Social Security Administration's Program for Reviewing the Continuing Eligibility of Disabled Persons

GAO discussed the Social Security Administration's (SSA) efforts over the past 2 years in reexamining the continued eligibility of persons on the disability rolls. These reexaminations are referred to as continuing disability investigations (CDI's). SSA has taken several initiatives over the past year to improve the review process, and the Secretary of Health and Human Services recently announced a major reform package to improve the process for the mentally impaired as well. In a prior report, GAO stated that SSA had not adequately followed up to verify that disability insurance beneficiaries remained disabled. Congressional concern over medical reexaminations and other inadequate review procedures led to the enactment of the Social Security Disability Amendments of 1980. GAO found several weaknesses in the SSA and the States' disability determination services (DDS's) adjudicative policies and practices. Specific weaknesses were: (1) an overly restrictive interpretation of the criteria to meet SSA medical listings; (2) inadequate development and consideration of a person's residual functional capacity and vocational characteristics; (3) inadequate development and use of existing medical evidence; and (4) insufficient psychiatric resources in most State DDS's. An important policy question confronting SSA and Congress is whether there should be a medical improvement requirement to terminate beneficiaries who are already on the disability rolls. Currently, CDI cases are treated as though they are initial applications; however, from 1969 to 1976 SSA operated under the principle that termination from the disability rolls had to be based upon demonstrated medical improvement. GAO continues to believe that the issue of a medical improvement standard should be addressed by Congress.