- The Washington Times - Thursday, July 31, 2014

They may work all the live-long day, but railroad workers shouldn’t be receiving at least $1 billion in benefits they don’t qualify for, a top government watchdog says.

The problem is a federal agency — the Railroad Retirement Board — that’s been using outdated information, sometimes by as long as a year, to pay out disability benefits. That’s meant disability money is often going to beneficiaries who have healed from their injuries and are no longer considered disabled.

The RRB handed out $276 million in benefits in 2012, but ongoing investigations by the Justice Department and Government Accountability Office estimate that over the last several years, $1 billion was likely given to people who didn’t qualify for the payments.

“Without such a commitment to fraud awareness and prevention, fraudulent claims may go undetected, and the agency risks undermining public confidence in its ability to administer the important programs under its jurisdiction,” said the GAO, Congress’ top investigative agency.

The payment problems are the latest in a long line of government troubles dealing with retirement and disability benefits, said Romina Boccia, a senior policy analyst at the conservative Heritage Foundation.

“There’s a lot of problems,” she said. “The process is unfortunately broken and that is to the detriment of those who actually need disability benefits.”

For paying out up to $1 billion dollars of taxpayer money giving disability payments to people who aren’t disabled, the Railroad Retirement Board wins this week’s Golden Hammer, a distinction from The Washington Times given to examples of fiscal waste, fraud or abuse with taxpayer money.

The disability program provides “an important safety net for individuals who are unable to work due to a disability,” the GAO said, but is being harmed by the inability to “detect and prevent fraudulent claims system-wide.”

The Justice Department has been investigating and prosecuting railroad employees who have been filing false benefits claims. But the GAO said that without a more robust oversight system to prevent the fraud in the first place, the process is akin to “pay and chase.”

The RRB said they are trying to fix the problems, and officials said they are going to petition Congress for the authority to look at more up-to-date medical and employment databases run by the Department of Health and Human Services.

“We are in the process of strengthening our pre-payment fraud detection effort which will include formal procedures and regular training to implement that procedure and that communicates the anti-fraud responsibilities of staff,” a response from the RRB said.

Part of the problem, investigators said, is that the RRB is accepting medical opinions about a person’s ability to work from sometimes questionable sources, and not checking to make sure the disability rulings are coming from legitimate licensed medical professionals.

Indeed, RRB policy is that its field operatives are to “make no judgment as to the acceptability of a medical source,” according to the agency’s manuals.

Ms. Boccia argued there is usually little incentive for government to improve its oversight for benefit payments.

“A private insurance company has an interest in reducing the number of people who receive benefits because then [it pays] less,” she said. “But a government bureaucracy, if they save money by identifying people who no longer need disability benefits, there aren’t any benefits to the bureaucracy for doing so.”

Although the RRB’s disability program is separate from the Social Security Administration, they suffer from many of the same issues. Changes to disability and retirement benefits have long been debated in Congress, as the SSA is warning that many benefit programs could go bankrupt in the next few years — including some forms of disability payments.

“In the 1990s, there was an effort by Congress to cut down on disability payments for people who no longer deserved them, who had medical improvement,” Ms. Boccia said. “There was a huge political backlash.”

Sen. Tom Coburn, Oklahoma Republican and a medical doctor, has argued there need to be changes to the way the benefits system is run.

“If you put people on disability who are not truly disabled, and you send a postcard saying, ‘Are you still disabled?’, they’re going to answer ‘yes,’” he said in testimony at a June House Oversight and Government Reform Committee hearing.

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