Social Security Disability:

Implementation of the Medical Improvement Review Standard

HRD-87-3BR: Published: Dec 16, 1986. Publicly Released: Jan 21, 1987.

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In response to a congressional request, GAO monitored the Social Security Administration's (SSA) and the state disability determination services' (DDS) implementation of the medical improvement review standard and reported on the SSA effort to resume continuing disability reviews (CDR).

GAO found that: (1) SSA took more than a year to develop final regulations and procedures to implement the medical improvement review standard; (2) DDS were not able to handle the volume of CDR the SSA resumption plan required, and adjustments to the caseload plan were necessary to provide work-load relief for DDS; (3) the primary impediment to conducting CDR was the lack of DDS resources, because they were working on a backlog of about 230,000 initial mental impairment cases; (4) as of September 26, 1986, SSA completed 46,509 CDR cases, compared to the 347,000 projected cases in its original plan for fiscal year (FY) 1986; (5) at the end of FY 1986, SSA estimated a backlog of 270,000 medical-improvement-expected cases; (6) based on its progress, as of September 1986, in processing CDR cases, SSA will not meet its original projection of becoming current during the first 24 to 36 months of operation; (7) SSA projects that it will process 223,000 CDR cases in FY 1987 and will give priority to the medical-improvement-expected cases; and (8) nearly all DDS have shown an upward trend in production rates in the first three quarters of FY 1986.

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