Social Security

The Social Security Administration's (SSA) new process for conducting continuing disability reviews relies on computer profiling and beneficiary self-reported data. Beneficiary self-reported data, when used with other key information SSA has, appear reliable for making decisions about when to do full medical examinations of beneficiaries scheduled for reviews. SSA has also taken steps to further assess the reliability of the self-reported data and plans to continually refine its use of computerized beneficiary data to better predict medical improvements and likely benefit terminations. The mailer process appears to be a significant step by SSA to make the review process more efficient and cost-effective, with the process being substantially less costly than SSA's previous review process. SSA needs to send out more mailers and conduct more full medical reviews of program beneficiaries. As SSA gains more experience with the mailer process and improves its ability to accurately identify beneficiaries with the greatest potential for medical improvement, it should do more full medical reviews of those persons to achieve the most effective use of agency resources. By focusing on beneficiaries with the greatest likelihood of improvement, SSA can save taxpayers millions of dollars each year and help preserve the programs' integrity by removing ineligible persons from the rolls.

GAO found that: (1) the previous CDR process was labor-intensive but cost-effective, despite a 94-percent continuing eligibility rate; (2) in recent years, SSA has reduced the number of CDR because of a large increase in new applicants and budget constraints; (3) SSA experience with the new CDR process has shown that beneficiary self-reported data are reliable when used with other key SSA information; (4) SSA has established reasonable procedures for determining when to do full medical examinations; (5) SSA is taking further steps to assess the reliability of self-reported data and will continue to refine its use of computerized beneficiary data to predict medical improvement and benefit terminations; (6) the mailer process costs $23.50 per case versus the average $1,000 cost of full medical CDR; (7) SSA continues to fall short of the number of CDR required by law; and (8) SSA could save the disability trust fund millions of dollars annually and preserve the program's integrity by removing ineligible beneficiaries.

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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