SSA Plans to Conduct Required SSI CDRs and Test the Use of the Mailer CDR

For fiscal year 1996, SSA planned to conduct full medical CDRs for the legally required SSI CDRs and to test the mailer CDR process on over 100,000 additional SSI recipients. As of June, DDSs had completed about 60 percent of the required reviews in each category. Resources Appear Sufficient for Required SSI CDRs, but Competing Priorities Pose Challenges

SSA plans to use CDR funds to conduct the legally required SSI CDRs and disability eligibility redeterminations in fiscal years 1996 through 2002. For children, SSA limited its selection to low-birth-weight babies, who totaled about 7,200. SSA currently estimates that CDRs will remove only about 5 percent of SSI recipients from the rolls in the long run. However, if the CDR process was not in place, recipients’ continuing disability eligibility would be uncertain and the number of ineligible recipients would likely increase over time. SSA estimates that CDRs on adults SSA has classified as MIE or MIP save about $3 in federal SSI and Medicaid benefits for every $1 spent conducting CDRs on those categories. Options exist for making SSI CDRs more cost-effective and helping SSA meet the challenge of conducting all required CDRs. Specifically, we recommended that SSA replace the routine scheduling of CDRs with a new process that, if extended by the Congress to all recipients, would (1) be cost-effective by selecting for review individuals with the greatest potential for medical improvement and subsequent benefit termination, (2) correct a weakness in SSA’s current CDR process by reviewing a random sample of all other recipients, and (3) improve program integrity by instituting contact with those not selected for CDRs or financial eligibility redeterminations. As part of this effort, we also recommended that the Commissioner of Social Security develop a legislative package to obtain the authority the agency needs to enact this new process for those portions of the SSI and DI populations that are subject to routinely scheduled CDRs. This database contained records on all recipients SSA had determined were due or overdue for a CDR in fiscal year 1996. Social Security Disability: Improvements Needed to Continuing Disability Review Process (GAO/HEHS-97-1, Oct. 16, 1996). 24, 1996). 2, 1995).
Why GAO Did This Study

Pursuant to a congressional request, GAO reviewed the Social Security Administration's (SSA) strategy for conducting legally required continuing disability reviews (CDR) on Supplemental Security Income (SSI) recipients, focusing on: (1) SSA plans to conduct legally required SSI CDR in fiscal years 1996 through 1998; (2) the resources committed to meeting this requirement; (3) how SSA selects recipients for SSI CDR; (4) the potential benefits of conducting CDR on the SSI population; and (5) potential options for improving the CDR process.

What GAO Found

GAO found that: (1) SSA planned to conduct required CDR on about 118,000 SSI recipients in fiscal year (FY) 1996; (2) SSA also planned to conduct an additional 100,000 CDR on SSI recipients that were not legally required; (3) as of June 1996, SSA had completed about 60 percent of the required CDR; (4) other competing priorities may make it difficult for SSA to conduct all required SSI CDR after FY 1996; (5) in FY 1996, SSA limited its selection for CDR to those recipients for whom medical improvement is either expected or possible; (6) SSA estimates that conducting CDR will result in removing only about 5 percent of SSI recipients from the rolls, but without CDR, the number of ineligible recipients will likely increase over time; (7) SSA estimates that conducting CDR on SSI adult recipients for whom medical improvement is expected or possible results in about $3 in federal program savings for every $1 spent conducting CDR; and (8) SSA needs to establish less rigid requirements for determining who should be scheduled for CDR, ensure that contact is made with all SSI recipients, and develop a legislative proposal to obtain the authority needed to extend this new process to all recipients.