Social Security Disability Insurance: SSA Actions Could Enhance Assistance to Claimants with Inflammatory Bowel Disease and Other Impairments

GAO-05-495 Published: May 31, 2005. Publicly Released: May 31, 2005.
Jump To:
Skip to Highlights
Highlights

Advocates for patients with inflammatory bowel disease (IBD) believe that the Social Security Administration's (SSA) process for determining eligibility for Disability Insurance (DI) may treat some claimants unfairly. As a result, claimants with IBD believe they are likely to be denied benefits at the initial decision and reconsideration levels, making it necessary for them to appeal to SSA's hearings level to have their claims allowed. This congressionally mandated study focuses on (1) how SSA evaluates claims involving IBD to establish disability under Title II of the Social Security Act and (2) what unique challenges claimants with IBD encounter when applying for DI benefits, and what actions, if any, SSA has taken to address these challenges.

Skip to Recommendations

Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Social Security Administration To help ensure that claimants with IBD and other claimants are informed of and ultimately provide SSA with information critical to a complete assessment of their impairment at the earliest possible point in the decision-making process, SSA should update its Web site to include more accessible information that clarifies the type and importance of information that claimants must submit for steps four and five of the sequential evaluation process. SSA should also consider making the information currently in its interactive adult disability report--including instructions, explanations and examples--more readily available to all claimants on its Web site.
Closed – Implemented
SSA has made significant changes to its disability web site in response to GAO's recommendations. Specifically, SSA has updated SS Online to include an explanation of all steps of the 5-step disability determination process and has added more detailed explanations, examples, and frequently-asked questions. Information concerning steps 4 and 5 of the sequential evaluation process, formerly available only to a claimant actually filling out a DI application, is now readily available online. These changes will help ensure that claimants are informed and ultimately will provide SSA with information critical to the complete assessment of their impairment at the earliest possible point in the decision-making process.
Social Security Administration To help ensure that claimants with IBD and other claimants are informed of and ultimately provide SSA with information critical to a complete assessment of their impairment at the earliest possible point in the decision-making process, SSA should update the Disability Starter Kit--which is provided to all claimants who apply by phone or in person--to include an explanation of the types and importance of information that claimants must submit for steps four and five of the sequential evaluation process. SSA should consider adding instructions, explanations, and examples that are currently available in the on-line form, to the extent that it is cost-effective to do so.
Closed – Implemented
In response to this recommendation, SSA is updating the Adult Disability Starter Kit to reflect recent changes made to the SSA-3368. As part of the update, the agency is also considering adding information and/or instructions along with other suggestions to the Disability Starter Kit to address the importance of obtaining information from the disability applicant about steps four and five of the sequential evaluation process, as we recommended.
Social Security Administration To help ensure that claimants with IBD and other claimants are informed of and ultimately provide SSA with information critical to a complete assessment of their impairment at the earliest possible point in the decision-making process, SSA should explore options for ensuring that field office and DDS staff appropriately explain and collect the types of information needed to assess how claimants' impairments impact their ability to work.
Closed – Implemented
SSA agreed with this recommendation. SSA noted that each regional office website currently provides access to a "Disability Interview Guide" for the field office claims representative (CR) to use for the front-end interview process. SSA reiterated that it recognizes the need for (and has conducted) additional field office training regarding the disability interview process to better assist the DDSs in their determination process. SSA acknowledged that some, not all, field offices use the Disability Interview Guides. In addition, the DDS generally submits functional reports to applicants that address limitations in activities of daily living and symptom questionnaires to further address limitations.

Full Report