Social Security Disability:

Disappointing Results from SSA's Efforts to Improve the Disability Claims Process Warrant Immediate Attention

GAO-02-322: Published: Feb 4, 2002. Publicly Released: Feb 27, 2002.

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The number of people applying for benefits from the Social Security Administration's (SSA) two disability programs grew dramatically during the 1990s. As a result, the Disability Insurance and Supplemental Security Programs began to experience huge backlogs of undecided claims. SSA has spent $39 million during the past seven years on various initiatives to help it better manage its caseloads and ensure high-quality service. SSA spent another $71 million to develop an automated disability claims process. This report reviews the status and outcomes of five initiatives intended to improve SSA's disability claims process. GAO found that the results of the initiatives have been disappointing.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: The Social Security Administration (SSA) implemented several actions to address this recommendation. In July 2002, SSA streamlined techniques for decision drafting (e.g., short-form, full favorable decision) in order to issue decisions sooner after the hearing. At the same time, it began allowing Administrative Law Judges to issue decisions from the bench immediately after a hearing. In early 2003, the agency created a law clerk position and terminated the hearing office technician rotation requirement. In addition, SSA enhanced the process for screening new receipts so that the Agency can more quickly identify cases that can be paid on-the-record. Finally, the agency implemented the use of speech recognition technology. The first pilot site for digital recording of hearings is scheduled to start in November 2003; complete implementation is scheduled for the end of 2004.

    Recommendation: To best ensure that SSA's disability decision-making process initiatives improve customer service by providing more timely and accurate processing of claims, SSA should implement short-term strategies to immediately reduce the backlog of appealed cases in the Office of Hearings and Appeals. These strategies could be based on those that were successfully employed to address similar problems in the mid-1990's.

    Agency Affected: Social Security Administration

  2. Status: Closed - Implemented

    Comments: As part of its long-term strategy to provide more timely and accurate claims processing, the Office of Hearings and Appeals (OHA) developed the Case Processing and Management System (CPMS). According to SSA, CPMS, which was recently rolled out nationwide, creates a unified (nationwide) system with increased functionality that will assist in the processing of the hearings and appeal workload, and should reduce the amount of time required to reach a hearing or appeal decision. SSA also expects the introduction of the electronic folder to result in additional efficiencies by eliminating lost folders and repetitive data entry, and speeding up the transfer of cases to OHA from other levels in the disability determination process. In June 2004, OHA began implementation of CPMS Release II, which provides electronic folder (EF) interface functionality and which OHA expects to result in additional reductions in processing time when fully functional. To date, OHA has installed EF in 13 hearing offices, and expects to complete national rollout by October 2005.

    Recommendation: To best ensure that SSA's disability decision-making process initiatives improve customer service by providing more timely and accurate processing of claims, SSA should develop a long-range strategy for a more permanent solution to the backlog and efficiency problems at the Office of Hearings and Appeals. This strategy should include lessons learned from the Hearings Process Improvement initiative, the use of limited pilot tests before implementing additional changes nationwide, and consideration of some of the fundamental, structural problems as identified by the Social Security Advisory Board.

    Agency Affected: Social Security Administration

  3. Status: Closed - Implemented

    Comments: SSA has taken decisive action toward a more comprehensive and sophisticated Quality Assurance program, with imminent milestones. In March, SSA established a new Office of Quality Performance (OQP), thereby elevating management control over quality to the deputy commissioner level. This new office is now embarking on several, promising changes to its quality assurance system, including replacing regional with central review of decisions made at the initial and first level of appeal (thereby removing a potential cause of inconsistency), instituting decision writing tools at each adjudication level to improve documentation of the rational behind decisions and to serve as a feedback tool for the previous level of adjudication; and establishing a Decision Review Board that will review error-prone and complex decisions made at the hearing level. Cases filed in Region IX (Boston) in or after August 2006 will be processed under the new quality assurance system. The agency anticipates negligible increases, if any, in administrative costs as a result of these and other changes to its disability process.

    Recommendation: To best ensure that SSA's disability decision-making process initiatives improve customer service by providing more timely and accurate processing of claims, SSA should develop an action plan for implementing a more comprehensive and sophisticated Quality Assurance Program. This plan should include among other things implementation milestones and estimated resource needs.

    Agency Affected: Social Security Administration

 

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