SSA Disability:

Enhanced Procedures and Guidance Could Improve Service and Reduce Overpayments to Concurrent Beneficiaries

GAO-02-802: Published: Sep 5, 2002. Publicly Released: Sep 5, 2002.

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In calendar year 2001, the Social Security Administration (SSA) paid cash benefits of $60 billion to more than six million working-age adults with disabilities and eligible family members under its Social Security Disability Insurance (DI) program, and $20 billion to more than 3.5 million working-age adults with disabilities under the Supplemental Security Income (SSI) program. Some beneficiaries, known as concurrent beneficiaries, receive cash and medical benefits from both programs. Concurrent beneficiaries comprised about 14 percent of SSA's disability population; 58 percent have mental impairments, and about 53 percent are female. Eleven percent of concurrent beneficiaries worked and earned a median income of approximately $250 per month. There is little coordination between SSI and DI program rules for individuals who work and receive benefits from both programs concurrently. Because most field office staff specialize in one program, they may not be sufficiently knowledgeable of the procedures for the other program to ensure that concurrent beneficiaries who work are paid the appropriate benefit amount under both programs. Applying both SSI and DI program rules to concurrent beneficiaries may make it difficult for them to make informed decisions about attempting work and could result in an increase or decrease in overall income, depending on the amount of earnings. Concurrent beneficiaries may not receive adequate explanations from SSA staff or published materials about the complete effect work has on their disability benefits. However, because the rules are complex and may be difficult to understand even with a detailed explanation, beneficiaries who do not understand them could possibly make decisions about work that would not meet their needs or improve their situation.

Status Legend:

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  • Review Pending-GAO has not yet assessed implementation status.
  • Open-Actions to satisfy the intent of the recommendation have not been taken or are being planned, or actions that partially satisfy the intent of the recommendation have been taken.
  • Closed-implemented-Actions that satisfy the intent of the recommendation have been taken.
  • Closed-not implemented-While the intent of the recommendation has not been satisfied, time or circumstances have rendered the recommendation invalid.
    • Review Pending
    • Open
    • Closed - implemented
    • Closed - not implemented

    Recommendations for Executive Action

    Recommendation: SSA needs to undertake the necessary steps to ensure it adequately serves concurrent beneficiaries and exercises its stewardship over program funds by avoiding overpayments. The Commissioner of SSA should develop procedures and integrated guidance to ensure information about work activity is collected and shared between the DI and SSI programs. One option would be to improve the cross-references used in its program guidance to more specifically target needed information to take actions to adjust benefits for both programs. Another option would be to require that some staff are knowledgeable about both programs and that they collect and act on work activity information for both programs. Regardless of the option selected, SSA should also consider adding to its guidance explanations and examples of the effect of work activity for individuals receiving both DI and SSI benefits.

    Agency Affected: Social Security Administration

    Status: Closed - Implemented

    Comments: SSA developed training to enhance field office employees' technical proficiency in both programs. The agency also developed and refined Modernized Return to Work (MRTW) software to provide improved cross-references between the two programs. For example, the MRTW system actually prints referral forms for SSI and DI that can be routed to the appropriate person specializing in the other program.

    Recommendation: SSA needs to undertake the necessary steps to ensure it adequately serves concurrent beneficiaries and exercises its stewardship over program funds by avoiding overpayments. The Commissioner of SSA should develop comprehensive systems to monitor the progress of DI cases as they move between SSA components and set timeliness goals for the entire process for each action and component. In addition, the Commissioner of SSA should use this information to help ensure timely actions and minimize overpayments of DI benefits when individuals return to work.

    Agency Affected: Social Security Administration

    Status: Closed - Implemented

    Comments: SSA developed the Disability Control File, in part, to provide a comprehensive system that monitors the progress of Social Security disability insurance cases as they move among SSA components. Although the system released in 2002 had limited functionality in that it was a series of location-specific databases, SSA has since converted this database from location-specific systems to a comprehensive one that allows access by SSA employees nationwide. Several additional enhancements to this system were made in 2005. In addition, SSA's Inspector General (IG) began auditing the system in July 2005 to determine its effectiveness, allowing SSA to help ensure timely actions and prevent overpayments. The final report from the IG was issued March 2006 and recommended several enhancements to the system. SSA agreed with all of the IG recommendations and, according to SSA's responses, are in the process of developing the enhancements into their computer system.

    Recommendation: SSA needs to undertake the necessary steps to ensure it adequately serves concurrent beneficiaries and exercises its stewardship over program funds by avoiding overpayments. The Commissioner of SSA should develop public information materials targeted to concurrent beneficiaries that explain the complex interaction of the two programs in language that beneficiaries can understand. SSA may wish to consider revising its publication, Working While Disabled--How We Can Help, to include a basic explanation of the effects of work when an individual receives both DI and SSI benefits and examples that illustrate these effects. For more detailed explanations, SSA could direct beneficiaries to contact an SSA representative knowledgeable of both programs.

    Agency Affected: Social Security Administration

    Status: Closed - Implemented

    Comments: SSA revised its 2003 and 2004 publications of "Red Book: A Summary Guide to Employment Support for Individuals with Disabilities" under the Social Security Disability Insurance and Supplemental Security Income Programs to include a discussion of the effects of work when an individual receives both types of benefits. These revisions include an extended six-page example of the effects of work activity on each type of benefit for a hypothetical beneficiary.

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