A little known fact is that Social Security can suspend benefits for a variety of reasons even for what the agency calls “miscellaneous” reasons.
Most of the time benefits are suspended, reduced or eliminated due to factors that impact a beneficiary’s qualifications to receive benefits. One example is when a disability beneficiary is receiving benefits, but also working and they earn more income than guidelines permit to qualify for the benefits. When and if Social Security discovers the issue they would suspend and possibly eliminate the benefits. This is a straight forward example of when the agency decides to suspend benefits, but it can also suspend benefits when the reason is not clear at all.
According to Social Security, when an SSA employee suspends benefits they identify the issue that needs to be resolved by inputting a suspend code, but when the issue is not clear they can use the code “miscellaneous.” This potentially can allow Social Security to suspend benefits for an unknown reason, which can be devastating to the person who is receiving those benefits. A recent study performed by the Office of the Inspector General (OIG) for Social Security shows that on average that these “miscellaneous” suspensions can last for up to 36 months. As you can see from the findings and recommendations from the OIG report, many times these suspensions were not resolved. The OIG wants more controls over these “miscellaneous” suspensions in the future and there should be defined reasons why benefits are suspended.
Findings
As of February 2020, SSA had not completed follow-up actions to resolve issues that caused it to withhold benefits using the miscellaneous suspense code for 41 of the 100 beneficiaries. As a result, SSA withheld almost $748,000 from these beneficiaries.
- For 18 beneficiaries, SSA withheld over $541,000 and did not resolve the miscellaneous suspensions.
- SSA took actions to determine whether it should resume benefits for the remaining 23 beneficiaries but did not determine whether it should pay the beneficiaries for all months it withheld benefits. SSA continued withholding over $206,000 that may be due these beneficiaries.
We project SSA withheld approximately $378 million from almost 21,000 beneficiaries without resolving the issues that caused the benefit suspensions.
SSA does not have controls to monitor beneficiaries in miscellaneous suspense status or an oversight process to ensure employees use the miscellaneous suspense code appropriately. SSA relies on the employee who suspended benefits to create his/her own reminder to take future resolution actions. For these 41 beneficiaries, this process did not ensure SSA completed necessary actions to resolve outstanding issues.
Based on our review, SSA took action to resolve the miscellaneous suspensions for 10 of the 41 beneficiaries. SSA still needs to resolve the miscellaneous suspensions for the remaining 31 beneficiaries.
Recommendations
We made 3 recommendations for SSA to resolve miscellaneous suspensions for the 31 beneficiaries, analyze and resolve issues for other beneficiaries with benefits in miscellaneous suspense for an extended period, and implement controls over employees’ use of the miscellaneous suspense code. SSA agreed with our recommendations.
