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GAO-20-641R 1 (2020-08-13)

handle is hein.gao/gaobaebnp0001 and id is 1 raw text is: GO U.S. GOVERNMENT ACCOUNTABILITY OFFICE 441 G St. N.W. Washington, DC 20548 August 13, 2020 The Honorable Bernard Sanders Ranking Member Committee on the Budget United States Senate The Honorable John Larson Chairman Subcommittee on Social Security Committee on Ways and Means House of Representatives Social Security Disability: Information on Wait Times, Bankruptcies, and Deaths among Applicants Who Appealed Benefit Denials The Social Security Administration (SSA) manages two large disability benefit programs, Disability Insurance (DI) and Supplemental Security Income (SSI). In fiscal year 2019, these programs received more than 2.34 million applications and provided about $185 billion in benefits; as of December 2019, approximately 12.3 million adults with disabilities and their eligible dependents received benefits.1 SSA uses a five-step process to determine if an applicant qualifies for disability benefits. An applicant who is dissatisfied with the initial determination on their disability benefits application 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.2 We have 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.3 Given potentially long wait times for a final decision on benefits, and that those applying for disability are likely to have health and financial challenges, you asked us about worsening medical and financial conditions for DI and SSI applicants. This report examines the status of disability applicants while they awaited a final benefits decision including 1) their total wait times 1The 12.3 million adults with disabilities described here do not include individuals who receive SSI benefits because they are 65 or over and meet the income and asset requirements. 2Some applicants filed more than one application for disability benefits during this period. In some cases, their applications were denied and so they filed more than one appeal. As such, 7.9 million distinct individuals filed the 9 million appeals. 31n this report, we use the term 'final decision' to refer to the last decision an applicant receives on an appeal. Because SSA's appeal process includes several steps, an applicant who abandons an appeal at an earlier step could receive a decision earlier than one who pursues all administrative appeals. SSA uses the word determination to refer to the conclusion reached at the initial and reconsideration stage of review. SSA uses the word decision to refer to the conclusion reached by an ALJ or the Appeals Council. For ease of reference, in this report, we use the terms determination and decision interchangeably. An applicant who receives a final decision will have received some number of earlier decisions and determinations, depending on how many levels of review they pursued. For our prior report, see GAO, Social Security Disability- Better Timeliness Metrics Needed to Assess Transfers of Appeals Work, GAO-1 8-501 (Washington, D.C.: July 19, 2018) GAO-20-641 R Social Security Disability Page 1

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