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Social Security Disability: Better Timeliness Metrics Needed to Assess Transfers of Appeals Work

GAO-18-501 Published: Jul 19, 2018. Publicly Released: Jul 25, 2018.
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Highlights

What GAO Found

Over the past decade, the Social Security Administration (SSA) increasingly transferred appealed disability cases awaiting decisions from offices with backlogs to offices with more capacity as processing times lengthened. From fiscal years 2008 through 2017, the percentage of cases that were transferred increased from 14 to 43 percent. Although transfers are meant to improve timeliness of appeal decisions, average processing times grew and older pending cases increased over fiscal years 2012 through 2017. According to SSA officials, multiple factors, such as an increase in hearing requests after the 2007-2009 recession, contributed to longer processing times.

Percentage of Appeals Transferred to Redistribute Work and Average Processing Time of Appeals, Fiscal Years 2008-2017

Percentage of Appeals Transferred to Redistribute Work and Average Processing Time of Appeals, Fiscal Years 2008-2017

SSA monitors transfers of appealed cases to improve timeliness, but lacks measures to accurately assess how individual offices contribute to processing times. According to SSA officials, staff in both SSA headquarters and the offices that receive transfers check that older cases are being prioritized for transfer. SSA ranks offices on various dimensions including timeliness metrics. However, its metrics do not hold individual offices accountable for the time they were responsible for a case because the entire processing time is attributed to the office that finalizes the case. GAO work has shown that managers need appropriate measures to create incentives and accurate performance information to make decisions. Because of other priorities, SSA has not changed its performance metrics to give individual offices credit for the work performed, so it cannot assess how offices contribute to processing times.

SSA staff described and GAO observed challenges related to case transfers. For example, hearing office staff demonstrated difficulties they face in accurately and efficiently identifying cases to transfer because of software limitations. As a result, staff use a variety of time-consuming workarounds that could increase the chance of transferring cases that do not meet SSA's selection criteria. SSA's plans call for technology improvements that remove inefficiencies in its case processing systems and redirect staff from manual work. However, SSA does not intend to address these software limitations as it upgrades its case processing systems this year, thus contributing to ongoing impediments to staff productivity.

Why GAO Did This Study

Individuals who do not agree with an initial decision on a claim for Social Security disability benefits can ultimately appeal by requesting a hearing before an administrative law judge. At the end of fiscal year 2017, more than 1 million claimants who had appealed were awaiting a decision, and they waited, on average, 605 days. To help reduce processing times of appeals, SSA transfers cases from backlogged offices to those with greater capacity. GAO was asked to review SSA's efforts to redistribute its appeals work.

This report examines (1) trends in SSA's transfers and processing times of appealed cases over the past decade, (2) SSA's monitoring of efforts to meet processing time goals through case transfers, and (3) any challenges SSA faces in transferring cases between offices.

GAO analyzed SSA case processing data from fiscal years 2008-2017; reviewed SSA policies and operational guidance; observed SSA's systems for case transfers; and interviewed SSA officials at the agency's headquarters and offices in 3 of its 10 regions, selected for the large number of cases transferred and proximity to national centers established to process transferred cases.

Recommendations

GAO recommends SSA (1) develop timeliness metrics that more accurately reflect offices' performance in light of case transfers, and (2) evaluate costs and benefits of changing system limitations that hinder users from correctly and efficiently identifying cases to transfer. SSA agreed with both recommendations.

Recommendations for Executive Action

Agency Affected Recommendation Status
Social Security Administration The Deputy Commissioner for Hearings Operations should develop a timeliness metric or set of metrics that more accurately reflect offices' performance in light of case transfers. For example, SSA could develop additional average processing time metrics for cases that are permanently transferred that reflect the time the originating and assisting offices held cases. (Recommendation 1)
Closed – Implemented
SSA created metrics and reports that more accurately reflect offices' performance in light of case transfers. For example, in November 2018, for permanently-transferred cases, SSA developed a timeliness metric that reflects the time that each assisting office held cases.
Social Security Administration The Deputy Commissioner for Hearings Operations should evaluate the costs versus the benefits of changing system limitations that hinder users' ability to correctly and efficiently identify and transfer batches of cases. (Recommendation 2)
Closed – Implemented
SSA agreed with this recommendation and in May 2019 stated that it was in the early stages of developing and rolling out a new case processing system to replace its Case Processing and Management System called the Hearings and Appeals Case Processing System (HACPS). SSA created HACPS to provide end-to-end disability claims processing infrastructure to support the full life-cycle of a disability claim and give users greater flexibility in correctly and accurately transferring cases to and from hearing sites process. It includes hearings and appeals case processing functionality. In November 2020, SSA began deploying HACPS to all hearing offices. In November 2021, SSA implemented batch case transfer functionality through HACPS.

Full Report

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Topics

Administrative lawAppeals processClaims processingDisability benefitsJudgesPerformance measurementSocial security disabilityTimelinessPhysical disabilitiesHuman capital management