Social Security

The number of children receiving Supplemental Security Income disability benefits has more than doubled during the last four years. Although much of the attention has focused on the Sullivan v. Zebley Supreme Court decision as the cause of this growth--that decision made the Social Security Administration's disability criteria for children less restrictive--GAO found that most of the children who received new awards would have qualified for them even without the functional assessment process mandated by the Zebley decision. Huge increases in the number of children awarded benefits because of mental impairments account for more than two-thirds of the growth in awards. Most awards to the mentally impaired go to mentally retarded children. Although the portion of mental awards to children with "behavior problems," such as attention deficit hyperactivity disorder, personality disorders, and autism, is growing, it is still relatively small. From February 1991 through 1993, children with "behavior problems" have received 22 percent of awards made to children with mental impairments.

GAO found that: (1) in the last 4 years, the number of children receiving SSI benefits more than doubled after the Social Security Administration changed the eligibility criteria for benefits; (2) the new regulations place more emphasis on how children's mental and functional impairments limit their ability to act appropriately for their age; (3) 70 percent of children receive benefits under strict SSI medical standards; (4) the new functional assessment process has accounted for only about 30 percent of all SSI awards since its implementation and for 41 percent of the increase in SSI awards; (5) more than two-thirds of the increase in SSI awards is due to the qualifying mental impairments of children, predominantly mental retardation; and (6) SSI benefits for behavior problems such as attention deficit hyperactivity disorder, personality disorders, and pervasive developmental disorders are increasing.