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Highlights

For years, the Social Security Administration (SSA) has experienced processing delays and significant backlogs of disability claims. At the end of fiscal year 2006, some 1.5 million disability claims were awaiting a decision. About 576,000 of these claims were backlogged--exceeding the number of claims that should optimally be pending at year-end. In response to the congressional request, GAO (1) examined trends in disability claims backlogs and the time required for SSA to decide a claim, (2) identified key factors contributing to the backlogs and processing times, and (3) described the steps SSA is taking to reduce them. To address these issues, GAO analyzed SSA administrative data, conducted an extensive literature review, interviewed SSA officials as well as key program personnel, and conducted site visits in three SSA regions.

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Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Social Security Administration To ensure that current and future modifications to the disability determination process achieve the desired and optimal outcome, the Commissioner of the Social Security Administration should establish a "target pending" for cases in the reconsideration stage as the agency does for the other stages, to allow identification and monitoring of backlogs.
Closed - Not Implemented
In 2008, SSA agreed that tracking claims pending at this stage should be part of the agency's routine and comprehensive monitoring of all Disability Determination Services (DDS) workloads. However, SSA believed that instead of the number of reconsideration cases pending, cases over a certain age could be used as an alternative indicator of performance, a measure that is consistent with the agency's current direction of focusing on aged claims. A target number of reconsideration cases over a certain age could be used as an alternative to the total number of reconsideration cases pending. However, SSA has not established what would be an acceptable number of reconsideration cases over a certain age. In 2010, SSA reiterated that it did not believe establishing a target for reconsideration cases was warranted, therefore, it did not create a number or percentage of reconsideration cases over a certain number of days old as an indicator. SSA has, however, stressed the importance of processing the budgeted number of reconsiderations and carefully track that number. For example, SSA processed 90.3% of its budgeted reconsiderations and are on track to process 100% of this budgeted workload by the end of FY10. GAO continues to believe that SSA should establish such a target for the reconsideration stage as it does for the other three stages - initial, hearings, and Appeals Council - of the disability process. This would help SSA determine when the number of reconsideration claims pending exceeds the optimal level that should be in the pipeline, indicating a backlog exists, so that the agency can better determine where to focus its attention. In 2011, SSA stated that the agency's position has not changed and SSA continued to disagree with this recommendation.
Social Security Administration To ensure that current and future modifications to the disability determination process achieve the desired and optimal outcome, the Commissioner of the Social Security Administration should conduct a thorough evaluation of the Disability Service Improvement (DSI) initiative before deciding which elements should be implemented nationwide and which should be discontinued.
Closed - Not Implemented
In 2008, SSA partially agreed with this recommendation and noted that it would continue to collect data and monitor outcomes to evaluate Disability Service Improvement (DSI) and was implementing parts of DSI it believed successful, such as Quick Disability Determination (QDD). SSA conducted only limited assessments of DSI. SSA has discontinued this initiative and is currently focusing on its Hearings Backlog Reduction Plan. The intent of our recommendation was to help ensure that SSA incorporates a strong evaluation component in the DSI initiative so that the agency could obtain reliable data that would help it improve the disability claims process by identifying which aspects of DSI should be continued, discontinued, or modified. Such an evaluation could also help inform future initiatives.
Social Security Administration To ensure that current and future modifications to the disability determination process achieve the desired and optimal outcome, the Commissioner of the Social Security Administration should take needed steps to increase the likelihood that new initiatives will succeed through comprehensive planning to anticipate the challenges of implementation, by including the appropriate staff in the design and implementation stages, by establishing feedback mechanisms to track progress and problems, and by performing periodic evaluations.
Closed - Implemented
Although SSA discontinued the Disability Service Improvement (DSI) project, it focused its attention on reducing the hearings backlog and developed a plan for doing so. SSA involved key stakeholders in its planning and implementation efforts. SSA has also reported a number of successes, including a reduction in the hearings backlog and opening a number of national hearing centers.

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