SOCIAL SECURITY
ADMINISTRATION
CFDA 96.001 SOCIAL
SECURITY--DISABILITY INSURANCE
CFDA 96.006 SUPPLEMENTAL
SECURITY INCOME (SSI)
I. PROGRAM OBJECTIVES
The Social Security
Administration (SSA) is responsible for disability determinations under
the Disability Insurance (DI) and the Supplemental Security Income (SSI)
programs. The DI program was established in 1954 under Title II of the
Social Security Act and provides benefits to disabled wage earners and
their families in the event the family wage earner becomes disabled. (Section
221 of the Social Security Act) In 1974, Congress enacted Title XVI, the
SSI program, which provides benefits to financially needy individuals
who are aged, blind or disabled (Section 1633 of Social Security Act).
II. PROGRAM PROCEDURES
The disability process
begins when a person, referred to as a claimant, completes a claim for
DI or SSI benefits. SSA field office staff verifies the claimant's non-medical
eligibility. The claim is then forwarded to the cognizant State Disability
Determination Services (DDS) for a medical determination of disability.
To assist in making proper disability determinations, the DDS is authorized
to purchase medical examinations, x-rays and laboratory tests on a consultative
basis to supplement evidence obtained from the claimants= physicians or
other treating sources.
SSA pays the DDS
for 100 percent of the costs incurred in making disability determinations.
Each year the State DDS submits a budget request to SSA for review and
approval. The DDS is notified of budget approval by Form SSA-872 (State
Agency Budget Approval for SSA Disability Programs). Once approved,
the DDS is allowed to withdraw Federal funds through the Department of
Treasury's Automated Standard Application for Payment system to meet immediate
program expenses. At the end of each quarter of each fiscal year, the
DDS submits a Form SSA-4513 (State Agency Report of Obligations for
SSA Disability Programs) to account for program disbursements and
obligations and a Form SSA-4514 (Time Report of Personnel Services
for Disability Determination Services) to account for employee time.
III. COMPLIANCE
REQUIREMENTS
In developing the
audit procedures to test compliance with the requirements for a Federal
program, the auditor should first look to Part 2, Matrix of Compliance
Requirements, to identify which of the 14 types of compliance requirements
described in Part 3 are applicable and then look to Parts 3 and 4 for
the details of the requirements.
A. Activities
Allowed or Unallowed
DDSs make disability
determinations based on the law and regulations and on written guidelines
issued by SSA. Each State making disability determinations is entitled
to receive from the Trust funds reimbursement for the cost of making
those disability determinations for SSA. Activities shall be in accordance
with the budget request approved by SSA. Purchased medical services,
such as Medical Evidence of Record (MER) and Consultative Examinations
(CE), must be in accordance with the DDS's fee schedule for purchased
medical services. Activities allowable under the disability programs
include personnel services, purchased medical services, indirect costs
and other non-personnel costs (42 USC 421 (e) and (f); 20 CFR section
404.1626).
B. Allowable Costs/Cost
Principles
1. Direct Costs
The SSA Program
Operations Manual System (POMS) contains guidance on direct costs for
both the DI and SSI programs. Personnel services (POMS DI 39518) include
personnel costs and employee benefits. Purchased medical services (POMS
DI 39545) include MER and CE. Other non-personnel costs include travel
(POMS DI 39524), space (POMS DI 39527), equipment (POMS DI 39530), and
contracted services (POMS DI 39542).
2. Indirect
Costs
Indirect costs
which may be charged to the disability program generally arise from
three sources: (a) administrative costs of the parent agency related
to DDS; (b) business costs associated with the accounting, billing,
and procurement services provided by the parent agency for the DDS;
and (c) automated services provided to the DDS that are operated by
the parent agency. Indirect costs charged to the disability program
should be based on the rate approved by the cognizant Federal agency
as evidenced by a written agreement.
3. Non-SSA Work
Some DDSs make
disability determinations for claims not related to SSA benefits. When
DDS performs non-SSA work, a Memorandum of Understanding should exist
between the State and the SSA Regional Commissioner that outlines the
specifics of the non-SSA work. The SSA should not be charged the costs
on the non-SSA program work (POMS DI 39563).
L. Reporting
1. Financial
Reporting
- SF-269, Financial
Status Report - Not Applicable
- SF-270, Request
for Advance or Reimbursement - Not Applicable
- SF-271, Outlay
Report and Request for Reimbursement for Construction Program
- Not Applicable.
- SF-272, Federal
Cash Transactions Report - Not Applicable effective May 1998.
- SSA-4513, State
Agency Report on Obligations for SSA Disability Programs (OMB No.
0960-0421) - This report is due quarterly to account for program
disbursements and unliquidated obligations (20 CFR section 404.1625(a)).
- SSA-4514, Time
Report of Personnel Services (OMB No. 0960-0408) - This report
is due quarterly to account for employee time.
2. Performance
Reporting - Not Applicable
3. Special
Reporting - Not Applicable