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.
Improve the Timeliness and Quality of the Disability Process
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.
Disability determination services (DDS) in each State or other responsible jurisdiction perform disability determinations under the Social Security Administration’s (SSA) Disability Insurance and Supplemental Security Income programs. DDSs are required to perform such determinations in accordance with Federal law and regulations. Each DDS is responsible for determining claimants’ disabilities and ensuring adequate evidence is available to support its determinations.
In November 2010, SSA released its Strategy to Address Increasing Initial Disability Claims Receipts. The strategy outlined four objectives to address the increase in initial claims and the growing pending levels.
We initiated this review at the Dallas Regional Commissioner’s request. Our objectives were to determine whether (1) indirect costs claimed for Federal Fiscal Years 2011 and 2012 were allowable and properly allocated and (2) applicant travel expenses were reasonable, properly authorized, and adequately supported.
The Social Security Administration (SSA) conducts continuing diability reviews (CDR) on Disability Insurance (DI) beneficiaries and Supplemental Security Income (SSI) disability recipients to determine whether they remain medically eligible for disability payments. Individuals profiled as having a high likelihood of medical improvement undergo a full medical CDR by a disability determination services (DDS).