SSI Annual Statistical Report, 2008
The tables in this section provide data on the outcomes of applications for SSI benefits based on blindness or disability. The data on applications are derived from the Social Security Administration's (SSA's) Disability Research File (DRF) maintained by the Office of Disability Programs. Each year the DRF is updated with information about applications for disability benefits that is then used to determine the outcome of those applications. The outcome data in these tables are reported by year of filing and include decisions made through the administrative appeals process.
Table 69 shows the total number of applications filed in a year, the number that are pending a final decision, the number denied for nonmedical reasons before a medical decision is made (technical denials), the outcome of applications for which a medical allowance or denial was made, and award and allowance rates. Applications for which a medical allowance or denial decision was made but which were subsequently denied for nonmedical reasons are shown under the medical decision header as subsequent denials. The most common nonmedical reason for denying a claim is excess income.
The allowance rate is calculated by dividing the number of medical allowances (including subsequent technical denials) by the total number of medical decisions made for a 1-year cohort. The award rate is a broader program measure that is calculated as the number of allowances minus subsequent denials divided by total applications (minus pending claims) filed for a given year.
Claims that remain pending after 6 years are probably the result of imperfect data rather than excessive delays in the decisionmaking process. It is highly probable that decisions have been rendered on most of the older claims. For more recent years, the award and allowance rates will change as decisions are made on pending claims.
Tables 70–72 show the allowance rate for SSI only and the SSI portion of concurrent (a claim for both Social Security and SSI disability benefits) applications, one for each level in the administrative decisionmaking process, that is, initial, reconsideration, and hearing or higher level.
Beginning with fiscal year 2000, the proportion of claims awarded at each level of the process changed as a result of the Prototype Process being tested in 10 states. Under this test, the reconsideration step of the appeals process was eliminated for applications filed October 1, 1999, or later. Elimination of the reconsideration level in these states results in a decrease in the aggregate proportion of claims awarded at this step.
This section also includes one table that shows the reason for medical allowance and one that shows reason for medical denial (Tables 73 and 74). The reasons are derived from the sequential evaluation process used by decisionmakers. SSA maintains a list of impairments that are considered disabling under its regulations. An applicant can be found to be disabled if he or she:
An applicant can be denied benefits if he or she:
