Appealed Disability Claims:

Despite SSA's Efforts, It Will Not Reach Backlog Reduction Goal

HEHS-97-28: Published: Nov 21, 1996. Publicly Released: Nov 21, 1996.

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Barbara D. Bovbjerg
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Pursuant to a congressional request, GAO reviewed the Social Security Administration's (SSA) Short-Term Disability Plan (STDP), focusing on: (1) progress made by SSA's Office of Hearings and Appeals (OHA) in meeting STDP backlog reduction and case processing goals; (2) the current OHA allowance rate for appealed cases compared with pre-STDP levels; and (3) the accuracy of OHA decisions made under STDP.

GAO found that: (1) OHA has made progress in reducing its inventory of appealed cases, but SSA will not reach its goal of reducing this backlog to 375,000 by December 1996; (2) activities under the plan's key initiatives allowed OHA to dispose of about 66,500 more cases than it would have had STDP not been implemented, but despite OHA's increased productivity, as of August 1996 its backlog of appealed cases was about 3 percent higher than in November 1994; (3) since STDP was initiated, the allowance rate has decreased from about 75 percent in fiscal year (FY) 1994 to about 69 percent through the third quarter of (FY) 1996; and (4) SSA has not completed any analysis of the accuracy of STDP decisions or clearly established to what extent, if any, STDP has affected OHA's allowance rate.

Recommendation for Executive Action

  1. Status: Closed - Implemented

    Comments: Based on its analysis of the STDP productivity and decisional quality, SSA previously determined that STDP enhanced the agency's ability to manage its caseload of hearing requests. SSA extended one of STDP's key initiatives, the senior attorney position, through April 2001. This rule, however, also eliminates the possibility of another extension. Recognizing that processing times for appealed cases are still high, in August 1999 SSA issued a Hearing Process Improvement Plan (HPI), which contained a number of broad initiatives intended to institute a permanent process that ensures the timely and expeditious disposition of appeals. By September 2000, SSA had phased out the senior attorney position and implemented HPI in 37 offices in 10 states. As of December 2000, the agency implemented HPI nationwide. The HPI initiative modifies the STDP Senior Attorney program by removing Senior Attorneys' ability to sign of on on-the-record awards, which was the key feature allowing the Senior Attorney program to accelerate case processing. Moreover, to date HPI has not yet been successful in reducing the backlog of disability claims in hearing offices.

    Recommendation: Because STDP has shown that it can help reduce the backlog of appealed cases, and if SSA determines that accurate decisions are being made, the Commissioner of Social Security should extend STDP until the agency institutes a permanent process that ensures the timely and expeditious disposition of appeals.

    Agency Affected: Social Security Administration


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