
*Mr. Becerra. Yes, so ‑‑
*Ms. Disman. So I think we have a dual approach to recover the money.
*Mr. Becerra. So I want to make sure that, on the record, it doesn’t look like you are giving a bureaucratic response when you say, “The investigation is underway.” It is just that you can’t go out there and say publicly, as a government official, “Yes, these corrupt guys are guilty, and we’re going to get the money.” You are judging them before they have had their day in court. And we want them to be judged, and we want the judgment to be severe if they are found guilty. But, until then, we don’t have a right to say you’re guilty before we prove it.
*Ms. Colvin. Mr. Becerra, we also are taking some actions in the cases that Chairman Johnson raised. We would be happy to brief you privately, but we don’t want to say anything publicly that is going to compromise the investigation, and that is why I kept stressing that it is an open investigation.
*Mr. Becerra. I appreciate that.
*Ms. Colvin. But there have been some actions taken.
*Mr. Becerra. I appreciate that. Maybe the chairman will let us take advantage of that.
Ms. Disman, again, you are in charge back there in New York. So, tell me, how many of the ‑‑ of your Social Security employees were involved in the conspiracy that was discovered?
*Ms. Disman. None. Unlike Puerto Rico, where you had a former Social Security employee, the extensive investigation and extensive analysis ‑‑ and, let me just stress, my people worked directly with the Office of the Inspector General over the years. We helped do all the analytical work on the cases.
And let me reassure you on this New York case. It is a lot different than Puerto Rico. This is an affinity group of people that were involved in, most of them, New York City pensions that actually committed this awful conspiracy.
*Mr. Becerra. So, Mr. O’Carroll, let me get this straight. In New York City, not one Social Security employee was involved in this conspiracy of what you found?
*Mr. O’Carroll. Correct, Mr. Becerra. It was facilitators in this case, not SSA employees.
*Mr. Becerra. Not SSA employees. And in Puerto Rico, there weren’t any Social Security employees involved, or at least not current. It was a former employee. But those that are on the line, on the job, getting paid by the taxpayers, were not involved in the conspiracies in New York or Puerto Rico.
*Mr. O’Carroll. Correct.
*Mr. Becerra. Okay. They are the ones that detected it. They weren’t involved in it.
*Mr. O’Carroll. Yes.
*Mr. Becerra. Okay. Let’s be clear on that. I think all of you know that this congress has continued to cut your funding over the last several years. And, Ms. Colvin, you mentioned that, as well. You mentioned $421 million less that you have received to do the fraud busting that we are talking about today.
*Ms. Colvin. We are very pleased that it appears that our Fiscal Year 2014 appropriation may be approved. It has been approved in the House.
I would just say that we are very aggressively involved in anti‑fraud activities. That is one of the reasons that we first established the CDI units back in 1998. At that time I was in charge of operations for all of the field offices. And we have seen that the CDI units are effective. These cases are very complex, so you need the cooperation of the DDSs and SSA, the Inspector General, and local law enforcement. And that is what we have under the CDI, we have those formal arrangements.
But because of the lack of resources, we only have 25 CDI units. With the program integrity money, if we get it, one of the things I want to do is expand some of those units, because we only have 25 states right now that have a CDI unit.
*Mr. Becerra. So let me conclude with this, because I know my time has expired. So, Mr. Chairman, let me just ask one quick question that I hope Mr. O’Carroll and Ms. Disman can both answer.
First, do you have enough of those fraud busters, these CDI units, where you need them? And secondly, how many of the staffers that you had in 2008, when you detected the conspiracy, the fraudulent conspiracy in New York, how many do you have now?
*Ms. Disman. Well, if you are talking about how many people are in the New York DDS now, I can just tell you, compared to 2010, that staff is down 22 percent. And so, when you look at that, there are certainly less people on the line to do this work, and to report the detection. But they are really focused on fraud.
I will tell you this case and the Puerto Rico case made our employees even more aware. And what is important is not only will you report it, it will be investigated, but what the Manhattan DA did and the U.S. Attorney in Puerto Rico allows us to do more referrals, because they see results as a result of their referrals.
*Mr. Becerra. Inspector General?
*Mr. O’Carroll. The CDI units, I have got to say, with the support of you, the chairman, and every ‑‑ the members of this Committee, this is probably one of our best tools in terms of fighting fraud. The best part of it, it gets the money and identifies the money before it goes out the door. It is pre‑effectuation.
With the support of this Committee, we are anticipating expanding them. We are adding people to the CDI units that we have now, with just the purpose of identifying fraudulent doctors, lawyers, and facilitators. And I think we have a pretty good story. And, moving forward, that is going to be one of our, you know, priorities, with any resources that we have.
*Mr. Becerra. Thank you. Thank you, Mr. Chairman ‑‑
*Mr. O’Carroll. And we would like to be in all 50 states, is what we would like to do.
*Mr. Becerra. Thanks, Chairman.
*Chairman Johnson. Thank you. Mr. Griffin, you are recognized.
*Mr. Griffin. Thank you, Mr. Chairman. I want to talk a little bit about this 99 percent accuracy, 1 percent inaccurate payment of overpayments and underpayments. You hear that general talking point or that factoid, whatever you want to call it, and you think, well, hey, everything is cool. It sounds like it is all great.
But correct me if I am wrong, Mr. O’Carroll. Until we learned about the folks that you showed upon the screen, we thought those were legitimate, correct?
*Mr. O’Carroll. Correct.
*Mr. Griffin. So how can anyone tell me what they don’t know? I mean the people that we saw on the screen were part of your accuracy. Sure, you can guess. You can estimate. But you have no idea what you don’t know. That is the nature of fraud. If you knew what the fraud was, the next question would be, “Why are we allowing it to happen?”
So, the idea that we can sit here and say, “Well, it is only one percent,” you have no idea what it is, it could be 5 percent, it could be 10 percent, unless you have got a crystal ball that I am not familiar with. So, I know that makes for a good sound bite to say, well, it was only one percent, you know, let’s go to the House.
But it is just not true. You don’t know. You don’t know. I don’t know. And I am sure you would say, if you had more money, you would know more. I have never heard a federal agency say they need less money, ever. It will never happen, I guess. So, I just want to get that point out there.
I know there is a lot of hard‑working people doing a good job. And you are a great guy, and I have worked with you on some stuff. But I just wanted to clarify that. That really ‑‑ that entire talking point just needs to be erased. I am sure it won’t be. But it just makes no sense.
The second thing I would say is ‑‑ and I cannot speak for the Chairman ‑‑ he does a great job on his own ‑‑ but getting to the other cases of fraud, West Virginia and New York, and ‑‑ the Chairman asked about employees. I certainly understand innocent until proven guilty in a court of law with regard to these guys’ jet skis, and all this nonsense. Gymnast? I mean, you know.
But when you are talking about employees, civil servants who may or may not have been involved ‑‑ and only you all know the details, you know, there is a lot of stuff you can’t probably talk about here ‑‑ we all know that, in order to fire someone, they do not have to be innocent until proven guilty in a court of law applying a beyond‑a‑reasonable‑doubt standard. That is not the standard to fire people.
So, a lot of times, when things are discovered in an agency ‑‑ IRS, for example, elsewhere ‑‑ people are fired long before the case has made its way through the system fully, because you get enough, as an employer, to say, “Hey, this person shouldn’t be working for me.”
Now, I understand it takes a whole lot of bad action in the Federal Government under the civil service rules to get rid of somebody. I mean I have worked in those agencies, and sometimes you think, short of a murder, we just got to move them around to some other desk, right? I mean let’s all ‑‑ we are all laughing, because we know it is true. If there are people identified as potentially bad actors, what do we do with them? We don’t have to wait for courts to act to take action on that. I will wait on an answer on that.
One more thing I want to mention. And, you know, there is always a danger with anecdotal evidence. But anecdotal evidence is important for Members of Congress, because we go back home and we hear stories, right? And I can tell you. I don’t know if the rules that we have that a lot of people comply with make it easy to commit fraud, I don’t know exactly. But I could tell you that almost every time I go home ‑‑ and I am thinking right now about the Christmas holidays.
There is a guy that I know, and I have talked with some folks about him, and he is a former professional. He rides a motorcycle, he is very active, he does all sorts of things. And he is on full disability, Social Security disability. And I don’t think it is fraud like this. I think he went right through the system. And I think they said, “You know what? There is nothing in the world that you can do. You must just get a check. Now go ride your motorcycle.” You know, there is a lot of that that goes on. And I know that is not in your 1 percent, 99 percent calculus.
So, I am out of time. But, Mr. O’Carroll, if you could, just speak to the issue of employees that might need to be fired, even though they are not guilty in a court of law.
*Mr. O’Carroll. Mr. Griffin, I will try to get both of them, real quick.
First one, on the employees one, it is ‑‑ you ‑‑ just as this thing ‑‑ you know, it is important when an SSA employee goes bad, we watch very closely on it. I must tell you. I get a report every day about every one of our employee investigations that we are having.
And amongst them, kind of along your lines, I have two columns. I have ‑‑ one column is what has happened to that employee now, meaning are they still working at SSA or are they, you know, on ‑‑ if they are not at SSA, are they on leave with pay, or are they on leave without pay? And what we try to do is put them immediately on leave without pay while we are doing any of their criminal activities. Sometimes we will leave them in place, because that is the only way we are going to be able to catch any co‑conspirators on it.
But I must assure you. First and foremost of all of our priorities is employee fraud. And I must say that it is a small percentage, as we talked before. But any percentage, when you are talking about fraud, is unacceptable.
And on the other one, for the person who is riding the motorcycle and looking very healthy, that is the reason why we have the CDI units, that is why we bring the videos in, to show you that we go out when there is a suspicion like that and do it. We get 140,000 allegations a year in our hotline, and we try to run out as many as we can.
*Chairman Johnson. Mr. Renacci, you are recognized.
*Mr. Renacci. Thank you, Mr. Chairman, and I want to thank all of the witnesses with their testimony.
You know, when I got here this morning and I heard the Chairman’s opening remarks, you know, I agree 100 percent. He used words “shocking,” “outrageous.” And when I heard the Ranking Member’s remarks, I almost thought, well, there is no problem. We ought to just go leave and ‑‑ it is the bad guys, those bad guys out there.
And, the truth of it is, there are bad guys. And we do have a lot of good employees. The issue, though, isn’t just the bad guys, because there are always going to be bad guys, and we are always going to have to deal with bad people. The issue, really, is what are we doing to make sure we protect taxpayer dollars?
You know, when I was mayor of my community, I didn’t start every Monday morning meeting by saying, “We got bad guys out there, we better be careful.” What I started out every meeting was, “The number one goal of every one of us in this Administration is to make sure we protect the taxpayers’ dollars.” So, when I go home, I have to listen to my constituents who aren’t going to say, “You guys are okay, it’s the bad guys.” They are going to say, “What are you doing to fix the problem?”
So, when you hear some of these fraud cases, and you see some of the pictures, yes, there are bad guys out there. But the question is, what are we doing to fix the problem? So I am going to go back to I know one question that the Chairman asked. I have got a couple as follow‑ups.
You know, we have some issues. And, of course, there are some employees who were involved, because somebody approved a disability payment. So, at that point in time ‑‑ and I am not saying that was fraudulent, I am not saying it was wrong. But somebody had to approve a bad payment. So there is an employee somewhere that was involved. I am not saying that is a bad employee; that could be a good employee. The question is, do we review our staff? And have we made any changes in staff since Puerto Rico or, now, with New York? Any changes in staff because of these fraudulent activities? Yes or no?
*Ms. Colvin. I am going to let Bea speak specifically to New York. But I don’t see a reason to change our staff. There is nothing that has come to my attention that suggests that our staff has done anything wrong.
*Mr. Renacci. I am not saying they did.
*Ms. Colvin. Remember that the cases were identified by our staff. The medical information was fabricated, so there is no way that staff would have known that it was not ‑‑
*Mr. Renacci. Okay, let’s move past that. Let’s hold on. Any changes in policy, then? Let’s move ‑‑ we have great staff. Let’s ‑‑
*Ms. Colvin. All right.
*Mr. Renacci. We’ve got that one. Now, any changes in policy?
*Ms. Colvin. We are looking at a number of policy areas. We are working with the Institute of Medicine to ‑‑
*Mr. Renacci. How long ago was the Puerto Rico issue?
*Ms. Colvin. How many?
*Ms. Disman. The Puerto Rico issue was investigated over a period of years. And it actually came to fruition, as you know, in August of this past year.
*Mr. Renacci. Okay. Any changes in policy since August, because of the Puerto Rico incident?
*Ms. Disman. Well, there has been a number of initiatives. As we looked at Puerto Rico, over the years ‑‑
*Mr. Renacci. Any changes in policy ‑‑
*Ms. Disman. Well, I am going to tell you. There has been ‑‑ our policy staff has been in touch with the Administrative Conference of the United States, and the Institute of Medicine ‑‑
*Mr. Renacci. You are not answering the question.
*Ms. Colvin. Mr. Renacci, we have to have data and research to make ‑‑
*Mr. Renacci. I am just asking a simple yes‑or‑no question. Have there been any changes in policies?
*Ms. Colvin. You don’t make changes that quickly.
*Mr. Renacci. Okay.
*Ms. Colvin. You have to have time to ‑‑
*Mr. Renacci. All right. We will move to the next one. Any changes in procedures?
*Mr. Becerra. You have to let them answer.
*Mr. Renacci. I am asking yes or no questions. I am trying to move on. I have five minutes.
*Mr. Becerra. They are answering ‑‑
*Mr. Renacci. Any changes in procedures?
*Ms. Colvin. I am sorry. If you are looking for yes‑or‑no questions ‑‑ answers, I can’t give them to you.
*Mr. Renacci. You can’t answer whether there has been any changes in policies and procedures, or ‑‑ since the Puerto Rico issue?
*Ms. Colvin. [No response.]
*Mr. Renacci. All right. Let me give you a policy, then, and just see what your thoughts are on it. Because, clearly, we are not getting anywhere.
And I got to tell you. The people back in my district, they are concerned about this. They are concerned and they want to see action, that is why I am saying, I am not saying this is bad people, and I am not saying we are bad employees. I think you probably have a lot of great employees. And I think you are working as hard as you can. But I do think we have to move when we have dollars being lost, taxpayer dollars.
You know, the Medicare program, doctors convicted of defrauding Medicare are banned from serving Medicare beneficiaries. Can you tell me if doctors that are kicked out of the Medicare program for previous fraud convictions are allowed to give medical advice in these situations, and are we accepting medical advice?
*Ms. Colvin. They are not. We have a list of doctors that have been barred, and we check against that now. For information that is coming in from individual providers, we are not able to determine that. But for anyone that we hire or engage, they are not allowed to do that.
*Mr. Renacci. Well, that is good. That is ‑‑
*Ms. Colvin. And the local states and governments are very careful in checking those people who have been disbarred, if their attorneys have lost their medical license or been disciplined.
*Mr. Renacci. Well, I just ran ‑‑
*Ms. Disman. If I could add to that, all the DDSs have professional relations people whose job it is to look at the licensing, and to also be alert to all of this. So they basically take them off any consultative panels and the medical evidence.
*Mr. Renacci. I am out of time. But I know that I heard Mr. O’Carroll say that there are additional cases coming down the line.
I would just ask you one thing, if you could get to my office. I would like to hear what policies and procedures you are going to change and have changed, hopefully within the next three to six months. I would like to hear some of those things and get some ideas. Policies and procedures, that is all I am asking for.
*Ms. Colvin. We would be very happy to do that. That is why I said it couldn’t be a yes‑or‑no answer, but there are a number of things in the works that I would be very happy to discuss.
We are also looking at more data and analytics, so that we can look at the patterns. Because we knew these individual cases would not stand up alone, but when you see the pattern, the language pattern or whatever, and that is why the CDI units have been so effective, because we are able to work together and see those patterns.
*Mr. Renacci. Thank you.
*Chairman Johnson. Thank you for your comments. Mr. Rangel, you are recognized.
*Mr. Rangel. Thank you, Mr. Chairman. And let me thank you for ‑‑ I really came down to congratulate you for this fantastic investigation. I had hoped that ‑‑ an example of these terrible frauds that are being committed at the expense of men and women that put up their lives every day, and probably find it more difficult to get the type of assistance they need.
The tone of the questions, I hope you understand, is because we do have a Democratic president, and sometimes anything that is done by the Administration is not appreciated. But in this particular case, I think, more than just the fact that you have indicted 100 people, you have sent a message to every policeman, every fireman, that the government does not intend to allow these things to happen.
My question would be, did this information ‑‑ was it received by the southern district of New York, United States Attorney’s office, before it was turned over to District Attorney Vance?
*Mr. O’Carroll. Yes. What happened in the early stages of this investigation was our investigators went to the southern district in New York and presented on it. And, in fact, I will have ‑‑ let Mr. Ryan here, who ‑‑ our agent in charge, he can kind of walk you through the two approaches, or the several attempts that we did, or several discussions that we had with southern district.
*Mr. Rangel. Well, before we get involved in that, did they reject the evidence that was given to them as ‑‑ whether or not they would prosecute?
*Mr. O’Carroll. Yes. Early on in 2009, December of 2009, the case coordinators went over to the southern district of New York.
*Mr. Rangel. And then you presented it to the ‑‑
*Mr. O’Carroll. We presented it. They initially accepted it. Nine months later, we went back. Nine months later ‑‑ I believe it was in September of 2010 we went back to them, explained what happened in that 9‑month period. They decided at that point in time to decline the investigation, because they needed additional evidence to prove more than making false statements.
*Mr. Rangel. Okay. I can’t think of a program that has done more to take people out of poverty and to bring a sense of self‑esteem and make such a tremendous contribution to our great nation than Social Security.
You did turn it over to one of the greatest district attorney’s offices that we have in the country. But as a former assistant U.S. Attorney it bothers me that, with the type of evidence that you presented to the New York County DA, that the U.S. Attorney’s office did not see fit to follow through on this.
In any event, I want to personally thank Ms. Disman for the cooperation that you have given with the difficult cases I have had in my congressional district. And I want to thank all of you for recognizing that it is rough being on that side of the table. But when you know that you are right, when you know that you have done the right thing, when you know that you have made a contribution to stop corruption, and when you can see 100 people have been indicted, I think this should serve as an example for all of our federal agencies and Department as to what can happen when the front‑line troops are looking for this.
No U.S. Attorney’s office, no district attorney’s office can prosecute anything unless the evidence is presented to them in a way that is probably cause that they did violate the law. So I want you to know that it is appreciated. But these things happen politically, and all of you are mature enough to understand it. I do. And thank you so much for coming before this Subcommittee.
And thank you so much, Mr. Chairman, for having this very interesting hearing.
*Chairman Johnson. Thank you. Mr. Kelly, you are recognized.
*Mr. Kelly. Thank you, Chairman. First of all, I appreciate you all being here. And, as you know, Mr. Renacci was talking about, you know, when I go back home ‑‑ and it doesn’t matter where I go ‑‑ people come up to me and say, “You know what? We know this is going on. And why aren’t you guys doing something about it?” They don’t say to me, “Listen, you need to get with the SSA people and find out who is not doing a good job.” They say, “You need to do something about this.”
And all of us in this room today, both you testifying and us up here, we all work for the American people. You don’t work for SSA and I don’t work for the Republican Party. In fact, this is not a Republican or Democrat issue, this is an American issue. Because, as you know ‑‑ and, Ms. Colvin, you can probably state it better than anybody else ‑‑ how is Social Security funded?
*Ms. Colvin. Taxpayer dollars. We are funded through ‑‑
*Mr. Kelly. Wage taxes.
*Ms. Colvin. ‑‑ FICA taxes.
*Mr. Kelly. Yes, wage taxes.
*Ms. Colvin. Absolutely.
*Mr. Kelly. Wage taxes are paid by people who are working, and their employer: 6.2 percent from the employer, 6.2 percent from the associate. There is 12.4 percent of everybody’s payroll going into a fund to take care of Social Security recipients. So when we talk about these things, it really isn’t Republican versus Democrat, us versus you, it is about us, as a group, representing the American people. They sent us here to do a job. Our job in Congress is oversight, investigate and expose when we think there is something wrong.
Ms. Colvin, I was looking at your bio. You have an incredible bio. And if you don’t mind, I am just going to go through it, because I don’t know if people understand everything that you do. Now, this is since 1995. You are a Regional Commission. You have direct authority over Social Security Administration’s in New York, New Jersey, Puerto Rico ‑‑
*Ms. Colvin. Ms. Disman.
*Mr. Kelly. Ms. Disman. But this is all in your region, right?
*Ms. Colvin. I am the Acting Commissioner for the entire country.
*Mr. Kelly. Okay.
*Ms. Colvin. Ms. Disman ‑‑
*Mr. Kelly. Ms. Disman?
*Ms. Colvin. ‑‑ has the New York Region.
*Mr. Kelly. Okay, I am sorry. Ms. Disman, right. You are doing all of these different things.
In addition to that ‑‑ now, that is an administrative budget of about $400 million. You have 3,900 employees, 113 field offices, 4 teleservice centers, 4 Social Security card centers, the northeast program service center, and the regional office administrative staff. Throughout the region, more than 7 million beneficiaries receive more than $88 billion ‑‑ that is billion ‑‑ in Social Security and supplemental Social Security income benefits, annually.
Now, you are also ‑‑ you were asked by the Commissioner of the Social Security to chair the Agency’s Medicare planning and implementation task force. Right? You are responsible for implementing the responsibilities given to Social Security in the Medicare Modernization Act of 2003, the Medicare Improvement Acts ‑‑ for Patients and Providers Act of 2008, and the Affordable Care Act of 2010.
I am looking at all the different hats you wear. Right now ‑‑ and correct me if I am wrong on this, because I don’t know how you do these things ‑‑ the reason you are here today is about this crime ring in New York. All right? You were here before because of Puerto Rico. But you are also the executive in charge of implementing the Affordable Care Act on behalf of the Social Security Administration. I understand that Social Security Administration must confirm the Social Security number of everyone who signs up for Obamacare.
So, as you come here today, is your concern ‑‑ has to be split. Of all these different things ‑‑ really? You can do all these things? You are amazing.
*Ms. Colvin. Excellent staff.
*Mr. Kelly. You are amazing.
*Ms. Disman. I also ‑‑ it is more than just me. I have to credit it with all the employees that work for me, my executive team, and certainly all my years of analytical and experience, institutional knowledge.
*Mr. Kelly. Okay, all right. How many people we talking about getting Social Security numbers for, verifying?
*Ms. Disman. Well, we are talking about ‑‑ are you talking about for the Affordable Care Act?
*Mr. Kelly. Yes, ma’am.
*Ms. Disman. Well, for the Affordable Care Act at this point in time, we wait for the CMS hub to send us ‑‑
*Mr. Kelly. Just ballpark it. I am not ‑‑ listen, this is not a gotcha, I am just trying to figure out how many people you are trying ‑‑
*Ms. Disman. Yes. We are basically over 30 million right now.
*Mr. Kelly. Thirty million?
*Ms. Disman. Right.
*Mr. Kelly. Okay. And you have all this fraud going on, too.
*Ms. Disman. Well, this situation has not ‑‑ has nothing to do ‑‑
*Mr. Kelly. You are a remarkable lady, then, for what you are doing. A remarkable person ‑‑ I will take the gender specificity out of it. You are a remarkable person to be able to do all of this.
Ms. Colvin, you said that you are underfunded, as an agency.
*Ms. Colvin. That is correct.
*Mr. Kelly. Okay. How do you define “underfunded”? What do you base that on?
*Ms. Colvin. We are able to identify in our budget what we can do with the amount of dollars that you give us.
*Mr. Kelly. Okay.
*Ms. Colvin. As a result of ‑‑
*Mr. Kelly. If I were to give you, from the United States taxpayers, $11.5 billion, would that be considered a sizeable amount?
*Ms. Colvin. Our budget is ‑‑
*Mr. Kelly. No, no. Is that a sizeable amount? Because, you know, as Mr. Griffin said, there is never enough money for any of the agencies. Do you know this year it is $11.5 billion, and we are underfunding you?
*Ms. Colvin. Well, if you give us ‑‑
*Mr. Kelly. And not “we.” I am talking about American taxpayers.
*Ms. Colvin. If we receive the 2014 budget, we will certainly be able to ‑‑
*Mr. Kelly. Okay, all right. All right.
*Ms. Colvin. ‑‑ focus on that program ‑‑
*Mr. Kelly. No, I just wanted to make sure that we are talking the right way here, because sometimes we get confused about who we are actually working for. I work for the people of America, that is who I work for. Taxpayers is who I work for. I got to tell you. What you are doing is fine. The work is noble. I am not criticizing your work. And I know that the number is absolutely incredible, the overpayments.
Now, Mr. Becerra said it is only a half‑a‑percent.
*Ms. Colvin. Well, as we said ‑‑
*Mr. Kelly. A half‑a‑percent is ‑‑ well, wait a minute, wait ‑‑ is $1.29 billion. Let’s not minimize it by saying it is a half‑percent. You know the debt owed from these overpayments has gone from $5.4 billion in 2010 to $6.1 billion in 2012? So I don’t want to identify it as “only a half‑a‑percent.”
These are huge dollars. And what I don’t want to do, I don’t want to minimize what we are talking about by reducing it down to a percentage. A percentage, a small percentage of a very large number is a very large number to the people I represent in Western Pennsylvania. These are hard‑working American taxpayers that are funding Social Security. They are putting 6.2 percent of every time they get paid, and their employer is matching it. This is not government money. This is taxpayer money.
And I really get aggravated. I have only been here for three years. This is not Republicans versus Democrats. This is Republicans and Democrats working together to serve the American people. I get so damn mad when it becomes political, but this is not a political issue. This is an issue we are defrauding the American people. We are not defrauding Social Security. And we better start to understand who we represent here. I did not get elected by all Republicans are all Democrats.
But, damn it, I will tell you what. I watch this ‑‑ this is not a criticism of you. We have raised a group of people that look at a program and say, “I think I can game this. I think I can crawl under the wire here. I think I can do this and take advantage of the government.” No, no, no, no, no. You took advantage of every woman and man who gets out of bed in the morning, puts their feet on the floor, and goes to a job, and every time they get paid, contributes 6.2 percent of their paycheck, matched by their employer 6.2 percent, to fund this. And if we think it is about defrauding the government, we are really way off the line on this. We better wake up and smell the coffee. No wonder the American people have such a low opinion of us. We are not protecting them.
I don’t want you to take the blame for anything. Listen. You have a much higher approval rating than I do. But you know what? I get blamed for anything that happens in this government, because we didn’t step up to do it. So the purpose of us being here isn’t to go after you, it is to make sure that we protect the integrity of this system for the American taxpayers.
Listen, I thank you all for being here. Mr. O’Carroll, I know you have a great, great tour of duty. All you, I thank you for what you do. It is not about you. It never will be about you. It is about us, working with you, to get to where we need to be. I just have a hard time, Ms. Colvin, when I look at $11.5 billion and think, my God, we are underfunding? That is a lot of money.
*Chairman Johnson. The time of the gentleman has expired. Thank you.
*Mr. Kelly. I have expired.
*Mr. Kelly. Thank you, Chairman. Thanks for bringing it up.
*Chairman Johnson. Yes, sir. Thank you for your comments.
*Mr. Tiberi. Do I have to go next?
*Mr. Tiberi. Wow.
*Chairman Johnson. Only if you will talk for five minutes.
*Mr. Tiberi. Well, thank you all. I think Mr. Kelly’s tone expresses the frustration that we have, and it is not personal and it is not political. It is a frustration that we hear from our constituents. And I know, particularly the three of you that work for Social Security, share this concern that I am going to raise, and that is any time there is fraud, it hurts the integrity of the program. It hurts the integrity of the truly disabled. The whole program gets a black eye.
And I would say that ‑‑ to Mr. Griffin’s point, when I go back home, there is not a whole lot of confidence in the program when they read stories like the New York story, because they don’t think that is the one percent. They think it is the one that got caught. And so, while Mr. Rangel is correct ‑‑ thank you for helping identify this ‑‑ a constituent of mine might ask Mr. Ryan, “Well, it is great that you caught it, but why did it take 20 years to catch?”
Mr. Ryan, is it true that this goes back to 1988? And if that is true, what took so long to allow these criminals to operate for 20 years without getting caught?
*Mr. Ryan. Well, there is a long, drawn‑out answer to that. But I will try to break it down ‑‑
*Mr. Tiberi. Okay.
*Mr. Ryan. ‑‑ in segments. Number one, in 1998 it was identified through the diligence of SSA and the DDS in referring individual cases, individual referral, stating either this person was an NYPD or FDNY, or they had Lavallee as an attorney. Individual cases. We worked those individual CDI cases, and returned it back with our report mechanism, video surveillance, interviews, whatever. Went back to DDS. DDS, in 95 percent of the time, denied them at the application stage.
Subsequent to the application stage, there is the ODAR, which is the administrative law judges. Some of those, regardless of what was in the file, was placed on the rolls, based on the definitions ‑‑
*Mr. Tiberi. Outrageous.
*Mr. Ryan. ‑‑ of mental disability, based on the medical evidence in that file.
The second part of the question is that total number was minuscule, and was not detected as a conspiracy, criminal conspiracy case, until 2008. And there was a lot of reasons for it. Automation. We were able to get in through the diligent efforts of Social Security, into the individual files electronically, and print that data, the analytics that Ms. Disman mentioned. We were able to get that, and we were able to identify the patterns then ‑‑ Lavallee, et cetera ‑‑ in this New York case.
So, it is difficult to go back from 2008 to 1998, but in 2008 we went full boat with the investigation. We knew what we had. It took us where we wanted to go with the prosecution, and get that money back. And it now rests with the Manhattan district attorney’s office to get that money back to the American taxpayers.
*Mr. Tiberi. It does go back to 1988, though, right? With the four facilitators?
*Mr. Ryan. There was individual allegations.
*Mr. Tiberi. Okay. Back to 1988.
*Mr. Ryan. 1988.
*Mr. Tiberi. Okay, thank you.
*Mr. Ryan. And that was before ‑‑ that was pension fraud. It was before when OIG was even in existence, and it was before CDI units were created ‑‑
*Mr. Tiberi. And Ronald Reagan was president, so we can blame him, too, right? Hey, but no one is trying to blame anybody. The point is that this ‑‑
*Mr. Crowley. I was in the other hearing room.
*Mr. Tiberi. It was a joke. Ronald Reagan. You weren’t here when Mr. Rangel talked about the President.
So, you know, this is real in American people’s minds. And this is great that we caught this. But how much more of this is going on? I mean that is a question that people ask me all the time.
And so, I got a question, Ms. Colvin. Last year your agency conducted 1.6 million continuing disability reviews.
*Ms. Colvin. Yes.
*Mr. Tiberi. Three‑quarters of which were completed through self‑reported questionnaires, my understanding ‑‑
*Ms. Colvin. Yes.
*Mr. Tiberi. ‑‑ correct me if I am wrong ‑‑ called mailers. Were the reviews of these defendants in the New York case, were they completed via mailers, or full medical reviews, do you know?
*Ms. Colvin. Which ones?
*Mr. Tiberi. The defendants in this particular case, the New York case, with the 100 defendants.
*Ms. Disman. Yes, these were not CDRs when they were reported. These were initial claims. But in my just doing some analysis on the 102, looking at it ‑‑ remember, I can’t look at the files right now ‑‑
*Mr. Tiberi. Yes, yes.
*Ms. Disman. ‑‑ there were a number that had CDRs conducted on it. They were medical CDRs. As a matter of fact, we used that also as part of the investigation.
So ‑‑ but remember one thing. If you worked with your facilitators and your coaching, you would have the continuance, based on what the medical reports were.
*Mr. Tiberi. Does it ‑‑ last question, because my time has expired. With respect to these mailers, if you are a criminal and you have got this disability benefit illegally, three‑quarters of the recipients are getting mailers. How many ‑‑ it doesn’t give me much comfort that if you are a criminal, that you are going to answer a mailer honestly. Is that a concern going back to the procedures that we have talked about earlier that might be under review because of this? Because why would a criminal answer a mailer?
*Ms. Disman. If I could just address the mailing system, because I was involved in disability, helping years ago. It is a profiling system. And that is to be smart with the budget that Congressman Kelly says, that you really want to identify those that are more likely to have medical improvement, and more likely to change.
So, in doing the mailers, those are the high‑risk people that are identified through a system, through analytics. And a number of the mailers are also reviewed and become medical CDRs, as well.
*Mr. Tiberi. Okay. I look forward to those procedures that Mr. Renacci talked about. I yield back.
*Chairman Johnson. Thank you. I am not sure that answer answered your question.
Mr. Crowley, you are recognized.
*Mr. Crowley. Thank you, Mr. Chairman. I apologize I was not here for Mr. Rangel’s statement, nor did I get the joke. Apparently, no one else got the joke, either. So I apologize, Mr. Tiberi, for that.
Thank you, Mr. Chairman. I have tremendous respect for you, and so I do appreciate your holding this hearing today. We all know that we are people who will always try to ‑‑ there are always people who will try to game the system in all walks of life. We see it throughout ‑‑ it is throughout our society. What we need to do as policy‑makers is to hamper their abilities to corrupt the system by putting into place systems to detect, catch, and bring those who violate the law to justice.
From the standpoint of that test, what we are looking at today is proof positive that we have put in place those resources, both technical and human, to weed out, detect, apprehend people trying to defraud the Social Security disability program. We should commend the actions of the Social Security Administration.
This hearing has been turned upside down on its head. This panel before us should be lauded for the work that they have done to uncover the fraud and corruption, and for bringing these cases to light. We here in Congress must also ensure our actions do not hinder their ability to continue these anti‑fraud programs.
Listened very closely to the chairman’s opening statement. I akin it to blaming the homeowner when their house is broken into. The homeowner, in this case, cried foul, got the cops on the beat, and brought those who invaded their home to justice. And we ought to be lauding that.
I also want to laud the fact ‑‑ in reference to the 1988 number, those cases, as I understand it, Mr. Ryan, go back to 1988 because they involved New York NYPD pension fraud. Is that not correct?
*Mr. Ryan. You are correct.
*Mr. Crowley. In essence, people who are police officers ‑‑ my dad was a police officer, my grandfather before him ‑‑ individuals who are on the job, and then apply for what is known as three‑quarter pay, is that correct, for disability?
*Mr. Ryan. That is correct, three‑quarters.
*Mr. Crowley. And they get that in perpetuity, isn’t that correct?
*Mr. Ryan. Correct.
*Mr. Crowley. And these are individuals who actually could work that you have helped to uncover. That not only saves the Social Security Administration dollars, but helps to save in conjunction with Mr. Vance’s work, the district attorney of Manhattan, his work, millions and millions of dollars in New York City’s pensions. Is that correct?
*Mr. Ryan. That is correct.
*Mr. Crowley. I thank you, once again, for that work, as well.
Let me be clear. The people accused of perpetrating fraud on the American public under the guise of the worst terror attacks in American history are an outlier among the brave first responders in New York City. I come from a family of both police and firefighters, so I defend the reputation of both those departments and the men and women who serve in those departments, and do not defend in any way, shape, or form those outliers who would abuse the system.
But there are far too many brave firefighters and police officers who are suffering today from real illnesses and real disabilities as a result of their service on what was known as The Pile, cleaning up Ground Zero after the horrific attack upon our nation. Let’s remember it was the Federal Government that declared the air at Ground Zero safe and toxic free. But that wasn’t the case. And the air and the elements that they were working in were not safe. Yet we allowed thousands of first responders to search without the proper protective gear for the remains of almost 3,000 victims. We did so to bring some relief and closure to those victims’ families.
We allowed thousands to work without protective gear to extinguish the fire, a fire, by the way, that burned for three months after the attack. We allowed those first responders to run into harm’s way when the rest of us ran away. As a result, many of these heroes suffered and continue to suffer the after‑effects of this service. These men and women are legitimate recipients of a federal Social Security disability insurance program, and we should not and cannot let the few human nature, the few, to ruin a necessary program for the many.
One of my proudest moments in Congress came when, under a Democratic majority, we passed the 9/11 First Responders Health Act. It came after years of obstruction and partisan delays, delays that never should have occurred.
So, let me be clear. If any Member of Congress tries to use the fraudulent activities to taint the sick and wounded first responders of 9/11, they will have to deal with me directly. Congress has oversight and responsibilities and obligations. But we also have to make sure we don’t actually hamper the ability of federal investigators to do their job of fraud detection. Some in Congress have tried to cut off the very federal resources that stop fraud through budget cuts, furloughs, and downsizing, taking the very cops off the beat who are looking out for fraud and abuse in these programs. Ultimately, this lack of resources encourages more, and not less, fraud.
Thank you all again, each of you, for being here today. And, Mr. Chairman, thank you for holding the hearing. I do appreciate it. But I don’t appreciate the tone of turning it upside its head and blaming the victims in this case for the work that they did to uncover this fraud and this abuse. There is always more to be done.
I have news. There will be fraud for the rest of the existence of the United States and the world, as long as human beings exist on this planet. We are an inherently flawed people, and we have to get used to that. Let’s get beyond this.
Let’s find ‑‑ if we have ‑‑ if there is an agenda of amendments that can reduce fraud and abuse, I ask the Majority to hold a hearing on your proposals. Bring them forward. If there is a way we can mitigate and stop waste, fraud, and abuse in this system, I am all for it. And, Mr. Chairman, I await your agenda, and let me know when the meeting notice will be. I will be here with bells on. I yield back the balance of my time.
*Chairman Johnson. Thank you. Ms. Black, you are recognized.
*Ms. Black. Thank you, Mr. Chairman. And, Mr. Chairman, thank you for allowing me to sit in on this Committee, although I am not a member of this hearing.
However, I was a member of the Subcommittee for the first two years that I was here. And this issue has become one that I have delved into pretty deeply. And I have also, as a result of that, spent time when I was back in my district going through the entire system, from my local office to the determination unit to meeting with the ALJ’s and also meeting with those who are on the Social Security Advisory Board. So, this is an issue that I feel like I have really spent a lot of time in trying to understand.
As Mr. Renacci has said, how do we fix the problem? I thank you all for what you do. It is not an easy place to be. And, having gone through the entire system, I know that the determinations are not easy to make. There are a lot of things that we can fix, however, and I want to go to one of those.
Mr. O’Carroll, more than half of the defendants in the New York case faked mental disabilities. Is that correct?
*Mr. O’Carroll. Yes, Ms. Black, that is correct.
*Ms. Black. Okay. And then, following up on that, I am also looking back at the defendants in the Puerto Rico case ‑‑ also faked mental disabilities. Is that correct?
*Mr. O’Carroll. Yes.
*Ms. Black. Okay. Would you say that mental disabilities are easier to fake than other conditions?
*Mr. O’Carroll. Yes. And the reason for it is is that it is so subjective. As you well know, from being in the medical community, there aren’t x‑rays that will determine it, there aren’t CAT Scans that do it. There is no test. So it is pretty much you are relying on the voracity of the patient, and then you are relying on the voracity of the doctor. And that is where our problem in Puerto Rico and New York was, is that they ‑‑ it was collusion.
*Ms. Black. Okay. And so, let’s go just another step further, because we have discussed this in hearings previously, that the criteria for awarding these benefits or medical disabilities or mental illnesses has not been updated. The last update was 1985.
So, if we talk about how do we fix the problem so that we have better tools ‑‑ not necessarily more money, but just better tools, Ms. Colvin, can you help me with why we haven’t updated this? Is there a plan to update it? Are we working on that? Because this is 30 years now since it has been updated.
*Ms. Colvin. That is an excellent question. Yes, we are. We are working with the Institute of Medicine, and they are reviewing more objective instruments that might be out there to test ‑‑
*Ms. Black. When do you expect something from this? I mean, again, 30 years’ worth, I think I would like to have some kind of idea about what the plan is. You know, give us the timeline of when you would expect that there is going to be an actual update of looking at mental illnesses.
*Ms. Colvin. We have just given the task order to the Institute of Medicine, so I don’t have a date of when we will get their report. I will be very happy, once I talk with staff, to see what the timeline is there.
But we also have been updating our medical listings. As you know, many of them had not been updated for many years. We have gotten ‑‑
*Ms. Black. You mean the grid? Are you talking about the grid?
*Ms. Colvin. No, no, the listings, the medical listings that we use ‑‑
*Ms. Black. Oh, the listings, okay.
*Ms. Colvin. And, in fact, I think right now we have updated 10 of 15. The others are in the process of being updated. Our goal is to have all of them updated and then have them reviewed every three years.
*Ms. Black. Okay. I am sorry, I am going to reclaim my time, because I don’t have very much time and I want to get to a couple of other things ‑‑ but this updating is something that I have seen continuously throughout all of the departments that I have walked through. We have not updated this, and we can’t wait for the medical community to say, “Oh, we got to do another five years of research.” I want to hear a plan of getting this done and getting it through.
Grids are another thing. And looking at updating what currently jobs are available, we haven’t updated that in years. So my own disability determination unit tells me that their hands are tied because there is not even computer skills that are out there now to say that you can be retooled to work with a computer skill if your knees are gone, or something where you have to have a job where you are sitting, that has not even been done. And it has been suggested for over 15 years now, so that one needs to happen, as well.
So, when we talk about what can we do to fix the problem, there are tools out there that would help you to be able to do a better job, so that perhaps people wouldn’t get on disability that don’t need to be on disability. And that is what I want to hear back from you all, is when that is going to happen.
Now, I want to go to Mr. O’Carroll again about using the Internet. So, Mr. O’Carroll, your agents were able to determine many of the defendants were working. And how were you able to do that? Did you use any of these more up‑to‑date kinds of tools that you could possibly use?
*Mr. O’Carroll. Yes. We have been using social media. In fact, that was some of the video that we showed at the beginning on it. Normally, what we do with our CDI units is, as soon as we get an allegation that somebody is riding a motorcycle or doing something that is outside of the normal way they portrayed their disability, first thing we do is we start taking a look at probably public service type ‑‑ not public ‑‑ public information, taking a look at licenses, see that type of information on it.
Next step that we go to is we go to social media. And, often times, these people that are claiming that they can’t go out in public, that they are afraid of crowds and things like that, will show on their social media that they are, you know, leading tours through rock concerts and things like that.
*Ms. Black. Certainly. So ‑‑
*Mr. O’Carroll. So we use that, and we think it is a very good lead, and it is something that should be considered when people make an application.
*Ms. Black. So, if I could just complete this, Mr. Chairman ‑‑ I know my time has run out, but going back to the decision‑makers, I understand the decision‑makers are prohibited from using these kinds of resources. Is that correct, Ms. Colvin?
*Ms. Colvin. That is correct.
*Ms. Black. And is there a reason for that?
*Ms. Colvin. Well, there are a number of reasons for it. We believe that using those media, one, it opens up to having PII data exposed. We also believe that it is an appropriate thing for the investigators to use, not for the adjudicators to use.
*Ms. Black. Well, I am going to suggest it is another tool. When we say how can we fix this problem to give those who are the decision‑makers as much information as they possibly can, why not use things that are right at their fingertips, to be sure that they are getting all of the information, as well‑rounded a picture as they can?
And I will tell you that the disability determination unit told me they would like to have the ability to be able to use things at their fingertips, but they are prohibited from doing so. I think this is something we should look into as a subcommittee, in giving them the opportunity, and maybe the ability to be able to use those.
Thank you again, Mr. Chairman, for allowing me to sit on this Committee, and I yield back.
*Chairman Johnson. Thank you, Ms. Black. And I want to thank our witnesses for your testimony today, and thank the Members that were here and are still here. And I, along with my colleagues, are beyond outraged at this, and for good reason. So it is up to you, Commissioner, or Acting Commissioner ‑‑ I will call you Commissioner ‑‑ to take the actions you need to restore Americans’ trust.
And, with that, I thank you all for being here. The committee stands adjourned.
[Whereupon, at 10:34 a.m., the subcommittee was adjourned.]
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