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SOCIAL SECURITY ADMINISTRATION AT A GLANCE: 2006 Discretionary Budget Authority: (Increase from 2005: 8 percent) $9.5 billion Major Programs: • Old-Age and Survivors Insurance • Disability Insurance • Supplemental Security Income MEETING PRESIDENTIAL GOALS Promoting Economic Opportunity and Ownership • Helping people with disabilities make the transition to work. Supporting a Compassionate Society • Providing Supplemental Security Income payments, Social Security Disability Insurance benefits, and Survivor Insurance benefits to eligible individuals. • Assisting in the administration of the new Medicare prescription drug benefit by determining eligibility for low-income subsidies. • Extending eligibility for Supplemental Security Income for roughly 4,000 refugees and asylees who have not yet become U.S. citizens. Making Government More Effective • Converting from paper to electronic disability application folders to speed decision-making and reduce administrative costs. • Providing access to video hearings for some people who live a long distance from a hearing office, allowing them to have hearings scheduled sooner when they appeal decisions made by the Social Security Administration. • Ensuring that more than 99 percent of benefits are paid correctly. Agency-specific Goals • Improving the timeliness and accuracy of the Social Security Administration’s disability decision-making process while continuing to improve productivity. 317 318 SOCIAL SECURITY ADMINISTRATION PROMOTING ECONOMIC OPPORTUNITY AND OWNERSHIP Demonstrations to Help Transition from Disability to Work Individuals with disabilities face many barriers in making the transition to work. The Social Security Administration (SSA) has launched two demonstrations: one to support adults with disabilities who want to enter the workforce and one to support children with disabilities making the transition from school to work. Under the Ticket to Work and Work Incentives Improvement Act of 1999, SSA is exploring ways to more gradually reduce Disability Insurance (DI) benefits as beneficiaries enter the workforce. Under current law, DI beneficiaries who exhaust their nine-month trial work period and three-month grace period have their DI benefits completely stopped if they earn more than $830 per month. Under the DI Benefit Offset Demonstration, such beneficiaries would be able to earn more than $830 per month and still receive a portion of their DI benefits. This change would encourage them to return to work by allowing a more gradual transition. SSA is also testing approaches to support the successful transition of youth with disabilities from school to post-secondary education and/or employment. Under the Youth Transition Demonstration projects, California, Colorado, Iowa, Maryland, Mississippi, and New York have created service-delivery systems that blend education, rehabilitation, health care, and employment services. Each project is different, but all show how communities can blend services and resources from Federal, State, and local partners to support youth with disabilities as they progress through high school and go on to work or post-secondary education. Services include mentoring, skills training, career planning, and job search and placement services. The Budget includes $9 million for these demonstration projects. Patrick’s Story Patrick has successfully returned to work through SSA’s Ticket to Work program. Patrick was an outgoing young man working on his cosmetology license. That was in 1994—the year his life took a drastic turn. Patrick began to feel weak, lost a lot of weight, and had constant headaches. His doctor diagnosed him with end-stage renal disease. For the next seven years, Patrick underwent kidney dialysis. He abandoned his career goals and was approved for Social Security disability benefits. His days were long and unfulfilling. Then, in 2001, he became eligible for a kidney transplant. “After all this time, I couldn’t believe my good fortune,” said Patrick. “Finally, a kidney was available, and all I could think of was going back to living a normal, healthy life.” After the transplant, Patrick had some problems with his health, but finally began regaining his strength. It was around that time that his Ticket to Work came in the mail from Social Security. He found out that he could use his Ticket to go back to work without risking the loss of his Medicare benefits. Patrick started working as an interim accountant, and now has a permanent position as a buyer for a manufacturer. THE BUDGET FOR FISCAL YEAR 2006 319 The Budget proposes to require full-time school attendance as a condition of entitlement for Social Security child’s benefits for children beginning at age 16. Current policy allows eligible children to receive Social Security benefits up to the month they reach age 18, regardless of school attendance. School attendance is required for children ages 18 and 19 to continue receiving benefits. Changing the policy to age 16 will further encourage eligible children to remain in school. SSA has put a priority on helping people get back to work, as evidenced by the new performance measure it developed for the Supplemental Security Income (SSI) program. SSA is committed to increase the number of SSI and DI beneficiaries with “tickets” who go to work, relative to 2003, by 20 percent in 2004, 40 percent in 2005, and 60 percent in 2006. Tickets allow beneficiaries to choose employment services, whether from a more traditional vocational rehabilitation agency or other participating public and private providers. 320 SOCIAL SECURITY ADMINISTRATION SUPPORTING A COMPASSIONATE SOCIETY SSA will pay nearly $40 billion in SSI payments to needy elderly and disabled people in 2006 and about $90 billion in Social Security disability benefits. In addition, SSA will pay $68 billion in Survivors Insurance benefits to widows and surviving children. In 2006, more than 20 million beneficiaries will receive benefits from the SSI, DI, and Survivors programs. Discounted Drugs for Seniors The Medicare Prescription Drug Improvement and Modernization Act of 2003 includes a major role for SSA in administering the new Medicare prescription drug benefit. Starting in the summer of 2005, SSA will determine whether Social Security and Medicare beneficiaries are eligible for the additional low-income prescription drug assistance that is part of the drug benefit. Senior citizens and individuals with disabilities who have income less than 135 percent of the poverty level and who have resources equal to or less than $6,000 will be eligible in 2006 for Medicare drug coverage with no premium and limited cost-sharing. Other beneficiaries—those with income between 135 and 150 percent of poverty and somewhat higher resources—will be eligible for Medicare drug coverage with a reduced premium and cost-sharing. Individuals will have the option of applying for assistance through the Internet, telephone, mail, or at a local Social Security office. SSA employees will also be on-site at many local community associations to assist individuals with the filing of applications. The Budget continues funding for processing low-income prescription drug assistance applications and related activities. Online Benefit Application To meet increasing public demands, SSA allows the public to apply for Social Security retirement, spousal, and disability benefits online in addition to applying in person or by phone. The online services provide opportunities for the public to conduct SSA business electronically in a private and secure environment. In 2004, 217,000 claimants submitted applications for Social Security benefits online, an increase of 47 percent over the previous year. Other online services allow current beneficiaries to check their benefits, enter changes to their address or direct deposit information, and obtain replacement 1099s and proof of income letters. These services can be accessed through SSA’s website, www.socialsecurity.gov. SSA’s online services provide greater convenience to the public while allowing the Agency to process its workloads more efficiently. SSA now makes it possible for claimants to apply for benefits online. Assisting Low-Income Refugees The Budget would allow refugees and asylees to receive SSI for eight years after entry into the country. Currently, refugees and asylees who have not become citizens can only receive SSI for seven years after entry. Consistent with the President’s goals for immigration reform, this measure would provide legal asylees and refugees a greater opportunity to achieve citizenship. Funding for SSI comes from general Government revenues—not from the Social Security trust funds. The policy would continue through 2008. Beginning in 2005, SSA will send letters annually to those refugees and asylees receiving SSI reminding them of the requirement to become a citizen for continued benefits. THE BUDGET FOR FISCAL YEAR 2006 321 MAKING GOVERNMENT MORE EFFECTIVE Electronic Disability Folder Electronic Disability (eDib) Process Becoming a Reality Starting in January 2004, Speedier service of disability claims is proving to be a reality. SSA began implementation of an In January 2004, the Mississippi Disability Determination Serelectronic disability file folder. This vice (DDS) received a premature baby boy’s SSI claim, along increased use of technology will with medical evidence from the local children’s hospital. This replace a paper-driven process with baby weighed less than 1,200 grams and had serious meda more efficient one, resulting in ical complications. The formal SSA application was submitted electronically and the medical evidence was scanned into significantly reduced processing a document repository. The disability examiner had access to times and improved decisional all documents on her computer screen and made an allowance accuracy for initial disability that same day. Social Security expects eDib to be used in all claims and hearings. So far, SSA DDSs by June 2005. has implemented the electronic disability folder in 25 States and plans to complete implementation in 2006. Once fully implemented, SSA will have the largest repository of medical records in the world, and will see greater progress in eliminating avoidable delays in the disability claims process. Performance Evaluation of Select Programs SSA assessed for 2006 the SSI program using the Program Assessment Rating Tool (PART). The PART found that SSI has a clear purpose and addresses a specific need. SSA is working to ensure that the correct benefits are paid to the right persons on a timely basis. SSA evaluated the DI program previously and is converting from using a paper folder to an electronic one for the disability claims process, as discussed above. The PART evaluation cited a need to implement an improved claims process. Stewardship and Program Integrity Stopping Fraud Another challenge faced by SSA is weeding out fraudulent claims of disability among the applications it gets every year. The Federal Government filed suit last year against a woman who had received $190,000 in disability payments. In January 1999, she claimed that even lifting a gallon of milk caused her to suffer migraines that prevented her from reading and writing, and that she was unable to walk more than 10 minutes without experiencing debilitating pain. In March 1999, she competed and won the “Mrs. Minnesota International” pageant in which she engaged in stage walking, a production number, and competed in the aerobic and evening gown competitions. A Federal jury convicted her in August 2004 on nine counts of defrauding SSA. Source: U.S. Department of Justice, Office of the U.S. Attorney, District of Minnesota, Press Release. A crucial aspect of good management in income support programs is ensuring that only eligible individuals receive benefits, and that they receive the correct benefits. SSA undertakes a variety of program integrity activities to minimize improper payments by verifying beneficiaries’ eligibility status, collecting debt, investigating and deterring fraud, and other methods. 322 SOCIAL SECURITY ADMINISTRATION MAKING GOVERNMENT MORE EFFECTIVE—Continued The Budget proposes to improve payment accuracy by requiring that SSA review at least 50 percent of favorable SSI disability and blindness decisions before starting payments. Further, the Administration will conduct more continuing disability reviews (CDRs) in 2006. This is a proven, sound investment since SSA generates savings of approximately $10 for each $1 spent on such activities. SSA’s 2003 CDRs are expected to yield over $5 billion in program savings. Improved Productivity and Efficiency SSA is committed to improve its productivity and efficiency in providing services to citizens. 110 SSA performs a variety of tasks for citizens, such as processing applications for retirement 105 and disability benefits, answering questions through its 1–800 number, and conducting Average Processing Time 100 hearings for people who have appealed the decision SSA makes on their application for 95 benefits. SSA measures its productivity in conducting all of these transactions, and pushes 90 for greater efficiencies through increased use of technology and changes in business processes. 85 SSA, for example, measures the number of 1999 2000 2002 2003 2004 2005 2006 2001 applications for disability benefits the average Source: SSA. worker processes each year, and strives to increase this number. Using these kinds of measures, SSA has documented that the agency increased productivity by an annual average of nearly three percent from 2000-2004. In addition, SSA has reduced average processing time for initial disability claims by over 10 percent since 2001 (see accompanying chart). Processing Time for Initial Disability Claims Number of Days Video Hearings Save Time and Money In 2004, individuals who were initially denied disability benefits and who appealed to an Administrative Law Judge (ALJ) had to wait over a year before a final decision was made. Wait times can be especially long for individuals living long distances from major cities; ALJs may only visit rural areas a few times per year since they need to schedule enough hearings to justify the expense of their travel. Also, it can be difficult obtaining the appropriate expert witnesses outside major cities. Video hearings can benefit claimants in two ways. Their hearings may be scheduled sooner than if they choose faceto-face hearings, and there may be a broader range of expert witnesses available. For example, a claimant in Sioux City, Iowa, can go to a video hearing location in his or her local community, rather than traveling nearly 200 miles to the hearing office in West Des Moines or waiting many months before an ALJ could travel to Sioux City. Video hearings A claimant and representative (not shown) watch from a remote hearing site as expert witnesses are sworn in for a video hearing. THE BUDGET FOR FISCAL YEAR 2006 323 save travel expenses and time for both the claimant and the ALJ. In 2006, SSA plans to schedule 30,000 hearings via video. Update on the President’s Management Agenda The table that follows provides an update on SSA’s implementation of the President’s Management Agenda as of December 31, 2004. Human Capital Competitive Sourcing Financial Performance E-Government Budget and Performance Integration Status Progress Arrow indicates change in status since evaluation on September 30, 2004. SSA has achieved some significant milestones in its effort to implement the President’s Management Agenda. The agency now has a multi-tiered performance appraisal system for executives and managers that effectively differentiates between different levels of performance. SSA is working to include all employees under such a system. Further, SSA is able to determine full and marginal cost of achieving performance goals and uses that information to make decisions. In the area of Financial Performance, SSA is improving the quality, consistency, and timeliness of data so managers can drive better results such as reducing the administrative costs of SSA’s benefit programs. In Competitive Sourcing, SSA completed it first full competition, the Systems Help Desk (covering 68 positions). The estimated savings from this competition is $35 million over a five-year period. In addition, SSA identified a number of challenges involved in completing small competitions, and proposed an alternate study approach to better address these competitions that was approved as a limited pilot. Initiative Status Progress Eliminating Improper Payments SSA measures improper payments for its three major benefit programs: Old Age and Survivors Insurance (OASI), Disability Insurance, and Supplemental Security Income (SSI). SSA has a corrective action plan and reduction targets in place. The OASI program consistently has a very low improper payment rate. SSA did not meet its target for improper payments for SSI in 2003. SSA is working to meet future targets with initiatives that would allow for quicker and more accurate eligibility determinations. (Because this is the first quarter that agency efforts in the Eliminating Improper Payments Initiative were rated, progress scores were not given.) 324 SOCIAL SECURITY ADMINISTRATION AGENCY-SPECIFIC GOALS SSA sets goals to provide high-quality service, which is reflected in the Agency’s commitment to increase productivity, timeliness, and accuracy in processing applications for disability benefits. With this Budget, SSA expects to achieve the performance targets outlined in the table below. 2004 Actual Goal Productivity: Disability Decisions, Per Worker Per Year 1 ........................................................ SSA Hearings Decisions, Per Worker Per Year ................................................. Timeliness (in days): Average Processing Time for Initial Disability Claims ...................................... Average Processing Time for Hearing Decisions .............................................. Accuracy: Disability Determination Services Accuracy Rate ............................................. Accuracy Rate for Hearing Decisions .................................................................... 1 Goal 2005 2006 273 100 278 103 284 105 95 391 93 442 91 442 NA NA 97% 90% 97% 90% In 2004, an SSA worker on average made 273 disability decisions. A higher number in a given year represents greater productivity. Social Security Administration (In millions of dollars) 2004 Actual Estimate 2005 2006 Spending Discretionary Budget Authority: Limitation on Administrative Expenses (LAE) Base 1 ............................ Office of the Inspector General ....................................................................... Research and Development ............................................................................. Subtotal ............................................................................................................................. Medicare Reform Administrative Expenses 1 ..................................................... Total, Discretionary budget authority ...................................................................... 8,313 88 40 8,441 500 8,941 8,733 90 28 8,851 — 8,851 9,083 93 20 9,196 320 9,516 Mandatory Outlays: Old-age, Survivors, and Disability Insurance ............................................. Supplemental Security Income........................................................................ Special Benefits for Certain World War II Veterans ................................. Offsetting Collections .......................................................................................... Undistributed Offsetting Receipts ................................................................... Legislative proposals ...................................................................................... Total, Mandatory outlays ........................................................................................ 491,623 33,725 10 2,583 10,601 — 512,174 515,126 39,027 11 2,613 10,911 — 540,640 540,121 38,314 10 2,727 11,357 13 564,374 1 The LAE account includes funding from the Hospital Insurance and Supplementary Medical Insurance trust funds for services that support the Medicare program, including implementation of Medicare Reform.
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