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We are revising our regulations regarding when and how often we conduct continuing disability reviews (CDR), which are periodic reviews of eligibility required for benefit continuation.  Under our revised rules, we will add a category to the existing medical diary categories that we use to schedule CDRs and revise the criteria for assigning each of the medical diary categories to cases. The revised rules will also change the frequency with which we perform a CDR for claims with the medical diary category for permanent impairments. The revised changes will ensure that we continue to maintain appropriate stewardship of the disability program and identify medical improvement (MI) at its earliest point. The medical improvement standard is not changed.

Statement of Need:

Section 221(i) of the Social Security Act established the periodic review or Continuing Disability Review (CDR) requirement as one of the most valuable program integrity tools that allows us to maintain good stewardship of taxpayer dollars by ensuring only those who continue to meet our standards for disability continue to receive benefits. We are updating our rules to ensure that we continue to identify medical improvement at its earliest point, consistent with current medical knowledge, to ensure the ongoing integrity of our disability programs.

Summary of the Legal Basis:

Section 221(i) of the Social Security Act, which required us to conduct Continuing Disability Reviews (CDR) at least once every 3 years for all title II disability beneficiaries with nonpermanent impairments, and at our discretion for all title II disability beneficiaries with permanent impairments.

Anticipated Costs and Benefits:

Our Actuary estimates the additional full medical reviews are estimated to result in a net reduction in OASDI benefit payments and Federal SSI payments of $2.4 billion and $0.7 billion, respectively, from FY 2021 to FY 2030.

Our Office of Budget, Finance, and Management estimates increased administrative program integrity costs, in addition to current costs, of approximately $1.8 billion for the 10-year period from FY 2021 to FY 2030.