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Social Security Disability: Additional Outreach and Collaboration on Sharing Medical Records Would Improve Wounded Warrior's Access to Benefits

GAO-09-762 Published: Sep 16, 2009. Publicly Released: Oct 15, 2009.
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Highlights

Disability benefits available through the Social Security Administration (SSA) can be an important source of financial support for some wounded warriors, and Congress has mandated that the Departments of Defense (DOD) and Veterans Affairs (VA) help them learn about and apply for such benefits. GAO was asked to determine: (1) how many wounded warriors have applied and been approved for SSA benefits and the extent to which they are receiving benefits from across the three agencies; (2) what steps DOD, VA, and SSA have taken to inform wounded warriors about SSA benefits, and the challenges that confront this process; and (3) steps taken by all three agencies to facilitate the processing of wounded warrior disability claims. Focusing on those wounded since 2001, GAO reviewed policy documents, contacted DOD and VA medical facilities, surveyed wounded warriors, and analyzed administrative data.

Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status Sort descending
Social Security Administration To improve wounded warriors' access to SSA disability benefits, the Commissioner of Social Security should move ahead with his consideration of the need for a legislative proposal to amend the DI program's retroactive benefit period for wounded warriors, given the unique challenges faced by this population in applying for benefits in a timely manner.
Closed – Implemented
The Social Security Administration (SSA) reported that it recognizes that disabled service members face special circumstances that may lead to a loss of benefits due to delays in filing for benefits. On August 30, 2011, the Commissioner approved a legislative proposal that would provide that if a military service member becomes disabled while on active duty, the application would be filed in the month he became disabled. This proposal would be an exception to the current rules on DI retroactivity.
Social Security Administration To improve wounded warriors' access to SSA disability benefits, the Secretary of Veterans Affairs and the Commissioner of Social Security should work together to improve outreach to veterans on SSA disability benefits. In doing so, the VA and SSA should, in particular, seek to reach veterans who either were discharged between 2001 and 2007; have disabilities that manifest after service such as PTSD; or were assigned a 100 percent disability rating. Specific actions that VA could take include issuing guidance to VA medical centers and regional offices for referring veterans to SSA and including information about SSA disability benefits in VA's phone outreach campaign to OEF/OIF veterans. In addition, SSA could work with VA to ensure stronger coordination between local SSA offices and VA medical facilities, for example by making sure that VA medical centers have a point of contact at a local SSA office or receive training from SSA staff on SSA benefits.
Closed – Implemented
Senior VA and SSA officials met in December 2009 and developed several new initiatives for helping wounded warriors access SSA disability benefits. VA and SSA have made some progress in implementing these initiatives. For example, SSA is now evaluating VA's Disability Examination Worksheets with the goal of recommending additional questions that would address SSA's need for functional assessment. Also, VA and SSA have entered a data sharing agreement, and VA has provided SSA with a list of all veterans who received a 100 percent disabled or Individual Unemployability rating between 2000 and 2008. SSA is using this list and its own databases to conduct research on the characteristics of veterans who have applied and been approved for Social Security benefits, with the goal of conducting more targeted outreach to potentially eligible veterans.
Social Security Administration To improve wounded warriors' access to SSA disability benefits, the Secretary of Defense and the Commissioner of Social Security should work together to better meet SSA's need for obtaining military medical records in a timely manner for processing Disability Insurence (DI) and Supplemental Security Income (SSI) applications from wounded warriors. This effort should consider how to ensure records that are stored electronically are also electronically transferable.
Closed – Implemented
The Social Security Administration (SSA) and the Department of Defense (DoD) have taken steps towards more efficient sharing of electronic medical records. On August 22, 2011, SSA and DoD implemented the interim solution pilot project. The pilot involved five SSA State Disability Determination Services (DDS) and a DoD centralized site. The DDSs sent a single electronic request for medical records to a DoD centralized site, which in turn responded electronically to the request for medical records. After evaluating the pilot, the agencies implemented this process nationwide in August 2012. Since then, according to SSA, the agency has seen a reduction in the average time it takes to receive DoD medical records from about five weeks to about two days, with a 100 percent response rate.
Department of Veterans Affairs To improve wounded warriors' access to SSA disability benefits, the Secretary of Veterans Affairs and the Commissioner of Social Security should work together to improve outreach to veterans on SSA disability benefits. In doing so, the VA and SSA should, in particular, seek to reach veterans who either were discharged between 2001 and 2007; have disabilities that manifest after service such as PTSD; or were assigned a 100 percent disability rating. Specific actions that VA could take include issuing guidance to VA medical centers and regional offices for referring veterans to SSA and including information about SSA disability benefits in VA's phone outreach campaign to OEF/OIF veterans. In addition, SSA could work with VA to ensure stronger coordination between local SSA offices and VA medical facilities, for example by making sure that VA medical centers have a point of contact at a local SSA office or receive training from SSA staff on SSA benefits.
Closed – Implemented
Senior VA and SSA officials met in December 2009 and developed several new initiatives for helping wounded warriors access SSA disability benefits. VA and SSA have made some progress in implementing these initiatives. For example, SSA is now evaluating VA's Disability Examination Worksheets with the goal of recommending additional questions that would address SSA's need for functional assessment. Also, VA and SSA have entered a data sharing agreement, and VA has provided SSA with a list of all veterans who received a 100 percent disabled or Individual Unemployability's rating between 2000 and 2008. SSA is using this list and its own databases to conduct research on the characteristics of veterans who have applied and been approved for Social Security benefits, with the goal of conducting more targeted outreach to potentially eligible veterans.
Department of Defense To improve wounded warriors' access to SSA disability benefits, the Secretary of Defense and the Commissioner of Social Security should work together to better meet SSA's need for obtaining military medical records in a timely manner for processing Disability Insurence (DI) and Supplemental Security Income (SSI) applications from wounded warriors. This effort should consider how to ensure records that are stored electronically are also electronically transferable.
Closed – Implemented
The Social Security Administration (SSA) and the Department of Defense (DoD) have taken steps towards more efficient sharing of electronic medical records. On August 22, 2011, SSA and DoD implemented the interim solution pilot project. The pilot involved five SSA State Disability Determination Services (DDS) and a DoD centralized site. The DDSs sent a single electronic request for medical records to a DoD centralized site, which in turn responded electronically to the request for medical records. After evaluating the pilot, the agencies implemented this process nationwide in August 2012. Since then, according to SSA, the agency has seen a reduction in the average time it takes to receive DoD medical records from about five weeks to about two days, with a 100 percent response rate.

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Topics

Aid for the disabledClaimsClaims processingClaims settlementDisabilitiesDisability benefitsEligibility determinationsEmployment of the disabledFederal social security programsMedical recordsMilitary disability retirement payMilitary personnelPeople with disabilitiesSocial security benefitsSocial security numberSupplemental security incomeVeterans benefitsVeterans disability compensationPolicies and procedures