Social Security Disability Single Decision Maker Program on the Chopping Block
In 1993, the Social Security Administration (SSA) proposed setting up a Single Decision Maker (SDM) system, which would “authorize disability examiners to make certain initial determinations without requiring a medical or psychological consultant's signature.” The SSA set up a pilot program in 1996 and expanded it in 1999. The SSA Office of the Inspector General reviewed the pilot program and issued a report on August 2013. Background on the Program In addition to allowing disability examiners to make determinations without a medical consultant, the program also “allowed examiners to decide when to involve medical consultants in complex claims.” The SDM program requires examiners to have a medical consultant's signature on certain claims, such as a mental disability denial. As noted, the SDM model was implemented in 10 Disability Determination Services (DDS) sites in 1996. Then the program was expanded to an additional 10 DDS sites in 1999. The pilot program was extended multiple times since then. During the program, the SSA “collected limited management information to assess the pilot's effectiveness.” The Office of Quality Performance determined that the program “resulted in a small increase in initial allowance rates and a small decrease in DDS processing time.” The Office of the Inspector General reviewed back disorder and genito-urinary disability claims cases from the 2011 calendar year. Out of a total of 327,248 initial claims within these two types of cases (297,662 back disorders and 29,586 genito-urinary disorders), the review randomly sampled a total of 3,900 cases or just under 2 percent of the total identified claims. SDM sites averaged 26 days less time for a decision in back disorder cases and 11 days less time for genito-urinary cases than DDS sites without the SDM program. The pilot sites “noted improved service to the public, DDS case processing times, and employee morale as well as decreased administrative costs to process disability cases since medical consultants were not involved in all claims. The SDM sites also reported their offices maintained disability determination quality and accuracy.” The Office of Inspector General Recommendation The SSA Office of the Inspector General reviewed all the information and recommended that the SDM program be terminated to have significant savings to both the disability trust fund and the general fund. The “preliminary estimate was based on SSA gradually eliminating the pilot over a 3-year period, which would result in billions of dollars in SSA program savings from 2015 to 2023–roughly $3 billion in total Old-Age, Survivors and Disability Insurance savings and $700 million in Supplemental Security Income savings.” Even though the review showed there was a significant decision time reductions and the SDM program had positive reviews from those who went through it as well as those who worked within the program, the cost savings is the single strongest reason the Office of the Inspector General gave for terminating the SDM program. The Inspector General looked at the 2010 report from the Office of Quality Performance that said “expanding the SDM model in its present form nationwide would increase overall disability allowance rates by 0.61 percent.” While this is not a huge amount, the Inspector General stated “because of the size of the Disability Insurance program, even a modest change in disability allowance rates significantly affects program costs.” While the SSA published notice in the Federal Register in July 2013 that the SDM program would be extended, the SSA stated in an appendix to the Inspector General report that it agreed with the report and would use the information in making the final determination about the SDM program. See Related Posts: National Disabilities Professional Week Hits a Milestone SSD Insolvency? How Will Obama's Budget Proposal Effect Social Security?