I-1-3-1.Distinguishing Between the Office of the Inspector General and Cooperative Disability Investigations Units

Last Update: 12/13/13 (Transmittal I-1-69)

A. Purpose

The purpose of the Office of the Inspector General (OIG) is to investigate allegations of fraud, waste, and abuse within the Social Security Administration (SSA) and its programs.

The purpose of the Cooperative Disability Investigations Units (CDIU) is to focus solely on allegations of disability fraud.

B. Scope

OIG investigates allegations of any benefit fraud, including cases that are already in pay status. For example, OIG can investigate fraud relating not only to a claim for benefits, but issues relating to representative payee misuse, stolen checks, misuse of Social Security numbers, and allegations of fraud by SSA employees.

The CDIUs primarily focus on pending claims rather than cases that are in pay status. However, CDIUs also investigate continuing disability reviews. The primary mission of the CDIU is to obtain evidence that can resolve questions of fraud before benefits are ever paid. For example, CDIUs frequently investigate issues relating to feigned impairments, concealed medical improvement, concealed work activities, identity fraud, and inconsistent statements or facts.

NOTE:

Evidence from OIG or the CDIU can be favorable or unfavorable to a claimant.

C. Organization

The SSA OIG is an independent audit and investigative unit, separate and distinct from SSA's administration of benefit programs.

The CDIUs were jointly established by SSA and OIG in fiscal year 1998, in conjunction with the Disability Determination Services (DDS) and State or local law enforcement agencies. SSA, OIG, DDS, and State and local law enforcement all have representatives that form the CDIU. There are 25 CDIUs nationwide, each of which is headed by an OIG Special Agent as Team Leader.

NOTE:

For more information on CDIUs, see http://oig.ssa.gov/cooperative-disability-investigations-cdi.

D. Outcome

An OIG investigation can result in a criminal prosecution, civil action by the Department of Justice, imposition of a civil monetary penalty, or administrative sanctions or other action by SSA.

A CDIU investigation can result in a criminal prosecution, imposition of a civil monetary penalty, or administrative sanctions or other action by SSA.