SSA's Disability Programs:

Improvements Could Increase the Usefulness of Electronic Data for Program Oversight

GAO-05-100R: Published: Dec 10, 2004. Publicly Released: Dec 10, 2004.

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In 2003, we added the federal government's disability programs to our high-risk list in part because of difficulties agencies faced in managing these programs and the expected growth in the rolls as baby boomers reach their disability-prone years. The Social Security Administration (SSA) manages the federal government's two largest disability programs, the Disability Insurance (DI) program and the Supplemental Security Income (SSI) program, which together paid out $91 billion in federal benefits to 11.4 million individuals with disabilities in 2003. To help address management difficulties and prepare for expected growth in the rolls, SSA must have reliable administrative data from its disability decision-making process to adequately understand the population it serves and the possible effect of proposed program changes on this population. However, in a prior study, we identified potential problems with the reliability of SSA's electronic administrative data. This report examines (1) the extent to which SSA collects useful and reliable electronic administrative data in order to effectively manage its DI and SSI programs and (2) whether ongoing and planned changes to SSA's computer systems and internal controls will address any weaknesses that we identified.

While most types of information collected by SSA are useful for program management purposes, the agency lacks sufficient internal controls to ensure that these data are reliable. In its electronic records, SSA collects information related to the claimant, process, and decision--all of which are important for informing aspects of program management. However, SSA does not collect some information that would enhance program oversight. At the same time, SSA collects other information in its electronic disability record that the agency considers of limited value. Although the types of information SSA collects in its electronic records generally contribute to the management of the disability programs, the accuracy of the records is unknown. In addition, inadequate data entry controls have resulted in missing data for some information, such as the claimant's educational level, which is a critical factor in the disability decision and is therefore important in a study of the disability decision-making process. Most important, because SSA's policy does not require that the electronic record be verified against the information in the case file, the agency does not know the extent to which codes that appear valid reflect the claimant's actual information, such as the claimant's actual impairment or education level. While SSA's ongoing and planned changes to computer systems and internal controls may reduce the chance for some inaccuracies, SSA's plans do not provide adequate assurance of the accuracy of its electronic administrative data. SSA's ongoing transition from a paper-based disability system to an electronic one should reduce some of the inaccuracies we identified by limiting the amount of data re-entered at various levels in the process. However, SSA's planned changes will not address data entry problems found by GAO that could be prevented with additional data entry controls. SSA's current plans also do not include an internal control strategy for ensuring that electronic data match the information in the case file, nor do they provide for corrective action when inaccuracies are found. Finally, although SSA has proposed far-reaching changes to its disability decision-making process and is currently reassessing the processes for ensuring the quality of its disability decisions, the agency has not yet made any plans for evaluating the types of information it currently collects and whether other types of information would improve program management and oversight.

Status Legend:

More Info
  • 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: To improve the value of SSA's electronic administrative data for managing its disability programs, the Commissioner of Social Security should develop a comprehensive strategic plan to ensure the reliability and usefulness of the data the agency collects. In doing so, the agency should establish a cost-effective internal control strategy for ensuring the reliability of data in the electronic disability records that would include both front-end controls on data entry and a tracking and feedback system for back-end verification of the electronic records.

    Agency Affected: Social Security Administration

    Status: Closed - Implemented

    Comments: SSA's Strategic Plan explains that the 54 unique case processing systems currently used by the Disability Determination Services (DDS) is being replaced with a common case processing system. One of the goals of the business process modeling currently taking place is to identify SSA's future data needs. The resulting system will minimize repeated data inputs that lead to erroneous data, and make extensive use of health information technology to capture detailed information about beneficiaries' medical histories that is not available today. In addition, SSA is fully engaged in the development of the Health Information Technology (HIT) initiative, led by Department of Health and Human Services (DHHS), in collaboration with other agencies, health care providers, and insurers. The initiative will create uniform diagnostic codes, medical report formats, and other data fields for standardized electronic storage of medical records. This will allow SSA to identify disabling conditions quickly and automatically, and to search its vast database of medical records to track trends in disability cases and design more objective methods to identify disabling conditions.

    Recommendation: To improve the value of SSA's electronic administrative data for managing its disability programs, the Commissioner of Social Security should develop a comprehensive strategic plan to ensure the reliability and usefulness of the data the agency collects. In doing so, the agency should take steps to review the usefulness of the types of information collected and consider whether additional types of information could improve program oversight. This effort could include a survey of users of electronic disability data.

    Agency Affected: Social Security Administration

    Status: Closed - Implemented

    Comments: SSA's Strategic Plan explains that the 54 unique case processing systems currently used by the Disability Determination Services (DDS) will soon be replaced with a common case processing system. One of the goals of the business process modeling currently taking place is to identify SSA's future data needs. The resulting system will minimize repeated data inputs that lead to erroneous data, and make extensive use of health information technology to capture detailed information about beneficiaries' medical histories that is not available today. In addition, SSA is fully engaged in the development of the Health Information Technology (HIT) initiative, led by the Department of Health and Human Services (DHHS), is expected to revolutionize the health care industry. SSA is collaborating with other agencies, health care providers, and insurers to create uniform diagnostic codes, medical report formats, and other data fields for standardized electronic storage of medical records. This will allow SSA to identify disabling conditions quickly and automatically, and to search its vast database of medical records to track trends in disability cases and design more objective methods to identify disabling conditions.

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