Social Security Disability:

SSA Needs to Improve Continuing Disability Review Program

HRD-93-109: Published: Jul 8, 1993. Publicly Released: Jul 8, 1993.

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Pursuant to a congressional request, GAO reviewed the Social Security Administration's (SSA) continuing disability reviews (CDR) of disability beneficiaries, focusing on: (1) the number of CDR required by law and the number conducted by SSA since 1987; (2) the cost to the Disability Insurance Trust Fund of not conducting all of the required reviews; and (3) SSA initiatives to improve the CDR process.

GAO found that: (1) SSA did not perform enough CDR to meet statutory requirements in fiscal year (FY) 1987 through FY 1992 and, as a result, 1.1 million cases are past due; (2) the decision to perform fewer CDR than required costs the fund hundreds of millions of dollars while program integrity diminishes as ineligible beneficiaries continue to receive benefits; (3) in FY 1991, SSA revised its medical criteria for scheduling CDR to be more selective about which beneficiaries received CDR; and (4) SSA plans to perform too few CDR in FY 1993 and in each of the next several years.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: The 103rd Congress mandated that SSA conduct at least 100,000 CDRs in the SSI Program,and the 104th Congress increased the amounts authorized for CDRs in both the SSI and DI programs through FY 2002. In response to the congressional mandate, SSA dramatically increased the number of full SSI CDRs in FY 1996; the number done in FY 1996 exceeds the total of all SSI CDRs done in FY 1991 through FY 1995. The number of DI CDRs has also increased. Further, SSA has plans to conduct over 8 million CDRs between FY 1996 and 2002, which is twice as many CDRs as the agency has conducted over the past 20 years combined.

    Recommendation: The Commissioner of Social Security should continue to examine ways to increase the number of CDR beyond planned levels.

    Agency Affected: Social Security Administration

  2. Status: Closed - Implemented

    Comments: SSA has improved the process for identifying which beneficiaries should undergo full CDRs and has planned improvements over the next 2 years that will further increase its ability to identify beneficiaries who should undergo a full CDR. Also, SSA has plans to conduct over 8 million CDRs between FY 1996 and 2002, which is twice as many CDRs as the agency has conducted over the past 20 years combined. However, SSA continues to have a backlog of about 4.3 million CDRs due or overdue for review. In addition, the agency has new CDR requirements imposed by the recent Welfare Reform Act (Personal Responsibility and Work Opportunity Reconciliation Act of 1996). For example, the law requires SSA to do full CDRs on all children on the SSI program every three years. GAO will monitor SSA's future progress in this regard as part of ongoing and future work.

    Recommendation: The Commissioner of Social Security should continue to examine ways to improve the CDR process so as to make optimal use of SSA resources. As more experience with the mailer process is gained, the Commissioner should monitor the results and make adjustments in CDR case-selection criteria to achieve the most effective resource utilization.

    Agency Affected: Social Security Administration

 

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