	Background

SSA’s disability programs provide cash benefits to people with long-term disabilities. Despite SSA’s Efforts, SSA Still Faces a High Backlog

Despite SSA attempts to reduce the backlog through its STDP initiatives, the agency did not reach its goal of reducing this backlog to 375,000 by December 1996. SSA attributes its difficulties in meeting its backlog target to start-up delays, overly optimistic projections of the number of appealed cases that would be processed, and an unexpected increase in the number of appealed cases. The actual backlog in December was about 486,000 cases and has risen in the last few months to 491,000 cases, still about 116,000 over the goal. This study indicated that DDS and ALJ decisionmakers reached different results even when presented with the same evidence. In the longer term, SSA plans to develop a simplified decision-making process, which will expand the role of functional capacity assessments. Because differences in functional capacity assessments are the primary reason for inconsistent decisions, SSA should proceed cautiously with its plan to expand the use of such assessments. Quality Reviews Do Not Focus on Inconsistency Between DDSs and ALJs

Although SSA has several quality review systems to examine disability decisions, none is designed to identify and reconcile factors that contribute to differences between DDS and ALJ decisions. In addition, SSA is beginning to move ahead with more systemwide changes in its redesign of the disability claims process. In particular, it is on the verge of implementing initiatives to redesign the process, including ones for improving decisional consistency and the timeliness of overall claims processing. However, competing workload demands could jeopardize SSA’s ability to make progress in reducing inconsistent decisions. 2, 1995). Social Security: Results of Required Reviews of Administrative Law Judge Decisions (GAO/HRD-89-48BR, June 13, 1989).
Why GAO Did This Study

GAO discussed the Social Security Administration's (SSA) actions to reduce the current backlog of cases appealed to the agency's administrative law judges, focusing on: (1) how functional assessments, differences in procedures, and quality review contribute to inconsistent results between different decisionmakers; and (2) SSA'a strategy to obtain greater decisional consistency.

What GAO Found

GAO noted that: (1) GAO's work shows that while SSA has developed broad-based plans to improve the management of its disability programs, many initiatives are just beginning and their effectiveness can be assessed only after a period of full-scale implementation; (2) for example, in the short term, SSA has taken action to try to deal with the backlog crisis, but it is still about 116,000 cases over its December 1996 goal of 375,000 cases; (3) in the longer term, SSA needs to come to grips with the systemic factors causing inconsistent decisions, which underlie the current high level of appealed cases and, in turn, the backlog crisis; (4) for example, GAO found that differences in assessments of functional capacity, different procedures, and weaknesses in quality reviews contribute to inconsistent decisions; and (5) although SSA is on the verge of implementing initiatives to deal with these factors, GAO is concerned that other congressionally mandated workload pressures, such as significantly increasing the number of continuing disability reviews and readjudicating childhood cases, could jeopardize the agency's ability to move ahead with its initiatives to reduce inconsistent decisions.