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Highlights

The Social Security Administration's (SSA) Disability Insurance and Supplemental Security Income programs provided around $128 billion to about 12.8 million persons with disabilities and their families in fiscal year 2005. Claimants who are denied benefits by SSA may appeal to federal courts. Through current initiatives, SSA is attempting to reduce the number of cases appealed to courts and remanded back to SSA for further review. In addition, there have been long-standing concerns about how SSA responds to court decisions that conflict with its policies. GAO was asked to examine: (1) trends over the past decade in the number of appeals reviewed by the courts and their decisions, (2) reasons for court remands and factors contributing to them, and (3) SSA's process for responding to court decisions that conflict with agency policy. GAO reviewed SSA data and documents on court decisions, remands and SSA's processes and interviewed agency officials and stakeholders on data trends, reasons for remands, and SSA processes.

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Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Social Security Administration 1. To ensure the agency has accurate and well-managed information to use in identifying corrective actions for reducing remands, the Commissioner of SSA should take steps to ensure the reliability of data on reasons for remands.
Closed - Implemented
SSA reported that an update of its Case Processing and Management System (CPMS) in June 2007 required a mandatory input of the "remand reason" codes on all pending Appeals Council and court remands, thereby improving the completeness of data on reason for remands. CPMS can now generate reports for all pending Appeals Council and court remands by month at the national, regional, or hearing office level. Further, the Office of Appellate Operations (OAO) implemented the Appeals Review Processing System (ARPS) on March 3, 2008, providing the ability to track and run reports on Appeals Council remands, including reports on reason for remand using the coding provided by the Office of the General Counsel (OGC). By late 2009, OAO was able to run reports on court remands worked in OAO division offices, thereby replacing OGC as the tracker of these data. In July 2010, court remand data were being collected and some data had already been shared with the Office of the Chief Administrative Law Judge. By July 2011, SSA provided us with software documentation showing that OAO's ARPS had a mandatory field requiring SSA official to enter a reason for remands for each case, as well as a data report from this system showing a number of reasons for remands to cases.
Social Security Administration 2. To ensure the agency has accurate and well-managed information to use in identifying corrective actions for reducing remands, the Commissioner of SSA should coordinate agency data collection on remands and ascertain how best to use this information to reduce the proportion of cases remanded by federal courts.
Closed - Implemented
In June 2009, SSA reported that the Office of Disability Adjudication Review (ODAR) and the Office of General Counsel formed a working group to develop a plan to ensure the reliability of remand data, coordinate the collection of remand data, and improve the legal sufficiency of hearing decisions to reduce the proportion of cases remanded by the courts. In January 2011, in an effort to improve the overall quality of disability decisions made by all SSA adjudicators (including at the hearing appeals level), SSA established the Division of Quality within the Office of Appellate Operations to provide oversight of the decisions. According to SSA, the Division of Quality is responsible for establishing a plan for using data on court remands, among other information, to improve disability decisions. In 2010, in an effort to further enhance the consistency of decisions and minimize the number of remands in accordance with the above recommendation, ODAR implemented the Findings Integrated Templates (FIT) and began collecting data on the occurrence of remands for cases that were developed using this tool.

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