Effective Dates: 06/19/2014 - Present Previous | Next

TN 40 (02-20)

GN 02401.920 Referral to the Office of the Inspector General (OIG) for Investigation

A. Background on OIG investigations

OIG investigates fraud cases that meet prosecutorial guidelines for the federal judicial district where the fraud occurred. OIG has several other courses of action it can take in addition to seeking federal prosecution. OIG may refer the case to federal, state, or local courts.

In addition, under the Social Security Protection Act of 2004, the Office of the Chief Counsel to the Inspector General may impose civil monetary penalties (CMPs) against persons who make or cause others to make, false statements (including wrongful conversions by representative payees) or omissions of material facts to our agency. There is no required or suggested minimum dollar loss to refer an allegation for CMP consideration.

For cases that OIG does not open as a criminal investigation, they will advise if the case meets the criteria for sanctions. For more information on the disposition of OIG’s investigations, see GN 04123.005. For more information on the criteria for imposing administrative sanctions, see GN 02604.405.

B. Forwarding cases to OIG for possible investigation

OIG bases their determination on a combination of several factors, including the dollar amount of the loss and other facts. In the event that the money is in the process of being refunded (repayment agreement), make note of that fact when forwarding the case to OIG. OIG may still initiate a CMP action if deemed appropriate.

Follow the procedures in this chart when forwarding a case to OIG for possible investigation:

STEP

ACTION

1

Contact your servicing OIG field office regarding your specific allegation. For addresses, telephone numbers, and jurisdictions, see GN 04124.010.

2

Refer the case to OIG via the Allegation Referral Intake System (ARIS). You may call your servicing OIG office for guidance.

3

When submitting the ARIS:

  • •

    Processing Center (PC) employees should follow instructions in GN 04111.025 “How the PC Reports Program Violations.”

  • •

    Field Office (FO) employees should follow instructions in GN 04111.010 “How the FO Reports Program Violations.”

C. Procedure following referral to OIG

Follow the instructions below after referring a case to OIG

1. Handling the record if OIG investigates

If OIG decides to investigate, do not take action on the record or send out an overpayment notice.

NOTE: Send a Limited Payability (LP) Notice to the beneficiary or recipient in those cases where there will be a delay in the check replacement until after completion of OIG's investigation. For LP notices, see NL 03001.030.

2. Handling the record if OIG does not investigate

If OIG accepts the case but decides the case does not merit an investigation, they will provide our agency with a written explanation of their decision not to pursue. For additional information, see GN 04123.005B.

Review the explanation. If a repayment agreement was proposed, accepted or filed, proceed with collection under the agreement. If no repayment agreement was proposed, see GN 02604.405 through GN 02604.447 for administrative sanction instructions. If overpayment recovery is appropriate, take steps to recover the overpayment. For overpayment recovery instructions, see GN 02210.000 through GN 02210.230 and SI 02220.000.

3. Written determination of the outcome

After OIG investigates and resolves the fraud aspects of the case, the Office of Investigations Field Division (OIFD) returns the case to our agency with a closing memorandum. If we recover any funds, credit the recovered funds. For more information on notification of disposition by OIFD see GN 04123.005C

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0202401920
GN 02401.920 - Referral to the Office of the Inspector General (OIG) for Investigation - 06/19/2014
Batch run: 01/19/2024
Rev:06/19/2014