More disability case reviews sought Social Security effort aimed at discovering if recipients can work

March 18, 1996|By John B. O'Donnell | John B. O'Donnell,SUN NATIONAL STAFF

WASHINGTON - The Clinton administration plans to ask Congress this week for special funding to sharply increase the review of disability check recipients to determine whether they can return to work, officials said yesterday.

In a move that could save the government hundreds of millions of dollars, 1.4 million cases over the next two years would be reviewed 600,000 more cases than had been planned.

Beyond that, the Clinton administration proposes to increase the reviews to more than 1 million annually by 2002, said Phil Gambino, a spokesman for the Social Security Administration, which conducts the reviews.

While more than 90 percent of recipients retain their benefits after being reviewed, the 6 percent or 7 percent who are dropped from the rolls represent significant savings to the government. The General Accounting Office, the investigative arm of Congress, said two years ago that the government saves as much as $6 for every $1 it spends on these reviews.

The Clinton administration will request a special allocation of $320 million for SSA to perform the additional reviews, officials said.

"It is good news," said Jane Ross, a GAO official who follows the Social Security program closely.

The scale of the reviews is similar to a Reagan administration sweep of the disability rolls in the early 1980s, when 1.4 million recipients were reviewed and 40 percent were terminated half of whom won their benefits back. The public outcry was so loud that Congress stopped the purge and passed legislation to make it more difficult for Social Security to remove a beneficiary.

Under that law, a beneficiary even one who got on the rolls through a Social Security error cannot be removed unless caseworkers can show an improvement in his or her condition.

"It hobbles the process," said Ms. Ross, "but it was put there so something like the 1980s won't happen again."

The reviews are conducted in several steps. The first consists of a questionnaire which asks recipients about their current

condition. Based on the responses and a review of their files, about one-third of the recipients are kept on the rolls at this


The other two-thirds are subjected to further review, including updated medical checks for which Social Security pays if the recipients don't submit information from physicians.

Currently, 4 million disabled workers collect an average of $682 a month from the Social Security trust fund through a program called Disability Insurance (DI).

Social Security is required to review each recipient whose improvement is considered possible. Each case is studied every three years. Those with permanent conditions, such as quadriplegics or AIDS patients, are exempted.

During the early 1990s, Social Security virtually abandoned those re-examinations so it could concentrate on an explosion of applications for new benefits, which rose from 1.5 million in 1988 to 2.7 million in 1994.

As a result, Social Security has a backlog of 1.5 million disability cases that are overdue for their triennial review. The funds proposed by the Clinton administration would permit Social Security to do 400,000 reviews that should be done annually to keep pace and to begin chipping away at the backlog as well.

The GAO estimated two years ago that if Social Security had done the required reviews between 1990 and 1993, it could have saved $1.4 billion by next year through termination of beneficiaries who are no longer disabled.

Last year, the Clinton administration sought funding to do 400,000 reviews this year and next, but the agency's budget has been caught in the spending deadlock on Capitol Hill, and it hasn't received that money.

Last year, under criticism from the GAO and Congress, the agency did 184,000 reviews, half of what it needs to do but far more than the 118,000 it did in 1994.

The agency still has a backlog of 1.2 million applications. It now takes an applicant 80 days to get an initial decision. If benefits are denied and the claimant appeals to an administrative law judge, the average wait from the date of application is 16 months.

In addition to the $41 billion DI program, Social Security also runs a second disability program, Supplemental Security Income (SSI) for people who can't qualify for DI because they have little or no work history. Until last year, Social Security was not required to do any reviews of SSI recipients, although it does a few. A law that took effect last year now requires the agency to annually review a small fraction of SSI recipients.

Congress is expected to welcome the Clinton administration proposal, which seeks to exempt the added money for the reviews from the overall cap on discretionary spending that applies to the federal budget. Normally, an agency like Social Security which is subject to that cap can receive additional funds only if they are taken from another agency.

Indeed, a bill passed by the House and awaiting Senate action contains a different financing mechanism that would also exempt the reviews from the spending cap.

One Clinton administration official said it was possible that the mechanism being proposed would be included in that bill, which is expected to come to the Senate floor possibly as early as this week.

Pub Date: 3/18/96

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