The Social Security Administration Needs To Improve Its Disability Claims Process

HRD-78-40: Published: Feb 16, 1978. Publicly Released: Feb 16, 1978.

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The Social Security Administration's (SSA) procedures for processing approved disability insurance claims were reviewed to determine if the process could be improved. The review covered claims processing steps at the Bureau of Disability Insurance and at district offices and included an analysis of a sample of 498 approved disability insurance claims processed by 15 SSA district offices.

The disability claims processing function in district offices has not been effectively managed by the SSA. Forty-six percent of the sample claims reviewed were delayed unnecessarily; the number of claims delayed unnecessarily varied from 10 percent to 78 percent at the 15 district offices. Controls designed to assure prompt processing and timely payment of disability claims in district offices and to guard against loss or misplaced files are inadequate and, in some cases, nonexistent. SSA has failed to provide district offices with claims processing standards, to monitor the computer-generated alerts to determine adequacy and usefulness, and to assure that adequate and accurate management information is provided to operating managers. The need for review by SSA headquarters of claims containing conspicuous characteristics is questionable.

Recommendation for Executive Action

  1. Status: Closed

    Comments: Please call 202/512-6100 for additional information.

    Recommendation: The Secretary of Health, Education, and Welfare should direct the Commissioner of Social Security to: establish district office processing time goals, develop and implement an alert system using meaningful timeframes to monitor claims, and develop a management information system using the above controls. The Commission should also: realign the Supplemental Security Income and disability insurance payment input to eliminate undeserved payments, develop and implement special procedures to expedite processing those claims that cannot now be completed by district offices, and determine the feasibility of relocating the conspicuous characteristics review in the district offices.

    Agency Affected:

 

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