Disability Insurance (DI)
High-priority program
Program level Payment Integrity results
Sponsoring agency: Social Security Administration
View on Federal Program InventoryPROGRAM METRICS
$143,443 M
in FY 2025 outlays, with a
98.4%
payment accuracy rate
-
Improper payment estimates over time
View as:
Chart toggle amounts:Proper paymentsOverpaymentUnderpaymentTechnically improperUnknown
Payment Integrity results
-
FY 2025 improper payment estimates
Chart legend and breakdown
Payment accuracy rate
Improper payment rate
Unknown payment rate
Sampling & estimation methodology details
Sampling timeframe:
10/2023 - 09/2024
Confidence interval:
95% to <100%
Margin of error:
+/-0.2
Causes
Improper payments outside the agency’s control occur when we are unable to access the data needed to calculate an accurate payment because the beneficiary or a third-party either did not provide the requested information or provided inaccurate information necessary to compute the accurate benefit amount. It occurs because of beneficiaries’ or representative payees’ failure to report changes. For this reporting period, the leading cause of improper payments outside the agency’s control was primarily our reliance on timely self-reporting of employment and wage information.
| Overpayment root cause | Overpayment amount |
|---|---|
| Amount of overpayments within the agency's control | $927.25 M |
| Amount of overpayments outside the agency's control | $905.22 M |
| Amount of overpayments that occurred because the data/information needed to validate payment accuracy prior to making a payment does not exist | $0.0 M |
| Amount of overpayments that occurred because of an inability to access the data/information needed to validate payment accuracy prior to making a payment | $905.22 M |
| Amount of overpayments that occurred because of a failure to access data/information needed to validate payment accuracy prior to making a payment | $927.25 M |
| Underpayment root cause | Underpayment amount |
|---|---|
| Amount of underpayments | $505.29 M |
| The amount of underpayments that occurred because the data/information needed to validate payment accuracy prior to making a payment does not exist | $0.0 M |
| The amount of underpayments that occurred because of an inability to access the data/information needed to validate payment accuracy prior to making a payment | $3.1 M |
| The amount of underpayments that occurred because of a failure to access data/information needed to validate payment accuracy prior to making a payment | $502.18 M |
| The amount of improper payments that were paid to the right recipient for the correct amount but were considered technically improper because of failure to follow statute or regulation | $0.0 M |
| The amount that could either be proper or improper but the agency is unable to determine whether it was proper or improper as a result of insufficient or lack of documentation | $0.0 M |
Prevention
SGA is the performance of significant physical or mental activities in work for pay or profit, or in work of a type generally performed for pay or profit, regardless of the legality of the work. Beneficiaries are required to report changes in their work activity and increases in earnings to ensure proper payments and continued eligibility for benefits. Improper payments based on SGA are a leading cause of improper payments in the OASDI program; most occurring as a result of beneficiaries or representative payees failing to report changes in work.
To reduce our reliance on beneficiary and representative payee reporting of employment and wage information, we published the Use of Electronic Payroll Data To Improve Program Administration final rule in December 2024. Through the process known as the payroll information exchange (PIE), we obtain wage and employment information from a commercial payroll data provider for individuals who have provided authorization. On April 7, 2025, we began the phased implementation of PIE with an initial exchange of 1 million Social Security numbers (SSN). We gradually increased the exchanges each month until reaching full implementation of 10.7 million SSNs in September 2025. We continued monthly exchanges with the full authorized population after September. As part of the PIE implementation activities, we provided training to technicians, updated our policies and instructions, and released communication to the public. In FY 2026 and beyond, we will implement measures to increase PIE authorizations; develop requirements for requesting historical wage data through PIE; develop a process for handling SSNs that are flagged for name mismatch and excluded from subsequent changes; streamline and improve notices, forms, and receipts related to PIE based on customer experience feedback; develop and implement enhanced management information; mismatch exclusions; and other enhancements. PIE will improve payment accuracy, reduce improper payments, and reduce the reporting burden on individuals when they authorize us to obtain this information through an information exchange, and we receive it. We also anticipate that implementation will result in more efficient use of our limited administrative resources because our technicians would reduce the amount of time they spend manually requesting this information from payroll data providers and employers; manually entering data into our systems from an individual’s pay records; contacting individuals; and assisting individuals with the results of incomplete or untimely reporting.
For individuals or employers not participating in PIE, we continue to offer electronic wage reporting tools, such as the myWageReport (myWR) online tool. myWR allows Disability Insurance beneficiaries, Supplemental Security Income (SSI) recipients, concurrent beneficiaries, and representative payees to report wages and view, print, or save a receipt. Self-reporters and their representative payees can report wages that occurred within a two-year timeframe from the reporting date. From April-May 2025, we released social media posts on Facebook and X sharing a link to our YouTube video to help beneficiaries learn why it is important to report wages and the automated electronic options for wage reporting. This included instructional videos with step-by-step instructions on how to use the agency’s self-reporting wage applications. In FY 2026, we will continue to use our social media channels to post reminders for our beneficiaries about the importance of promptly reporting changes that impact their eligibility and payment amounts. These posts will inform beneficiaries how we are required by law to adjust payments or recover debts when people receive payments they are not entitled to.
In July 2025, we started a national Targeted Work Review Process (TWRP) for specific work continuing disability reviews (CDR). The TWRP leverages the expertise of a cadre of technicians to use readily available earnings data to formulate a proposed work CDR decision prior to requesting work activity report. Technicians will send both the work activity report and due process notice simultaneously. The TWRP aims to reduce work CDR processing time by allowing one technician to process the case from start to finish and reducing delays in sending/receiving evidence. TWRP continued into early FY 2026, and we plan to evaluate its outcomes later in FY 2026. We are also developing a new Electronic Work Continuing Disability Review (eWCDR) application to replace and modernize the system technicians use to process CDRs based on work activity. The new system will enforce policy and best practices with an intuitive user interface and will eliminate current system limitations that lead to large improper payments through delays and processing errors. The application will streamline the disability review process and will have a positive impact in reducing substantial gainful activity improper payments. In FY 2025, efforts continued to develop eWCDR capabilities that allow technicians to receive beneficiaries’ reports of work, document and evaluate pay stubs and self-employment income, mail out forms and notices, and collect Management Information. We plan to release the minimum viable product to technicians by the end of FY 2026. We also use WorkSmart, a tool that helps identify DI beneficiaries whose earnings may place them at risk of overpayment. WorkSmart continues to alert cases for work CDRs based on available earnings data. In addition, with the appropriate authorization, WorkSmart will utilize PIE data to identify and alert cases that may require a work CDR.
We complete Work CDR Quality Reviews to ensure compliance with policy and the Bipartisan Budget Act (BBA) of 2015 by evaluating a monthly, stratified random sample of processed Work CDRs. This review captures processing times, assesses Trust Fund impact from policy non-compliance, measures accuracy rates, identifies procedural and training improvements, and collects data on new processing procedures. We provide case-level feedback and share the broader data analysis with stakeholders. We completed data analysis of FY 2023 and FY 2024 reviews and plan to publish them in FY 2026. We are planning the FY 2026 review to evaluate Work CDR accuracy amid the implementation of PIE and other procedural changes.
To improve understanding and reduce the burden on our customers and their employers, we are updating several disability-related forms. In February 2025, we published a revised SSA-3033, Employee Work Questionnaire, and clarified policy and procedures for technicians developing subsidy for DI and SSI initial claims, and DI work continuing disability reviews. The Office of Management and Budget (OMB) approved the SSA-821 Work Activity Report in July 2025, which we published in September 2025. The revised SSA-820 Self-Employment Work Activity Report is currently pending OMB approval; we expect completion of the form in FY 2026.
WEP and GPO reduced or offset Social Security monthly benefits to beneficiaries who received a pension based on non-covered earnings. Most of these workers had non-covered earnings from federal, state, or local governments. Errors relating to WEP/GPO have been one of the leading causes of OASI improper payments. We had previously relied on applicants, beneficiaries, or their representative payees to report their entitlement to current or future non-covered pensions; however, they did not always report the receipt of or changes to a pension, resulting in benefit calculation and payment errors. WEP and GPO errors also occurred when the agency did not correctly impose reductions or offset, misapplied exceptions or exemptions, or applied WEP but not GPO (or vice versa) for dually entitled beneficiaries.
We developed a comprehensive corrective action plan to address multiple underlying causes of WEP/GPO improper payments. We assessed the root causes of improper payments based on these changes and developed policy, data, systems, and training solutions in line with each of the root causes of improper payments. On January 5, 2025, the Social Security Fairness Act of 2023 was signed into law, thereby repealing WEP/GPO. December 2023 is the last month that WEP and GPO will apply. This means that those rules no longer apply to benefits payable for January 2024 and later. The agency worked quickly and successfully to implement these changes. As of July 7, 2025, we completed sending over 3.1 million payments, totaling $17 billion, to beneficiaries eligible under the Social Security Fairness Act. The average retroactive payment was $7,208. As of September 30, 2025, we have taken over 387,000 new initial claims. We began releasing higher monthly benefit payments in April 2025. We anticipate the WEP/GPO repeal will significantly reduce and eventually eliminate WEP/GPO improper payments in future years.
Computational errors occur due to many factors. Generally, these factors include: systems limitations for complex cases; manual calculation of benefits involving complicated policies; technician errors; incorrect earnings postings; beneficiaries not reporting complete and pertinent information; and lack of accurate and accessible data. We developed processes using UIPath software to create automated “robotic” programs that perform routine or repetitive tasks and increase the speed and accuracy of manual processing. Robotic Processing Automation (RPA), or “BOTs,” are available to Processing Center (PC) technicians to assist with processing manual awards or post-entitlement actions. Since January 2021, seven PC-specific BOTs have been created to assist with DI and Old-Age and Survivors actions and placed into production. In December 2024, we provided general reminders and guidance for PC technicians on BOT usage. We completed the final testing stages of the UiPath Assistant software and rolled out the new platform to PC users in August 2025. We are making a long-term investment in robotics technology using the software to improve business processes and eliminate manual actions.
In January 2025, we released instructions to field office technicians to review earning records for identified pending retirement and disability claims. Validating earnings records associated with pending claims ensures accurate eligibility and payment amounts. In April 2025, we released a reminder to frontline technicians including information on reducing improper payments related to benefit computations. When automated systems cannot compute benefit amounts in certain situations, there are a variety of computations tools that technicians should use to ensure accuracy. In May 2025, we updated policy instructions associated with temporary and ongoing earnings inaccuracies and coding used to trigger an alert for technicians to review and ensure the accuracy of earnings records and Primary Insurance Amounts before automatic benefit increases. In the May 2025 policy update, we expanded the coding to include “all disclaimed wages and those institutionalized.” This action stemmed from an Office of the Inspector General report on institutionalized beneficiaries who have earnings.
The Federal Employee Compensation Act (FECA) provides income and medical cost protection to covered Federal civilian employees injured on the job, employees who have incurred a work-related injury or occupational disease and beneficiaries of employees whose death is attributable to a job-related injury or occupational disease. FECA is administered by the Department of Labor (DOL), and receipt of FECA benefits can offset DI benefits. In December 2023, we established a Memorandum of Understanding with DOL for use of an employee compensation portal. Technicians can submit individual real-time queries in the portal to obtain FECA data and complete computations. We continue to explore data exchange opportunities that would improve efficiency and accuracy of related computations by eliminating the need for a manual query and transition to a batch process. We are working to complete the computer matching agreement and will begin implementation of the data exchange in FY 2026 should funding be available.
Marital status and child relationship factors are material when determining entitlement to certain auxiliary and survivor benefits. Improper payments occur due to beneficiaries failing to report changes in marital status, the agency’s inability to automate, and difficulty expanding data exchanges to include the exchange of marital information. To address these issues, in FY 2025, we have been airing relationship and dependency reminders on televisions in field office reception areas. In April 2025, we released a reminder to frontline technicians on checking for program entitlement when an individual changes their name due to marriage or divorce. The guidance also included a reminder on verifying that all child-in-care information is entered in the system correctly. In FY 2026, if resources allow, we will explore options to expand the Internet Social Security Number Replacement’s current process and incorporate downstream application alerts to reduce instances of improper payments.
We collect death data from a variety of sources and work to improve our death data processing so that we can effectively administer our programs. We have a contract with every State Bureau of Vital Statistics (the custodians for death records) and with some jurisdictions to provide us death data. Since 2002, we worked with States that want and are able to build a streamlined death registration process known as Electronic Death Registration (EDR). As of July 2025, all 50 States, New York City, Washington, D.C., Puerto Rico, and the Commonwealth of the Northern Mariana Islands report deaths through the EDR process. On September 30, 2024, we awarded a contract with the National Association for Public Health Statistics and Information Systems (NAPHSIS) on the acquisition of historical State death records. In FY 2025, we worked with NAPHSIS on establishing the infrastructure required to receive the historical death data. This multi-year effort will increase the accuracy, integrity, and completeness of our death data.
In March and June 2025, we updated Numident records with additional death information for non-beneficiary individuals that were over 120 years of age when there was no death record present on the Numident. These efforts resulted in over 12 million death records being added to the Numident. In March 2025, we also provided the Internal Revenue Service a one-time file concerning individuals listed in the agency’s enumeration system who are age 120 or older based on available information as recorded in that system. Efforts are ongoing to update our Numident records for individuals over 100 years of age with death data. We also increased the frequency with which the agency provides updates concerning the full file of death information to the Bureau of the Fiscal Service for use in the Do Not Pay system.? We implemented this change (from weekly to daily) on April 1, 2025. In July 2025, we released a reminder to field office technicians to verify and record the death when a report of death on form DS-2060 U.S. Consular Report of Death Abroad is received.
For root causes where the data or information needed to process a payment correctly does not exist or the agency is unable to access the data or information needed, we are establishing alternate sources of information. For example, we conducted 22 computer-matching agreements (CMA) with various Federal partners to help us determine eligibility and offset benefits for our programs. The total annual savings attributed to these CMAs is approximately $14.9 billion, with an annual cost of approximately $510 million, yielding a positive benefit-to-cost ratio of about $29 to $1. We plan to continue current CMAs that yield a positive cost-benefit ratio, expand effective CMAs to meet additional program needs, research current programs, work with internal stakeholders to identify data exchange needs, and pursue new data exchanges with potential partners. In December 2024 and April 2025, we held Data Exchange Community of Practice meetings. In FY 2026, we are working to reestablish the relationships with the current agency contacts, update the invitation list, and determine future topics for the meetings as resources allow.
We have several broad-based initiatives in place or underway that are designed to ensure technician compliance with policy and improve payment accuracy.
We complete Transaction Accuracy Reviews (TAR) on a triennial basis to assist in assessing operational quality. TAR focuses on a review of the nonmedical factors of entitlement and eligibility for OASI and DI payments in initial claims awards and disallowances. TAR findings provide insight to causes of improper payments and identify recommendations for improvement, which are shared with agency stakeholders. TAR is completed on a triennial basis. We will complete the next TAR report in FY 2027 based on reviews of FY 2026 case samples.
In September 2024, we released the 21st Century PolicyNet (21CPN), which replaced PolicyNet, the 20+ year-old software platform that contains multiple applications and hosts tens of thousands of pages of policy instruction. The overall goals of 21CPN are an improved user experience, process efficiencies for the author, publisher, and researcher role, as well as improving searching capabilities, including the use of intelligent search. In December 2024, we launched improvements that introduced new message types, enhanced search functionalities, upgraded navigation features, included spell check for technician searches, and provided access to a variety of operational resources, archives, and margin notes. In April 2025, we successfully finished the data migration process and implemented enhanced search features. These improvements now encompass the hearings, appeal, and litigation law manual, as well as Social Security rulings and acquiescence rulings, along with policy documents and ownership details. Additionally, we provided quick access to agency form repositories and included a user guide for 21CPN. In June 2025, we launched an advanced search feature designed to improve the accessibility of policies, procedures, and instructions. Additionally, we upgraded the application's presentation and usability by incorporating a series of content clusters and a "Trending" topics section to showcase and highlight agency initiatives for key stakeholders. In September 2025, we broadened the data set to incorporate various procedural content clusters, link libraries, question and answer sections, and related instructions links. Furthermore, we improved the presentation functionality by introducing subscriptions and daily messages. Finally, by the end of FY 2026, contingent upon successful testing and evaluation, we plan to launch a generative AI "Policy Assistant Tool (PAT)" designed to simplify the search process for policies, procedures, and instructions. This tool will assist technicians in quickly and accurately finding and understanding relevant information to aid in decision-making.
We developed the Technician Experience Dashboard (TED) as an enterprise customer relationship management solution that will provide a single location for information about our customers’ interactions with the agency to make it easier for our employees to help the public and increases efficiency and accuracy, improving the overall customer experience. In February 2024, we rolled TED out nationally to all field offices (FO) and workload support units. In November 2024, we expanded TED to all teleservice (TSC) centers. TED modernized the previous 30-year-old Customer Help and Information Program (CHIP) that assisted TSC technicians when responding to customer inquiries via telephone. In January and March 2025, we released two iterations of TED enhancements, improving upon the functionality for field office and teleservice centers. In April and June 2025, we enhanced the identity verifications procedures within TED to send a Security Authentication Personal Identification Number to authenticated customers (that technicians subsequently verify) before making direct deposit and direct express enrollments, changes, or cancellations over the phone.
In December 2025, we will release a workflow in TED that allows FO and TSC technicians to update payment information for Supplemental Security Income (SSI) recipients. The release will also include the FO expansion of the ability to automate the process for collecting the customer SSN and starting an interaction in TED. In addition, TSC technicians will have the ability to access the workflow for handling customer requests for special notice options and other accommodations. Modernization efforts will also include the replacement of older technology used to pass data from legacy systems. In FY 2026, business workflow development efforts will focus on a streamlined process for assisting SSI recipients with updating address and telephone information, scheduling appointments and sending customers agency forms/links via their “my Social Security” account, text, or email. In addition, the product will continue to work towards CHIP replacement by implementing the use of artificial intelligence to develop high volume informational workflows such as Medicare, Social Security Statement etc. Lastly, we are working to implement the first iteration of Customer Intake in TED in FY 2026. This feature empowers technicians to seamlessly manage reception traffic and appointments for their office. With streamlined check-in, identity verification, and task management capabilities, technicians can deliver faster, more accurate and personalized service without switching between multiple applications.
In March 2024, we expanded the Upload Documents and eSignature services, which allows beneficiaries and recipients to submit and sign documents electronically, to all field offices and workload support units nationwide. We completed various enhancements and expanded available forms throughout FYs 2024 and 2025. Beginning March 29, 2025, a new customer-initiated option is available allowing customers to electronically submit certain forms to the agency without technician initiation. This self-service approach empowers customers to initiate document uploads as soon as they recognize a need, eliminating delays caused by waiting for technician outreach. In FY 2026, we will continue to webify forms for a mobile friendly experience and increase the number of forms. We plan to expand customer-initiated submissions to allow individual representative payees to submit documents.
To improve accuracy of processing overpayment actions, from July 2024 to September 2025, we conducted in-line quality reviews of almost 4,300 high-dollar overpayments exceeding $50,000. From September 2024 to September 2025, we conducted post adjudicative reviews of almost 9,400 overpayments exceeding $10,000. We make corrections to identified errors and use the analysis and findings to conduct training and issues reminders to processing center (PC) technicians. Additionally, in October 2024, we conducted a probe of recently processed overpayments to obtain a baseline accuracy, inform a further in-depth study, determine specific causes of overpayment errors, whether technicians and automated systems had difficulty processing one type of overpayment as compared to another, and to see the effects of changes made to the overpayment process based on prior quality reviews (e.g., requiring a second review for overpayments posted to a record in excess of $50,000). Based on the results of the probe, in May 2025, we began conducting a quality review of recently processed overpayments stratified by PC and providing case level feedback to the PCs. In spring 2026, we plan to provide overall accuracy findings to each PC, along with information on the errors identified, and recommendations for improvement. We are considering further reviews in FY 2026, dependent upon FY 2025 findings, available resources, and competing priorities.
We provided resources for technicians to use when reviewing and processing requests for waiver of an overpayment. In February 2025, within an existing waiver processing toolkit, we added links to live waiver training sessions and an updated overpayment waiver decision tree. In June 2025, we created the updated SSA-632-BK, Request for Waiver of Overpayment Recovery, to streamline the process for submitting overpayment waiver requests and improve ease of use for the public.
In FY 2024, we published the revised Notice Language Clearance Process policy, which incorporates review and approval of notice language through the plain language and the customer experience lens. In FY 2025, we used this new policy to provide a plain language review of 22 notices.
For the root cause of overpayments due to our failure to access data or information needed (approximately $927.2 million), our corrective actions and strategies fall within several high-level categories such as automation, training, and cross enterprise sharing. For overpayments outside of the agency’s control (approximately $905.2 million), we are addressing the challenge of reliance on self-reporting by promoting timely wage reporting and issuing reminders on reporting responsibilities. We also began utilizing an automated information exchange with a commercial payroll data provider to reduce the reliance on self-reporting of wages; this exchange is referred to as the Payroll Information Exchange.
We monitor the status of improper payment corrective actions through recurring stakeholder and senior executive meetings. We evaluated existing initiatives and developed a comprehensive approach to identify, support, and prioritize new and planned reduction initiatives that target the root causes of leading causes of improper payments. The purpose of this effort is to strategically align agency wide initiatives that will have the most significant impact to the detection and prevention of improper payments. By identifying and analyzing the root causes of the improper payments, we channel our efforts in the most efficient manner ensuring that we are fiscally responsible as we implement a corrective action plan.
We will continue to find opportunities to explore cost-effective corrective action plans based on our evaluations. However, we continue to note that the complexity of our Disability Insurance program makes it extremely difficult to determine the dollar value associated with a particular corrective action.
We focus on efforts to address the root causes of improper payments. For improper payments within the agency’s control, we pursue workflow adjustments, policy and notice changes, training and reminders for technicians, and automation solutions to improve accuracy. For improper payments outside the agency’s control, we continue to influence change where possible.
We have a team dedicated to monitoring and measuring the effectiveness of the progress of improper payment mitigation strategies and corrective actions. We evaluated completed corrective actions to determine whether changes in the outcome could be attributed to the implementation of the corrective actions. We compared data before and after the implementation of corrective actions to determine whether we need additional actions.
Improper payments outside the agency’s control occurs when we are unable to access data needed to calculate an accurate payment because the beneficiary or a third-party either did not provide the requested information or provided inaccurate information necessary to compute the accurate benefit amount. It occurs because of beneficiaries or representative payees’ failure to report changes. We are addressing these root causes, by establishing alternate sources of information to administer the Disability Insurance (DI) program. For example, to reduce the reliance on self-reporting of wages, we developed an automated information exchange with commercial payroll data providers as a strategy to reduce improper payments. This exchange is referred to as the Payroll Information Exchange (PIE).
In FY 2025, we began utilizing PIE to improve efficiency in processing wage reports for the DI and Supplemental Security Income (SSI) programs. PIE allows us to receive wage and employment information electronically from payroll data providers monthly for individuals who have given authorization and whose employers participate with the payroll data providers. PIE will improve payment accuracy, reduce improper payments, and reduce the reporting burden on individuals when they authorize us to obtain this information through an information exchange, and we receive it. We also anticipate that PIE will result in more efficient use of our limited administrative resources because it would reduce the amount of time our technicians spend manually requesting this information from payroll data providers and employers; manually entering data into our systems from an individual’s pay records; contacting individuals; and assisting individuals with the results of incomplete or untimely reporting.
In addition, we are promoting timely wage reporting and issuing reminders on reporting responsibilities. We will influence change where possible by simplifying communications and the way information is presented as our approach to reduce cognitive burden and improve understanding and readability.
We will continue our quality reviews and cost-effective program integrity work including medical continuing disability reviews.
Improper payments within the agency’s control are due to our failure to take timely and proper actions. To address these improper payments, we are investing in information technology modernization to provide our employees with user-friendly systems and tools to better serve the public, including a single unified process for benefit applications and a consolidated source with all information and agency interactions with our customers. To meet the challenges of our growing workloads and provide the best service possible, we are streamlining our policies and procedures, issuing reminders to technicians, and automating more of our business processes. We will continue to issue periodic reminders and policy clarifications, as needed.
There are some DI improper payments that have historically been caused by actions both outside of and within agency control. For example, the Social Security Act used to include two provisions – the Windfall Elimination Provision (WEP) and Government Pension Offset (GPO) – that reduced or offset Social Security monthly benefits to beneficiaries who receive a pension based on non-covered earnings. On January 5, 2025, the Social Security Fairness Act of 2023 was signed into law, thereby repealing WEP/GPO. December 2023 is the last month that WEP and GPO will apply. This means that those rules no longer apply to benefits payable for January 2024 and later. We anticipate the WEP/GPO repeal will significantly reduce and eventually eliminate WEP/GPO improper payments in future years.
| Payment type | Mitigation strategies taken | Mitigation strategies planned |
|---|---|---|
| Overpayments | Audit, Automation, Behavioral/Psych Influence, Change Process, Cross Enterprise Sharing, Predictive Analytics, Statutory Change, Training | Audit, Automation, Behavioral/Psych Influence, Change Process, Cross Enterprise Sharing, Predictive Analytics, Training |
| Underpayments | Audit, Automation, Behavioral/Psych Influence, Cross Enterprise Sharing, Predictive Analytics, Statutory Change, Training | Audit, Automation, Behavioral/Psych Influence, Cross Enterprise Sharing, Predictive Analytics, Training |
| Eligibility element/information needed | Description of the eligbility element/information |
|---|---|
| Age | The biological age of the recipient/beneficiary |
| Death | Date of death of the recipient/beneficiary |
| Employment | The employment status of the recipient/beneficiary |
| Household | Number of family members in a household |
| Military Status | The condition of being, or having been in the uniformed services |
| Receiving Benefits from Other Sources | Beneficiary or recipient is receiving benefits from an additional source |
Additional information
The annual sample in our Stewardship Reviews is sufficient to provide statistically reliable data on the overall payment accuracy. However, the annual sample does not provide statistically reliable information about individual deficiencies in a given year; therefore, we use an average of a 5-year period. The data call is based on fiscal year (FY) 2024 (single year) stewardship findings.
We issued $143.4 billion in Disability Insurance benefit payments in FY 2024; even the slightest error in the overall payment process can result in billions of dollars in improper payments. It is important to note that we maintain a high payment accuracy rate. As good stewards of our programs and as required by law, we continue our quality reviews, cost-effective program integrity work, and payment accuracy efforts to ensure individuals receive the benefits for which they are eligible.
Reduction target
0.4 %Internal Controls: We have a strong internal control environment that has always included controls over our benefit payment and debt management processes. Our existing internal control environment and assurance processes provide reasonable assurance that our internal controls over improper payments are in place and operating effectively.
As part of our internal control environment, we have a well-established, agency-wide management control program as required by the Federal Managers’ Financial Integrity Act.
We established the Improper Payments Oversight Board, consisting of senior executive membership, to ensure that we are focusing on improper payment prevention, formulating clear and innovative strategies, and driving timely results agency-wide.
Human Capital: Our program integrity work is labor-intensive and dependent on having the necessary trained staff to do the work. For the most part, our employees who handle our program integrity work also handle applications for benefits and other mission-critical work. Sustained, sufficient funding is critical to maintain the workforce necessary to balance our service and stewardship work.
Information Systems: Our staff rely on our information technology (IT) infrastructure to serve the public and safeguard our programs. Our technology modernization investments focus on simple, seamless, and secure service by delivering customer-centric digital capabilities with human-centered design, business intelligence, and mobile accessible platforms. We plan on continuing to implement new digital services that focus on enhancing the customer experience and removing barriers to service to meet the needs and preferences of our customers, partners, and employees. We are prioritizing self-service options to improve customer service while reducing manual work completed by frontline staff. Sustained, sufficient funding is necessary to continue to modernize our IT.
Other Infrastructure: Cybersecurity is vital to protecting the personally identifiable information of everyone we serve. Maintaining the public’s trust in our ability to protect sensitive data housed in our systems requires advanced cybersecurity controls, constant assessment of the threat landscape, and continual improvements and enhancements of our cybersecurity program. Our cybersecurity program uses a risk-based approach to balance protection and productivity and focuses on continuous improvement. We are expanding our cybersecurity program in support of Executive Order 14028, Improving the Nation’s Cybersecurity, and Office of Management and Budget Memorandum 22-09, Moving the U.S. Government Toward Zero Trust Cybersecurity Principles. In addition, we are strengthening our digital identity processes to comply with the Creating Advanced Streamlined Electronic Services for Constituents Act.
Our cybersecurity efforts help us to maintain our vigilance and protect against network intrusions and improper access of data by strengthening our defensive cyber capabilities, sharing cyber threat information with our Federal and industry partners, and moving toward a Zero Trust Architecture that focuses on the secure flow of information from the network perimeter across the enterprise.
The Fiscal Year 2026 President’s Budget included resources for internal controls to prevent improper payments. As part of our stewardship responsibilities and our efforts to reduce improper payments, we also requested $2.397 billion in dedicated funding for program integrity activities. Many of the tools we use, such as our medical Continuing Disability Reviews, Supplemental Security Income redeterminations, and the Cooperative Disability Investigations program, save billions of program dollars with a proportionally small investment of administrative resources.
We are committed to being good stewards of taxpayer dollars and ensuring the public has confidence that we manage their tax dollars wisely. We demonstrate a commitment to sound management practices. To ensure stewardship and the efficient administration of our programs, we have established performance measures in our Annual Performance Plan for fiscal years (FY) 2025–2026 to track our progress. Under the third focus area, “Fight Fraud and Waste,” there are two performance measures directly related to reduction of improper payments: Improve the integrity of the Supplemental Security Income program by focusing our efforts on reducing overpayments; and Maintain a high payment accuracy rate by reducing overpayments in the Old-Age, Survivors, and Disability Insurance (OASDI) program.
We hold managers, program officials, and senior executives accountable for reducing improper payments. These employees’ annual performance plans reflect their responsibility to support efforts to maintain sufficient internal controls to prevent, detect, and recover improper payments and meet targets to reduce improper payments. In FY 2025, we revised the Manages Performance element to incorporate “Holding Employees Accountable” as a requirement for all managers and supervisors. To achieve a successful performance rating, managers and supervisors must now meet this standard.
We assess managers throughout the agency on these standards each year and hold them accountable for meeting improper payment reduction targets. Each agency department adds expectations that are more detailed for their positions describing what is expected for meeting these performance standards.
If management or employees do not meet established performance expectations, they may be placed on an Opportunity to Perform Successfully. Failure to demonstrate improvement may result in an unsuccessful performance rating, which could lead to demotion or removal from Federal service.
Senior Executive performance plans must clearly align with organizational goals and objectives under the Results Driven Critical Element. Performance levels in the performance requirements must reflect agency targets.
We established the Improper Payments Oversight Board (IPOB), consisting of senior executive membership, to ensure that we are focusing on improper payment prevention, formulating clear and innovative strategies, and driving timely results agency-wide. The Chief Risk Officer or their designee serves as the executive chair for the IPOB. To further our focus on reducing improper payments, in FY 2019, we established an Improper Payments Prevention Team, now the Improper Payments team. The team worked with key agency stakeholders to develop Improper Payments Alignment Strategies (IPAS) that outline innovative and effective strategies to mitigate the root causes of improper payments. As part of our IPAS, we evaluated the effectiveness of each planned or ongoing mitigation initiative. We will continue pursuing cost-effective strategies to remediate the underlying causes of payment errors and monitor, measure, and revise the strategies, as needed. IPOB is responsible for reviewing, approving, and implementing all improper payment initiatives.
We have a strong internal control environment that has always included controls over our benefit payment and debt management processes. We directly leverage our existing internal control environment and assurance processes to provide reasonable assurance that our internal controls over improper payments are in place and operating effectively.
As part of our internal control environment, we have a well-established, agency-wide management control program as required by the Federal Managers’ Financial Integrity Act.
The effective internal controls we incorporate into our business processes and financial management systems, as well as the program integrity efforts, support our Commissioner’s annual assurance statement to the President and Congress.
In April 2019, we established the Enterprise Fraud Risk Management (EFRM) program to systematically assess fraud risks across our major programmatic and administrative areas. Through our EFRM program we have conducted multiple fraud risk assessments on key areas such as Disability, Electronic Services, Administrative Services, and the Representative Payee program. After each fraud risk assessment, our senior executives review each fraud risk and determine whether our controls are effective or whether we need to develop additional controls to further reduce the risk. For each risk designated as “reduce” by our executives, we develop additional mitigation strategies to further prevent or detect the fraud. The risk response and the designated mitigation strategies form the basis of the fraud risk profile for each fraud area.
We completed a maintenance fraud risk assessment of agency’s Administrative Services during FY 2024 and continued the reassessment of the disability fraud risk profile, consistent with the Government Accountability Office guidance, to reassess fraud risk profiles on a three-year cycle. We also finalized the Fraud Risk Profiles for the Enumeration program at the end of calendar year 2023.
For recovery of overpayments, in March 2025, we resumed use of the Treasury Offset Program (TOP) after suspending it in March 2020 because of the effects of the COVID-19 pandemic. From March-September 2025, we collected approximately $60 million from those who were notified of TOP debt referral prior to program suspension. We resumed sending pre-offset notices for all debt incurred after March 2020, beginning in August 2025.
We changed the benefit withholding rate for OASDI overpayments to 50 percent. Beginning April 25, 2025, we informed overpaid individuals that we will begin recovering their overpayment by withholding 50 percent of their benefit amount. This rate replaces the previous benefit withholding rate of 10 percent that was implemented on March 25, 2024. If an individual was notified of an overpayment prior to April 25, 2025, they will retain the 10 percent withholding rate unless we notify them of a new overpayment. There will be limited exceptions to this change, such as when an overpayment resulted from fraud.