The Social Security Administration each year processes millions of applications for Social Security Disability Insurance and Supplemental Security Income disability benefits. Currently, 10 states lack a second level review process, known as reconsideration, for disability claims that are initially denied and appealed. SSA has begun to reestablish the reconsideration stage in these states. This move has raised concerns and broader questions about SSA’s overall disability determination process.

In this paper we examine SSA’s disability determination process and past efforts to improve SSA’s process, and challenges and lessons for future reform. We identify a path forward that could improve the quality and timeliness of decisions by enhancing the reconsideration process to make it more robust, allowing better decisions to be made earlier, while keeping long-term program costs neutral. To support this approach, we put forward three options Congress could consider to provide sustained funding and commitment to the agreed-upon vision for reform. These options would allow SSA to test strategies and gather evidence to support decision making.