State DDSs provide crucial support to the initial disability claims process— one that accounts for most of SSA’s workload—through their role in  determining an individual’s medical eligibility for disability benefits. To address concerns regarding the program’s efficiency, in 1992 SSA  initiated a plan to redesign the disability claims process, emphasizing the  use of automation to achieve an electronic (paperless) processing  capability. AeDib’s Strategy Calls For Developing and Integrating Multiple Disability System Projects

In undertaking AeDib, SSA has embarked on a major initiative consisting of  multiple projects that are intended to move all partners in its disability  claims adjudication and review to an electronic business process. The AeDib strategy focuses on developing the capability for claimant  information and large volumes of medical images, files, and other  documents that are currently maintained in paper folders to be stored in  electronic folders, and then accessed, viewed, and shared by the disability  processing offices. SSA is undertaking five key projects to support the  strategy:   An Electronic Disability Collect System to provide the capability for SSA  field offices to electronically capture information about the claimant’s  disability and collect this structured data in an electronic folder for use  by the disability processing offices;  A Document Management Architecture that will provide a data  repository and scanning and imaging capabilities to allow claimant  information and medical evidence to be captured, stored, indexed, and  shared electronically between the disability processing offices. By late January 2004,  SSA plans to have developed these two components. SSA Has Completed Important AeDib Tasks, But Much Work Remains

SSA has performed several important project tasks since beginning the  accelerated initiative in 2002. Nonetheless, the agency still has a significant amount of work to  accomplish to achieve the electronic disability folder by the end of next  January. The pilot tests were to  begin this month, and some of the test results upon which decisions are to  be based are not expected to be available until the end of December at the  earliest, leaving little time to incorporate the results into the system that is  to be implemented by late January. Further, even when completed, the pilot  tests will provide only limited information about the electronic folder’s  functionality. In addition, given the technological complexity of the AeDib project, the  need for end-to-end testing is substantial. Compounding AeDib’s vulnerability is that SSA has not yet undertaken a  comprehensive assessment of project risks to identify facts and  circumstances that increase the probability of failing to meet project  commitments, and taking steps to prevent this from occurring. SSA disability program and systems officials told us that the agency has  involved its various stakeholders in developing AeDib. However, officials that we contacted in nine of the ten DDS offices stated  that their concerns were not adequately heard and considered in the  decision-making process for the development of AeDib, despite the critical  and extensive role that states play in making disability determinations. Our review to date has not assessed the validity of the concerns expressed  by the stakeholders, or SSA’s responses to them. Nonetheless, SSA’s accelerated strategy may involve risks of delivering a  system that will not sufficiently address its needs. Given the importance of this project to SSA’s future  service-delivery capability, it is essential that the agency satisfy itself that  AeDib will perform as intended with minimal risk before it is deployed  nationwide.
Why GAO Did This Study

Providing benefits to disabled individuals is one of the Social Security Administration's (SSA) most important service delivery obligations--touching the lives of about 10 million individuals. In recent years, however, providing this benefit in a timely and efficient manner has become an increasing challenge for the agency. This past January, in fact, GAO designated SSA's disability programs as highrisk. Following a prior unsuccessful attempt, the agency is now in the midst of a major initiative to automate its disability claims functions, taking advantage of technology to improve this service. Seeking immediate program improvements, SSA is using an accelerated approach--called AeDib--to develop an electronic disability claims processing system. At the request of the Subcommittee on Social Security, House Committee on Ways and Means, GAO is currently assessing the strategy that underlies SSA's latest initiative to develop the electronic disability system. For this testimony, GAO was asked to discuss its key observations to date regarding the AeDib initiative, including strategy, risks, and stakeholder involvement. GAO plans to discuss more fully the results of this continuing review in a subsequent report

What GAO Found

SSA's goal to establish a more efficient, paperless disability claims processing system is important, and one that could benefit millions. To achieve this goal, SSA's immediate focus is on developing an electronic folder to store claimant information and large volumes of medical images, files, and other documents that are currently maintained in paper folders, and then make this information accessible to all entities involved in disability determinations. SSA's accelerated strategy calls for development of this capability by January 2004 rather than in 2005, as originally planned. Since accelerating this effort, SSA has performed important tasks toward establishing this initial electronic capability. Nonetheless, it has substantial work to accomplish in order to develop the technologically complex electronic folder and begin implementation by late next January. While responsive to the agency's need for an operational system as soon as possible, SSA's accelerated strategy involves risks. For example, pilot tests that are to provide important information about the electronic folder's performance are not expected until late December--just 1 month before its planned implementation. In addition, a strategy for end-to-end testing to demonstrate that the individual components will work together reliably has not been completed. Further increasing the system's vulnerability is that SSA has not yet comprehensively assessed project risks. Unless addressed, these factors could ultimately derail the initiative. While SSA has taken steps to involve key stakeholders in the systems development process, officials in state Disability Determination Services offices that we contacted expressed concerns that they had only limited involvement in the development effort. They stated that their concerns were not adequately heard and considered in the decision-making process. Unless SSA addresses these issues, it cannot be assured of stakeholder agreement with and full use of the system.