General Fraud

The SIU submits a referral to initiate an overpayment and overissuance claim as follows:

 

  • If the SIU discovers income verification for a year or less during its investigation, this information is sent to the currently assigned EW to assess any potential overpayment and/or overissuance and to establish an OP/OI claim.
  • If the SIU discovers income verification on a closed case or for a period longer than one year, it is referred to the IEVS unit to establish OP/OI claims. 

Reminder: General Frauds must be completed within 30 days from the date the referral was received from the Special Investigations Unit (SIU).

 

This subsection describes the procedures for handling General Fraud referrals received from the SIU.

Step Who Action
1 SIU
  • Completes SSA SIU Welfare Fraud Report & SIU Welfare Fraud Request for OP/OI Computaion (includes all supporting documentation).
  • Emails to IEVS.VerificationDesk@ssa.sccgov.org.
2 IEVS Clerical 
  • Receives a referral
  • Enters a General Fraud (GF) case in SCCIEVS and a GF efolder in OneDrive
  • Assigns case to EE based on language via round robin assignment.
3 EE
  • Receives assignment in SCCIEVS as eFolder from the clerical staff.
  • Determines if additional verifications are needed.
  • If verification is:
    • Incomplete, then EE:
      • Emails the investigator the list of missing verifications, due date, and copies the SIU and IEVS Supervisor.
      • Updates case status to Pending Verification in SCCIEVS.
      • REMINDER: If required verification is not received within 30 days, the working folder must be submitted to the EE lead/Supervisor for follow-up with the SIU supervisor.
    • Complete, then EE:
4 IEVS Supervisor
  • Reviews the completed GF case in the Supervisor Folder in OneDrive 
  • If the case is correct, moves the case folder to the Clerical Folder called "Special Completed" for clerical to upload to CalSAWS.

  • Note: Removes the copy of the SSA SIU Welfare Fraud Report (DEBS/IMG 574) from the completed eFolder before moving to the Clerical Folder. 

  • If the case is incorrect, returns the case to EE for corrections and updates the case status to Return to EE in SCCIEVS.
  Clerical
  • Receives completed eFolder in OneDrive 
  • Uploads to CalSAWS.
  IEVS Supervisor
  • Emails a copy of the completed GF case files to the requesting investigator and SIU Supervisor.