SSA expects IT to help decisions

GAO report on disability claims

Social Security Administration officials say technology projects will go a long way to solve decision-making problems cited in a new report from the General Accounting Office.

GAO auditors say SSA officials have inconsistent disability decisions that cause unnecessary expense and delays in processing disability claims. Social Security officials responded to the July 2 report by asserting that the agency is automating its disability claims processing procedures and that the automated systems will largely eliminate the longstanding problem of inconsistent decision-making.

Each year, about 2.5 million people file claims with SSA for disability benefits. Claims that are denied can be appealed, but the high number of successful appeals has become a problem for SSA.

According to the new report, one-third of applicants with disability claims denied at the state level file appeals and get hearings. Hearing officers allow more than half of the claims, suggesting that state officials are interpreting and applying SSA's disability criteria differently than decision-makers at the appeals level.

SSA officials have proposed several changes to introduce more consistency into the disability claims process, including providing decision-makers access to what the GAO report describes as a complex and "as yet unproven" electronic case-file system.

Until SSA officials finish installing new systems, known collectively as the Accelerated Electronic Disability System, they plan to delay procedural changes that they say will bring more consistency into the disability claims process. That means the procedural changes will not occur until at least October 2005, according to the report.

But in their report, GAO auditors warn that SSA officials run the risk of depending too much on the electronic case folder system to solve discrepancies in disability claims decisions.

"SSA expects the new system to provide critical management information for analyzing and reducing inconsistencies in disability decisions," the report says.

The auditors, however, cautioned that what they consider to be SSA's rushed approach to automated case processing "involves risks that could jeopardize the agency's successful transition to an electronic claims process."

GAO auditors, who prepared the report for Rep. Clay Shaw (R-Fla.), chairman of the House Ways and Means Committee's Social Security Subcommittee, conducted their study between February 2003 and March 2004.

Earlier this year, SSA officials rejected advice from GAO after auditors recommended that SSA slow down and run more tests on its electronic disability claims processing systems before putting them in SSA offices nationwide.