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Feb 1, 2007

Inspector General Wants Priority Processing For Cessation Cases

From a report by Social Security's Office of Inspector General:

We found that 53 percent of individuals in our population, who appealed a medical cessation decision and continued to receive payments throughout the appeals process, were overpaid. The overpayments were increased because SSA’s process for deciding medical cessation appeals is not financially efficient. Medical cessation appeals should not be processed in the same manner as cases not receiving payments. Therefore, to the extent possible, appeals that involve benefit payments should be processed separately from those that do not involve payments to avoid or minimize overpayments.

The President’s Management Agenda introduced the initiative of improved financial performance throughout Government agencies. By making SSA’s process for medical cessation determinations more efficient it would be better aligned with the President’s vision. If SSA would develop a process for making decisions on medical cessation appeals in a timely manner, financial performance of the DI program could be greatly increased.For example, if SSA decreased the processing time on medical cessation appeals (both reconsiderations and ALJ hearings) to 165 days, we project overpayments of approximately $30 million could have been avoided for FY 2003 and 2004. Based on the average of these 2 years, we estimate SSA could have avoided about an additional $15 million in overpayments in FY 2005.

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