In the late 1990s, different government agencies joined forces to start the Cooperative Disability Investigations (CDI) Program. The program is a joint initiative by the Social Security Administration and the Office of the Inspector General (OIG). These agencies work with State Disability and Determination Services (DDS) offices and local law enforcement offices to investigate suspicious Social Security claims that they think might be fraudulent.
Disability fraud includes claiming to be disabled when no disability exists, filing multiple disability applications, and lying about disabilities, work, or other activities on a disability application.
Generally, a CDI may occur as follows:
- A fraud referral is made to the appropriate CDI unit. DDS or the Social Security Administration usually makes the referral. However, a referral may also be made by the Social Security Administration’s Office of Hearing Operations, a law enforcement agency, a private citizen, or an anonymous source.
- The CDI Unit investigates. The CDI Unit consists of a Special Agent from OIG who serves as team leader. The other members of the team include state DDS employees, a Social Security Administration employee, and state or local law enforcement officers. The investigation may include a thorough review of your educational, work, and medical records, video surveillance of you whenever you leave your home, and third-party interviews.
- The CDI Unit issues a report. The detailed report explains the investigation and the unit’s findings. It is sent to the state DDS office for review.
- DDS decides if fraud occurred and whether the applicant should get disability benefits. DDS decides whether the applicant should start or continue receiving benefits. If the person is already receiving disability benefits, then DDS may stop payments. In some cases, the case may be referred to the government for criminal prosecution.
The OIG estimates that from the time the program began in 1997 through May 2020, the CDI Program saved the country approximately $4.2 billion in Social Security disability payments. Additionally, the CDI Program saved an estimated $3.2 billion in non-Social Security government benefits such as Medicaid and food stamps.
Since a CDI could result in a report that prevents you from receiving Social Security disability benefits, it is important to understand your rights as a claimant if you are the subject of an investigation. Specifically, you have the right to:
- Review the Report of Investigation. The report is part of your claims file, and as a disability claimant, you have the right to access your file.
- Challenge the significance of evidence included in the Report of Investigation. You may, for example, present contradictory witnesses or provide evidence that the events described in the report are isolated occurrences that do not accurately reflect your condition.
In many cases, the goal of the investigation was to prove that you should not get disability benefits, and you should examine everything in the report with that premise in mind.
By: Joyce Trudeau of Premier Disability Services, LLC®