Objective

To determine the financial impact to the Disability Insurance and Supplemental Security Income programs as a result of conducting fewer full medical continuing disability reviews (CDR).

Background

After an individual is determined to be disabled, the Social Security Administration (SSA) is required to conduct periodic CDRs to determine whether the individual continues to be disabled.

To view the full report, visit http://www.ssa.gov/oig/ADOBEPDF/A-07-09-29147.pdf

Our Findings

The number of full medical CDRs SSA conducted in recent years has decreased, particularly between Fiscal Years (FY) 2004 and 2008 with a decline of approximately 65 percent.  According to SSA, resource limitations and increases in its core workloads prevented it from conducting full medical CDRs when they became due.  As a result, SSA estimates a backlog of over 1.5 million full medical CDRs will exist at the end of FY 2010.

SSA has made, and will continue to make, benefit payments to individuals who would no longer be eligible if the backlog of 1.5 million full medical CDRs had been conducted when they became due.

• From Calendar Year (CY) 2005 through CY 2010, we estimate SSA will have made benefit payments of between $1.3 and $2.6 billion that could have potentially been avoided if the full medical CDRs in the backlog had been conducted when they became due. 
• Although SSA plans to conduct an increased number of full medical CDRs in FY 2011, the 1.5-million full medical CDR backlog will most likely remain.  Therefore, we estimate SSA will pay between $556 million and $1.1 billion during CY 2011 that could have potentially been avoided if the full medical CDRs in the backlog had been conducted when they became due.

Our Recommendation

We recommended SSA continue to work with Congress to secure the funds necessary to eliminate the existing full medical CDR backlog and to conduct the CDRs that become due each year.  To the extent the resources are not available to conduct the CDRs that become due each year, SSA should report the reasons and the associated impact on Federal benefit payments in its annual CDR Report to Congress.

SSA partially agreed with our recommendation.  According to SSA, the amount of time it takes to prepare the annual CDR Report to Congress undermines the usefulness of reporting the reasons and associated impact on Federal benefit payments of not conducting all CDRs that become due each year.  However, in accordance with the President’s commitment to transparency and open Government, we believe SSA should fully disclose this information to Congress as timely as possible.