Social Security:

Continuing Disability Review Process Improved, But More Targeted Reviews Needed

T-HEHS-94-121: Published: Mar 10, 1994. Publicly Released: Mar 10, 1994.

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GAO discussed the Social Security Administration's (SSA) new process for conducting continuing disability reviews (CDR) using computer profiling and beneficiary-reported data. GAO noted that: (1) although SSA is required to conduct CDR every 3 years, it is not legally required to perform CDR of individual supplemental security income (SSI) disability beneficiaries; (2) approximately $1.4 billion in unnecessary benefits will be paid through 1997 to ineligible beneficiaries because SSA has only performed half of the required CDR; (3) SSA has developed a new, cost-effective process for conducting CDR that uses computer profiles and mailers to acquire beneficiary-reported data, rank beneficiaries' medical status, and prioritize full medical reviews; (4) although the new CDR process appears to be working, there is insufficient data on the first-year results of the process; (5) it supports SSA efforts to make the CDR process more efficient and cost-effective; (6) the combination of self-reported data and other information SSA has about individual beneficiaries provides a reasonable basis to determine whether full medical reviews are warranted; and (7) SSA needs to ensure that it meets CDR requirements, target its mailers and full medical reviews primarily on those beneficiaries that are not classified as disabled, and provide increased attention to SSI beneficiaries.

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