On average, workers receiving DI and adult SSI beneficiaries have been receiving benefits for over 9 years and their predominant disability is mental disorders. Individuals who have responded to a mailer CDR and are found to be still disabled are not referred for full medical CDRs, and SSA sets a future CDR date. Because SSA has not finished incorporating the new CDR requirements into its plans, it is too early to determine whether the authorized funding will be adequate for all required CDRs. Recommendations to the Commissioner of Social Security

We recommend that, to the extent SSA is authorized to act, the Commissioner of SSA replace the routine scheduling for CDRs of all who receive DI and SSI program benefits with a more cost-effective process that would (1) select for review beneficiaries with the greatest potential for medical improvement and subsequent benefit termination, (2) correct a weakness in SSA’s CDR process by conducting CDRs on a random sample from all other beneficiaries, and (3) help ensure program integrity by instituting contact with beneficiaries not selected for CDRs. To determine the number of SSI beneficiaries currently due or overdue for a CDR, we used OD’s database that contains information on all SSI beneficiaries SSA has determined were due or overdue for a CDR in fiscal year 1996. In conjunction with data on the beneficiaries’ impairment, age, and other characteristics, SSA uses responses to mailer CDRs to help identify those beneficiaries most likely to have medically improved who thus should receive full medical reviews. Not available. GAO Comments

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Why GAO Did This Study

Pursuant to a congressional request, GAO reviewed the Disability Insurance (DI) and Supplemental Security Income (SSI) programs, focusing on: (1) the backlog of DI and SSI cases due for continuing disability reviews (CDR); (2) the number and characteristics of individuals who are due for CDR; (3) whether adequate resources are available for conducting CDR; and (4) ways to improve the CDR process.

What GAO Found

GAO found that: (1) almost half of all DI and SSI beneficiaries are due or overdue for CDR in fiscal year 1996; (2) the typical beneficiary awaiting CDR is under age 59, has been receiving benefits for an average of 8 years, is unlikely to medically improve, and has been overdue for CDR for 3 years; (3) SSA uses either a full medical examination or a mail-in form to conduct CDR, depending on the likelihood that it will find reason to terminate a recipient's benefits; (4) it is too soon to tell if authorized funding will be adequate to conduct all required CDR through 2002; (5) the SSA plan to conduct over 8 million CDR over 7 years is ambitious; and (6) SSA could improve the CDR process by reviewing beneficiaries most likely to medically improve, conducting CDR on a random sample from all other beneficiaries, and using CDR contact to determine beneficiaries' rehabilitation needs.