Social Security Administration's Program for Reviewing the Disability of Persons with Mental Impairments

GAO discussed the Social Security Administration's (SSA) process for determining whether persons with mental impairments qualify for disability under the two SSA disability programs. The adjudicative process is carried out by the States according to SSA guidelines and instructions. GAO found that, although the adjudicative process needs to be more critical of individual's problems, many of the individuals whose benefits have been terminated have little or no capacity to function in a competitive work environment due to the severity of their impairments. Weaknesses in the adjudicative process which lead to premature or unfair terminations include: (1) an overly restrictive interpretation of the criteria to meet SSA medical listings, resulting principally from narrow assessments of individuals' daily activities; (2) inadequate development and consideration of a person's residual functional capacity and vocational characteristics; (3) inadequate development and use of existing medical evidence, resulting in an overreliance and misuse of consultations; and (4) insufficient psychiatric resources in most State services. GAO concluded that there is a shortage of in-house psychiatric medical staff available for advice within the SSA and the State adjudicative system.