Social Security Disability: SSA Actions to Reduce Backlogs and Achieve
More Consistent Decisions Deserve High Priority (Testimony, 04/24/97,
GAO/T-HEHS-97-118).

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.

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.

--------------------------- Indexing Terms -----------------------------

 REPORTNUM:  T-HEHS-97-118
     TITLE:  Social Security Disability: SSA Actions to Reduce Backlogs 
             and Achieve More Consistent Decisions Deserve High
             Priority
      DATE:  04/24/97
   SUBJECT:  Hearings
             Disability benefits
             Claims adjudicators
             Eligibility determinations
             Administrative law judges
             Federal social security programs
             Compensation claims
             Claims settlement
             Claims processing
             Administrative remedies
IDENTIFIER:  SSA Short Term Disability Plan
             Social Security Disability Insurance Program
             Supplemental Security Income Program
             Medicare Program
             
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Cover
================================================================ COVER


Before the Subcommittee on Social Security, Committee on Ways and
Means, House of Representatives

For Release on Delivery
Expected at 9:00 a.m.
Thursday, April 24, 1997

SOCIAL SECURITY DISABILITY - SSA
ACTIONS TO REDUCE BACKLOGS AND
ACHIEVE MORE CONSISTENT DECISIONS
DESERVE HIGH PRIORITY

Statement of Jane L.  Ross, Director
Income Security Issues
Health, Education, and Human Services Division

GAO/T-HEHS-97-118

GAO/HEHS-97-118T


(207005)


Abbreviations
=============================================================== ABBREV

  ALJ - administrative law judge
  CDR - continuing disability review
  DDS - disability determination service
  DI - Disability Insurance
  OHA - Office of Hearings and Appeals
  SSA - Social Security Administration
  SSI - Supplemental Security Income
  STDP - Short Term Disability Project Plan

SOCIAL SECURITY DISABILITY:  SSA
ACTIONS TO REDUCE BACKLOGS AND
ACHIEVE MORE CONSISTENT DECISIONS
DESERVE HIGH PRIORITY
============================================================ Chapter 0

Mr.  Chairman and Members of the Subcommittee: 

Thank you for inviting me to testify on the Social Security
Administration's (SSA) management of the Disability Insurance (DI)
and Supplemental Security Income (SSI) programs.  In 1995, these
programs paid benefits approaching $60 billion a year and served
nearly 7 million working-age adults.  As you are aware, SSA's process
has been overwhelmed with a large number of appealed cases, which
grew from about 225,000 in fiscal year 1986 to about 498,000 in
fiscal year 1996. 

Today I will discuss actions that SSA undertook, beginning in 1994,
to improve the timeliness, efficiency, and consistency of disability
decisions.  Its actions resulted from a realization that the lengthy
and complicated decision-making process and the inconsistency of
decisions between adjudicative levels compromise the integrity of
disability determinations.  More specifically, I will describe SSA's
actions to reduce the current backlog of cases appealed to the
agency's administrative law judges (ALJ).  Then I will discuss how
functional assessments, differences in procedures, and quality review
contribute to inconsistent results between different decisionmakers
and describe SSA's strategy to obtain greater decisional consistency. 
My testimony is based on our reports and our ongoing studies of SSA's
disability programs being conducted for the Chairman of the
Subcommittee.  (See the list of related GAO products.)

In summary, our 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.  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.  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.  For example, we found that
differences in assessments of functional capacity, different
procedures, and weaknesses in quality reviews contribute to
inconsistent decisions.  Although SSA is on the verge of implementing
initiatives to deal with these factors, we are 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. 


   BACKGROUND
---------------------------------------------------------- Chapter 0:1

SSA's disability programs provide cash benefits to people with
long-term disabilities.  The DI program provides monthly cash
benefits and Medicare eligibility to severely disabled workers; SSI
is an income assistance program for blind and disabled people.  The
law defines disability for both programs as the inability to engage
in substantial gainful activity because of a severe physical or
mental impairment that is expected to last at least 1 year or result
in death. 

Both DI and SSI are administered by SSA and state disability
determination services (DDS).  SSA field offices determine whether
applicants meet the nonmedical criteria for eligibility and at the
DDSs, a disability examiner and a medical consultant (physician or
psychologist) make the initial determination of whether the applicant
meets the definition of disability.  Denied claimants may ask the DDS
to reconsider its finding and, if denied again, may appeal to an ALJ
within SSA's Office of Hearings and Appeals (OHA).  The ALJ usually
conducts a hearing at which applicants and medical or vocational
experts may testify and submit new evidence.  Applicants whose
appeals are denied may request review by SSA's Appeals Council and
may further appeal the Council's decision in federal court. 

Between fiscal years 1986 and 1996, the increasing number of appealed
cases has caused workload pressures and processing delays.  During
that time, appealed cases increased more than 120 percent.  In the
last 3 years alone, average processing time for appealed cases rose
from 305 days in fiscal year 1994 to 378 days in fiscal year 1996 and
remained essentially the same for the first quarter of fiscal year
1997.  In addition, "aged" cases (those taking 270 days or more for a
decision) increased from 32 percent to almost 43 percent of the
backlog.\1

In addition to the backlog, high ALJ allowances (in effect,
"reversals" of DDS decisions to deny benefits\2 ) have been a subject
of concern for many years.  Although the current ALJ allowance rate
has dropped from 75 percent in fiscal year 1994, ALJs still allow
about two-thirds of all disability claims they decide.  Because
chances for award at the appeals level are so favorable, there is an
incentive for claimants to appeal.  For several years, about
three-quarters of all claimants denied at the DDS reconsideration
level have appealed their claims to the ALJ level.\3

In 1994, SSA adopted a long-term plan to redesign the disability
decision-making process to improve its efficiency and timeliness.  As
a key part of this plan, SSA developed initiatives to achieve similar
decisions on similar cases regardless of whether the decisions are
made at the DDS or the ALJ level.  In July 1996, several of these
initiatives, called "process unification," were approved for
implementation by SSA's Commissioner.  SSA expects that process
unification will result in correct decisions being made at the
earliest point possible, substantially reducing the proportion of
appealed cases and ALJ allowance rates as well. 

Because SSA expects that implementation of its redesigned disability
decision-making process will not be completed until after the year
2000, SSA developed a Short Term Disability Project Plan (STDP) to
reduce the existing backlog by introducing new procedures and
reallocating staff.  STDP is designed to expedite processing of
claims in a way that will support redesign and achieve some near-term
results in reducing the backlog.  SSA expects that STDP's major
effect will come primarily from two initiatives--regional screening
unit and prehearing conferencing activities.  In the screening units,
DDS staff and OHA attorneys work together to identify claims that
could be allowed earlier in the appeals process.  Prehearing
conferencing shortens processing time for appealed cases by assigning
OHA attorneys to perform limited case development and review cases to
identify those that could potentially be allowed without a formal
hearing.  The plan called for reducing the backlog to 375,000
appealed cases by December 31, 1996. 


--------------------
\1 Processing time represents total OHA workloads, which include
appealed Medicare cases. 

\2 ALJ decisions are said to be de novo, or "afresh."

\3 About one-third of claimants denied at the initial DDS-level
appeal, while the rest abandon their cases. 


   DESPITE SSA'S EFFORTS, SSA
   STILL FACES A HIGH BACKLOG
---------------------------------------------------------- Chapter 0:2

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.\4 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.  Although SSA did not reach its backlog goal,
about 98,000 more cases may have been added to the backlog if STDP
steps had not been undertaken.  The contribution made by STDP
underscores the need for SSA to continue its short-term effort while
moving ahead to address the disability determination process in a
more fundamental way in the long term. 


--------------------
\4 SSA's goal included Medicare claims, which ALJs also decide. 
However, the STDP initiatives focused only on disability claims,
which represented about 94 percent of the backlog in fiscal year
1996. 


   DECISION-MAKING PROCESS YIELDS
   HIGH DEGREE OF INCONSISTENCY
   BETWEEN DDSS AND ALJS
---------------------------------------------------------- Chapter 0:3

In addition to the backlog problem, SSA's decision-making process has
produced a high degree of inconsistency between DDS and ALJ awards,
as shown in table 1.  Although award rates representing DDS
decision-making vary by impairment, ALJ award rates are high
regardless of the type of impairment.  For example, sample data
showed that DDS award rates ranged from 11 percent for back
impairments to 54 percent for mental retardation.  In contrast, ALJ
award rates averaged 77 percent for all impairment types with only a
smaller amount of variation among impairment types. 



                          Table 1
          
            Award Rates at DDS and ALJ Levels by
                      Impairment Type

                                   DDS award     ALJ award
                                       rates         rates
                                   (percent)     (percent)
------------------------------  ------------  ------------
Physical                                  29            74
Musculoskeletal                           16            75
Back cases                                11            75
Other musculoskeletal                     23            76
Other physical                            36            74
Mental                                    42            87
Illness                                   39            87
Retardation                               54            84
All impairments                           30            77
----------------------------------------------------------
Note:  ALJ data are from an ongoing SSA study.  Data include ALJ
cases decided from September 1, 1992, through April 30, 1995.  Study
samples excluded certain types of cases, such as children's cases. 
DDS data for the same period and types of cases were obtained from
SSA's administrative database. 


      DISABILITY DETERMINATIONS
      REQUIRE COMPLEX JUDGMENT
-------------------------------------------------------- Chapter 0:3.1

SSA's process requires adjudicators to use a five-step sequential
evaluation process in making their disability decisions (see table
2).  Although this process provides a standard approach to
decision-making, determining disability often requires that a number
of complex judgments be made by adjudicators at both the DDS and ALJ
levels. 



                          Table 2
          
          Five-Step Sequential Evaluation Process
                 for Determining Disability

                                 Action or decision taken
                                if answer to question is:
                                --------------------------
      Questions asked in the
Step  sequential process        Yes           No
----  ------------------------  ------------  ------------
1     Is the claimant engaging  Stop--        Go to step 2
      in substantial gainful    claimant is
      activity?                 not disabled

2     Does the claimant have    Go to step 3  Stop--
      an impairment that has                  claimant is
      more than a minimal                     not disabled
      effect on the claimant's
      ability to perform basic
      work tasks and is
      expected to last at
      least 12 months?

3     Do the medical facts      Stop--        Go to step 4
      alone show that the       claimant is
      claimant's impairment     disabled
      meets or equals the
      medical criteria for an
      impairment in SSA's
      Listing of Impairments?

4     Comparing the claimant's  Stop--        Go to step 5
      residual functional       claimant is
      capacity with the         not disabled
      physical and mental
      demands of the
      claimant's past work,
      can the claimant perform
      his or her past work?

5     Based on the claimant's   Claimant is   Claimant is
      residual functional       not disabled  disabled
      capacity and any
      limitations that may be
      imposed by the
      claimant's age,
      education, and skill
      level, can the claimant
      do work other than his
      or her past work?
----------------------------------------------------------
As the application proceeds through the five-step process, claimants
may be denied benefits at any step, ending the process.  Steps 1 and
2 ask questions about the claimant's work activity and the severity
of the claimant's impairment.  If the reported impairment is judged
to be severe, adjudicators move to step 3.  At this step, they
compare the claimant's condition with a listing of medical
impairments developed by SSA.  Claimants whose conditions meet or are
medically equivalent to the listings are presumed by SSA to be unable
to work and are awarded benefits.  Claimants whose conditions do not
meet or equal the listings are then assessed at steps 4 and 5, where
decisions must be made about the claimant's ability to perform prior
work and any other work that exists in the national economy.  To do
this, adjudicators assess the claimant's capacity to function in the
workplace. 

DDS and ALJ adjudicators exercise considerable judgment when making
these functional assessments.  They must consider and weigh all
available evidence, including physician opinions and reported
symptoms, such as pain.  Mental impairment assessments include
judgments about the claimant's ability to understand, remember, and
respond appropriately to supervision and normal work pressures.  For
physical impairments, adjudicators judge the claimant's ability to
walk, sit, stand, and lift.  To facilitate this, SSA has defined five
levels of physical exertion ranging from very heavy to sedentary. 
However, for those claimants unable to perform even sedentary
activities, adjudicators may determine that a claimant can perform
"less than a full range of sedentary" activities, a classification
that often results in a benefit award. 


   DDSS AND ALJS DIFFER PRIMARILY
   OVER CLAIMANTS' FUNCTIONAL
   ABILITIES
---------------------------------------------------------- Chapter 0:4

Our analysis found that differing functional assessments by DDSs and
ALJs are the primary reason for most ALJ awards.  Since most DDS
decisions use all five steps of the sequential evaluation process
before denying a claim, almost all DDS denial decisions appealed to
ALJs included such a functional assessment.  On appeal, the ALJ also
follows the same sequential evaluation process as the DDS and also
assesses the claimant's functional abilities in most awards they
make. 

Data from SSA's ongoing ALJ study indicate that ALJs are much more
likely than DDSs to find that claimants have severe limitations in
functioning in the workplace (see table 3). 



                          Table 3
          
           DDS and ALJ Differences in Functional
          Assessment Classifications for Physical
                     Impairment Awards

                                   Percentage of awards
                                --------------------------
                                     Quality
Level of physical exertion         reviewers      Original
determined by functional           using DDS      awarding
assessment                          approach          ALJs
------------------------------  ------------  ------------
Heavy work (or no limiting                 0             0
 effect on physical effort)
Medium work                               22             1
Light work                                56             8
Sedentary work                            15            25
Less than the full range of                6            66
 sedentary work
----------------------------------------------------------
Note:  Data are for ALJ awards made from September 1992 through April
1995. 

Most notably, in the view of the awarding ALJs, 66 percent of the
cases merited a functional capacity assessment of "less than the full
range of sedentary" work--a classification that is likely to lead to
an award.  In contrast, reviewers using the DDS approach found that
less than 6 percent of the cases merited this classification. 

Functional assessment also played a key role in a 1982 SSA study,
which controlled for differences in evidence.  This study indicated
that DDS and ALJ decisionmakers reached different results even when
presented with the same evidence.\5 As part of the study, selected
cases were reviewed by two groups of reviewers--one group reviewing
the cases as ALJs would and the other reviewing the cases as DDSs
would.  Reviewers using the ALJ approach concluded that 48 percent of
the cases should have received awards, while reviewers using the DDS
approach concluded that only 13 percent of those same cases should
have received awards. 

The use of medical expertise appears to influence the decisional
differences at the DDS and ALJ levels.  At the DDS level, medical
consultants are responsible for making functional assessments.  In
contrast, ALJs have the sole authority to determine functional
capacity and often rely on claimant testimony and the opinions of
treating physicians.  Although ALJs may call on independent medical
experts to testify, our analysis shows that they do so in only 8
percent of the cases resulting in awards. 

To help reduce inconsistency, SSA issued nine rulings on July 2,
1996, which were written to address pain and other subjective
symptoms, treating source opinions, and assessing functional
capacity.\6 SSA also plans to issue a regulation to provide
additional guidance on assessing functional capacity at both the DDS
and ALJ levels, specifically clarifying when a "less than sedentary"
classification is appropriate.\7 In addition, based on the nine
rulings, SSA completed nationwide process unification training of
over 15,000 adjudicators and quality reviewers between July 10, 1996,
and February 26, 1997.  In the training, SSA emphasized that it
expects the "less than sedentary" classification would be used
rarely.  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. 


--------------------
\5 Implementation of Section 304 (g) of Public Law 96-265, Social
Security Disability Amendments of 1980:  Report to the Congress by
the Secretary of Health and Human Services, SSA, Department of Health
and Human Services (Jan.  1982).  This report is commonly known as
the "Bellmon Report."

\6 Federal Register, 61 F.R.  34466-34492 (July 2, 1996). 

\7 SSA told us that the notice of proposed rulemaking on the "less
than sedentary" regulations is ready for release but did not provide
the date when it would be issued. 


   PROCEDURES LIMIT USE OF DDS
   DECISIONS AS A FOUNDATION FOR
   ALJ DECISIONS
---------------------------------------------------------- Chapter 0:5

Procedures at the DDS and ALJ levels limit the usefulness of the DDS
decision as a foundation for the ALJ decision.  Often, ALJs are
unable to rely on DDS decisions because they lack supporting evidence
and explanations of the reasons for denial, laying a weak foundation
for the ALJ decision if the case is appealed.  Moreover, although SSA
requires ALJs to consider the DDS medical consultant's assessment of
functional capacity, procedures at the DDS level do not ensure that
such assessments are clearly explained.  In a 1994 study, SSA found
that written explanations of critical issues at the DDS level were
inadequate in about half of the appealed cases that turned on complex
issues.\8

Without a clear explanation of the DDS decision, the ALJ could
neither effectively consider it nor give it much weight. 

At the ALJ level, claimants are allowed to claim new impairments and
submit new or additional evidence, which also affects consistency
between the two levels.  Moreover, in about 10 percent of cases
appealed to the ALJ level, claimants switch their primary impairment
from a physical claim to a mental claim.  In addition, data from a
1994 SSA study show that claimants submit additional evidence to the
ALJ in about three-quarters of the sampled cases and that additional
evidence was an important factor in 27 percent of ALJ allowances. 

To address the documentation issues, SSA plans to take steps to
ensure that DDS decisions are better explained and are based on a
more complete record so that they are more useful if appealed.  On
the basis of feedback during the process unification training, SSA
plans further instructions and training in May 1997 for the DDSs on
how and where in the case files they should explain how they reached
their decisions.  SSA also plans to issue a regulation clarifying the
weight given to the DDS medical consultants' opinions at the ALJ
level.\9

To deal with the potential effect of new evidence, SSA plans to
return to the DDSs about 100,000 selected cases a year for further
consideration when new evidence is introduced at the ALJ level.  In
cases where the DDS would award benefits, the need for a more
time-consuming and costly ALJ decision would be avoided.  SSA plans
to implement this project in May 1997.  Moreover, SSA's decision to
limit such returns to about 100,000 cases may need to be reassessed
in light of the potential benefits that could accrue from this
initiative. 


--------------------
\8 Findings of the Disability Hearings Quality Review Process, Office
of Program and Integrity Reviews, SSA (Sept.  1994). 

\9 SSA told us that the notice of proposed rulemaking on the DDS
medical consultants' opinions is in final clearance within SSA. 


   QUALITY REVIEWS DO NOT FOCUS ON
   INCONSISTENCY BETWEEN DDSS AND
   ALJS
---------------------------------------------------------- Chapter 0:6

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.  For
example, although ALJs are required to consider the opinion of the
DDS medical consultant when making their own assessment of a
claimant's functional capacity, such written DDS opinions are often
lacking in the case files.  Quality reviews at the DDS level do not
focus effectively on whether or how well these opinions are explained
in the record, despite the potential importance of such medical
opinion evidence at the ALJ level.  Moreover, SSA reviews too few ALJ
awards to ensure that ALJs give appropriate consideration to the
medical consultants' opinions or to identify means to make them more
useful to the ALJs.  Feedback on these issues could help improve
consistency by making the DDS decision a more useful part of the
overall adjudication process. 

To improve consistency, SSA is completing work on a notice of
proposed rulemaking, with a target issue date of August 1997 for a
final regulation, to establish the basis for reviewing ALJ awards,
which would require ALJs to take corrective action on remand orders
from the Appeals Council before benefits are paid.  SSA has just
started conducting preliminary reviews of ALJ awards, beginning with
200 cases a month.  After the regulation is issued, they plan to
increase the number of cases per month.  SSA has set a first-year
target of 10,000 cases to be reviewed, but this reflects only about 3
percent of approximately 350,000 award decisions made by ALJs in
1996.  Ultimately, SSA plans to implement quality review measures to
provide consistent feedback on the application of policy.  By doing
this, the agency hopes to ensure that the correct decision is made at
the earliest point in the process. 


   COMPETING WORKLOADS COULD
   JEOPARDIZE INITIATIVES TO
   IMPROVE CONSISTENCY OF
   DECISIONS
---------------------------------------------------------- Chapter 0:7

At the same time that SSA is trying to begin implementation of its
process unification initiatives, it faces significantly increasing
workloads at all levels of adjudication.  In particular, efforts to
improve decisional consistency will compete with specific
congressional mandates for time and resources.  For example, the
Social Security Independence and Program Improvements Act of 1994 and
the Personal Responsibility and Work Opportunity Reconciliation Act
of 1996 require hundreds of thousands of more continuing disability
reviews (CDR) to ensure that beneficiaries are still eligible for
benefits.  By law, SSA will be required to conduct CDRs for at least
100,000 more SSI beneficiaries annually through fiscal year 1998. 
Last year, the Congress increased CDR requirements for children on
SSI, requiring them at least every 3 years for children under age 18
who are likely to improve and for all low-birthweight babies within
the first year of life.  In addition, SSA is required to redetermine,
using adult criteria, the eligibility of all 18-year-olds on SSI
beginning on their 18th birthdays and to readjudicate 332,000
childhood disability cases by August 1997.  Finally, thousands of
noncitizens and drug addicts and alcoholics could appeal their
benefit terminations, further increasing workload pressures. 


   CONCLUDING OBSERVATIONS
---------------------------------------------------------- Chapter 0:8

Despite SSA's Short Term Disability Project Plan, the appealed case
backlog is still high.  Nevertheless, because the backlog would have
been even higher without STDP, SSA will need to continue its effort
to reduce the backlog to a manageable level until the agency, as a
part of its long-term redesign effort, institutes a permanent process
to ensure timely and expeditious disposition of appeals. 

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. 

We urge the agency to follow through on its initiatives to address
the long-standing problem of decisional inconsistency with the
sustained attention required for this difficult task.  To do so, SSA,
in consultation with this Subcommittee and others, will need to sort
through its many priorities and do a better job of holding itself
accountable for meeting its deadlines.  Otherwise, plans and target
dates will remain elusive goals and may never yield the dual benefits
of helping to restore public confidence in the decision-making
process and contributing to permanent reductions in backlog. 


-------------------------------------------------------- Chapter 0:8.1

Mr.  Chairman, this concludes my prepared statement.  At this time, I
will be happy to answer any questions you or the other Subcommittee
members may have. 


   CONTRIBUTORS
---------------------------------------------------------- Chapter 0:9

For more information on this testimony, please call Cynthia Bascetta,
Assistant Director, at (202) 512-7207.  Other major contributors are
William Hutchinson, Senior Evaluator; Carol Dawn Petersen, Senior
Economist; and David Fiske, Ellen Habenicht, and Carlos Evora, Senior
Evaluators. 

RELATED GAO PRODUCTS

Appealed Disability Claims:  Despite SSA's Efforts, It Will Not Reach
Backlog Reduction Goal (GAO/HEHS-97-28, Nov.  21, 1996). 

Social Security Disability:  Backlog Reduction Efforts Under Way;
Significant Challenges Remain (GAO/HEHS-96-87, July 11, 1996). 

Social Security Disability:  Management Action and Program Redesign
Needed to Address Long-Standing Problems (GAO/T-HEHS-95-233, Aug.  3,
1995). 

Disability Insurance:  Broader Management Focus Needed to Better
Control Caseload (GAO/T-HEHS-95-233, May 23, 1995). 

Social Security:  Federal Disability Programs Face Major Issues
(GAO/T-HEHS-95-97, Mar.  2, 1995). 

Social Security Disability:  SSA Quality Assurance Improvements Can
Produce More Accurate Payments (GAO/HEHS-94-107, June 3, 1994). 

Social Security:  Most of Gender Difference Explained
(GAO/HEHS-94-94, May 27, 1994). 

Social Security:  Disability Rolls Keep Growing, While Explanations
Remain Elusive (GAO/HEHS-94-34, Feb.  8, 1994). 

Social Security:  Increasing Number of Disability Claims and
Deteriorating Service (GAO/HRD-94-11, Nov.  10, 1993). 

Social Security:  Rising Disability Rolls Raise Questions That Must
Be Answered (GAO/T-HRD-93-15, Apr.  22, 1993). 

Social Security Disability:  Growing Funding and Administrative
Problems (GAO/T-HRD-92-28, Apr.  27, 1992). 

Social Security:  Racial Difference in Disability Decisions Warrants
Further Investigation (GAO/HRD-92-56, Apr.  21, 1992). 

Social Security:  Results of Required Reviews of Administrative Law
Judge Decisions (GAO/HRD-89-48BR, June 13, 1989). 


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