Advertisement

Potential Savings From Redetermining Disability Among Children Receiving Supplemental Security Income Benefits

Published:September 17, 2012DOI:https://doi.org/10.1016/j.acap.2012.07.001

      Abstract

      Objective

      To compare the costs of redetermining disability to potential savings in Supplemental Security Income payments associated with different strategies for implementing Continuing Disability Reviews (CDRs) among children potentially enrolled in SSI from 2012 to 2021.

      Methods

      We reviewed publicly available reports from the Social Security Administration and Government Accountability Office to estimate costs and savings. We considered CDRs for children ages 1–17 years, excluding mandated low-birth weight and age 18 redeterminations that SSA routinely has performed.

      Results

      If in 2012 the Social Security Administration performs the same number of CDRs for children as in 2010 (16,677, 1% of eligibles) at a cessation rate of 15%, the agency would experience net savings of approximately $145 million in benefit payments. If CDR numbers increased to the greatest level ever (183,211, 22% of eligibles, in 1999) at the same cessation rate, the agency would save approximately $1.6 billion in benefit payments.

      Discussion

      Increasing the numbers of CDRs for children represents a considerable opportunity for savings. Recognizing the dynamic nature of disability, the agency could reassess the persistence of disability systematically; doing so could free up resources from children who are no longer eligible and help the agency better direct its benefits to recipients with ongoing disability and whose families need support to meet the extra costs associated with raising a child with a major disability.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Academic Pediatrics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. The Social Security Act § 1601 et. Seq., 42 U.S.C. § 1381 et. Seq. Compilation of the Social Security Laws Web site. Available at: http://www.ssa.gov/OP_Home/ssact/title16b/1601.htm. Accessed July 12, 2011.

      2. Social Security Administration. SSI: History of Provisions. Public Law 92-603. Social Security Administration Web site. Available at: http://www.ssa.gov/history/pdf/ssi.pdf. Accessed July 25, 2011.

      3. Social Security Administration. Disability Evaluation Under Social Security (Blue Book- September 2008). Available at: http://www.ssa.gov/disability/professionals/bluebook/general-info.htm. Accessed March 6, 2012.

      4. Social Security Administration. Annual Report of the Supplemental Security Income Program. 2011. Available at: http://www.ssa.gov/oact/ssir/SSI11/ssi2011.pdf. Accessed July 2, 2011.

        • Kenney G.M.
        • Ruhter J.
        • Selden T.M.
        Containing costs and improving care for children in Medicaid and CHIP.
        Health Affairs (Millwood). 2009; 28: w1025-w1036
      5. Social Security Administration. Annual Statistical Report of the Supplemental Security Income Program. 2001. Available at: http://www.ssa.gov/policy/docs/statcomps/di_asr/2001/di_asr01.pdf. Accessed July 6, 2011.

      6. Social Security Administration. Annual Statistical Report of the Supplemental Security Income Program. 2006. Available at: http://www.ssa.gov/policy/docs/statcomps/ssi_asr/2006/ssi_asr06.pdf. Accessed July 6, 2011.

        • Van Cleave J.
        • Gortmaker S.L.
        • Perrin J.M.
        Dynamics of obesity and chronic health conditions among children and youth.
        JAMA. 2010; 303: 623-630
        • Berwick D.M.
        • Hackbarth A.D.
        Eliminating waste in US health care.
        JAMA. 2012; 307: 1513-1516
        • Wen P.
        A Legacy of Unintended Side Effects.
        Boston Globe. December 12th, 2010; (Available at:) (Accessed August 14th, 2011)
        • U. S. Government Accountability Office
        Report to Congressional Requesters. Supplemental Security Income: Better management oversight needed for Children's benefits. GAO-12–497.
        General Accounting Office, Washington, DCJune 2012
        • Sheldon J.R.
        Medical Continuing Disability Reviews and Related Concepts: A Discussion of Medical CDRs and then Age 18 Redetermination.
        Cornell University, Ithaca, NYJuly 2003 (Available at:) (Accessed March 6, 2012)
      7. Office of the Inspector General, Social Security Administration. Full Medical Continuing Disability Reviews. 2010;A-07–09–29147. Available at: http://oig.ssa.gov/sites/default/files/semiannual/Fall%202010.txt. Accessed July 14, 2011.

      8. United States General Accounting Office, Statement of Jane L. Ross. Continuing Disability Reviews Improved, But More Targeted Reviews Needed. Testimony Before the Subcommittee on Social Security Committee on Ways and Means, House of Representatives. 1994. Available at: http://www.gao.gov/new.items/d03662.pdf. Accessed July 12, 2011.

      9. Social Security Administration. Report on Continuing Disability Reviews, Fiscal Year 2009. 2011. Available at: http://www.ssa.gov/legislation/SSIRedeterminationFY09-Signed-062411.pdf. Accessed July 12, 2011.

      10. Office of the Inspector General, Social Security Administration. O'Carroll Jr PP. Inspector General Response to Honorable Charles Boustany and Honorable Sam Johnson regarding August 1, 2011 correspondence asking questions for the record. 2011. Available at: http://waysandmeans.house.gov/UploadedFiles/SSA.OIG.RESPONSE.QFRs.pdf. Accessed December 1, 2011.

      11. Office of the Inspector General, Social Security Administration. Childhood Continuing Disability Reviews and Age 18 Redeterminations. 2006;A-01–06–21093. Available at: http://oig.ssa.gov/sites/default/files/audit/full/pdf/A-01-06-21093.pdf. Accessed July 12, 2011.

        • U.S. General Accounting Office
        Social Security Disability: Reviews of Beneficiaries' Disability Status Require Continued Attention to Achieve Timeliness and Cost-Effectiveness. GAO-03–662.
        General Accounting Office, Washington, DC2003
        • Hemmeter J.
        • Gilby E.
        The age-18 redetermination and postredetermination participation in SSI.
        Soc Secur Bull. 2009; 69: 1-25
        • Kuhlthau K.
        • Hill K.S.
        • Yucel R.
        • et al.
        Financial burden for families of children with special health care needs.
        Matern Child Health J. 2005; 9: 207-218