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.
Table V.D1.—SSI Redeterminationsa and Limited Issues Completed, Fiscal Years 1986‑2012 c 1,900 d 1,597 e 1,725 e 1,071 e 692 e 900 e 1,390 f 2,223 f 234 f 2,457
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 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 the profiling process to SSI adults who were scheduled for a CDR. In fiscal year 2012, we deferred full medical reviews for 392,960 adult SSI recipients scheduled for a CDR as a result of the screening process.For 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.1 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 results2 on CDRs of SSI recipients performed in the most recent 15 years.3 These tables include only cases for which we conducted a full medical review. In particular, they do not include:
•
• Administrative closures — cases for which we curtail development for technical reasons;
• Miscellaneous other CDRs processed by the State disability determination services (DDS) but not as part of the normal CDR scheduling process (such as voluntary and third-party reports of medical improvement, post-transplant end-stage renal disease cases, and rehabilitation reports).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 decision.
Total full medical reviews Reviews of concurrent Title II/XVI cases initiated under Title II Title XVI initiated reviews Total SSI adult reviews Reviews of low-birth-weight children Redeterminations at age 18 All other reviews of SSI disabled children Total SSI children reviews
Table V.D3.—SSI Disabled Adult Reviews: Disposition a of Continuing Disability Medical Reviews by Year of
Initial Decision and Level of Decision, Fiscal Years 1998-2012 Total initial
DDS decisions
Table V.D3.—SSI Disabled Adult Reviews: Dispositiona of Continuing Disability Medical Reviews by Year of
Initial Decision and Level of Decision, Fiscal Years 1998-2012 (Cont.) Appeals to beyond
reconsideration
Table V.D3.—SSI Disabled Adult Reviews: Disposition a of Continuing Disability Medical Reviews by Year of
Initial Decision and Level of Decision, Fiscal Years 1998-2012 (Cont.) Total initial
decisions a Data reflect results as of February 2013. 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 Continuing Disability Medical Reviews by Year of
Initial Decision and Level of Decision, Fiscal Years 1998-2012 Total initial
DDS decisions
Table V.D4.—SSI Disabled Child Reviews: Disposition a of Continuing Disability Medical Reviews by Year of
Initial Decision and Level of Decision, Fiscal Years 1998-2012 (Cont.) Appeals to beyond
reconsideration
Table V.D4.—SSI Disabled Child Reviews: Disposition a of Continuing Disability Medical Reviews by Year of
Initial Decision and Level of Decision, Fiscal Years 1998-2012 (Cont.) Total initial
decisions a Data reflect results as of February 2013. 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.
Individuals concurrently receiving OASDI and SSI benefits where the OASDI benefit is not based on the individuals’ disability are initiated as title XVI CDRs. The results of the review only affect the individual’s eligibility for SSI benefits.
We included in these tables the SSI recipients whose benefits terminate as a result of CDRs. We report estimates of Federal SSI program savings resulting from the cessation of benefits to Congress in the Annual Report of Continuing Disability Reviews. The most recent such report, issued May 1, 2012, presented estimates of the effects of CDRs conducted in fiscal year 2010.
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