Social Security Administration

This report provides findings from the project team's review of SSA's quality assurance system for disability determinations and options for improvement. The report finds that SSA's QA system reflects the end-of-line inspection type of system that was prominent in the health care industry and other industries when it was developed, and needs to be transformed to a more advanced, state-of-the-art quality management system. This will require a sustained effort over many years. Program leadership will play a critical role. Options are presented for improving leadership, developing a culture of quality, improving pre-effectuation reviews, improving measurement of quality in initial determinations, improving SSA's relationship with the state Disability Determination Services, continuously improving the disability determination process, and improving the quality of appellate decisions.

"Throughout the engagement, Lewin consultants listened to us and delivered superb analyses and thoughtful guidance–not canned solutions."  NONPROFIT HEALTH SYSTEM