Lack of timeframes and follow-ups led Social Security to delay some priority disability applications
An inspector general’s audit found that while the agency identified and processed 96% of the priority cases reviewed, a slice of applications slipped past monitoring, leading to longer wait times.
By and large, the Social Security Administration appropriately tracks and processes disability applications it receives and qualifies as a priority, an inspector general’s report found, but a sliver of the cases reviewed also escaped scrutiny and faced unnecessary delays.
The Aug. 8 report reviewed 180 initial disability applications that could be deemed priority cases because they meet SSA criteria, such as a Quick Disability Determination, Compassionate Allowances, Terminal Illness, Military Casualty/Wounded Warrior, Veterans Affairs 100 Percent Permanent and Total, homeless cases, Presumptive Disability or Blindness, dire need cases, critical cases, cases receiving inquiries from public officials, are being reviewed by administrative law judge or Appeals Council or have already been delayed.
The OIG found that of the sample cases, SSA processed 117 in less than three months, the minimum goal for processing a standard disability application. Fifty-two cases were delayed longer than three months due to factors outside of the agency’s control, but 11 cases slipped beyond three months, with some taking seven months to resolve.
The report noted that during its audit, SSA did not have timeframes or goals for how long it took to process a priority disability, though the agency did have specific guidance for following up on terminal illness applications to ensure they were processed.
With the SSA receiving an estimated 200,000 priority disability applications a year, the OIG estimates the 11 cases could represent up to 40,844 claimants facing potential benefits delays.
The cause of the delays for the sampled reports varied. In one case, the agency received requested medical records from a claimant, and its system sent an alert when they were received, by a Disability Determination Services employee “did not address the alert timely, which resulted in a break in development” that delayed application processing by a month.
The OIG found in five of the cases studied, there were periods of inactivity on the files ranging from 19 to 33 days. Three cases had errors made by SSA field offices, such as not ensuring the claimant signed the application, not verifying the claimant’s mailing address or failing to contact them. In three cases, the agency could not determine a reason for the delay.
In five Quick Disability Determination cases studied, the SSA had unexplained and/or unsupported delays that led to an average of 60 days of processing time, well above the fiscal 2021 average of 34 days. Another six cases had delays averaging nearly seven months.
The OIG recommended implementing appropriate timeframes for processing priority applications and follow-up procedures into application processing instructions. In comments to the OIG, SSA officials agreed with the recommendation and detailed steps they had taken to address it.