Redeterminations are reviews of all of the nonmedical factors of eligibility to determine whether a recipient is still eligible for Supplemental Security Income (SSI) and still receiving the correct payment amount. There are two types of redeterminations: scheduled and unscheduled. All recipients are subject to periodic scheduling for a redetermination. Every year the Social Security Administration (SSA) schedules redeterminations for the cases most likely to have payment error, but the agency can also schedule reviews for cases unlikely to have payment error. SSA completes unscheduled redeterminations on an as-needed basis when recipients report, or we discover, certain changes in circumstances that could affect the continuing SSI payment amount. The numbers of redeterminations completed fluctuate from year to year due to variation in: (1) the numbers of unscheduled redeterminations completed; and (2) the numbers of scheduled redeterminations that we are able to complete during the fiscal year because of limitations on administrative resources and the impact of other workload requirements on the field offices. Redeterminations that we cannot complete in the scheduled fiscal year carry over into the next fiscal year.Between scheduled redeterminations, SSA uses the limited issue process to detect situations that have the potential to affect the continuing eligibility of SSI recipients and SSI payment amounts. SSA conducts periodic computer matches between its own systems and the systems of other Federal and State agencies to determine if the income and resources information on SSI recipients’ records conflicts with data that we obtain from the other systems. We post an indicator to the individual’s Supplemental Security Record1 when a match detects conflicting information. We select these limited issue cases for field office review of the issues for which we posted indicators. Beginning in fiscal year 2007, redetermination completions reported in SSA’s Agency Financial Report2 included limited issue completions.Table V.D1 provides historical data on numbers of redeterminations and limited issues by fiscal year.
Table V.D1.—SSI Redeterminationsa and Limited Issues Completed, Fiscal Years 1986‑2016 c 1,900 d 1,597 e 1,725 e1,071 e 692 e 900 e1,390 f2,223 f234 f2,457
Following enactment of the Social Security Disability Amendments of 1980, section 221(i) of the Social Security Act generally requires SSA to review the continuing eligibility of Old-Age, Survivors, and Disability Insurance (OASDI) disabled beneficiaries at least every 3 years. No legislation required the same review process for disabled SSI recipients at that time. Although the Committee on Finance of the Senate stated in its report on this legislation that the same medical continuing disability review (CDR) procedures should apply to both the OASDI and SSI programs, no new legislation amended Title XVI to accomplish this. Section 1614(a)(4) of the Act gives SSA discretionary authority to conduct periodic CDRs on SSI recipients. On September 28, 1994, SSA issued a Federal Register notice that periodic SSI CDRs would begin on October 1, 1994. In 1994 and again in 1996 Congress enacted new legislation adding some mandates for CDRs under the SSI program.Beginning in 1993, SSA developed a screening process for OASDI cases scheduled for a CDR in order to handle the large CDR workload mandated by these various provisions. The screening process included a mailer questionnaire for selected cases. In 1996, SSA extended this profiling process to SSI adults who were scheduled for a CDR. In fiscal year 2016, we deferred full medical reviews for 455,727 adult SSI recipients scheduled for a CDR as a result of the screening process.In 2007, SSA implemented a streamlined failure to cooperate (FTC) process for medical CDRs. Under this process, recipients who fail to comply with the field office requests for information necessary for processing their medical CDRs have their benefits suspended. After 12 consecutive months of suspension for noncompliance, SSA terminates their eligibility for disability benefits. SSA initially terminated 4,452 centrally initiated medical CDRs involving SSI recipients in fiscal year 2016 as a result of the streamlined FTC process. A more detailed discussion of CDRs can be found in the Annual Report of Medical Continuing Disability Reviews.3For individuals who receive both OASDI and SSI benefits on the basis of their own disability, SSA initiates CDRs as Title II CDRs, and the results of the review affect eligibility for benefits under both programs.4 Table V.D2 presents the numbers of centrally initiated periodic medical CDRs of SSI recipients we performed under Titles II and XVI since 1993. Tables V.D3 and V.D4 present the latest available detailed results5 on CDRs of SSI recipients performed in the most recent 15 years.6 These tables include only cases for which we conducted a full medical review. In particular, they do not include:
•
• In contrast with the allowance data presented in section V.C, we tabulate the CDR data on a cohort basis by the date of initial CDR decision.
Table V.D2.—SSI Continuing Disability Full Medical Reviews a by Year of Initial Decision, Fiscal Years 1993-2016
Table V.D3.—SSI Disabled Adult Reviews: Disposition a of Medical Continuing Disability Reviews by Year of
Initial Decision and Level of Decision, Fiscal Years 2002-2016
a Data reflect results as of February 2017. The ultimate numbers of continuations and cessations are subject to change until all appeals are final.e We do not reflect the status and disposition of cases in the Federal courts here. However, we have included information on the status and disposition at the Office of Disability Adjudication and Review (ODAR) for cases remanded to us by the courts. The excluded experience in the Federal courts has a minimal impact on the number of continuations.
Table V.D4.—SSI Disabled Child Reviews: Disposition a of Medical Continuing Disability Reviews by Year of
Initial Decision and Level of Decision, Fiscal Years 2002-2016
a Data reflect results as of February 2017. The ultimate numbers of continuations and cessations are subject to change until all appeals are final.e We do not reflect the status and disposition of cases in the Federal courts here. However, we have included information on the status and disposition at the Office of Disability Adjudication and Review (ODAR) for cases remanded to us by the courts. The excluded experience in the Federal courts has a minimal impact on the number of continuations.
Publication No. 31-231 is available at www.ssa.gov/finance/index.html.
The most recent such report can be found at www.ssa.gov/legislation/FY%202014%20CDR%20Report.pdf.
SSA Home | Privacy Policy | Website Policies & Other Important Information | Site Map | Actuarial Publications | September 1, 2017 |