HomeFacts and FiguresDid You Know ChartsContinuing Disability Reviews

DID YOU KNOW? In fiscal year 2013, SSA completed almost 429,000 full medical continuing disability reviews (CDRs) that resulted in 115,000 initial decisions to end benefit payments.

Contents:
Chart 1: Estimated Number of CDR Cessations by Program (2011-2013)
Chart 2: Number of CDRs Processed (1990-2012)
Chart 3: Present Value of Estimated Lifetime Benefit Savings from Medical CDRs (FY 2012)
Chart 4: Estimated Return on Investment for Every $1 Spent on Medical CDRs, by Beneficiary Type (FY 2000-2012)

 
Charts

Chart 1: Estimated Number of CDR Cessations by Program (2011-2013)


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Background: People receiving disability benefits may be subject to periodic examinations to determine if they have capacity to engage in substantial gainful activity.  These examinations are called 'continuing disability reviews.'  Such reviews may find that the beneficiary continues to be eligible for benefits or that the beneficiary's medical condition has improved so that he/she can work more than a minimum amount, in which case benefits are stopped.  Most benefit cessations occur when SSI children who were adjudged disabled turn age 18 and are found capable of work. 

*The “other” category includes CDRs initiated for reasons other than the maturing of a CDR (such as beneficiaries voluntarily reporting they may no longer be disabled) or CDRs closed administratively (for example, when a beneficiary dies before the CDR is completed). 

Note: The numbers included in this chart are reported as "estimated" because they do not take into account final cessations after all appeals.


Chart 2: Number of CDRs Processed (1990-2012)

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Continuing Disability Reviews (CDRs) are conducted for both DI and SSI beneficiaries to determine if their disabling condition has improved and if so, whether they continue to remain eligible for benefits.  SSA uses statistical profiling to identify beneficiaries’ probability of medical improvement; those with higher probability are scheduled for medical CDRs and those with a lower probability of medical improvement are sent CDR “mailers” with questions about their medical condition.  If the answers to the mailer indicate that medical improvement may have occurred, the beneficiary is scheduled for a full medical CDR.  As Chart 2 illustrates, the number of CDRs completed each year has fluctuated over the past two decades.

 

Chart 3: Present Value of Estimated Lifetime Benefit Savings from Medical CDRs (FY 2012)

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Estimated lifetime benefit savings from conducting medical CDRs are found in not only the Social Security and SSI programs, but also in the Medicare (i.e. Hospital Insurance under Part A and Supplementary Medical Insurance under Parts B & D) and Medicaid programs.  However, in recent years CDR cessations have represented a net cost to the Medicaid program due to changes in eligibility rules as a result of the 2010 Affordable Care Act.  As Chart 3 shows, SSI benefit savings are typically the largest relative to the other programs.  Again, this is at least partly due to the fact that SSI Children CDRs are prioritized by the agency due to statute.  It is also worth noting that the SSI category represents general revenue savings, not Trust Fund savings.

 

Chart 4: Estimated Return on Investment, on Average, per $1 Spent on Medical CDRs, by Beneficiary Type (FY 2000-2012)

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Chart 4 shows estimated returns on investment (ROI) by type of beneficiary from 2000 to 2012.  The green line represents SSDI beneficiaries, while all other lines represent SSI beneficiaries.  While the majority of CDRs do not result in cessation, SSA’s medical CDR process has historically yielded a favorable ratio of savings-to-costs.  Low-birth weight reviews and Age-18 redeterminations are typically associated with the highest ROI[1]: roughly $34:1 and $20:1 in 2012, respectively.  This is unsurprising since these two types of reviews are statutorily mandated and are therefore highly prioritized by SSA.

[1] ROI is calculated by dividing the estimated present value of total lifetime benefits saved due to CDR cessations by the total amount spent on carrying out CDRs in a given fiscal year.  SSA expects year-to-year fluctuations in the savings-to-cost ratio due to changes in the distribution of CDRs processed by program and the percentage of cases in which there is a high likelihood of medical improvement.


Sources

Chart 1: U.S. Social Security Administration, FY 2011 & FY 2012 Annual Report on Continuing Disability Reviews; for 2013: unpublished data provided by SSA.

Chart 2: U.S. Social Security Administration, FY 2012 Annual Report on Continuing Disability Reviews.

Chart 3: U.S. Social Security Administration, FY 2012 Annual Report on Continuing Disability Reviews.

Chart 4: Unpublished memo provided by SSA’s Office of the Chief Actuary, dated April 23, 2014.