POMS Reference

DI 39569: Program Integrity

TN 3 (01-12)

The Social Security Administration (SSA) must protect its programs against fraud, waste, and abuse. The Office of the Inspector General (OIG) investigates:

  • allegations of fraud, waste, and abuse within SSA programs and operations; and

  • suspected violations involving disability cases processed by federal employees, Disability Determination Services (DDS) employees, and contractors.

A. Examples of violations and fraud

  • Conflicts of interest

  • False evidence or alterations in documents

  • Fraud or misuse of contracting funds

  • Standards of conduct violations

B. Detecting, developing, and reporting violations or fraud

DDS management is responsible for reviewing cases selected by the Comprehensive Integrity Review Process (CIRP) to detect potential violations and fraud.

DDS employee responsibilities include:

  • detecting potential violations and fraud in SSA programs and operations; and

  • developing evidence needed to support or remove the suspicion that a violation or fraud may have been committed.

NOTE: Use the SSA-e8551, Reporting Form for Programmatic Fraud, to report potential violations to the Office of the Inspector General (OIG) Office of Investigations Field Division (OIFD). Reports submitted via the electronic SSA-e8551 are automatically routed to the proper OIFD. Instructions for using the e8551 are in GN 04111.065.

C. Reference

  • GN 04110.005, Detecting Potential Criminal Violations and Fraud

  • GN 04110.010, Detecting and Developing Program Fraud

  • GN 04111.005, Reporting Guidelines for Program Violations

  • GN 04111.035, How the Disability Determination Services (DDS) Report Program Violations