Summary

(SSA) has experienced processing delays and significant backlogs of disability claims at the hearings level. In May 2007, SSA began implementing a plan for eliminating the hearings backlog entitled Summary of Initiatives to Eliminate the SSA Hearings Backlog (the Plan). In response to a congressional request, GAO (1) examined the Plan's potential to eliminate the hearings-level backlog, (2) determined the extent to which the Plan included components of sound planning, and (3) identified potential unintended effects of the Plan on hearings-level operations and other aspects of the disability process. To address these objectives, GAO analyzed SSA data, conducted a risk analysis, assessed the Plan and its update--the May 2009 Draft Appomattox Plan--using planning criteria identified in previous GAO work, interviewed SSA officials, and conducted site visits in three SSA regions.

SSA's Plan should help the agency reduce its hearings-level backlog, but the likelihood that SSA will eliminate the backlog within its projected time-frame depends on the extent to which SSA's assumptions for improved administrative law judge (ALJ) hiring, availability, and productivity are achieved in practice. Both SSA and GAO believe that the agency has about a 78 percent chance of eliminating the backlog, that is, reducing the number of hearings-level pending claims below 466,000 claims, by the end of fiscal year 2013--SSA's target date--if those assumptions are fully realized. However, SSA's assumptions project higher levels of performance achieved than recent experience--from fiscal year 2008 to April 2009. ALJ productivity improvements are especially important to SSA's reaching its goal. The likelihood that SSA will eliminate the backlog by its target date changes under different scenarios for achieving its ALJ hiring, availability, and productivity goals. If SSA achieves its average ALJ productivity, but not its ALJ hiring and availability goals, GAO estimated that SSA's chances are reduced from about 78 percent to about 53 percent. Conversely, if SSA achieves its goals for ALJ hiring and availability, but not for average productivity, its chances are about 34 percent. If SSA is unable to achieve any of its ALJ workforce and performance goals, the likelihood of the agency eliminating the hearings-level backlog by its target date drops to about 14 percent. SSA's Plan includes important elements of the six components of sound planning GAO identified in previous work, but does not provide some key management information that could facilitate effective plan management. SSA did not fully address elements of two components. Specifically, the Plan does not include performance goals and measures for about half of the initiatives and cost estimates for many, which would allow SSA to evaluate the initiatives' effect on the hearings-level backlog and determine resource allocations and return on investment. Although the Plan does not identify implementation risks or strategies to address them, SSA officials said they are developing a system that will aid in creating formal performance goals and measures and risk analysis, several of which SSA plans to release in the fall of 2009. The Plan could have unintended effects on SSA offices involved in the disability process. For example, the Plan's initiatives to increase the number of hearings-level decisions could affect decisional quality and accuracy, and increase workloads in offices that are responsible for reviewing appeals of hearing office decisions, processing payments for claims, and conducting continuing disability reviews to determine whether beneficiaries remain eligible for benefits. Although SSA has developed plans to address increased workloads related to appeals of hearing decisions and monitors other disability workloads, it does not have a systematic approach to identify and address unintended effects caused by Plan initiatives over the course of the Plan.

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.

Recommendations for Executive Action