Social Security Disability

The Social Security Administration (SSA) is required to conduct periodic examinations, called continuing disability reviews, to determine whether the health of a person receiving disability benefits has improved to the point where the person is no longer considered disabled. Together, the disability insurance and the supplemental security income programs pay about $60 billion annually to 9 million disabled beneficiaries; another 1.6 million nondisabled dependents of beneficiaries also receive benefits. GAO's analysis of persons awaiting such reviews supports SSA's contention that there is little chance that a large proportion of beneficiaries will show enough medical improvement to no longer be considered disabled. As a result, if SSA is to decrease long-term reliance on these programs as the primary source of income for the severely impaired, it will need to rely less on assessing medical improvement and more on return-to-work programs to better gauge the potential for self-sufficiency. GAO believes that a more cost-effective approach to conducting reviews might involve (1) focusing on beneficiaries with the greatest likelihood of benefit termination because of medical improvement, (2) reviewing a random sample of all other beneficiaries to correct a weakness in SSA's process, and (3) contacting beneficiaries not selected for a review or a financial eligibility redetermination to strengthen program integrity.

GAO found that: (1) almost half of all DI and SSI beneficiaries are due or overdue for CDR in fiscal year 1996; (2) the typical beneficiary awaiting CDR is under age 59, has been receiving benefits for an average of 8 years, is unlikely to medically improve, and has been overdue for CDR for 3 years; (3) SSA uses either a full medical examination or a mail-in form to conduct CDR, depending on the likelihood that it will find reason to terminate a recipient's benefits; (4) it is too soon to tell if authorized funding will be adequate to conduct all required CDR through 2002; (5) the SSA plan to conduct over 8 million CDR over 7 years is ambitious; and (6) SSA could improve the CDR process by reviewing beneficiaries most likely to medically improve, conducting CDR on a random sample from all other beneficiaries, and using CDR contact to determine beneficiaries' rehabilitation needs.

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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