What GAO Found
GAO found that most applicants for disability benefits who appealed the Social Security Administration’s (SSA) initial disability determination from fiscal years 2008 through 2019 waited more than 1 year for a final decision on their claim. Median wait times reached 839 days for claims filed in fiscal year 2015, following an increase of applications during the Great Recession. Wait times have decreased since then as SSA made substantial progress in reducing the wait for a hearing before an administrative law judge prior to the Coronavirus Disease 2019 (COVID-19) pandemic. Individuals who filed appeals of disability benefits decisions were older and had less education than the overall population of working-age adults. Among these disability applicants, wait times for a final decision did not significantly vary by age, sex, or education levels.
GAO’s analysis of available data from SSA and the Administrative Office of the U.S. Courts (AOUSC) found that from fiscal years 2014 through 2019, about 48,000 individuals filed for bankruptcy while awaiting a final decision on their disability appeals. This represents about 1.3 percent of the approximately 3.6 million disability applicants who filed appeals during those years. The applicants who filed for bankruptcy while awaiting a disability appeals decision were disproportionately female, older, and had more than a high school education as compared to the total population of disability applicants who filed appeals. Bankruptcies among individuals who were awaiting decisions about disability appeals may have been unrelated to the applicant’s claimed disability.
GAO’s analysis of SSA disability administrative data and death data found that of the approximately 9 million disability applicants who filed an appeal from fiscal year 2008 through 2019, 109,725 died prior to receiving a final decision on their appeal. This represents about 1.2 percent of the total number of disability applicants who filed an appeal during those years. The annual death rate of applicants awaiting a final disability decision has increased in recent years. From fiscal years 2011 through 2018, the annual death rate for applicants pursuing appeals increased from 0.52 percent to 0.72 percent. Applicants who filed their initial disability claim during years of peak wait times and appealed their initial decision died at a higher rate while awaiting a final decision than applicants who filed their initial claim in years with shorter wait times. Disability applicants awaiting a final decision about their appeal who were male died at higher rates than applicants who were female and those who were older died at higher rates than those who were younger. Death rates were largely similar across reported education levels. Deaths among individuals who were awaiting decisions about disability appeals may have been unrelated to the applicant’s claimed disability.
Why GAO Did This Study
The Social Security Administration (SSA) manages two large disability benefit programs–Disability Insurance (DI) and Supplemental Security Income (SSI). As of December 2019, these programs provided benefits to approximately 12.3 million adults living with disabilities and their eligible dependents. A disability applicant who is dissatisfied with SSA’s initial disability determination can appeal the decision to multiple escalating levels of review. From fiscal years 2008 through 2019, SSA received approximately 9 million appeals of initial DI or SSI decisions. GAO has previously reported that applicants who appeal a benefits denial can potentially wait years to receive a final decision, during which time an applicant’s health or financial situation could deteriorate.
Given the heightened risk of worsening medical and financial conditions for disability applicants, GAO was asked to examine the incidence of such events while applicants await a final decision on their disability claim. This report examines the status of disability applicants while they awaited a final benefits decision including 1) their total wait times across all levels of disability appeals within SSA, 2) their incidence of bankruptcy, and 3) their incidence of death. For wait times, bankruptcies, and deaths, GAO also examined variations across certain demographic characteristics of applicants.
GAO obtained administrative data from SSA for all adult disability applicants from fiscal years 2008 through 2019 who filed an appeal to their initial disability determination. GAO used these data to calculate wait times across appeals levels, rates of approvals and denials, and appeals caseloads, and examined changes in these three areas over time. To describe the incidence of bankruptcy among individuals awaiting a disability appeals decision, GAO matched SSA disability data to AOUSC bankruptcy data for fiscal years 2014 through 2019. To describe the incidence of death among individuals awaiting a disability appeals decision, GAO matched the disability data to SSA’s Death Master File. For all of these analyses, GAO also examined variations across demographic characteristics of applicants, including age, sex, and reported education level. GAO also reviewed relevant policies, federal laws and regulations, and agency publications, and interviewed agency officials.
For more information, contact Elizabeth Curda at (202) 512-7215 or CurdaE@gao.gov.
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- Veterans Community Care Program: Improvements Needed to Help Ensure Timely Access to CareBy Sam NewsSeptember 30, 2020In a September 2020 report, GAO found that the Department of Veterans Affairs (VA) established an appointment scheduling process for its new Veterans Community Care Program (VCCP) but did not specify allowable wait times for some key steps in the process. Further, GAO found that VA had not established an overall wait-time performance measure—that is, the maximum amount of time it should take for veterans to receive care from community providers. In 2013, GAO recommended that VA establish a wait-time measure under a prior VA community care program, and in 2018 again recommended that VA establish an achievable wait-time goal to receive care under the VCCP. VA has not implemented these recommendations. Potential Allowable Wait Time to Obtain Care through the Veterans Community Care Program Note: This figure illustrates potential allowable wait times in calendar days for eligible veterans who are referred to the Veterans Community Care Program through routine referrals (not urgent), and have VA medical center staff—Referral Coordination Team (RCT) and community care staff (CC staff)—schedule the appointments on their behalf. Given VA's lack of action over the prior 7 years in implementing wait-time measures for various community care programs, GAO believes that Congressional action is warranted requiring VA to establish such an overall measure for the VCCP. This should help to achieve timely health care for veterans. GAO found additional VCCP challenges needing VA action: (1) VA uses metrics that are remnants from the previous community care program and inconsistent with the time frames established in the VCCP scheduling process. (2) Few community providers have signed up to use the software VA intends for VA medical center (VAMC) staff and community providers to use to electronically share referral information with each other. (3) Select VAMCs faced challenges scheduling appointments in a timely manner and most did not have the full amount of community care staff VA's staffing tool recommended. In June 2019, VA implemented its new community care program, the VCCP, as required by the VA MISSION Act of 2018. This new program replaced or consolidated prior community care programs. Under the VCCP, VAMC staff are responsible for community care appointment scheduling. This statement summarizes GAO's September 2020 report. It describes for the VCCP: (1) the appointment scheduling process that VA established for veterans, (2) the metrics VA used to monitor the timeliness of appointment scheduling, (3) VA's efforts to prepare VAMC staff for appointment scheduling, and (4) VA's efforts to determine VAMC staffing needs. In performing that work, GAO reviewed VA documentation, such as guidance, referral timeliness data, and VAMC community care staffing data; conducted site visits to five VAMCs; and interviewed VA and VAMC officials. In its September 2020 report, GAO recommended that Congress consider requiring VA to establish an overall wait-time measure for the VCCP. GAO also made three recommendations to VA, including that it align its monitoring metrics with the VCCP appointment scheduling process. VA did not concur with this recommendation, but concurred with the other two. GAO maintains that all recommendations are warranted. For more information, contact Sharon M. Silas at (202) 512-7114 or email@example.com.[Read More…]
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- Three Tribal Officials Charged in Bribery SchemeBy Sam NewsJuly 30, 2020Two current tribal government officials and one former tribal government official of the Three Affiliated Tribes of the Mandan, Hidatsa, and Arikara Nation (MHA Nation) were charged by criminal complaint unsealed today for their alleged acceptance of bribes and kickbacks from a contractor providing construction services on the Fort Berthold Indian Reservation (FBIR), which is the home of the MHA Nation.[Read More…]
- Secretary Michael R. Pompeo with Israeli Prime Minister Benjamin Netanyahu and Bahraini Foreign Minister Abdullatif bin Rashid Al Zayani Before Their MeetingBy Sam NewsNovember 18, 2020
- U.S. Trustee Program Reaches Settlement with McKinsey and Company to Withdraw and Waive its Fees in the Westmoreland Coal Bankruptcy CaseBy Sam NewsDecember 3, 2020The Department of Justice’s U.S. Trustee Program (USTP) has entered into a settlement agreement with global consulting firm McKinsey & Company (McKinsey) requiring McKinsey to forego payment of fees in the Westmoreland Coal bankruptcy case pending in the U.S. Bankruptcy Court for the Southern District of Texas (Westmoreland Case).[Read More…]
- The United States Takes Actions Against Supporters of the Illegitimate Maduro Regime’s Fraudulent ElectionsBy Sam NewsDecember 18, 2020
- Secretary Michael R. Pompeo and Saudi Foreign Minister Prince Faisal bin Farhan Al Saud After Their MeetingBy Sam NewsOctober 14, 2020
- Department of Justice Awards over $1.8 Billion in Grants to Assist Victims NationwideBy Sam NewsOctober 6, 2020The Office for Victims [Read More…]
- Paraguay Travel AdvisoryBy Sam NewsSeptember 26, 2020Reconsider travel [Read More…]
- Botswana Travel AdvisoryBy Sam NewsSeptember 26, 2020Reconsider travel [Read More…]
- Japan Travel AdvisoryBy Sam NewsSeptember 26, 2020
- The Impact of the Pandemic on Pregnancy: A Research ResponseBy Sam NewsJuly 29, 2020Maternal health and [Read More…]
- 2020 Indo-Pacific Business Forum Promotes Free and Open Indo-PacificBy Sam NewsOctober 30, 2020
- Belarus Travel AdvisoryBy Sam NewsSeptember 26, 2020Reconsider Travel due to [Read More…]
- CEO of Financial Firm Pleads Guilty to Running Multi-Million Dollar Securities and Tax Fraud Scheme, and Operating an Unlicensed Money Services BusinessBy Sam NewsOctober 7, 2020A California-based man pleaded guilty today to conspiring with others to defraud shareholders of publicly traded companies, transmitting millions of dollars through the operation of an unlicensed money-services business in California, and falsifying multiple years of federal tax returns.[Read More…]
- Protecting U.S. Investors from Financing Communist Chinese Military CompaniesBy Sam NewsDecember 29, 2020
- Air Deliveries Bring NASA’s Perseverance Mars Rover Closer to LaunchBy Sam NewsSeptember 26, 2020A NASA Wallops Flight [Read More…]
- Jeffrey Lowe and Tiger King LLC Ordered to Relinquish Big Cat Cubs to United States for Placement in Suitable FacilitiesBy Sam NewsJanuary 19, 2021On Jan. 15, 2021, a federal court issued a preliminary injunction in favor of the United States and against Jeffrey and Lauren Lowe, Greater Wynnewood Exotic Animal Park LLC, and Tiger King LLC based on claimed violations of the Endangered Species Act and the Animal Welfare Act.[Read More…]
- Husband Sentenced to 188 Months in Prison for Human Trafficking Convictions Related to Forced Labor of Foreign NationalsBy Sam NewsOctober 22, 2020The Justice Department today announced that former Stockton, California resident Satish Kartan, 46, was sentenced today to188 months in prison for forced labor violations. In addition, U.S. District Judge Morrison C. England Jr. ordered $15,657 be paid in restitution to three victims, in part to cover their back wages and other losses.[Read More…]
- Designation of Iranian Procurement NetworksBy Sam NewsNovember 11, 2020