Social Security:

Adjusting Continuing Disability Review Priorities

HRD-87-4, Oct 22, 1986

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GAO reviewed the Social Security Administration's (SSA) plans for resuming continuing disability reviews (CDR), involving the implementation of the medical improvement review standard. GAO stated its concern about the planned mix of cases SSA will send to state disability determination services (DDS).

GAO found that: (1) the SSA case load for the second half of fiscal year (FY) 1986 and for FY 1987 was revised to include decision review cases and medical-improvement-expected cases as its top priorities; (2) by the end of FY 1986, SSA will have a backlog of medical-improvement-expected and medical-improvement-possible cases that need review; and (3) there is uncertainty as to the number of CDR cases that can be processed in a given year. GAO suggested that: (1) approximately 58,000 CDR cases that were previously reviewed and not effectuated, or that had appeals pending, should be given high priority; and (2) delay in reviewing the 58,000 CDR cases could result in the trust fund paying excessive benefits to those individuals who remain on the disability rolls.

Status Legend:

More Info
  • 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

    Recommendation for Executive Action

    Recommendation: The Commissioner of Social Security should direct the Associate Commissioner, Office of Disability, to: (1) process the 58,000 cases immediately after completing the decision review cases; and (2) not process medical-improvement-not-expected cases until DDS become current with the decision review, medical-improvement-expected, and medical-improvement-possible cases.

    Agency Affected: Social Security Administration

    Status: Closed - Implemented

    Comments: SSA completed the 58,000 cases and decision review cases and concentrated on medical-improvement-expected cases.