Social Security Disability:

Additional Outreach and Collaboration on Sharing Medical Records Would Improve Wounded Warrior's Access to Benefits

GAO-09-762: Published: Sep 16, 2009. Publicly Released: Oct 15, 2009.

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Disability benefits available through the Social Security Administration (SSA) can be an important source of financial support for some wounded warriors, and Congress has mandated that the Departments of Defense (DOD) and Veterans Affairs (VA) help them learn about and apply for such benefits. GAO was asked to determine: (1) how many wounded warriors have applied and been approved for SSA benefits and the extent to which they are receiving benefits from across the three agencies; (2) what steps DOD, VA, and SSA have taken to inform wounded warriors about SSA benefits, and the challenges that confront this process; and (3) steps taken by all three agencies to facilitate the processing of wounded warrior disability claims. Focusing on those wounded since 2001, GAO reviewed policy documents, contacted DOD and VA medical facilities, surveyed wounded warriors, and analyzed administrative data.

As of December 2008, about 7,600 of the16,000 wounded warriors who have applied for SSA disability benefits since 2001 have been approved. The majority filed their applications since 2007. Also, a sizable minority of approved claimants filed long enough after injury that they lost some retroactive benefits; SSA is considering a legislative proposal to change the retroactive period for wounded warriors. Among wounded warriors receiving DOD or VA disability benefits, 4 percent were receiving SSA benefits. In addition, more than 6 percent had applied but were not receiving SSA benefits; some still had claims pending. Those with higher disability ratings from DOD or VA were more likely to receive SSA benefits. To varying degrees, SSA, DOD, and VA have increased outreach to help wounded warriors learn about and apply for SSA disability benefits. Since 2007, SSA has increased its outreach to DOD and VA medical facilities and has tailored benefit information for wounded warriors. DOD--and to some extent VA--have incorporated SSA information into their case management practices as well. Locally, DOD and SSA staff have worked together to reach servicemembers, but collaboration has been less common at VA hospitals. Meanwhile, there are challenges to reaching and working with this population. Many of the wounded warriors may not be ready or able to hear about SSA benefits early in their recovery. Also, brain injuries and mental health disorders can impede many wounded warriors' ability to absorb outreach information and complete the benefit application. With help from DOD and VA, SSA has been able to expedite processing of wounded warrior claims. SSA has established a nationwide policy requiring its offices to give priority to wounded warrior claims. For their part, DOD helps SSA identify claimants who are wounded warriors, and VA has expedited the transfer of its medical records and histories to SSA. However, DOD's paper-based transfer of medical records to SSA is slow, which can prolong the process by weeks or months, according to claims processing staff.

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 improve wounded warriors' access to SSA disability benefits, the Commissioner of Social Security should move ahead with his consideration of the need for a legislative proposal to amend the DI program's retroactive benefit period for wounded warriors, given the unique challenges faced by this population in applying for benefits in a timely manner.

    Agency Affected: Social Security Administration

    Status: Closed - Implemented

    Comments: The Social Security Administration (SSA) reported that it recognizes that disabled service members face special circumstances that may lead to a loss of benefits due to delays in filing for benefits. On August 30, 2011, the Commissioner approved a legislative proposal that would provide that if a military service member becomes disabled while on active duty, the application would be filed in the month he became disabled. This proposal would be an exception to the current rules on DI retroactivity.

    Recommendation: To improve wounded warriors' access to SSA disability benefits, the Secretary of Veterans Affairs and the Commissioner of Social Security should work together to improve outreach to veterans on SSA disability benefits. In doing so, the VA and SSA should, in particular, seek to reach veterans who either were discharged between 2001 and 2007; have disabilities that manifest after service such as PTSD; or were assigned a 100 percent disability rating. Specific actions that VA could take include issuing guidance to VA medical centers and regional offices for referring veterans to SSA and including information about SSA disability benefits in VA's phone outreach campaign to OEF/OIF veterans. In addition, SSA could work with VA to ensure stronger coordination between local SSA offices and VA medical facilities, for example by making sure that VA medical centers have a point of contact at a local SSA office or receive training from SSA staff on SSA benefits.

    Agency Affected: Department of Veterans Affairs

    Status: Closed - Implemented

    Comments: Senior VA and SSA officials met in December 2009 and developed several new initiatives for helping wounded warriors access SSA disability benefits. VA and SSA have made some progress in implementing these initiatives. For example, SSA is now evaluating VA's Disability Examination Worksheets with the goal of recommending additional questions that would address SSA's need for functional assessment. Also, VA and SSA have entered a data sharing agreement, and VA has provided SSA with a list of all veterans who received a 100 percent disabled or Individual Unemployability's rating between 2000 and 2008. SSA is using this list and its own databases to conduct research on the characteristics of veterans who have applied and been approved for Social Security benefits, with the goal of conducting more targeted outreach to potentially eligible veterans.

    Recommendation: To improve wounded warriors' access to SSA disability benefits, the Secretary of Veterans Affairs and the Commissioner of Social Security should work together to improve outreach to veterans on SSA disability benefits. In doing so, the VA and SSA should, in particular, seek to reach veterans who either were discharged between 2001 and 2007; have disabilities that manifest after service such as PTSD; or were assigned a 100 percent disability rating. Specific actions that VA could take include issuing guidance to VA medical centers and regional offices for referring veterans to SSA and including information about SSA disability benefits in VA's phone outreach campaign to OEF/OIF veterans. In addition, SSA could work with VA to ensure stronger coordination between local SSA offices and VA medical facilities, for example by making sure that VA medical centers have a point of contact at a local SSA office or receive training from SSA staff on SSA benefits.

    Agency Affected: Social Security Administration

    Status: Closed - Implemented

    Comments: Senior VA and SSA officials met in December 2009 and developed several new initiatives for helping wounded warriors access SSA disability benefits. VA and SSA have made some progress in implementing these initiatives. For example, SSA is now evaluating VA's Disability Examination Worksheets with the goal of recommending additional questions that would address SSA's need for functional assessment. Also, VA and SSA have entered a data sharing agreement, and VA has provided SSA with a list of all veterans who received a 100 percent disabled or Individual Unemployability rating between 2000 and 2008. SSA is using this list and its own databases to conduct research on the characteristics of veterans who have applied and been approved for Social Security benefits, with the goal of conducting more targeted outreach to potentially eligible veterans.

    Recommendation: To improve wounded warriors' access to SSA disability benefits, the Secretary of Defense and the Commissioner of Social Security should work together to better meet SSA's need for obtaining military medical records in a timely manner for processing Disability Insurence (DI) and Supplemental Security Income (SSI) applications from wounded warriors. This effort should consider how to ensure records that are stored electronically are also electronically transferable.

    Agency Affected: Department of Defense

    Status: Closed - Implemented

    Comments: The Social Security Administration (SSA) and the Department of Defense (DoD) have taken steps towards more efficient sharing of electronic medical records. On August 22, 2011, SSA and DoD implemented the interim solution pilot project. The pilot involved five SSA State Disability Determination Services (DDS) and a DoD centralized site. The DDSs sent a single electronic request for medical records to a DoD centralized site, which in turn responded electronically to the request for medical records. After evaluating the pilot, the agencies implemented this process nationwide in August 2012. Since then, according to SSA, the agency has seen a reduction in the average time it takes to receive DoD medical records from about five weeks to about two days, with a 100 percent response rate.

    Recommendation: To improve wounded warriors' access to SSA disability benefits, the Secretary of Defense and the Commissioner of Social Security should work together to better meet SSA's need for obtaining military medical records in a timely manner for processing Disability Insurence (DI) and Supplemental Security Income (SSI) applications from wounded warriors. This effort should consider how to ensure records that are stored electronically are also electronically transferable.

    Agency Affected: Social Security Administration

    Status: Closed - Implemented

    Comments: The Social Security Administration (SSA) and the Department of Defense (DoD) have taken steps towards more efficient sharing of electronic medical records. On August 22, 2011, SSA and DoD implemented the interim solution pilot project. The pilot involved five SSA State Disability Determination Services (DDS) and a DoD centralized site. The DDSs sent a single electronic request for medical records to a DoD centralized site, which in turn responded electronically to the request for medical records. After evaluating the pilot, the agencies implemented this process nationwide in August 2012. Since then, according to SSA, the agency has seen a reduction in the average time it takes to receive DoD medical records from about five weeks to about two days, with a 100 percent response rate.

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