A Plan for Improving the Disability Determination Process by Bringing It Under Complete Federal Management Should Be Developed

HRD-78-146: Published: Aug 31, 1978. Publicly Released: Aug 31, 1978.

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The most important step in considering claims for Social Security disability benefits is determining whether a claimant is disabled. State agencies carry out the disability determination process under contractual agreements with the Department of Health, Education, and Welfare (HEW). In 1977, about 6.7 million disability beneficiaries received disability benefits of about $14.0 billion.

The means used to make disability determinations differed considerably among States. A reasonable degree of uniformity and efficiency in the process may never be achieved because the existing Federal-State arrangement precludes direct managerial control by the Social Security Administration (SSA) of State agencies, and SSA has failed to correct other weaknesses in the process. Although the disability program was to be linked with an effective State vocational rehabilitation program, only a small proportion of workers have been rehabilitated, and there has been an increase in disabled workers on the rolls. SSA efforts to strengthen Federal-State agreements had only limited success because of the unwillingness of State officials to relinquish their prerogatives. Only a small proportion of States have said that they would sign a proposed agreement, submitted to States by SSA in response to earlier GAO recommendations, which expanded the Federal role to ensure uniformity. Also, there has not been adequate participation of physicians in the disability determination process. SSA has attempted to implement an acceptable quality assurance system, but further action is needed.

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