Social Security Disability: Information on Wait Times, Bankruptcies, and Deaths among Applicants Who Appealed Benefit Denials

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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    The Federal Deposit Insurance Corporation (FDIC) has designed policies to address the risk of regulatory capture by reducing the potential benefit to industry of capturing the examination process, reducing avenues of inducement, and promoting a culture of independence and public service (see figure). Framework for Reducing Risk and Minimizing Consequences of Regulatory Capture FDIC has several policies for documenting bank examination decisions that help promote transparent decision-making and assign responsibility for decisions. Such policies are likely to help reduce benefits to industry of capturing the examination process. However, GAO found that some examinations were not implemented consistent with FDIC policies and that gaps in FDIC policies limited their effectiveness. For example, GAO found that managers sometimes did not clearly document how they concluded that banks had addressed recommendations. By improving adherence to agency policies, FDIC management could better address threats to capture in the examination process. GAO found that FDIC has policies to address potential conflicts of interest that could help block or reduce avenues of inducement. For example, FDIC has post-employment conflict-of-interest policies designed to prevent former employees from exerting undue influence on FDIC and to reduce industry's ability to induce current FDIC employees with prospective employment arrangements. One such policy requires the agency to review the workpapers of examiners-in-charge who accept employment with banks they examined in the prior 18 months. However, FDIC has not fully implemented a process for identifying when to review the workpapers of departing examiners to assess whether independence has been compromised. In particular, FDIC does not have a process for collecting information about departing employees' future employment. By revising its examiner-departure processes, the agency could better identify when to initiate workpaper reviews. FDIC has identified regulatory capture as a risk as part of its enterprise risk management process. The agency has documented 11 mitigation strategies that could help address that risk. Identified mitigation strategies include rotating examiners-in-charge, national examination training, and ethics requirements. FDIC supervises about 3,300 financial institutions to evaluate their safety and soundness. Some analyses by academic researchers have identified regulatory capture in supervision as one potential factor contributing to the 2007–2009 financial crisis. Regulatory capture is defined as a regulator acting in the interest of the regulated industry rather than in the public interest. GAO was asked to review regulatory capture in financial regulation. This report examines FDIC's (1) processes for encouraging transparency and accountability in the bank examination process, (2) processes to minimize potential conflicts of interest among examination staff, and (3) agency-wide efforts to address the risks of regulatory capture and compromised independence. GAO reviewed FDIC's policies and enterprise risk management framework, analyzed bank examination workpapers, and interviewed supervisory staff. GAO is making four recommendations to FDIC related to managing the risk of regulatory capture, including improving documentation of banks' progress at addressing FDIC recommendations and revising examiner-departure processes. FDIC neither agreed nor disagreed with these recommendations, but described actions it would take in response to them. FDIC's actions, if fully implemented, would address two of the four recommendations. For more information, contact Michael Clements at (202) 512-8678 or clementsm@gao.gov.
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    In Crime News
    Two 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.
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    In Crime News
    The 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). 
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  • CEO of Financial Firm Pleads Guilty to Running Multi-Million Dollar Securities and Tax Fraud Scheme, and Operating an Unlicensed Money Services Business
    In Crime News
    A 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.
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    In Crime News
    On 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.
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    In Crime News
    The 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.
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