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SSA Disability Programs: Better Metrics and Evaluation Needed to Inform Decision-Making

GAO-18-677T Published: Jul 25, 2018. Publicly Released: Jul 25, 2018.
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Highlights

What GAO Found

In a report being released today, GAO found that processing times and pending caseloads at the appeals level of Social Security Administration's (SSA) disability programs have grown in recent years. Specifically, average processing time (APT) climbed by approximately 70 percent from fiscal years 2012 through 2017. Pending caseloads followed a similar pattern. According to SSA officials, multiple factors, such as an increase in hearing requests after the 2007-2009 recession, contributed to longer processing times.

SSA has taken steps to reduce processing times by transferring cases from hearing offices with backlogs to offices with more capacity, but lacks metrics to determine the effect of its efforts. SSA uses technology such as electronic case files and video conferencing to process transferred cases and hold hearings across locations. From fiscal years 2008 through 2017, the percentage of cases that were transferred increased from 14 to 43 percent. Despite the rising use of transfers over the past decade, SSA cannot assess the effectiveness of these efforts due to weaknesses in its timeliness metrics on APT. In particular, SSA lacks office-specific timeliness measures for transferred cases. Instead, SSA's current APT metric attributes the entire processing time for a case to the office that finishes it, regardless of the time the case was held by another office before being transferred. Without an office-specific measure of timeliness for transferred appeals cases, SSA does not have an accurate metric to assess how individual offices contribute to processing times--information critical to assessing the effectiveness of transferring cases in meeting timeliness goals.

While SSA has made strides in modernizing its information technology (IT) systems to address growing workload demands, it continues to face challenges with these modernization efforts in dealing with backlogs. SSA staff described and GAO observed challenges related to case processing software needed to transfer cases. For example, the current case processing system restricts search queries to a 6-month time period to avoid slowing down the system. As a result, staff cannot retrieve the universe of potential transfer cases at one time to facilitate transferring large batches of cases. Such limitations impeded productivity for the staff selecting cases to transfer and also created the potential for error and misuse. 

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. Across the country, there were wide variations in the number of pending cases and processing times, with some hearing offices taking over 750 days--more than 2 years--to issue an appeals decision. Transferring cases from backlogged offices to offices with greater capacity is one of several ongoing SSA efforts to reduce the number of pending cases and the average time claimants wait for a decision. GAO was asked to review SSA's efforts to redistribute its appeals work.

This testimony summarizes information contained in GAO's July 2018 report entitled Social Security Disability: Better Timeliness Metrics Needed to Assess Transfers of Appeals Work. It addresses (1) challenges SSA faces in managing its workloads, (2) the extent to which SSA has metrics to assess its efforts to reduce processing times, and (3) limitations in SSA's information technology systems that might impact its efforts to reduce processing times.

For its July 2018 report, 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

In the report GAO is releasing today, GAO recommends that 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.

Full Report

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Topics

Administrative lawAppeals processClaims processingDisability benefitsJudgesPerformance measurementSocial security disabilityPhysical disabilitiesAgency evaluations