2017 Annual Report of the SSI Program

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B. Numbers of SSI Program Recipients
This section presents projections of the numbers of persons receiving federally administered SSI payments by category and age group.1
1. Recipient Categories
SSI recipients are classified into one of two categories based on the criteria for which they are eligible, in addition to meeting other SSI eligibility requirements. The two general categories are (1) aged; or (2) blind or disabled. The following paragraphs discuss the recipient categories in more detail.
Aged recipients establish their eligibility for SSI payment by meeting the age-65 -or-older requirement2, the applicable income and resource limits, and other SSI eligibility requirements. In December 2016, 1.2 million aged individuals received federally administered SSI payments.
Blind or disabled recipients establish their eligibility for SSI payments by meeting the definition of blindness or disability and the applicable income and resource limits as well as any other SSI eligibility requirements. In December 2016, there were 7.1 million blind or disabled recipients of federally administered SSI payments. These recipients can fall into two subcategories based on age: blind or disabled adults (age 18 or older) and blind or disabled children (under age 18).
Blind or disabled adults meet the definition of blindness or disability for individuals age 18 or older and SSI income and resource limits. Students age 18 to 21 must meet the adult definition of disability; they differ from other adults only in that they qualify for a special student earned income exclusion. When blind or disabled adult recipients reach age 65, these individual generally continue to be classified as blind or disabled adults (rather than aged). In December 2016, 5.9 million blind or disabled individuals age 18 or older received federally administered SSI payments, including 1.0 million disabled or blind recipients age 65 or older.
Blind or disabled children meet the definition of blindness or disability for individuals under age 18 in addition to other SSI eligibility requirements. These children are subject to parent-to-child deeming until they reach the age of 18. At age 18 these individuals continue to be eligible for SSI if they meet the definition of blindness or disability for individuals age 18 or older as well as other eligibility criteria. Those individuals who continue to be eligible after attainment of age 18 are reclassified as blind or disabled adults. In December 2016, 1.2 million blind or disabled individuals under age 18 received federally administered SSI payments.
2. Applications and New Recipients
Figure IV.B1 presents historical and projected numbers of persons applying for SSI payments at SSA field offices by calendar year3. Following a 4-year period in the mid-2000s when the number of applications remained fairly level at 2.1 million per year, applications started increasing in 2008, largely due to the severe economic recession that began at the end of 2007 and continued into 2009. The level of applications continued to increase through 2010, decreased only slightly in 2011 as the economy recovered slowly, and generally decreased at a faster rate from 2012 through 2016. Applications in 2017 are projected to continue to decrease from 2016 levels. In 2018, the recent declining trend is projected to reverse and the number of applications is estimated to rise gradually to about 2.1 million applications per year by 2022, and then remain at roughly this level thereafter.4
The projected ultimate growth pattern of the applications incorporates continued refinement in the projection methodology designed to make the projections more consistent with the assumptions underlying the OASDI Trustees Report. Projected applications reflect: (1) the expectation that the portion of the population that meets SSI income and resource requirements will decline over time as average wages and income generally grow faster than the CPI, and therefore the SSI Federal benefit rate; (2) the fixed value of the countable resource limits and most of the income exclusions become more limiting over time as individuals’ income and asset levels grow generally; and (3) the portion of the Social Security area population composed of U.S. citizens or legal immigrants potentially eligible to become SSI recipients declines as a share of the overall population.
 
 
As part of SSA’s adjudication of these applications, the levels of income and resources available to the applicants are evaluated along with other eligibility factors including marital and citizenship status and living arrangements. In addition, well over 90 percent of the SSI applications are for disability payments that require the DDS to evaluate the alleged impairment. Applicants may appeal an unfavorable disability determination through several administrative levels of appeal. If an applicant exhausts all administrative levels of appeal, he or she may appeal to the Federal courts.5 An applicant may decide at any point in this process to file a new application for benefits in lieu of continuing through the prescribed appeals process, generally provided that the individual does not currently have an appeal of an SSI application pending in this process.6
Figure IV.B2 presents historical and projected numbers of persons who start receiving SSI payments as a result of this decision process7. From 2004 to 2007, the numbers of new recipients remained fairly level, roughly consistent with the applications received during this period. Starting in 2008, however, the numbers of new recipients increased substantially. This increase is attributable to: (1) the sharp increase in applications due to the economic recession; (2) improvements in claims processing; and (3) initiatives to accelerate the processing of cases pending adjudication.
 
The numbers of new recipients declined consistently from 2010 to 2016, similar to the change in applications. The projected total number of new recipients in 2017 rises slightly from the level experienced in 2016, even with the reduction in the level of projected applications in 2017, partially due to an assumed reduction in the backlog of cases pending adjudication. Over the longer term, the number of new recipients is projected to level off and remain roughly level throughout the remainder of the projection period, despite the growing size of the legal resident population. This leveling off reflects the effect of (1) the fixed-dollar value of certain SSI program parameters on the growth in the SSI-eligible population, and (2) the fact that the Federal benefit rate increases only with price inflation. For example, the countable resource limit for SSI eligibility is not adjusted for inflation, so it will continue to lose value over time. As a result, a smaller portion of the population is projected to meet the eligibility requirements for the SSI program because they will have excess countable resources.
3. Terminations
Some persons receiving SSI payments in a year will stop receiving payments during the year because of death or the loss of SSI eligibility. SSA uses two primary tools to assess continuing eligibility: (1) a nonmedical redetermination; and (2) a medical continuing disability review (CDR).8 In a redetermination, the recipient's nonmedical factors of eligibility are reexamined, including income and resources. In a medical CDR, the recipient’s medical condition is reevaluated to determine whether the recipient continues to meet the Social Security Act's definition of disability. For example, disabled children, upon attainment of age 18, lose eligibility if they do not qualify for payments under the disabled adult eligibility criteria. The net reduction in the number of SSI recipients in current-payment status during a period is referred to as the number of SSI terminations for that period.
For purposes of presentation in the following figures, as well as the tables presented at the end of this section, “terminations” refers to the total of: (1) deaths while in current-payment status during the period; plus (2) the number of persons during the period moving out of payment status into suspended status less those returning to payment status from suspended status. Figure IV.B3 presents historical and projected numbers of total terminations by calendar year9. The total number of terminations of federally administered recipients in 2016 decreased very slightly from 2015, by about 0.25 percent. This decrease in total terminations differs by reason for termination. Terminations due to death decreased by roughly 2 percent in 2016, while the number of terminations for all other reasons increased by about 1 percent in 2016. This increase in terminations for all reasons other than death is the net effect of recent increases in the number of medical continuing disability reviews and a decrease in the number of new SSI recipients concurrently eligible for OASDI disability benefits who received SSI payments only temporarily during the 5-month Social Security Disability Insurance waiting period.
Projected terminations over the next few years reflect the recent levels of increased Congressional appropriations during the last several years and the continuation of these increased appropriation levels allowing SSA to continue to reduce the backlog of medical reviews. This increase in appropriations resulted in, and will continue to result in, higher levels of SSI terminations other than death.
 
 
4. Recipients in Current Payment Status
 
Combining the number of new recipients of SSI payments during a year with the number of those already receiving payments at the end of the previous year, and subtracting the number of terminations during the year, yields the number of persons receiving federally administered SSI payments at the end of the year. Figure IV.B4 presents the number of individuals receiving Federal SSI payments, who comprise the great majority of federally administered recipients.10
The number of SSI recipients receiving Federal payments increased rapidly in the early 1990s mainly due to the growth in the numbers of disabled adults and children. The  growth  in  the  numbers  of  children  receiving  SSI  resulted  in large part  from  the  Supreme  Court decision in the case of Sullivan v. Zebley, 110 S. Ct. 885 (1990), which greatly expanded the criteria used for determining disability  for  children. The growth in   the numbers of  disabled adults  is  a more  complicated phenomenon. Extensive research conducted under contract to SSA and the Department of Health and Human Services suggested that this growth was the result of a combination of factors including: (1) demographic trends; (2) a downturn in the economy in the late 1980s and early 1990s; (3) long-term structural changes in the economy; and (4) changes in other support programs (in particular, the reduction or elimination of general assistance programs in certain States).11,12 The 1996 welfare reform legislation, the economic downturn in the early 2000s, and the recent economic recession that began late in 2007 have contributed to the more recent changes in program participation.
 
As figure IV.B4 illustrates, the implementation of Public Law 104-121 and Public Law 104-193 resulted in a decline in the Federal recipient population from 1996 to 1997. From the end of 1997 through the end of 2000, the Federal SSI recipient population grew at an annual rate of less than 1 percent. From the end of 2000 to the end of 2008, the Federal SSI recipient population grew an average of 1.7 percent per year. From the end of 2008 to the end of 2012, the Federal recipient population grew an average of 2.7 percent per year due largely to the economic recession and the slow recovery from that economic downturn. In 2013, the Federal SSI recipient growth slowed to 1.3 percent, with much smaller growth in 2014. The Federal SSI recipient population decreased slightly in 2015, by roughly 0.2 percent relative to 2014. In 2016, recipients in current-payment status at the end of the year continued to decrease from 2015 levels by about 0.7 percent. These decreases in the last several years reflect the lower numbers of applications and new recipients and the increased number of medical CDRs conducted in recent years. For 2017 and 2018, these decreases are projected to continue, for the reasons previously mentioned. Thereafter, as the economy continues to recover, the numbers of Federal SSI recipients are projected to grow more slowly at an average rate of less than 1 percent per year for the remainder of the 25-year projection period.
In order to place this projected growth in the context of overall population growth, figure IV.B5 presents Federal SSI prevalence rates by age group, defined as SSI recipients with Federal payments in current-payment status as percentages of the total Social Security area population for each age group.13
The prevalence rate for all Federal SSI recipients declined from 1975 through the early 1980s. In 1983, this percentage started increasing and continued to increase through 1996. The prevalence rate then declined in 1997, due to the implementation of Public Law 104-121 and Public Law 104-193, but leveled out over the next few years through 2004. It has increased slightly over the period 2005 through 2013, and experienced slight decreases in each of 2014, 2015, and 2016. The prevalence rate is projected to decline gradually throughout the projection period.
 
Figure IV.B6 presents prevalence rates for the two eligibility categories - blind and disabled and aged14 - as well as for the SSI program as a whole. It also shows these rates on an age-sex-adjusted basis, adjusted to the age-sex distribution of the Social Security area population for the year 2000. Adjusting these rates in this manner is useful when comparing rates over a long period of time because the age-sex-adjusted rates control for the effects that a changing age-sex distribution in the population can have on prevalence rates over time. That adjustment, however, does not account for the change over time of other factors that may affect the percentage of the Social Security area population that is SSI eligible.
Figure IV.B6 shows that the age-sex adjustment does not fundamentally change the overall pattern of the prevalence rates. The total SSI prevalence rate on an age-sex adjusted basis is higher before 2000 and lower after 2000 than the gross prevalence rate due to the changing age distribution of the total population. The adjustment generally results in a more noticeable effect for the aged, especially in the early years of the SSI program, because the prevalence rate for ages 75 and older was much higher than for ages 65 to 74.
 

Note: The originally published version of this report, as distributed on September 1, 2017, included an incorrect version of figure IV.B6. The graph presented here represents the correct version of this figure.

The prevalence rates for the eligibility categories of Federal SSI recipients follow significantly different growth patterns. The overall aged prevalence rate has declined steadily throughout the historical period. Gradual declines continue throughout the projection period. In contrast, except for decreases in the late 1990s due to the eligibility redeterminations and CDRs mandated by Public Law 104-193, the prevalence rate for blind or disabled children increased steadily through 2013, with the increase being relatively steep in the early 1990s. The prevalence rate for child recipients decreased slightly in 2014 and 2015. The prevalence rate for disabled children experienced a sharper decrease in 2016, primarily attributable to the increased number of medical CDRs for these children over the past few years. The total blind or disabled prevalence rate (as a percentage of the total population at all ages) remained fairly level until the early 1980s, when it started increasing and then continued to increase through 1996. The blind or disabled prevalence rate declined slightly in the late 1990s due to the effects of welfare reform legislation but resumed an upward trend in 2000. That upward trend continued through 2013, but experienced slight decreases in 2014 through 2016. The projected overall prevalence rate for blind or disabled recipients gradually declines throughout the projection period due to: (1) the SSI potentially eligible population (i.e., the legal resident population) growing more slowly than the overall population, (2) a smaller proportion of the population becoming new recipients than during the recent economic slowdown; (3) the changing age distribution in the population; and (4) the assumption that SSA will receive the resources authorized to process medical CDR and nonmedical redetermination workloads in the Bipartisan Budget Act of 2015.15
The total number of federally administered SSI recipients includes recipients only receiving a federally administered State supplement, as well as those receiving a Federal payment. Table IV.B8 presents historical and projected numbers of individuals who receive only a federally administered State supplement. Table IV.B9 displays the combined numbers of persons receiving either a Federal SSI payment or a federally administered State supplement. This is the total number of SSI recipients, which follows largely the same patterns of growth as the number of recipients receiving a Federal payment.
 
Table IV.B1.—SSI Federally Administered Applications,a Calendar Years 1974‑2041

a
Based on data reported in the Integrated Workload Management System (formerly known as the District Office Workload Report).

b
“All” column estimated by the Office of Research, Evaluation, and Statistics using a 10-percent sample and published in the SSI Annual Statistical Report.

c
Includes conversions from State programs and applications received in 1973.

d
Fewer than 500.

Note: Totals do not necessarily equal the sums of rounded components. The historical split among age groups is estimated on a calendar year of age basis.
 
Calendar year  a
1974 c

a
Represents period in which first payment was made, not date of first eligibility for payments.

b
Historical totals estimated based on 1-percent or 10-percent sample data.

c
Totals for 1974 include recipients converted from previous State programs as well as new recipients to the SSI program during 1974.

d
Fewer than 500.

Note: Totals do not necessarily equal the sums of rounded components. The historical split among age groups is estimated on a calendar year of age basis.
 
Table IV.B3.—SSI Federally Administered Terminations Due to Deatha, Calendar Years 1974‑2041 
Totals  b