More specifically, the objectives of our assignment were to determine (1) those factors contributing to the growth in the backlog of appealed cases, (2) what steps SSA has taken in the past to address this backlog problem, (3) what SSA is currently doing to reduce the appellate backlog, and (4) what needs to be done in the long term to make the disability appeals process more timely and efficient. IV); examined SSA’s previous initiatives to address OHA backlogs and improve the hearings and appeals process; and reviewed SSA’s Short-Term Disability Plan (STDP) and the agency’s longer-term Plan for a New Disability Claim Process (redesign plan). We also reviewed the above studies, and several other government and nongovernment reviews conducted over the last several decades, and categorized the key long-standing problems affecting SSA’s disability programs as (1) multiple levels of claims development and decision-making, (2) fragmented accountability for claims processing, (3) decisional disparities between DDS and OHA adjudicators, and (4) SSA’s failure to consistently define and communicate its management authority over the ALJs. As a result, SSA has experienced numerous legal and operational challenges to its efforts to better manage the appeals process. Our most recent field work confirmed that SSA still has not consistently defined and communicated the types of management actions that are legally permissible under APA. Previous SSA Efforts Did Not Reduce Backlog

Over the last decade, SSA attempted to address the growth in OHA’s backlog of pending cases. Screening Units Are Not Sufficiently Reducing the Number of Cases Requiring an ALJ Hearing

A second major initiative under STDP is intended to further reduce the flow of cases from DDSs to OHA hearing offices by increasing the effectiveness of SSA regional screening units. In the near term, STDP is designed to expedite the disability appeals process and reduce OHA’s pending case backlog to a manageable level. To ensure decisional accuracy, SSA intends to monitor the quality of STDP decisions and the overall allowance rate for its disability programs. However, the agency questioned the statement in our report that many ALJs believe they are exempt from nearly all management control.
Why GAO Did This Study

Pursuant to a congressional request, GAO examined the growth in the backlog of pending cases at the Social Security Administration's (SSA) Office of Hearings and Appeals (OHA), focusing on SSA initiatives to: (1) reduce backlogged cases; and (2) make the disability appeals process more timely and efficient.

What GAO Found

GAO found that: (1) the growth in OHA backlogs is a direct result of increased applications and appeals to OHA, as well as SSA inattention to long-standing problems; (2) these problems include multiple levels of claims development and decisionmaking, fragmented program accountability, decisional disparities between disability determination services and OHA adjudicators, and SSA failure to communicate its management authority over administrative law judges (ALJ); (3) SSA initiated short-and long-term efforts to manage its disability determination and appeals process in 1994; (4) the SSA Short-Term Disability Plan (STDP) should reduce OHA backlogs to a manageable level by December 1996; (5) STDP relies on the temporary reallocation of SSA resources and process changes to stem the flow of cases requiring ALJ hearings; (6) start-up delays and limited timeframes have affected SSA ability to reduce the number of backlogged cases; (7) SSA tracks and monitors STDP allowances to ensure decisional accuracy; (8) the SSA redesign plan is aimed at addressing systemic problems within the SSA disability program and reducing claims processing; (9) the redesign plan is still in its early stages, and does not address the types of management actions that are legally permissible for ALJ hearings; and (10) many ALJ believe that they are legally exempt from management control, and SSA is frustrated in its efforts to manage the appeals process and reduce the number of pending cases.