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HRD-84-11 1 (1984-07-20)

handle is hein.gao/gaobabked0001 and id is 1 raw text is: UNITED STATES GENERAL ACCOUNTING OFFICE WASHINGTON, D.C. 20548 PqWMAN S4rJ (OVCC DIVISION4 JUL 2 0 1984 The Honorable Robert Gielow Chairman Railroad Retirement Board Dear Mr. Gielow: Subject: Railroad Retirement Board Disability Determinations (GAO/HRD-84-11) In April 1982, the then Chairwoman of the House Government Operations Committee, Subcommittee on Manpower and Housing, asked us to compare and contrast the disability criteria being used by the Social Security Administration (SSA) and the Railroad Retirement Board and to determine the Board's adherence to its criteria. In June 1982, we presented our preliminary findings during hearings held by the Subcommittee. This letter summarizes the final results of our work and our observations on the progress made to remedy the problems identified by our analysis. Although the Board is solely responsible for determining benefit entitlements for former railroad workers and their families, it is required to comply with SSA's disability cri- teria. In fiscal year 1983 the Board paid about $446 million in total and permanent disability benefits to about 57,600 bene- ficiaries. SSA reimbursed the Board for 40 percent ($179 million) of the disability payments that would have been payable by social security if the Board did not exist. In our sample of 1981 Board disability decisions, we found that the Board's application of the criteria was not consistent with that of SSA examiners. We found instances of questionable disability decisions and cases where decisions were made with insufficient documentation. Although SSA finds that state disa- bility agencies (which make disability awards for the social security program) also make such errors, the Board had a higher percentage of such cases. RESULTS OF OUR REVIEW Based on a review of initial disability adjudications made by the Board from May through December 1981, we estimate that 6 percent of the awards we sampled should have been denied. This reflects a consensus of opinion among three reviewing groups-- SSA's Chicago regional office, SSA's central office, and our disability staff (See enclosure I for more detail on our object- ives, scope, and methodology). In addition, the SSA examiners who assisted us in our review found that in about 15 percent of the awards, the documentation was insufficient to establish (105201) 0 F ? 0C/o 4? Q 011Q 14U - 0 00

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