Feds Struggle To Fix Disability Determination Process

The Social Security Administration is suspending much of a disability claim reform effort it has been testing in Boston.

The Boston pilot program, launched in 2006, has cost $24 million more than expected, and the SSA has decided to cancel some components, even in Boston, and to postpone moves to introduce other components nationwide, U.S. Government Accountability Office analysts write in a review of the SSA’s Disability Services Improvement initiative.

The SSA instead will focus on implementing an electronic case processing system and on coping with a mounting backlog of pending hearing requests, the analysts write.

The aging of the population, the complexity of claim determinations and the difficulty of keeping Social Security Disability Insurance claims personnel have contributed to the backlog, David Bertoni, a GAO director, writes in a letter summarizing the GAO’s findings.

“Unfortunately, [the] SSA also has a history of implementing initiatives to improve claims processing that have been poorly executed and therefore compounded its problems.”

The GAO analysts prepared the review at the request of the leaders of the House Ways and Means Committee.

SSDI is the only disability insurance many U.S. residents have, and, in most cases, U.S. residents with disabilities must collect SSDI benefits for 2 years before they can qualify for Medicare health insurance benefits aimed at people with disabilities.

Private disability insurers are pushing for improvements in the SSDI claims process because many have policies that permit them to subtract SSDI benefits payments from the amounts they pay to claimants.

Although the SSA has been talking about reducing the backlog for years, the total number of backlogged SSDI claims increased to about 576,000 at the end of federal fiscal year 2006, up from fewer than 200,000 in 1999, the researchers write.

In fiscal year 2006, 30% of claims that went through determination hearings took 600 days or more

In Boston, the SSA tried a variety of reforms, such as creating a “quick disability determination process” for individuals with clear-cut cases of disability.

The process “has been successful in fully adjudicating 79% of targeted claims within 20 days or fewer, with an average decision time of 10 days,” Bertoni writes.

But, even in that program, there have been problems, Bertoni notes.