Social Security Disability:

Better Planning, Management, and Evaluation Could Help Address Backlogs

GAO-08-40: Published: Dec 7, 2007. Publicly Released: Jan 7, 2008.

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For years, the Social Security Administration (SSA) has experienced processing delays and significant backlogs of disability claims. At the end of fiscal year 2006, some 1.5 million disability claims were awaiting a decision. About 576,000 of these claims were backlogged--exceeding the number of claims that should optimally be pending at year-end. In response to the congressional request, GAO (1) examined trends in disability claims backlogs and the time required for SSA to decide a claim, (2) identified key factors contributing to the backlogs and processing times, and (3) described the steps SSA is taking to reduce them. To address these issues, GAO analyzed SSA administrative data, conducted an extensive literature review, interviewed SSA officials as well as key program personnel, and conducted site visits in three SSA regions.

From fiscal year 1997 through 2006, backlogged disability claims in the Social Security Administration's processing system doubled, reaching about 576,000 cases. Backlogs of varying degrees have occurred at most stages of the claims process. The only significant decline occurred at the last stage--the Appeals Council--where fewer cases are processed. At the initial claims level, handled by state Disability Determination Services (DDS), a backlog developed in fiscal year 1998 and grew to about 155,000 claims in fiscal year 2006. At the hearings level, backlogged claims exceeded 415,000 that year and accounted for 72 percent of the total backlog. Insufficient data prevented GAO from identifying trends in backlogs at the reconsideration stage. Processing times, meanwhile, increased with claimants generally waiting significantly longer--for example, an additional 95 days at the hearings level--for a decision. Substantial growth in the numbers of disability claims, staff losses and turnover, and management weaknesses have contributed to the backlog problem. Initial applications for benefits grew more than 20 percent over the period while SSA experienced losses in key personnel: claims examiners in the state determination offices and administrative law judges and support staff in the hearings offices. In addition, management weaknesses evidenced in a number of initiatives to address the backlogs have failed to remedy and sometimes contributed to the problem. In 2006, SSA introduced the Disability Service Improvement initiative (DSI), but suspended national rollout of it in order to concentrate on the hearings backlog and full implementation of SSA's electronic case-processing system. DSI is still underway in the Boston region; though hampered by rushed implementation, poor communication, and a lack of financial planning, DSI has shown mixed results, and SSA has proposed discontinuing certain components because of cost. Thorough evaluations that could help inform decisions about DSI's future have not yet been conducted.

Status Legend:

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  • Review Pending-GAO has not yet assessed implementation status.
  • Open-Actions to satisfy the intent of the recommendation have not been taken or are being planned, or actions that partially satisfy the intent of the recommendation have been taken.
  • Closed-implemented-Actions that satisfy the intent of the recommendation have been taken.
  • Closed-not implemented-While the intent of the recommendation has not been satisfied, time or circumstances have rendered the recommendation invalid.
    • Review Pending
    • Open
    • Closed - implemented
    • Closed - not implemented

    Recommendations for Executive Action

    Recommendation: To ensure that current and future modifications to the disability determination process achieve the desired and optimal outcome, the Commissioner of the Social Security Administration should establish a "target pending" for cases in the reconsideration stage as the agency does for the other stages, to allow identification and monitoring of backlogs.

    Agency Affected: Social Security Administration

    Status: Closed - Not Implemented

    Comments: In 2008, SSA agreed that tracking claims pending at this stage should be part of the agency's routine and comprehensive monitoring of all Disability Determination Services (DDS) workloads. However, SSA believed that instead of the number of reconsideration cases pending, cases over a certain age could be used as an alternative indicator of performance, a measure that is consistent with the agency's current direction of focusing on aged claims. A target number of reconsideration cases over a certain age could be used as an alternative to the total number of reconsideration cases pending. However, SSA has not established what would be an acceptable number of reconsideration cases over a certain age. In 2010, SSA reiterated that it did not believe establishing a target for reconsideration cases was warranted, therefore, it did not create a number or percentage of reconsideration cases over a certain number of days old as an indicator. SSA has, however, stressed the importance of processing the budgeted number of reconsiderations and carefully track that number. For example, SSA processed 90.3% of its budgeted reconsiderations and are on track to process 100% of this budgeted workload by the end of FY10. GAO continues to believe that SSA should establish such a target for the reconsideration stage as it does for the other three stages - initial, hearings, and Appeals Council - of the disability process. This would help SSA determine when the number of reconsideration claims pending exceeds the optimal level that should be in the pipeline, indicating a backlog exists, so that the agency can better determine where to focus its attention. In 2011, SSA stated that the agency's position has not changed and SSA continued to disagree with this recommendation.

    Recommendation: To ensure that current and future modifications to the disability determination process achieve the desired and optimal outcome, the Commissioner of the Social Security Administration should conduct a thorough evaluation of the Disability Service Improvement (DSI) initiative before deciding which elements should be implemented nationwide and which should be discontinued.

    Agency Affected: Social Security Administration

    Status: Closed - Not Implemented

    Comments: In 2008, SSA partially agreed with this recommendation and noted that it would continue to collect data and monitor outcomes to evaluate Disability Service Improvement (DSI) and was implementing parts of DSI it believed successful, such as Quick Disability Determination (QDD). SSA conducted only limited assessments of DSI. SSA has discontinued this initiative and is currently focusing on its Hearings Backlog Reduction Plan. The intent of our recommendation was to help ensure that SSA incorporates a strong evaluation component in the DSI initiative so that the agency could obtain reliable data that would help it improve the disability claims process by identifying which aspects of DSI should be continued, discontinued, or modified. Such an evaluation could also help inform future initiatives.

    Recommendation: To ensure that current and future modifications to the disability determination process achieve the desired and optimal outcome, the Commissioner of the Social Security Administration should take needed steps to increase the likelihood that new initiatives will succeed through comprehensive planning to anticipate the challenges of implementation, by including the appropriate staff in the design and implementation stages, by establishing feedback mechanisms to track progress and problems, and by performing periodic evaluations.

    Agency Affected: Social Security Administration

    Status: Closed - Implemented

    Comments: Although SSA discontinued the Disability Service Improvement (DSI) project, it focused its attention on reducing the hearings backlog and developed a plan for doing so. SSA involved key stakeholders in its planning and implementation efforts. SSA has also reported a number of successes, including a reduction in the hearings backlog and opening a number of national hearing centers.

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