2019 Annual Report of the SSI Program

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B. Numbers of SSI Program Recipients
This section presents historical data and projections of the numbers of (1) persons applying for SSI payments; (2) new recipients of SSI payments as a result of an application; (3) terminations from SSI payment status; and, (4) recipients of federally administered SSI payments. These historical data and projections are presented by category and age group.1 All of the corresponding tables are located at the end of this section.
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 2018, 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 2018, there were 7.0 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 may qualify for a special student earned income exclusion. When blind or disabled adult recipients reach age 65, these individuals generally continue to be classified as blind or disabled adults (rather than aged). In December 2018, 5.8 million blind or disabled individuals age 18 or older received federally administered SSI payments, including 1.1 million blind or disabled 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 2018, 1.1 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, including applications by telephone and online, 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 2018. Applications in 2019 are projected to stay at about the same level as experienced in 2018. Starting in 2020, the number of applications is projected to rise, reaching about 2.1 million applications per year for 2024, and then remain at roughly this level thereafter.4
In the shorter term, the rate of application underlying the projected number of applications gradually increases from the low level experienced in 2018 to the longer-term historical average level. Beyond the short term (after 2024) the application rate is assumed to gradually decline, with this declining rate being offset by the projected increase in the population yielding relatively stable numbers of applications, as shown in section IV.A. This gradual decline in the application rate after 2024 reflects the following assumptions: (1) 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. These assumptions are consistent with the assumptions underlying the 2019 OASDI Trustees Report.
 
 
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, over 90 percent of the SSI applications are for disability payments that require the State Disability Determination Services (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. From 2007 to 2010, however, the numbers of new recipients increased substantially. This increase is primarily attributable to the sharp increase in applications due to the economic recession.
 
The numbers of new recipients declined generally from 2010 to 2018, following the change in applications. With the proportion of the population applying for SSI payments assumed to return to longer-term historical levels by 2024, the projected number of new recipients rises from 2020 through 2024. Over the longer term, after 2024, the number of new recipients is projected to decrease slightly throughout the remainder of the projection period, despite the growing size of the legal resident population. This slight decrease reflects the effects of the same factors assumed to affect the level of projected applications, as discussed previously.
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 three primary tools to assess continuing eligibility: (1) a nonmedical redetermination; (2) a medical continuing disability review (CDR); and (3) medical redeterminations of SSI child recipients at age 18 using the adult initial disability criteria.8 In a non-medical redetermination, the recipient's non-medical factors of eligibility are reexamined, including income, resources, and living arrangements. 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. Medical redeterminations of disabled children attaining age 18 evaluate whether such recipients qualify for payments using the adult medical 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 the purposes of presentation in the following figures, and in the tables 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. This latter group is primarily comprised of individuals who have become ineligible for SSI payments due to excess income or financial resources, or no longer meeting the definition of disability based on medical improvement as set forth in the Act. For individuals who have concurrently filed an application for disability benefits under both the OASDI and SSI programs and are determined to meet the definition of disability, a portion are initially awarded an SSI payment and subsequently suspended for excess income. The primary reason for this suspension is the fact that not all such concurrent applicants have satisfied the 5-month waiting period for Social Security Disability Insurance benefits as of the first month of SSI eligibility. Individuals whose ongoing monthly OASDI benefit, in conjunction with their marital status, living arrangement, and all other income, renders them ineligible for SSI payments are only temporarily eligible for SSI payments. This group of concurrent applicants is currently about one-third of all SSI applicants. Changes in the portion of SSI applicants who also have the appropriate insured status for Social Security disability benefits can affect overall SSI terminations, as it has over the last ten years.
Figure IV.B3 presents historical and projected numbers of total terminations by calendar year9. The total number of terminations of federally administered recipients in 2018 increased from 2017, by about 3 percent. This change in total terminations differs by reason for termination. Terminations due to death decreased by less than 1 percent in 2018, while the number of terminations for all other reasons increased by about 5 percent in 2018 from 2017 levels.
This change in terminations for all reasons other than death varies by age. Terminations for reasons other than death for SSI children under age 18 decreased by 2 percent from the level experienced in 2017. For SSI adults age 18 or older, terminations for all reasons other than death increased by 6 percent.
Projected terminations over the next few years reflect the recent levels of increased Congressional appropriations to conduct program integrity activities during the last several years and the assumed continuation of these increased appropriation levels. These increased appropriations in the recent past allowed SSA to work down the backlog of such reviews. If increased appropriations persist into the future, they will allow SSA to continue to perform these reviews on a timely basis in the long term. The recent increase in appropriations, relative to such appropriations over the 10-year period from 2005 to 2014, resulted in, and will continue to result in, higher levels of SSI terminations from medical cessation.
 
 
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, the economic recession that began in 2007,and the recent strong economy and dramatic decline in applications, 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 and 2014, the Federal SSI recipient growth slowed, and beginning in 2015, the Federal SSI recipient population began to decrease. In 2018, recipients in current-payment status continued to decrease from 2017 levels by about 1.2 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 2019 through 2021, these decreases are projected to continue, for the reasons previously mentioned. Thereafter, as the proportion of the population applying for SSI payments is assumed to return to more nearly the historical long-term average, adjusted for the declining proportion of the population eligible for SSI payments as discussed in section 2, 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 increased slightly over the period 2005 through 2013, and experienced slight decreases in each of 2014 through 2018. 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.
 
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 medical 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. Since then, the prevalence rate for child recipients has decreased slightly each year from 2014 through 2018 which is primarily attributable to the (1) increased number of medical CDRs for these children over the past few years, and (2) the continuing drop in applications for SSI payments. 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 2018. 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 in the Bipartisan Budget Act of 2015 to process medical CDR and non-medical redetermination workloads.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. Such recipients have countable income that exceeds the Federal benefit rate but which is lower than the combined amount of the Federal benefit rate and the State supplementary benefit level. These individuals must meet all other criteria required in order to be eligible for a Federal SSI payment. The vast majority of these individuals are concurrently beneficiaries of OASDI benefits.
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 1975-2043

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
Fewer than 500.

Notes:
1. 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.
2. A complete table of historical and projected values is available at www.ssa.gov/OACT/ssir/SSI19.
 
Calendar year  a
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 sample data prior to 1993; 10-percent sample data for 1993-2006, and 100-percent data after 2006.
c
Fewer than 500.

Notes:
1. 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.
2. A complete table of historical and projected values is available at www.ssa.gov/OACT/ssir/SSI19.
 
 
Table IV.B3.—SSI Federally Administered Terminations Due to Deatha, Calendar Years 1975‑2043 
Totalsb