Social Security Disability

The Social Security Administration's (SSA) disability insurance and supplemental security income programs paid $60 billion in benefits in 1995 and served nearly 7 million working-age adults. SSA has been overwhelmed by a large number of appealed cases, which grew from 225,000 in fiscal year 1986 to 498,000 in fiscal year 1996. SSA has developed broad-based plans to improve the management of its disability programs, but it is too soon to know how successful these efforts will be. SSA has tried to deal with the backlog crisis, but it is still about 116,000 cases over its December 1996 goal of 375,000 cases. In the long term, SSA needs to come to grips with the systemic factors causing inconsistent decisions, which underlie the current high level of appealed cases and, in turn, the backlog crisis. Differences in assessments of functional capacity, different procedures, and weaknesses in quality reviews contribute to inconsistent decisions. Although SSA is on the verge of launching initiatives to deal with these factors, GAO is concerned that other congressionally mandated tasks, such as increasing the number of continuing disability reviews and readjudicating childhood cases, could jeopardize the agency's ability to reduce inconsistent decisions.

GAO noted that: (1) GAO's work shows that while SSA has developed broad-based plans to improve the management of its disability programs, many initiatives are just beginning and their effectiveness can be assessed only after a period of full-scale implementation; (2) for example, in the short term, SSA has taken action to try to deal with the backlog crisis, but it is still about 116,000 cases over its December 1996 goal of 375,000 cases; (3) in the longer term, SSA needs to come to grips with the systemic factors causing inconsistent decisions, which underlie the current high level of appealed cases and, in turn, the backlog crisis; (4) for example, GAO found that differences in assessments of functional capacity, different procedures, and weaknesses in quality reviews contribute to inconsistent decisions; and (5) although SSA is on the verge of implementing initiatives to deal with these factors, GAO is concerned that other congressionally mandated workload pressures, such as significantly increasing the number of continuing disability reviews and readjudicating childhood cases, could jeopardize the agency's ability to move ahead with its initiatives to reduce inconsistent decisions.