Social Security

The administration of the Social Security Administration's (SSA) disability programs has reached a crisis stage; service is poor and billions of dollars in payments will end up going to ineligible persons unless mandated continuing disability reviews are resumed. Claim backlogs and processing times for SSA's disability insurance and supplemental security income programs hit an all-time high in fiscal year 1992. The two programs have been unable to keep up with the high rate of claims for benefits, a trend that has continued into fiscal year 1993. Processing times have increased nearly 50 percent in recent years, and some states take more than five months to process claims. SSA has undertaken many short-term initiatives to keep up with claims--most significantly, the funding of overtime for disability determination services. According to administrators, staff are overworked and overtime is at record levels. SSA has also diverted staff from doing continuing disability reviews to processing initial claims. As a result, many ineligible persons are receiving program benefits at a cost of at least $1.4 billion. These short-term initiatives have only slightly reduced pending claims and processing times. SSA also has several long-term initiatives under way to improve its disability programs; exactly how, when, and to what extent these initiatives will improve service is unknown at this point, however.

GAO found that: (1) between 1990 and 1992, claims backlogs and processing times for Disability Insurance and Supplemental Security Income benefits increased nearly 50 percent; (2) SSA and DDS have not been able to keep up with the increase in benefit claims; (3) DDS tend to have the poorest processing performance in the more populous states; (4) problems resulting from increased workloads include increased workforce stress and use of overtime, employees not performing their normal duties, a decline in workforce morale, an increase in claims being set aside, and a decline in automated systems support; (5) SSA has initiated short-term initiatives to keep up with claims processing that include funding additional DDS overtime, reallocating resources from continuing disability reviews (CDR) to initial claim processing, and reducing the number of pending claims; (6) SSA has estimated that discontinuing CDR will cost at least $1.4 billion because ineligible individuals will continue to receive benefits; (7) although SSA has developed numerous short- and long-term initiatives, the effectiveness of these initiatives could not be determined; and (8) the Secretary of Health and Human Services needs to develop a plan to reduce benefit claims backlogs and resume mandated CDR.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

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