Measures to control fraud and abuse include desk reviews of claim papers, home visits, the issue of mail-shots to selected customers, database checking, medical reviews in the case of illness payments.
Controls are exercised at both the initial claim stage and at subsequent stages during the claim life cycle. Claims are reviewed on a regular and targeted basis. Means tested payments are reviewed at certain intervals or when there are indications that changes in circumstances have not been reported to the Department. Those in receipt of illness payments are called for a medical examination by the Department's medical assessors.
Customers in receipt of unemployment payments are checked on an ongoing basis to verify continued compliance with such requirements as being available for and genuinely seeking employment.
The Social Welfare Act, 2010 provided "penalty rates of payment" or a reduction in Jobseeker's Benefit, Jobseeker's Allowance and Supplementary Welfare Allowance where a person has, without good cause:
- refused to participate or to agree to participate in a course of training which is considered appropriate; or
- failed to avail of any reasonable offer of training provided or approved of by FAS; or
- refused or failed to avail of an opportunity of participating in the National Employment Action Plan, a programme administered by FAS.
These measures are being invoked since early in 2011.
In addition to control measures, the Department seeks to activate customers off social welfare dependency by way of a range of measures and options. For example, the Back to Work Enterprise Allowance is designed to encourage the long-term unemployed on a social welfare payment to develop a business while allowing them to retain a reducing proportion of their qualifying social welfare payment, plus they may retain secondary benefits, over two years. The Back to Education Allowance is a scheme which encourages and facilitates people on certain social welfare payments to improve their skills and qualifications and, therefore, their prospects of returning to the active work force. Under the employer job PRSI incentive scheme, if an employer takes on an additional member of staff, who had been unemployed for 6 months or more, s/he would be exempt from paying employers' PRSI for 12 months, provided the job is new and additional, for at least 30 hours a week and to last for at least six months.
The Employment Action Plan (EAP), operated jointly by the Department of Social Protection and FAS, is the main welfare to work measure under which all persons between the ages of 18 and 65 years who are approaching 3 months on the Live Register are identified by the Department and referred to FAS for interview with a view to assisting them to enter/ re-enter the labour market. The EAP process complements the Department's control processes in that recipients of Jobseeker payments who refuse or fail to attend for interview have their entitlement to benefit reviewed. Recent legislation, as outlined above, specifies that recipients of Jobseeker payments who, without good cause, refuse to participate in a course of training or other interventions arranged by DSP/FAS will have their payments reduced. These measures will have the advantage of keeping unemployed persons close to the labour market, as well as reinforcing existing control activity.
To address the prevention and detection of social welfare fraud the following actions will be undertaken:
- Reviews of entitlement: These will be systematically undertaken across all social welfare schemes having regard to the level of fraud risk associated with each scheme. The emphasis will be on targeting home visits by investigators and comprehensive face-to-face interviews of persons suspected of fraudulent activity.
- Identity and Payment Checks: Claimants for Jobseeker's payments are now exclusively paid through post offices. This requires them to attend the post office each week thus confirming their residency in the country. Photographic identification is also required when collecting payments at the post office.
- Direct Mailshots: The Department will supplement reviews of entitlement by the frequent use of direct mailshots to validate with customers that the conditions for receipt of benefits, allowances and child related payments are met. In addition they will also serve to heighten fraud awareness. In instances where the customer fails to respond, payments will be suspended or forwarded for investigation.
- Medical Eligibility Assessments: In the case of persons receiving illness and disability payments, recipients will be reviewed on a systematic basis through personal medical assessments and case reviews to ensure that the medical aspect of their entitlement is still fulfilled.
- Non-Residency: Residency checks on social welfare claims will be systematically undertaken nationwide by Departmental Inspectors in order to determine whether residency status is fulfilled.
- Reporting of Social Welfare Fraud: Good citizen reports of suspected fraudulent social welfare claims can be made by calling (01) 704 3000 and asking for Central Control Section. Alternatively, there is an on-line facility for members of the public to report their suspicions of social welfare fraud on www.welfare.ie. Members of the public are asked to provide as much detail about the case they are reporting as possible and with these facilities they can do so totally anonymously.
- Data Matching: The Department has, in the last number of years, been engaged in comprehensive data matching with other Government Departments and public bodies for fraud control purposes. Data matching is viewed as a very efficient and effective mechanism to target control-related activity. The Department will continue to proactively match data with agencies and enhance the range of data it uses to uncover and detect social welfare fraud. Examples of data matching to date for control purposes include: Prison Service, commencement of employment notifications and earnings data from Revenue, Third Level College students and the Commission on Taxi Regulation.
- Fraud and Error Surveys: Fraud and error surveys are an integral part of the Department's Control Plan. Fraud and error surveys provide the Department with an indicator of the estimated risk of the schemes surveyed to enable the Department to enhance procedures and processes to build control across the relevant schemes. The Department will establish the risk and exposure of fraud and error within its schemes by conducting fraud and error surveys at regular intervals.
- Employer Inspections: The Department will undertake a programme of employer inspections to ensure that accurate records of employees are kept; the correct class of PRSI is being deducted and remitted, employees are not concurrently working and claiming social welfare payments. In addition, they ensure that employers are aware of their responsibilities with regard to social welfare and tax legislation and incentives available to employers. There will be a re-emphasis towards on site inspections to increase a visible Departmental presence across those sectors of the economy where social welfare fraud is prevalent.
- Activation & Control Teams: As part of this plan and in order to ensure an integrated approach to fraud control, Activation & Control Teams will be established across the Department's Regional network in each Local Office area. These control teams will be comprised of Social Welfare Inspectors, Special Investigation Unit staff, Community Welfare Officers, FAS and Social Welfare Local Office staff. They will help to ensure that all control activities, established and new, are being vigorously applied and augment them with targeted specific approaches based on local knowledge and circumstances.