The Supplemental Security Income program is administered under Title XVI of the Social Security Act. The basic purpose of Title XVI is to provide a minimum level of support to qualified individuals who are blind, disabled, or aged and who have limited income and resources. To assist with obtaining Title XVI payments, claimants may appoint a qualified representative (attorney or non-attorney) to act on their behalf in matters before SSA.
Improve the Timeliness and Quality of the Disability Process
Michigan Auditor General conducted the single audit of the State of Michigan. SSA is responsible for resolving single audit findings related to its Disability programs. Department of Human Services is the Michigan Disability Determination Services’ parent agency. The objective of our audit is to report internal control weaknesses, noncompliance issues, and unallowable costs identified in the single audit to Social Security Administration for resolution action.
The Washington State Auditor conducted the single audit of the State of Washington. SSA is responsible for resolving single audit findings related to its disability programs. The Department of Social and Health Services (DSHS) is the Washington Division of Disability Determination Services’ (DDDS) parent agency.
The objective of this report is to report internal control weaknesses, noncompliance issues, and unallowable costs identified in the single audit to SSA for resolution.
Disability determinations under the Social Security Administration’s (SSA) Disability Insurance and Supplemental Security Income programs are performed by disability determination services (DDS) in each State in accordance with Federal regulations. Each DDS is responsible for determining claimants’ disabilities and ensuring adequate evidence is available to support its determinations.
We are issuing this report to convey information related to State disability determination services (DDS) with Fiscal Year (FY) 2013 average processing times for initial disability claims that were outside the typical range of DDS processing times.
SSA’s Medical Evidence Gathering and Analysis Through Health IT (MEGAHIT) system automatically obtains electronic records from SSA’s partners in minutes.
In 2011, the Governor of New York negotiated with unions representing DDD employees to reduce workforce costs. One measure negotiated to reduce workforce costs was Deficit Reduction Leave (DRL). Per the DRL provision, the State reduced Division of Disability Determinations (DDD) employees’ salaries by the value of 9 days in Fiscal Years 2011 through 2013. The employees were required to take 9 days of DRL in those years.
The Social Security Administration (SSA) uses a five-step sequential evaluation process for determining whether a claimant qualifies for disability benefits. In claims that reach the last step in the process, adjudicators use medical-vocational guidelines (grids) developed in the 1970s to guide them in deciding a claimant’s physical and vocational abilities to adjust to work in the national economy.
Claimants are required to prove they are disabled by providing medical and other evidence of disability. However, the Social Security Administration (SSA) is responsible for making every reasonable effort to help the claimant get medical reports from medical sources. The Agency considers all evidence in the claimant’s case record when it makes any determination.
Under the Medical Improvement Review Standard (MIRS), an individual’s disability continues unless the (1) disabling condition has improved since the last favorable disability determination and (2) individual can engage in substantial gainful activity.