2016 Annual Report of the SSI Program

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C. Historical Allowance Data
At the end of 2015, 86 percent of federally administered Supplemental Security Income (SSI) recipients were receiving benefits based on disability or blindness. Individuals file claims at a local Social Security office, and we send claims requiring an evaluation of disability to the State disability determination services (DDS) for a disability decision.1 Applicants may appeal unfavorable initial DDS decisions. Historically, the State DDS conducted the first level of appeal — the reconsideration appeal step. Claimants denied at the reconsideration level could then request a hearing before an administrative law judge (ALJ) and if dissatisfied with the hearing decision could request a review by the Appeals Council. Those dissatisfied with the Appeals Council’s action could seek further relief through the Federal court system. This appeals process is still in effect for the majority of new applicants.2 However, since the mid-1990s the Social Security Administration (SSA) has conducted small pilots testing revisions to this process and introduced a modification of this process that 10 States use for applications filed on or after October 1, 1999. The revised process eliminates the reconsideration step, so the first level of appeal of an initial determination is a request for hearing before an ALJ.
This process of application and appeal can span several years. However, before 1993, the only data available on the disability determination process resided in files compiled at each separate stage of the process and only captured various point-in-time snapshots. Only a longitudinal database of administrative records at all stages of appeal can provide a complete picture of the disability determination process. Beginning in 1993, SSA’s Office of Disability Programs constructed such a longitudinal database, the “Disability Research File,” to assist our agency in understanding and managing this process. However, we did encounter some problems in the construction of this database due to inconsistencies in the data collected from all the respective levels of appeal. The following sections present some additional details and qualifications essential to a complete understanding of the resulting data. Following these technical notes, tables V.C1 and V.C2 present the latest available summary of results on disability determinations under Title XVI.
1. Technical Notes on the Disability Research File
Methods used to build the Title XVI Disability Research File — The “base” file for the Title XVI research file is the Supplemental Security Record, the main computerized file for administering the SSI program. We match the “base” file against records from various other administrative sources, including transactions from the disability determination (SSA-831) files, Structured Data Repository (SDR), Social Security number identification records and earnings data, and Office of Disability Adjudication and Review (ODAR) appeals data.
Creating the Disability Research File is a cumbersome process; it involves about 200 steps and generally requires 2 to 4 months to complete. The process is complex because we assemble the file based on filing date cohorts, and many of the source files do not contain a filing date. The basic data sources provide information for the 3 most recent calendar year cohorts. Older calendar year cohorts reflect updated activity since the last time we built the file. Since the process is so time consuming, we update the research file only annually (usually beginning in July); research file data are not yet available for claims filed in 2015.
Methods used for estimating results (through January 2016) for claims filed in 2015 — Although decision counts are available for 2015 filers from many of the source files, those counts do not translate directly into the claims/appeals counts in the following tables because we consolidate multiple transactions and apply claims-based tolerance rules when we build the research file.
To prepare preliminary estimates of results through January 2016 for 2015 filers, we started from the latest available transaction data, such as the SSA-831 data, and took into account recent years’ experience of the relationship between corresponding earlier transaction data and the resulting claims/appeals data in completed research files. We estimate ODAR appeals activity from a file that tracks individual claimants, rather than individual claims, which has resulted in a slight undercount of ODAR individual claims. Recent revocation of the agency’s subsequent application (i.e., an application filed while an earlier claim is pending at a review level) policy should largely eliminate the disparity between the number of claims and claimants.
While we believe that these methods are reasonable, we emphasize that the resulting estimates may not be completely reliable, especially because the estimates give results only through January 2016, whereas the final research files will reflect information through at least June 2016. Actual data for 2015 will replace these estimates in the 2017 Annual Report.
2. General Considerations
Some general points that apply to tables V.C1 and V.C2 are as follows:
Data for 2015 filers are preliminary estimates as of January 2016, and reflect larger numbers of claims still pending. January 2016 data on number of appeals may be too low because larger numbers of claimants are still within the period allowed for filing an appeal (i.e., larger numbers of recently denied claimants who have not yet filed an appeal may appeal before the time limit runs out).
 
Table V.C1.—Disabled Adult Claims: Disposition of Applications for SSI Disability Benefits by
Year of Filinga and Level of Decisionb
 
 
a Data for claims filed in 1988‑2014 reflect results as of June 2015 at the DDS level and as of July 2015 at the ODAR level. The numbers of total claims filed for 2012-2014 are subject to change. Data for claims filed in 2015 are preliminary estimates as of January 2016. The ultimate numbers of allowances and denials are subject to change until all initial decisions have been completed and all appeals are final.
b For claims filed in 2000 or later, we count allowances at the earliest adjudicative level of allowance. We count allowances for claims filed prior to 2000 at the highest adjudicative level reached.
c Percentage of decisions at this level
d Includes certain cases that can be appealed directly to the hearing level.
e Percentage of denials at this level appealed to next level.
f Includes cases reviewed by the Office of the Federal Reviewing Official (OFedRO) during the period August 2006 through November 2008 as part of the DSI process.
g Includes cases appealed to the hearing and Appeals Council levels and cases appealed to the to the Federal courts.
h Number of persons appealing beyond the reconsideration level.
i Includes cases remanded to SSA from the Federal courts.
j Percentage of decisions at this level. For years in which decisions are still pending, the preliminary percentage shown is expected to ultimately be lower as all cases are processed. This occurs because allowances are generally processed more quickly than denials.
k Includes denied claims where the final administrative action was a dismissal of an appeal request (e.g., the appeal was not filed timely or the applicant failed to appear at the scheduled hearing).
 
Table V.C2.—Disabled Child Claims: Disposition of Applications for SSI Disability Benefits by
Year of Filinga and Level of Decision  b