SSA Disability Insurance Delays: We Must Fix This Together

Social Security Administration (SSA) Disability Insurance (DI) is a crucial lifeline for millions of Americans. This vital program provides income support to Americans who are unable to work due to a severe and long-lasting impairment. However, the DI application and appeal process is notoriously complex, lengthy, and inefficient, resulting in many eligible claimants facing significant delays in receiving their benefits.?

The SSA DI program is facing a backlog of cases, which leads to excessive wait times for decisions, causing hardship for the millions of Americans waiting for a decision on their case, while also contributing to the growing cost of healthcare. According to the SSA, last year there were over 1.1 million cases pending at the initial, reconsideration, and hearing levels, with an average processing time of 386 days. This means that many claimants have to wait more than a year to receive a decision on their eligibility, and some may have to wait even longer if they appeal a denial. [1 ] This is, of course, far above the 60 days the SSA defines as its minimum level of performance.?

There are a number of causes for this crisis, including staffing levels at their lowest point in 27 years and increased workloads. [2 ]? The SSA still references a 1991 list of occupations to determine a claimant’s ability to do some kind of work, so many jobs on the list are now obsolete and new jobs not considered. In addition, a significant proportion of initial claims are denied, compelling many claimants to enter the appeals process, which further burdens the system and prolongs the waiting period for applicants.

To compound these problems, the SSA, like too many other federal, state, and local government agencies, still operates using either old and outdated digital technologies, or, worse, that oldest technology of all – pen and paper. Applicants fill out paper forms, physicians must hand sign and fax or mail supporting documentation, and if there are follow up questions about the medical information from SSA staff, they are also handled by phone, fax, and mail.

The good news is that technology to automate the vast majority of this process already exists, and since 2022 Oracle Health has been working closely with SSA to utilize electronic health records (EHR) to do so. The information exchange can be done quickly and securely - data is retrieved from the EHR domain via FHIR (a new standard for exchanging healthcare information) transactions and aggregated into the format required by SSA.

What’s needed next is more dedicated resources at the SSA, streamlined application and appeal processes, and industry-wide cooperation to ensure timely and accurate decisions for claimants.?

Tragically, according to federal data, about 10,000 Americans die each year while their applications for disability benefits are slogging through the system. [3 ] This crisis is not just a bureaucratic delay; it is a profoundly painful societal problem that calls for immediate and decisive action. We should all feel an obligation to fix it, and SSA deserves credit for taking action to engage industry leaders like Oracle for support.?Oracle Health is proud to lead the way in helping SSA achieve this critical goal.

We can then turn our attention to the countless other opportunities to impact lives and help save costs that exist through the application of modern technologies and automation to other government interactions with citizens. It is long past time to bring our public sector into the world of 21st Century technology.