GAO has found that the SSA does not always detect when an individual is improperly drawing benefits both from its disability insurance program and from the Labor Department-run Federal Employees Compensation Act.
Both programs provide a form of safety net for workers with job-related illnesses or injuries, and in the case of the FECA program there is a charge-back that can be a significant factor in program budgets in some workplaces—especially in those involving hard physical labor and/or hazardous conditions.
GAO examined a three-year period ending in June 2014 and found that SSA successfully detected FECA payments for approximately 4,090 individuals (about 52 percent) of the approximately 7,860 individuals who received concurrent FECA and DI payments during that period. SSA did not detect it for about 13 percent, more than 1,000 individuals who received some $48 million in DI benefits during the period, while “due to limitations in the SSA data GAO received, GAO was unable to determine whether SSA detected concurrent FECA benefits for about 2,730 individuals (about 35 percent) who received concurrent FECA benefits.”
GAO looked more closely at 20 beneficiaries and found that for seven of them, SSA did not detect and prevent potential overpayments for more than a decade, resulting in potential overpayments totaling more than $100,000 for each.
SSA officials reported that the agency made an estimated $371.5 million in DI overpayments stemming from FECA benefits from fiscal year 2009 through fiscal year 2013, but GAO was unable to determine how much of these funds SSA has recovered.
SSA agreed with GAO’s recommendation that SSA review the potential overpayments GAO identified and determine how best to strengthen controls.
