United States Government Accountability Office

GAO Testimony 

Before the Subcommittee on Social 

Security, Committee on Ways and Means, 

House of Representatives 

SOCIAL SECURITY 

ADMINISTRATION 

Agency Is Positioning Itself 

to Implement Its New 

Disability Determination 

Process, but Key Facets Are 

Still in Development 

Statement of Robert E. Robertson, Director 

Education, Workforce, and Income Security Issues 

For Release on Delivery

Expected at 11:00 a.m. EDT 

Thursday, June 15, 2006 

 

GAO-06-779T 
What GAO Found

United States Government Accountability Office

Why GAO Did This Study

Highlights

Accountability Integrity Reliability

June 15, 2006

SOCIAL SECURITY ADMINISTRATION

Agency Is Positioning Itself to Implement 

Its New Disability Determination Process, 

but Key Facets Are Still in Development 

Highlights of GAO-06-779T, a report to 

House Committee on Ways and Means 

Subcommittee on Social Security 

In March 2006, the Social Security

Administration (SSA) published a 

rule that fundamentally alters the 

way claims for disability benefits 

are processed and considered. The 

rule establishes the Disability

Service Improvement process 

(DSI)—intended to improve the 

accuracy, timeliness, consistency,

and fairness of determinations.

DSI’s changes include an

opportunity for an expedited 

decision during the initial 

determination process and the 

elimination of the Appeals Council, 

which had given claimants the right 

to appeal administrative law judge 

(ALJ) decisions before pursuing 

federal court review. DSI replaces 

the council with a Decision Review

Board, which will selectively

review ALJ decisions. However,

dissatisfied claimants whose cases 

are not selected for board review 

must now appeal directly to the 

federal courts. 

Based on its ongoing work, GAO 

was asked to testify on (1) public

and stakeholder concerns about 

the elimination of the Appeals 

Council and its replacement by the 

Decision Review Board and SSA’s 

response to these concerns, as well

as (2) the steps that SSA has taken 

to help facilitate a smooth 

implementation of the DSI process.

Concerns regarding the replacement of the Appeals Council with the 

Decision Review Board—raised by the public and stakeholder groups, such 

as claimant representatives—generally fall into two areas: (1) potential for 

increasing the workload of the federal courts and (2) anticipated hardship 

for claimants in terms of the loss of an administrative appeal level and 

difficulties associated with pursuing their claim in federal court. SSA’s 

response to concerns regarding the federal court workload is that all 

changes associated with the new DSI process—taken together—should 

reduce the need for appeal to the federal courts; at the same time, SSA plans 

to implement this final step gradually and with additional safeguards to 

minimize impact on the courts. In response to concerns about the loss of 

appeal rights, SSA contends that DSI introduces enhanced levels of federal 

review earlier in the process and that claimants should experience a decline 

in the amount of time it takes to receive a final agency decision. 

SSA has prepared in significant ways for the initial rollout of DSI in its 

Boston region, but the agency’s timetable is ambitious and much work 

remains. The agency has moved forward in key areas that underpin the new 

system—human capital development, technical infrastructure, and quality 

assurance—taking actions consistent with past GAO recommendations for 

improving the disability determination process. For example, SSA has taken 

steps to ensure that key technical supports, particularly its electronic 

disability case processing system, are in place—even though it has allowed 

itself little time to address and resolve any glitches that may arise prior to 

implementation. SSA has also taken several steps to lay a foundation for 

quality assurance by centralizing its quality assurance reviews, establishing a 

Decision Review Board for reviewing decisions, and developing writing tools 

that should foster consistency and thorough documentation at all phases of 

the determination process. Further, we found that SSA’s decision to 

implement DSI first in one small region prior to its introduction nationally is 

a good change management strategy that reflects our earlier 

recommendations. Additionally SSA has taken a proactive, collaborative 

approach to both the design and the implementation of the new 

determination process. Nevertheless, key facets of SSA’s plan to monitor and 

evaluate the Boston rollout remain to be developed. For example, 

performance measures for assessing the execution of the rollout are still 

unclear to us, and mechanisms for delivering feedback to staff on the clarity 

and soundness of their decision writing have not yet been fully developed. 

www.gao.gov/cgi-bin/getrpt?GAO-06-779T.

To view the full product, including the scope 

and methodology, click on the link above. 

For more information, contact Robert E. 

Robertson at (202) 512-7215 or 

robertsonr@gao.gov. 
Social Security Administration

Mr. Chairman and Members of the Subcommittee: 

Thank you for inviting me today to discuss stakeholder concerns about 

various aspects of the Social Security Administration’s (SSA) new 

Disability Service Improvement process (DSI) and the steps that SSA has 

taken to address these concerns. SSA is preparing to implement its new 

process first in its Boston region for at least 1 year beginning in August 

2006. 

In July 2005, SSA issued a notice of proposed rule making to obtain public 

comment on DSI proposals that would fundamentally redesign the way 

claims for disability benefits are processed and considered, with the 

purpose of improving the accuracy, consistency and fairness of its 

disability decisions, and making correct decisions earlier in the process. 

After reviewing comments submitted in response to its notice, SSA issued 

its final rule in March 2006, codifying many of its proposed changes. One 

of the many changes envisioned under DSI is the elimination of the 

Appeals Council, which had afforded claimants the ability to appeal

unfavorable decisions made by administrative law judges (ALJ) to SSA 

before filing suit with a federal court. Once DSI is fully implemented, 

decisions made by the ALJs become the final agency decision, unless they 

are selected for review by a new Decision Review Board. The cases 

selected for review will be those identified through use of a statistical 

model as claims that are complex or prone to erroneous decisions. As you 

know, many have expressed concern over the elimination of the Appeals 

Council as a forum that claimants could avail themselves of before 

resorting to a federal court. 

The information I am providing today is based on work that we conducted 

between February 22, 2006, and June 2, 2006, as part of ongoing work in 

this area, in accordance with generally accepted government auditing 

standards. I will be discussing (1) concerns raised about the replacement

of the Appeals Council with the Decision Review Board and how SSA has 

responded to them, and (2) steps SSA has taken to help facilitate a smooth 

implementation of the DSI process. 

To conduct our work, we reviewed a large sample (252 in total) of the 

comment letters that were submitted by the public in response to SSA’s 

notice of proposed rule making and that focused on the replacement of the 

Appeals Council with the Decision Review Board. In addition, we 

interviewed 10 stakeholder groups—such as claimant representatives, 

employee groups, and disability advocacy organizations that SSA has 

previously consulted with—to learn more about their perspectives on the 

Page 1 GAO-06-779T
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elimination of the Appeals Council as well as on the near-term rollout of 

the DSI process in the Boston region. In addition, we conducted extensive 

interviews with SSA officials and reviewed available agency documents to 

determine their position on and collect data relevant to eliminating the 

Appeals Council, as well as their efforts and plans related to DSI 

implementation. Further, we reviewed our past reports on improving 

SSA’s disability process in a number of areas, including human capital; its 

electronic records system—known as eDib; quality assurance; and 

implementing change and managing for success. For a more detailed 

description of our methodology, please see appendix I. 

In summary, we found that the public and stakeholders expressed two 

overriding concerns regarding the replacement of the Appeals Council 

with the Decision Review board—that the workload of the federal courts 

will rise if the council is eliminated and that this change will present 

additional hardship for claimants. In our review of the comment letters 

submitted to SSA that specifically addressed the elimination of the 

Appeals Council, we found that about half expressed concern that 

petitions to federal courts would rise, given the council’s termination, and

that claimants would lose an additional level of administrative review. 

About 40 percent of comments highlighted recent improvements in the 

Appeals Council’s processes and noted that eliminating the council would 

not improve adjudication. Stakeholder groups we spoke with basically 

underscored these same two points—that eliminating the Appeals Council 

would result in an increase in disability claims cases that are appealed in 

federal district courts and that some claimants may drop meritorious 

claims rather than pursue a seemingly complicated and intimidating 

federal court appeal. Acknowledging these concerns, SSA contends that 

DSI will improve decision making earlier in the process, decrease the time

it takes the agency to reach a final decision, and reduce the need for 

appeal. SSA also maintains that because DSI affords claimants the right to

appeal their initially denied claims to reviewing officials who are now 

centrally managed, claimants will not experience an overall loss in 

administrative review at the federal level. At the same time, both 

stakeholders and SSA believe it will be important for the agency to closely 

monitor DSI in order to evaluate its impact on claimants and the courts. 

SSA has made substantial preparation for DSI on all fronts related to 

successful implementation—human capital, technical infrastructure, and

quality assurance. However, the timetable is ambitious and much work 

remains. While stakeholders have expressed concern that SSA will not be 

able to hire and sufficiently train staff in time for the new process to get 

under way, we found that the agency has, to date, posted hiring 

Page 2 GAO-06-779T
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announcements for new positions and developed training packages for 

onboard staff. SSA is also taking steps, as we had previously 

recommended, to ensure that key technical supports, particularly the 

electronic disability system known as eDib, are in place for Boston staff to 

adjudicate claims under the new process. At the same time, the agency has 

allowed itself very little time to identify and resolve any potential glitches 

that may arise before the Boston rollout in August. Regarding quality 

assurance, SSA has taken several steps to lay a foundation for a more 

cohesive program, as we had recommended in our earlier reports. For 

example, features of the new DSI process—including centralizing quality

assurance reviews of initial state disability determination service (DDS) 

decisions, establishing a Decision Review Board for hearing decisions, and 

developing several tools to aid decision writing—may address problems 

with decisional consistency that we have identified in the past by allowing

for a cohesive analysis of decisions. In addition, SSA officials plan to 

monitor and evaluate the execution of the Boston rollout, although some 

performance measures for this initiative, such as for assessing a new 

medical expert system that is part of DSI, are still unclear to us, and 

mechanisms for delivering feedback to staff on the clarity and soundness 

of their decision writing have not yet been fully developed. Finally, SSA is

undertaking other, broad steps that we consider consistent with effective 

change management strategies that we have previously recommended. For 

example, the decision to implement the new system first on a small 

scale—that is, in one small region—before introducing it elsewhere should 

allow for careful integration of the new systems and staff and for working 

out problems before they become serious impediments to success. 

Additionally, SSA has employed a proactive, collaborative approach with 

the stakeholder community in both designing and implementing the new 

disability determination process. 

SSA operates the Disability Insurance (DI) and Supplemental Security 

Income (SSI) programs—the two largest federal programs providing cash 

benefits to people with disabilities. The law defines disability for both 

programs as the inability to engage in any substantial gainful activity by 

reason of a severe physical or mental impairment that is medically 

determinable and is expected to last at least 12 months or result in death.

In fiscal year 2005, the agency made payments of approximately 

$126 billion to about 12.8 million beneficiaries and their families. We have 

conducted a number of reviews of SSA’s disability programs over the past 

decade, and the agency’s management difficulties were a significant 

reason why we added modernizing federal disability programs to our highrisk list in 2003. In particular, SSA’s challenges include the lengthy time 

Background 

Page 3 GAO-06-779T
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the agency takes to process disability applications and concerns regarding 

inconsistencies in disability decisions across adjudication levels and 

locations that raise questions about the fairness, integrity, and cost of 

these programs. 

The process SSA uses to determine that a claimant meets eligibility 

criteria—the disability determination process—is complex, involving more 

than one office and often more than one decision maker. Under the 

current structure—that is, DSI notwithstanding—the process begins at an 

SSA field office, where an SSA representative determines whether a 

claimant meets the programs’ nonmedical eligibility criteria. Claims 

meeting these criteria are forwarded to a DDS to determine if a claimant 

meets the medical eligibility criteria. At the DDS, the disability examiner 

and the medical or psychological consultants work as a team to analyze a 

claimant’s documentation, gather additional evidence as appropriate, and 

approve or deny the claim. A denied claimant may ask the DDS to review 

the claim again—a step in the process known as reconsideration. If the 

denied claim is upheld, a claimant may pursue an appeal with an ALJ, who 

will review the case. At this step, the ALJ usually conducts a hearing in 

which the claimant and others may testify and present new evidence. In 

making the disability decision, the ALJ considers information from the 

hearing and from the DDS, including the findings of the DDS’s medical 

consultant. If the claimant is not satisfied with the ALJ decision, the 

claimant may request a review by SSA’s Appeals Council, which is the final 

administrative appeal within SSA. If denied again, the claimant may file 

suit in federal court. 

In March 2006, SSA published a final rule to establish DSI, which is 

intended to improve the accuracy, consistency, and fairness of decision 

making and to make correct decisions as early in the process as possible. 

While DDSs will continue to make the initial determination, claims with a 

high potential for a fully favorable decision will be referred to a new Quick 

Disability Determination (QDD) process. If the claimant is dissatisfied 

with the DDS’s initial determination or QDD, the claimant may now 

request a review by a federal reviewing official—a new position to be 

staffed by centrally managed attorneys. The federal reviewing official 

replaces the reconsideration step at the DDS level, and creates a new level 

of federal review earlier in the process. The claimant’s right to request a 

hearing before an ALJ remains unchanged. However, the Appeals Council

is eliminated under the new process, and as a result the ALJ’s decision 

becomes the final agency decision except in cases where the claim is 

referred to the new Decision Review Board. Claims with a high likelihood 

of error, or involving new areas of policy, rules, or procedures, are 

Page 4 GAO-06-779T
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candidates for board review. 1 If the board issues a new decision, it 

becomes the final agency decision. As before, claimants dissatisfied with 

the final agency decision may seek judicial review in federal court. DSI 

also includes the introduction of new decision-writing tools that will be 

used at each adjudication level, and are intended to streamline decision 

making and facilitate training and feedback to staff. In addition, SSA is 

creating a Medical and Vocational Expert System, staffed by a unit of 

nurse case managers who will oversee a national network of medical, 

psychological, and vocational experts, which are together responsible for 

assisting adjudicators in identifying and obtaining needed expertise. In its 

final rule, SSA indicated that DSI will further be supported by 

improvements, such as a new electronic disability system and an 

integrated, more comprehensive quality system. 

As noted, the changes introduced by DSI were codified in SSA’s final rule

on the subject. Table 1 highlights these new features and associated 

elements. 

 1

According to SSA, for the first year of implementation in the Boston region, the board will 

review all ALJ decisions. 

Page 5 GAO-06-779T
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Table 1: Key Aspects of DSI 

New feature Associated elements 

Expedited processing for certain clear-cut cases. 

Use of a predictive model to screen for cases that have a greater likelihood of allowance 

and to act on those claims within 20 days. 

Nationally standardized training for examiners in DDS on this process. 

Quick Disability Determinations 

Medical or psychological experts must verify that the medical evidence is sufficient to 

determine that the impairment meets the standards. 

A national network of medical, psychological, and vocational experts who will be available to 

assist adjudicators throughout the agency. 

The national network will be overseen by a new Medical and Vocational Expert Unit. 

Medical and Vocational Expert System 

All experts affiliated with the network must meet qualifications, which are still under 

development. 

A cadre of federal reviewing officials—all attorneys—can affirm, reverse, or modify appealed 

DDS decisions. Federal reviewing officials cannot remand cases to the DDSs for further 

review, but they can ask that the DDSs provide clarification or additional information for the 

basis of their determination. 

Reviewing officials may obtain new evidence and claimants can submit additional evidence 

at this stage. If necessary, the reviewing official may issue subpoenas for documents. 

Federal reviewing officials 

If a reviewing official disagrees with the DDS decision, or if new evidence is submitted, he or 

she must consult with an expert in the expert system. 

The Decision Review Board will replace the Appeals Council. It will be composed of 

individuals selected by SSA’s Commissioner, and each member will serve a designated

term. 

The board will review both allowances and denials, and the board has the ability to affirm, 

modify, reverse, or remand ALJ decisions. 

A new sampling procedure—or predictive model—will identify ALJ decisions that are errorprone or complex for the board’s review. The predictive model, which is still under 

development, is expected to select 10 to 20 percent of ALJ decisions for the board’s review. 

The board has 90 days from the date the claimant receives notice of board review to make

its final decision. If it fails to act within that period, the ALJ decision remains SSA’s final 

decision. 

Decision Review Board 

A claimant may submit a written statement to the board within 10 days of receiving notice

that the board will review his or her case, explaining why he or she agrees or disagrees with 

the ALJ’s decision. This statement may be no longer than 2,000 words. 

Source: GAO analysis.

Note: While DSI does not change the structure or scope of ALJ reviews, the new process has several

elements that affect hearings at the ALJ level. Namely, SSA will notify claimants at least 75 days prior

to the hearing of the date and time for which the hearing has been scheduled. Additionally, claimants 

have to submit evidence at least 5 business days before the hearing date itself. 

Page 6 GAO-06-779T
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Implementation of DSI will begin on August 1, 2006, in the Boston region, 

which includes the states of Connecticut, Massachusetts, Maine, New 

Hampshire, Rhode Island, and Vermont.2

 Therefore, only those claims filed 

with SSA in the Boston region on or after August 1 will be subject to the 

new process.3

 All claims currently in process in the Boston region, and 

claims filed elsewhere, will continue to be handled under current 

procedural regulations until SSA takes further action.4

 In addition, for 

cases filed in the Boston region during the first year of DSI 

implementation, all ALJ decisions—both allowances and disallowances—

will be reviewed by a new Decision Review Board with authority to affirm, 

modify, reverse, or remand decisions to the ALJ.5 Since DSI will only affect

new claims initiated in the Boston region, claimants whose cases were 

already in process before August—as well as those filing outside the 

Boston region—will still have access to the Appeals Council. 

In their written comments to SSA and discussions with us, public and 

stakeholder groups, such as claimant representatives and disability 

advocacy groups, expressed two broad areas of concern regarding the 

replacement of the Appeals Council with the Decision Review Board: 

(1) potential for increasing the workload of the federal courts and 

(2) anticipated hardship for claimants in terms of loss of an administrative

appeal level and difficulties associated with pursuing their claims in 

federal court. SSA’s response to concerns regarding the federal court 

workload is that all changes associated with new DSI process—taken 

together—should reduce the need for appeal to the federal courts. At the 

same time, SSA plans to implement this final step gradually and with 

additional safeguards to minimize the impact on the courts. In response to 

concerns about the loss of appeal rights, SSA contends that under the new 

Concerns Include 

Fear of Increased 

Court and Claimant 

Hardship, while SSA 

Believes Its New 

Process Will Reduce 

the Need for Appeal 

 2

According to these regulations, SSA will publish a notice in the federal register when it 

decides to roll out DSI in another region, but this notice will not be subject to the formal

rule-making process.

3

If a claimant moves to another region from the Boston region, and initially filed the claim 

in the Boston region on or after August 1, 2006, the conditions of the DSI process will apply 

to that claimant no matter where he or she moves. If a claimant initially filed elsewhere and 

then moves to the Boston region, the DSI process will not apply to him or her. 

4

These procedures can be found in the Code of Federal Regulations, 20 CFR 404.900-

404.999d and 416.1400-416.1499. 

5

According to SSA, the predictive model used to identify cases that are complex or errorprone will be tested against the board’s review of all cases during the rollout in Boston. The 

model will be tested continually until it has been proven reliable. 

Page 7 GAO-06-779T
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DSI process, claimants will have a new level of federal review earlier in the 

process, and should experience a decline in the amount of time it takes to 

receive a final agency decision without being overly burdened by the 

Decision Review Board under the new process. 

Public and Stakeholders 

Anticipate a Larger

Caseload for Courts, while 

SSA Maintains That Better 

Decisions Earlier in the 

Process Will Reduce the 

Need for Appeal 

Concerns expressed in comment letters to SSA and in our interviews 

revolved largely around the possibility that the replacement of the Appeals 

Council with the Decision Review Board would result in rising appeals to 

the federal courts. Specifically, more than half of the 252 comment letters 

we reviewed indicated that the Appeals Council provides an important 

screening function for the federal courts, and that its replacement with the 

Decision Review Board could result in rising caseloads at the federal court 

level. Stakeholder groups with whom we spoke reiterated this concern. 

With the imminent rollout in the Boston region, several stakeholders 

suggested that SSA closely monitor the effectiveness of the board and the

impact of this change on the federal courts. 

Data from SSA suggest that the Appeals Council is both screening out a 

number of cases that might otherwise have been pursued in the federal

courts and identifying many claims that require additional agency analysis. 

Between 2001 and 2005, the number of disability cases appealed to SSA’s 

Appeals Council rose 13 percent. At the same time, the number of 

disability cases filed with the federal courts (both DI and SSI) declined 9 

percent.6

 Figure 1 illustrates the volume of receipts at both the federal 

court and the Appeals Council levels during this period. 

 6

According to data from the U.S. District Courts, claims from 15,416 disability insurance

cases (both DI and SSI), or 6 percent of the court’s total workload, were filed during the 12-

month period ending March 31, 2005—down from 16,921 in 2001. 

Page 8 GAO-06-779T
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Figure 1: Federal Court and Appeals Council Receipts between 2001 and 2005 

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

90,000

100,000

2001 2002 2003 2004 2005

Appeals received

Sources: SSA and the Administrative Office of the U.S. Courts.

Year

Federal court receipts

Appeals Council receipts

Note: Data on federal court cases are for the 12-month periods ending March 31 of the named year. 

Data on Appeals Council cases are collected on a fiscal year basis. 

Further, the Appeals Council consistently remanded about 25 percent of 

the claims it reviewed between 2001 and 2005 for further adjudication by

the administrative law judge—see figure 2—providing more evidence that

the Appeals Council is identifying a significant number of claims that 

require additional agency review and modification. 

Page 9 GAO-06-779T
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Figure 2: Disposition of Appeals Council Cases, by Fiscal Year, 2001-2005 

0 

10 

20 

30 

40 

50 

60 

70 

80 

90 

100 

2001 2001 2003 2004 2005 

Fiscal year 

Percentage of cases processed 

Remand 

Dismiss

Reverse 

Affirm 

Deny review 

Source: SSA. 

Note: The Appeals Council will deny review if cases do not meet the following criteria—there does not 

appear to be an abuse of discretion by the ALJ; there is no error of law; the actions, findings, or 

conclusions of the ALJ are supported by substantial evidence; or the case does not present a broad 

policy or procedural issue that may affect public interest. If the Appeals Council denies review, the 

ALJ decision stands as the final agency decision. 

SSA believes that the implementation of DSI as an entire process will help 

it make the correct disability determination at the earliest adjudication 

stage possible and thereby reduce the need for appeal. According to SSA, 

several elements of the DSI process will contribute to improved decision 

making. These include the federal reviewing official position, which 

presents an enhanced opportunity for the agency to thoroughly review 

case records—with the assistance of medical and vocational experts—-

early in the process, as well as new online policy guidance and new tools 

to aid decision writing, which will be used at each adjudication level to 

facilitate consistency and help the agency identify and correct errors more 

quickly. Last, SSA believes that the number of requests for voluntary 

Page 10 GAO-06-779T
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remands that SSA makes to the federal courts is an indicator that the 

Appeals Council is not fully addressing errors in the case or otherwise 

reviewing the case effectively so as to prevent the federal courts from 

reviewing appeals that should have been handled administratively. 7

 SSA 

believes the Decision Review Board will more effectively screen cases 

from federal court review by focusing on error-prone claims identified 

through a predictive model. 

SSA acknowledges that the agency cannot predict the likely impact on the 

federal courts’ workload and cannot prevent denied claimants from filing 

suit with the federal courts.8

 To reduce the likelihood of too many appeals 

reaching the federal court level, SSA stated in its final rule that it is 

pursuing a gradual rollout by implementing the DSI process in one small 

region—the Boston region—and plans to have the board initially review all 

of the ALJ decisions in that region. According to SSA officials, the board’s 

review of all ALJ decisions will allow them to test the efficacy of the new 

predictive model, to help ensure that the model is identifying the mosterror prone cases that might otherwise find their way to federal court. 

Further, SSA officials told us that they are working with the federal court 

system to develop a way to gauge changes in the court’s caseload. Finally, 

SSA’s internal counsel told us that the agency has begun a systematic data 

collection process to better understand the circumstances surrounding 

remands from the federal court. To date, SSA attorneys have analyzed the

reasons for federal court remands in more than 1,600 cases, but they are

still working on a quality control mechanism to ensure that their 

information has been entered properly and are therefore unwilling to 

report on the results of their analysis at this time. 9

 7

According to SSA officials, request for voluntary remands occur when a claimant files an 

appeal with the federal court and SSA’s Office of General Counsel determines that the case 

is not defensible. 

8

In the 1990s, SSA conducted a pilot—the Full Process Model—which included, among 

other changes, eliminating the Appeals Council. According to SSA officials, although they

collected some data on the number of direct appeals from the ALJ level to the federal 

courts, the agency discontinued its pilot before collecting sufficient data for a complete 

assessment of the model’s impact. 

9

SSA officials also indicated that they intend to develop a predictive model, to build on 

current efforts, that identifies error-prone cases among those denied by ALJs that are

subsequently remanded by the federal courts back to SSA for further adjudication. 

Page 11 GAO-06-779T
In their comments on the proposed rule and in subsequent conversations 

with us, stakeholders expressed concern that eliminating the Appeals 

Council would cause claimants hardship both by eliminating the 

opportunity to appeal an ALJ decision to the Appeals Council and by 

increasing the cost and difficulty associated with pursuing cases in federal 

court. 

In particular, 48 percent of the 252 comment letters we reviewed 

expressed concern that the replacement of the Appeals Council with the 

Decision Review Board would represent a loss in claimant appeal rights 

within SSA. These letters, as well as subsequent discussions with 

stakeholders, emphasized the concern that claimants will not have a say in

which cases are reviewed by the board. Further, stakeholders were 

concerned that in the Boston region, claimants whose cases were allowed 

at the ALJ level could be overturned by the board, presenting additional 

hardship for claimants as they await a decision. 

Public and Stakeholders 

Anticipate Increased 

Hardship for Claimants, 

but SSA Believes the New 

Federal Reviewing Official 

Position Will Improve 

Decision Making Earlier 

In addition, claimant representatives and disability advocacy organizations 

are concerned that appealing at the federal court rather than Appeals 

Council level would be costlier and more intimidating for claimants. For 

example, there is a filing fee associated with the federal courts, and 

stakeholders commenting on SSA’s final rule said that the filing procedure 

is more complicated than that required for an appeal before the Appeals 

Council.10 In addition, claimants seeking representation must find 

attorneys who, among other requirements, have membership in the district 

court bar in which the case is to be filed. As a result of these hardships, 

claimant representatives and disability advocacy organizations, in 

particular, were concerned that claimants would drop meritorious claims 

rather than pursue a seemingly complicated and intimidating federal court 

appeal. 

About 40 percent of the comment letters asserted that the amount of time 

the Appeals Council spent adjudicating cases—also referred to as its 

processing time—has improved recently, and letter writers did not believe 

that terminating the Appeals Council would improve the adjudicative 

process. Although SSA has contended that the Appeals Council has 

 10To appeal to the Appeals Council, applicants need only complete a one-page form and 

return it to SSA. For the federal courts, there is a $250 filing fee. Although this fee can be 

waived (based on need), claimant representatives and disability advocates assert that the

fee may be cost-prohibitive for some claimants, and representing oneself at the federal 

court level is challenging. 

Page 12 GAO-06-779T Social Security Administration
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historically taken too much time without providing claimants relief, 

stakeholders’ claims that the Appeals Council processing time has 

decreased significantly in recent years was confirmed by SSA data—see 

figure 3. In light of these concerns, many stakeholder groups we spoke 

with suggested that SSA should roll out the Decision Review Board 

carefully and closely evaluate outcomes from claimants’ perspectives. 

Figure 3: Appeals Council Processing Time and Volume of Dispositions, by Fiscal 

Year, 2001-2005 

0 

50 

100 

150 

200 

250 

300 

350 

400 

450 

500 

2001 2002 2003 2004 2005 

Days Dispositions

Source: SSA.

Fiscal year 

Appeals Council processing time

Dispositions

0 

20,000 

40,000 

60,000 

80,000 

100,000 

120,000 

140,000 

2001 2002 2003 2004 2005 

Note: SSA does not track how many of the cases remanded by the Appeals Council result in denials

that are appealed again to the council. 

In their final rule and in conversations with us, SSA officials stated that the 

new process still affords claimants comparable appeal rights along with 

the promise of a faster agency decision. Specifically, SSA stated that DSI 

includes two federal levels of thorough case development and 

administrative review—one by the new federal reviewing official and

another by an ALJ at the hearings level. SSA contends that the new federal 

reviewing official position is a marked departure from the reconsideration 

step, in that the position will be managed centrally and staffed by 

attorneys specifically charged with enhancing the development of a case 

Page 13 GAO-06-779T
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and working with a new cadre of medical and vocational experts to make 

decisions. SSA believes that this new position, along with other changes in 

the new process, will result in many more cases being correctly 

adjudicated earlier in the process, resulting in fewer decisions appealed 

and reviewed by ALJs at the hearings level. 

SSA also argues—recent improvements in processing time 

notwithstanding—that the elimination of the Appeals Council step will 

reduce the length of time it takes the agency to reach a final decision on 

behalf of the claimant. Further, SSA maintains that the replacement of the 

Appeals Council with the board will not be prejudicial to or complicated 

for the claimant. SSA indicated that claimants will have an opportunity to 

submit written statements to the Decision Review Board, thus providing 

another chance to assert their circumstances. SSA maintains that aside 

from the written statement, further action is not required on the part of the 

claimant until the board issues its decision. 

SSA has told us that it plans to monitor stakeholder concerns in several 

ways. For example, SSA plans to track the length of time it takes to reach 

final decisions as well as the allowance rate. SSA also plans to review 

written statements submitted by claimants to help assess the validity of

the board’s predictive model.11

SSA has prepared in significant ways for DSI, but the agency’s timetable is 

ambitious and substantive work remains. SSA has moved forward in key 

areas that should underpin the new system—human capital development, 

technical infrastructure, and quality assurance. However, some essential 

measures remain under development, particularly for quality assurance. 

Nevertheless, on balance, the agency has begun to employ a number of 

change management strategies we recommended earlier for successful 

transitioning. 

SSA Has Taken 

Constructive Steps to 

Implement the New 

DSI Process, but Its 

Schedule Is Ambitious 

and Many Details Are 

Not Yet Finalized 

 11Specifically, SSA plans to compare the contents of these statements to the results of the

predictive model. If SSA determines that using claimant statements will improve the model, 

SSA would consider revising the model to incorporate information from these documents. 

Page 14 GAO-06-779T
While stakeholders have expressed concern that SSA will not be able to 

hire and sufficiently train staff in time for the new process, we found that 

the agency has taken a number of steps in this area. With respect to hiring

for new positions, the agency has already developed position descriptions 

and posted hiring announcements for nurse case managers, who will work

in the new Medical and Vocational Expert Unit, as well as for federal 

reviewing officials. To date, SSA officials have begun assessing more than 

100 eligible applicants for the reviewing official slots, and expect to hire 70 

by late June and another 43 in early 2007. SSA officials also said they 

posted announcements to hire nurse case managers, and that they expect

to hire as many as 90 before the end of the rollout’s first year in the Boston 

region. 

SSA Has Moved to Hire 

and Train Staff, but It 

Faces Short Timetables 

SSA officials also said that the agency has posted announcements to hire 

support staff for both the reviewing officials and nurse case managers, but 

the exact number SSA is seeking to hire has not been decided. Several 

stakeholders we spoke with were particularly concerned that SSA will 

need to hire or otherwise provide adequate support staff for reviewing 

officials to ensure their effectiveness. Specifically, several of the ALJs we 

interviewed told us that at the hearings level, judges and their staff 

currently spend significant time developing case files. They noted that if 

the reviewing official position is designed to focus on case development, 

then attorneys in this role will need support staff to help them with this 

time-consuming work. 

With respect to training, the agency has been creating a variety of training 

materials for new and current staff, with plans to deliver training at 

different times, in different ways. SSA officials reported working on 

development of a uniform training package for all staff with some flexible 

components for more specialized needs. Specifically, about 80 percent of 

the package is common content for all employees, and 20 percent will be 

adaptable to train disability examiners, medical experts, ALJs, and others 

involved in the adjudication process. SSA officials said they developed the 

package with the federal reviewing officials in mind, but also with an eye 

toward a centralized training content that could apply to current and new 

staff down the line. SSA plans to provide the full training package, which 

constitutes about 8 weeks of course work and 13 modules, to reviewing 

officials in late June, once all attorneys for that position are hired. Among 

the sessions included are the basics of the disability determination 

process, eDib and its use, medical listings and their application, and 

decision writing. 

Page 15 GAO-06-779T Social Security Administration
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Given that the rule was finalized in March and rollout is set for August, 

agency timetables for hiring, training, and deploying more than 100 new 

staff—as well as for training existing examiners—in the six states in the 

Boston region are extremely short. SSA officials have acknowledged the 

tight time frame, but hope to deliver training by using more than one 

medium—in person, online, or by video. SSA still expects to accomplish 

all hiring and training for the Boston region staff in time for an August 1 

launch of the new process. 

SSA Has Readied eDib for 

the Boston Region, but 

Time for Resolving LastMinute Glitches before 

Rollout Will Be Limited 

SSA has also taken steps, as we had previously recommended, to ensure 

that key technical supports, particularly an electronic disability case 

recording and tracking system known as eDib, are in place in time for 

Boston staff to adjudicate claims under DSI electronically. The agency has 

made a variety of efforts to familiarize employees with the system and 

facilitate their ability to use it as early as possible. First, SSA positioned 

the Boston region for a fast transition to eDib by reducing the region’s 

paper case backlog. According to a Boston region ALJ, pending case 

records are being converted now to familiarize judges and decision writers 

with the eDib system so they will be comfortable with it when new cases 

reach that level after August 1. Then SSA worked with Boston region staff 

to certify that the region’s DDS offices were ready for full eDib

implementation. 

According to claimant representatives, SSA has also worked to facilitate 

their transition to eDib, and according to SSA officials, the agency has 

developed a system called Electronic Records Express to facilitate 

medical providers’ submission of records to SSA. A stakeholder group of 

claimant representatives told us that SSA has offered them training and 

that they have met regularly with agency staff to smooth out eDib issues, 

such as difficulties associated with the use of electronic folders—

electronic storage devices that replace paper folders as the official record 

of evidence in a claimant’s case file. This stakeholders group also reported 

that its members have voluntarily coordinated with SSA to test new 

techniques that might further facilitate eDib implementation. 

SSA has also been developing electronic templates to streamline decision 

writing. ALJs have already received some training on theirs, which is 

known as the Findings Integrated Template. According to SSA officials, 

this template is now used, voluntarily, by ALJs nationwide, after months of 

extensive testing and refinement. For DDS-level decisions, SSA is 

designing a template—called the Electronic Case Analysis Tool (E-CAT)—

which it expects to be partially operational by July and fully implemented 

Page 16 GAO-06-779T
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by November. DDS examiners in the Boston region will receive training on

the tool in July and will also receive training prior to then on the elements

of sound decision making. A similar tool is in development for the 

reviewing officials. 

While SSA officials expressed confidence in having technical supports 

sufficiently in place in time for implementation of DSI in August, 

unanticipated problems associated with new technology may challenge 

their ability to do so. In addition to eDib and E-CAT, SSA is implementing 

other new software systems to support the rollout (such as the predictive 

models and electronic medical records transmission)—any one of which 

may involve unexpected problems. For example, in 2005 we reported that

a number of DDSs were experiencing operational slowdowns and system 

glitches associated with the new eDib system.12 It remains to be seen 

whether the Boston region experiences similar problems with eDib, or 

problems with other new systems, and whether SSA will be able to resolve 

technical issues that may arise before implementation begins in August. 

SSA Is Improving Its 

Quality Assurance System 

as Part of DSI Rollout, 

although Key Elements 

Have Yet to Be Revealed 

SSA is taking steps to improve its quality assurance system that have

potential for improving the accuracy and consistency of decisions among 

and between levels of review, in a manner that is consistent with our past 

recommendations. As early as 1999, GAO recommended that in order to 

improve the likelihood of making improvements to its disability claims 

process, SSA should focus resources on initiatives such as process 

unification and quality assurance, and ensure that quality assurance 

processes are in place that both monitor and promote the quality of 

disability decisions.13 Consistent with these recommendations, many of 

SSA’s current efforts involve adding steps and tools to the decision-making 

process that promote quality and consistency of decisions and provide for 

additional monitoring and feedback. While these developments are 

promising, many important details of SSA’s quality assurance system have 

yet to be finalized or revealed to us. 

 12GAO, Electronic Disability Claims Processing: SSA Is Proceeding with Its Accelerated

Systems Initiative but Needs to Address Operational Issues, GAO-05-97 (Washington, 

D.C.: Sept. 23, 2005). 

13GAO, SSA Disability Redesign: Actions Needed to Enhance Future Progress, 

GAO/HEHS-99-25 (Washington, D.C.: Mar. 12, 1999). 

Page 17 GAO-06-779T
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SSA has recently elevated responsibility for its quality assurance system to 

a new deputy-level position and office—the Office of Quality Performance. 

This office is responsible for quality assurance across all levels of 

adjudication. Listed below are new aspects of the quality assurance system

that this office oversees and that hold promise for promoting quality and 

consistency of decisions.

• SSA will continue to provide accuracy rates for DDS decisions, but 

these accuracy rates will be generated by a centralized quality 

assurance review, replacing the agency’s older system of regionally 

based quality review boards and thereby eliminating the potential 

differences among regional reviews that were a cause for inconsistent 

decisions among DDSs. 

• As part of the DSI rollout, SSA plans to incorporate new electronic 

tools for decision writing to be used by disability examiners, federal 

reviewing officials, and ALJs. The tools are intended to promote quality 

in two ways. First, the tools will require decision makers to document 

the rationale behind decisions in a consistent manner while specifically

addressing areas that have contributed to errors in the past, such as 

failing to list a medical expert’s credentials or inaccurately

characterizing medical evidence. Second, the tools will help provide a 

feedback loop, by which adjudicators and decision writers can learn 

why and under what circumstances their decisions were remanded or 

reversed. SSA officials told us that once the tools are in full use, the 

Office of Quality Performance will collect and analyze their content to 

identify errors or areas lacking clarity. They also plan to provide 

monthly reports to regional managers in order to help them better 

guide staff on how to improve the soundness of their decisions and the 

quality of their writing.14

• The establishment of the Decision Review Board, with responsibility 

for reviewing ALJ decisions, is intended to promote quality and 

consistency of decisions in two ways. First, once DSI is rolled out 

nationwide, the board will be tasked to review error-prone ALJ 

decisions with the intent of further ensuring the correctness of these 

decisions before they are finalized. Second, during the initial rollout 

phase, SSA plans to have the board review all ALJ decisions to verify 

that the predictive model used to select error-prone cases is doing so as 

 14The purpose of this tool is consistent with GAO’s prior recommendations that SSA 

develop a more focused and effective strategy for ensuring uniform application of SSA’s 

guidance and to improve consistency of decisions. GAO, Social Security Administration: 

More Effort Needed to Assess Consistency of Disability Decisions, GAO-04-656

(Washington, D.C.: July 2, 2004). 

Page 18 GAO-06-779T
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intended. Importantly, both the tools and the board’s assessment are 

consistent with our prior recommendations that SSA engage in more 

sophisticated analysis to identify inconsistencies across its levels of 

adjudication and improve decision making once the causes of

inconsistency among them have been identified.15

In addition to these actions, SSA told us it plans to measure outcomes 

related to how DSI is affecting claimants, such as allowance rates and 

processing times at each adjudication stage, and the proportion of cases 

remanded from the federal courts and the rationales for these remands. 

Further, officials told us they will work with the federal courts to track 

changes in their workload. SSA officials also told us they are working to 

monitor changes in costs associated with the new DSI process, in terms of 

both the administrative costs of the process, as well as its overall effect on 

benefit payments. Officials also said that SSA will track the length of time 

it takes the agency to reach a final decision from the claimant’s

perspective, which we have recommended in the past.16 Although SSA 

officials told us that ALJ accuracy rates will be generated from the board’s

review of all ALJ decisions, they said they were not yet certain how they 

will measure these rates once DSI is rolled out nationwide and the board is

no longer reviewing all ALJ decisions. 

While these developments are promising, aspects of these changes and of 

SSA’s plans to monitor the DSI implementation have either not been 

finalized or not been revealed to us. For example, SSA has not yet revealed

the types of reports it will be able to provide decision makers based on the 

decision-writing tools. In addition, while SSA plans to measure the 

effectiveness of the new process, its timeline for doing so and the 

performance measures it plans to use have not been finalized. According 

to SSA officials, potential measures include how well the predictive 

models have targeted cases for quick decisions at the initial DDS level or 

error-prone cases for the board, and whether feedback loops are providing 

information that actually improves the way adjudicators and decision 

writers perform their work. 

 15GAO-04-656. 

16GAO, Observations on the Social Security Administration’s Fiscal Year 1999

Performance Report and Fiscal Year 2001 Performance Plan, GAO/HEHS-00-126R 

(Washington, D.C.: June 30, 2000). 

Page 19 GAO-06-779T
SSA’s efforts and plans show commitment to implementing DSI gradually,

using tested concepts, involving top-level management, and 

communicating frequently with key stakeholders—practices that adhere

closely to our prior recommendations on effective change management 

practices. 

SSA Has Employed Other 

Change Management 

Practices to Implement 

DSI 

With regard to gradual implementation, we had previously suggested that 

SSA test promising concepts in a few sites to allow for careful integration 

of the new processes in a cost-effective manner before changes are 

implemented on a larger scale.17 SSA’s decision to implement DSI in one 

small region is consistent with this recommendation. SSA officials told us 

they selected Boston because it represents the smallest share of cases 

reviewed at the hearings level and because it is geographically close to 

SSA’s headquarters to facilitate close monitoring. While SSA officials 

acknowledged that unanticipated problems and issues are likely to arise 

with implementation, they assert that they will be able to identify major 

issues in the first 60 to 90 days. SSA officials believe this will give them 

plenty of time to make changes before rollout begins in a second region. 

SSA has also indicated that it plans to roll DSI out next in another 

relatively small region. 

Also consistent with our past recommendations, SSA officials noted that 

some new elements of DSI have been tested prior to integration. For 

example, the ALJ tool for decision writing has been tested extensively 

during development, and they anticipate having fewer challenges when 

similar tools are used more widely. In addition, SSA has said that it has 

rigorously tested its model related to the Quick Disability Determination 

System and that it will continue to check the selection of cases and 

monitor the length of time it takes for quick decisions to be rendered. 

SSA’s efforts and plans are also consistent with effective change 

management practices in that they ensure the commitment and 

involvement of top management.18 Specifically, SSA’s Commissioner first 

proposed DSI-related changes in September 2003, and the agency began 

 17GAO, SSA Disability Redesign: Actions Needed to Enhance Future Progress, 

GAO/HEHS-99-25 (Washington, D.C.: March 12, 1999) and GAO, Correspondence to Jo

Anne Barnhart, Commissioner of the Social Security Administration. (Washington, D.C.: 

Dec. 19, 2003). 

18GAO, Business Process Reengineering Assessment Guide, GAO/AIMD-10.1.15

(Washington, D.C.: May 1997). 

Page 20 GAO-06-779T Social Security Administration
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restructuring itself soon after the rule was finalized. In addition, SSA 

created a deputy-level post for its new Office of Quality Performance and 

appointed a new Deputy Commissioner in its newly created Office of 

Disability Adjudication and Review, which oversees the hearing and 

appeals processes. 

We have also encouraged top managers to work actively to promote and 

facilitate change, and SSA appears to be adhering to these principles as 

well.19 For example, SSA officials told us that the Deputy Commissioners 

from SSA’s offices of Personnel and Human Capital have collaborated with 

their counterparts in policy units to develop position descriptions and 

competencies for nurse case managers and federal reviewing officials. 

According to SSA officials, these leaders are also collaborating to develop

interview questions for eligible candidates. Further, SSA officials told us 

their new human capital plan will be released sometime in July and that it 

will emphasize the goals of DSI, as well as the personnel changes that will 

accompany it. 

Finally, SSA’s communication efforts with stakeholders align with change 

management principles in several respects. For example, SSA has 

employed a proactive, collaborative approach to engaging the stakeholder

community both during DSI’s design and in its planning for 

implementation in order to explain why change is necessary, workable, 

and beneficial. Even before the notice of proposed rule making on DSI was 

published, SSA began to meet with stakeholder groups to develop the 

proposal that would eventually shape the new structure. Then, once the 

proposed rule was issued, SSA officials told us they formed a team to read 

and analyze the hundreds of comment letters that stakeholders submitted. 

In addition, they conducted a number of meetings with external 

stakeholders to help the agency identify common areas of concern and 

develop an approach to resolving the issues stakeholders raised before 

rollout began. According to SSA officials responsible for these meetings, 

the Commissioner attended more than 100 meetings to hear stakeholder 

concerns directly. Further, SSA recently scheduled a meeting for early 

July with claimant representatives to discuss that group’s particular 

concerns about how the new process will affect their work and their 

disability clients. SSA officials told us that senior-level staff will lead the 

 19GAO/AIMD-10.1.15 and GAO, Results-Oriented Cultures: Implementation Steps to Assist 

with Mergers and Organizational Transformations, GAO-03-669 (Washington, D.C.: July

2, 2003).

Page 21 GAO-06-779T
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meeting and that about 100 claimant representatives from the Boston 

region will attend. 

In addition, SSA officials have also worked to ensure that there are open 

lines of communication with its internal stakeholders, thereby ensuring 

that disability examiners and staff in the Boston region are knowledgeable 

about DSI-related changes. For example, SSA solicited comments and 

questions from the Boston region’s staff about the specifics of the rollout 

and held a day-long meeting in the region, led by Deputy Commissioners, 

to respond to these concerns. 

For some time, SSA has been striving to address long-standing problems in 

its disability claims process. From our perspective, it appears that SSA is 

implementing the new claims process by drawing upon many lessons 

learned from past redesign efforts and acting on, or at least aligning its 

actions with, our past recommendations. For example, significant aspects 

of the DSI rollout are consistent with our recommendations to focus 

resources on what is critical to improving the disability claims process, 

such as quality assurance and computer support. SSA’s incremental 

approach to implementing DSI—taking a year to monitor the process and 

testing new decision-writing tools, for example—is also consistent with 

our recommendation to explore options before committing significant 

resources to their adoption. Thus, the agency is positioning itself to make 

necessary modifications before implementing the new process in 

subsequent locations. Finally, and fundamental to all of this, SSA’s top 

leadership has shown a commitment to informing affected stakeholders 

and listening to their advice and concerns with respect to the development 

and implementation of this process. 

Concluding 

Observations 

While SSA’s steps and plans look promising, we want to stress the 

importance of diligence and follow-through in two key areas. The first is 

quality assurance, which entails both effective monitoring and evaluation. 

A solid monitoring plan is key to helping SSA quickly identify and correct 

problems that surface in the Boston rollout, because any failure to correct

problems could put the entire process at risk. An evaluation plan is critical

for ensuring that processes are working as intended and that SSA is 

achieving its overarching goals of making accurate, consistent decisions as 

early in the process as possible. The second key area is communication. It 

is important for SSA’s top leadership to support open lines of

communication throughout implementation if the agency is to facilitate a 

successful transition. Failure to, for example, provide useful feedback to 

staff—many of whom will be new to the agency or at least to the new 

Page 22 GAO-06-779T
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tools—could significantly jeopardize opportunities for improvement. Just 

as important, SSA’s top management needs to ensure that the concerns 

and questions of stakeholders affected by the new process are heard, and

that concerned parties are kept apprised of how SSA intends to respond. 

The eventual elimination of the Appeals Council and its replacement with 

the Decision Review Board with a very different purpose has been a great 

cause of concern for a number of stakeholders. SSA appropriately has 

plans to assess its impact by tracking decisions resulting from each stage 

of the new process, as well as the effect of the process on the federal 

courts’ caseloads and claimants at large. To its credit, SSA plans to reduce 

any immediate impact on the courts by requiring that the board initially 

review all ALJ decisions in the Boston region. However, given that the 

agency plans to rely heavily on new positions, such as the federal 

reviewing official, and on new technology, SSA will need to ensure that 

staff are well trained, and that each adjudicator has the support staff 

needed to work effectively. Focusing on one small region will, it is hoped, 

allow the agency to ensure that training, technology, and other resources 

are well developed to achieve expected goals before DSI is expanded to 

other parts of the country. 

Mr. Chairman, this concludes my prepared remarks. I would be happy to 

answer any questions that you or other members of the subcommittee may 

have. 

For future contacts regarding this testimony, please contact me at (202) 

512-7215 or RobertsonR@gao.gov. Contact points for our Offices of 

Congressional Relations and Public Affairs may be found on the last page 

of this testimony. 

The following individuals have made major contributions to this 

statement— Susan Bernstein, Candace Carpenter, Joy Gambino, Michele 

Grgich, Luann Moy, Daniel Schwimer, and Albert Sim. 

GAO Contact 

Staff 

Acknowledgments 

Page 23 GAO-06-779T
Appendix I: Objectives, Scope, and 

Methodology 

To learn more about the public’s and stakeholders’ views with regard to 

the Appeals Council and the Decision Review Board, we reviewed and 

analyzed a large sample of comment letters they submitted to the Social 

Security Administration (SSA) in response to its July 2005 notice of 

proposed rule making on the Disability Service Improvement process 

(DSI) that were related to these topics. We also interviewed a number of 

key stakeholder groups to solicit their opinions once the rule had been

finalized. 

Reviewing and Analyzing 

Comment Letters 

To review and analyze the comment letters, we first downloaded all 

1,143 comments that SSA had received and posted to its public Web site. 

In order to focus our review on only those letters that related to the 

Appeals Council and the Decision Review Board, we then applied a word 

search to restrict our analysis to the responses that used the terms 

“Decision Review Board,” “DRB,” and “Council.”20 Applying these search 

terms reduced the number of comment letters for review to 683. We

discarded 43 of these 683 letters over the course of our review because 

they were duplicates of letters by the same authors or did not contain 

relevant comments. As a result, our final analysis was based on the 

remaining 640 letters. 

To classify the nature of the comments contained in these 640 letters, we 

coded the opinions as related to one of more of the following concerns: 

• The Appeals Council is improving, and its termination will not 

improve the disability determinations process. 

• There is a risk that the Decision Review Board may not select the 

most appropriate cases for review. 

• There is a risk that Decision Review Board could unfairly evaluate 

or influence administrative law judge decisions. 

• In the absence of an Appeals Council, the claimant no longer has 

the right to initiate subsequent case review. 

• There is no opportunity for the claimant or his or her representative 

to argue before the Decision Review Board. 

• A claimant’s benefit might be protracted or delayed during Decision 

Review Board assessment. 

 20It is possible that statements could have been made about the Appeals Council and 

Decision Review Board that did not use these terms, and that we could have missed. If so, 

the number of responses related to these two entities could be greater than we are 

reporting. 

Page 24 GAO-06-779T Social Security Administration
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• Petitions to the federal court are likely to increase. 

• Appeals to the federal court are costly or intimidating, and 

claimants may not have the wherewithal to pursue the claim at this 

level. 

Of the 640 letters in our review, we initially identified 388 as form letters, 

or letters containing identical comments, even though they had different 

authors. To simplify our review, we coded these form letters separately

from the other letters. For the 252 letters that we did not initially identify 

as form letters, one analyst reviewed and coded each letter, while a second

analyst verified that he or she had coded the statements appropriately. If 

the first and second analysts did not come to an agreement, a third analyst 

reviewed the comment and made the final decision for how the content

should be classified. Table 2 below indicates the percentage of the 252 

letters citing one or more of the above concerns.

Table 2: Share of Comment Letters Including Each of the Concern Categories 

Included in This Study 

Concern category 

Percentage of

comment letters 

expressing concern

(n = 252)

Petitions to the federal court are likely to increase. 53

In the absence of an Appeals Council, the claimant no longer has 

the right to initiate subsequent case review. 

48

The Appeals Council is improving, and its termination will not 

improve the disability determinations process.

38

Appeals to the federal court are costly or intimidating, and 

claimants may not have the wherewithal to pursue the claim at 

this level. 

37

There is no opportunity for the claimant or his or her 

representative to argue before the Decision Review Board. 

28

There is a risk that the Decision Review Board may not select the 

most appropriate cases for review. 

25

There is a risk that Decision Review Board could unfairly evaluate 

or influence administrative law judge decisions. 

22

A claimant’s benefit might be protracted or delayed during 

Decision Review Board assessment. 

18

Source: GAO analysis 

For the 388 form letters, we coded one letter according to the process 

described above. Because the text of the form letters was identical for 

Page 25 GAO-06-779T
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each, we then applied the same codes to each of the other form letters. All 

388 form letters expressed each of the concerns above. 

Identifying and 

Interviewing Stakeholders 

To identify key stakeholders, we first referenced the list of organizations 

that SSA included in its notice of proposed rule making as having met with 

the agency during its development of the final rule. We then narrowed this 

list by obtaining suggestions from SSA officials about organizations that 

are the most active and cover a broad spectrum of disability issues. In 

total, we spoke with representatives from 10 groups: 

• Administrative Office of the U.S. Courts’ Judicial Conference 

Committee on Federal-State Jurisdiction, 

• Association of Administrative Law Judges (AALJ), 

• Consortium for Citizens with Disabilities’ Social Security Task

Force (CCD), 

• National Association of Councils on Developmental Disabilities 

(NACDD), 

• National Association of Disability Examiners (NADE), 

• National Association of Disability Representatives (NADR),

• National Council of Disability Determination Directors (NCDDD), 

• National Council of Social Security Management Associations 

(NCSSMA),

• National Organization of Social Security Claimants’ Representatives 

(NOSCCR), and 

• Social Security Advisory Board. 

Page 26 GAO-06-779T
Related GAO Products 

Social Security Administration: Administrative Review Process for 

Adjudicating Initial Disability Claims. GAO-06-640R. Washington, D.C.: 

May 16, 2006

Electronic Disability Claims Processing: SSA Is Proceeding with Its 

Accelerated Systems Initiative but Needs to Address Operational Issues.

GAO-05-97. Washington, D.C.: September 23, 2005 

Managing for Results: Enhancing Agency Use of Performance 

Information for Management Decision Making. GAO-05-927. Washington, 

D.C. September 9, 2005 

High-Risk Series: An Update. GAO-05-207. Washington, D.C.: January 

2005 

SSA’s Disability Programs: Improvements Could Increase the Usefulness 

of Electronic Data for Program Oversight. GAO-05-100R. Washington, 

D.C.: December 10, 2004

Social Security Administration: More Effort Needed to Assess

Consistency of Disability Decisions. GAO-04-656. Washington, D.C.: July 

2, 2004 

Electronic Disability Claims Processing: SSA Needs to Address Risks 

Associated with Its Accelerated Systems Development Strategy. 

GAO-04-466. Washington, D.C.: March 26, 2004 

Human Capital: A Guide for Assessing Strategic Training and 

Development Efforts in the Federal Government. GAO-04-546G. March, 

2004 

Social Security Administration: Strategic Workforce Planning Needed to

Address Human Capital Challenges Facing the Disability Determination 

Services. GAO-04-121. Washington, D.C.: January 27, 2004 

Results-Oriented Cultures: Implementation Steps to Assist Mergers and

Organizational Transformations. GAO-03-669. Washington, D.C.: July 2,

2003 

Highlights of a GAO Roundtable: The Chief Operating Officer Concept—

A Potential Strategy to Address Federal Governance Challenges. 

GAO-03-192SP. Washington, D.C.: October 4, 2002 

Page 27 GAO-06-779T Social Security Administration
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Social Security Disability: Disappointing Results from SSA’s Efforts to 

Improve the Disability Claims Process Warrant Immediate Attention.

GAO-02-322. Washington, D.C.: February 27, 2002 

Observations on the Social Security Administration’s Fiscal Year 1999 

Performance Report and Fiscal Year 2001 Performance Plan. GAO/HEHS-00-126R. Washington, D.C.: June 30, 2000 

Management Reform: Elements of Successful Improvement Initiatives.

GAO/T-GGD-00-26. Washington, D.C.: October 15, 1999 

SSA Disability Redesign: Actions Needed to Enhance Future Progress.

GAO/HEHS-99-25. Washington, D.C.: March 12, 1999 

Business Process Reengineering Assessment Guide. GAO/AIMD-10.1.15. 

Washington, D.C.: May 1997 

SSA Disability Redesign: Focus Needed on Initiatives Most Crucial to 

Reducing Costs and Time. GAO/HEHS-97-20. Washington, D.C.: December 

20, 1996 

SSA Disability Redesign: More Testing Needed to Assess Feasibility of 

New Claim Manager Position. GAO/HEHS-96-170. Washington, D.C.: 

September 27, 1996 

Page 28 GAO-06-779T (130584) 
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