Jun 10, 2014

Unthinkable Interference With ALJ Independence

     From the Associated Press:
Amid complaints about lengthy waits for Social Security disability benefits, congressional investigators say nearly 200 administrative judges have been rubber-stamping claims, approving billions of dollars in lifetime payments from the cash-strapped program. ...
House Oversight Committee Chairman Darrell Issa, R-Calif., was incredulous that so many judges would rule that initial rejections were so often wrong.
"Are the people below you always wrong?" Issa asked Judge Charles Bridges of Harrisburg, Pennsylvania.
"I would say they are not legally trained," replied Bridges, who approved 95 percent of the cases he decided.
When pressed further about his approval rate, Bridges said: "I don't pay attention to those figures. All I do is concentrate on each case, one at a time."
Issa: "You don't notice that you're essentially saying 'approved, approved, approved,' almost all the time?"
Bridges: "I don't want to be influenced by that."
The committee's report found that 191 judges approved more than 85 percent of the cases they decided from 2005 to 2013. All told, those judges approved $153 billion in lifetime benefits, the report said.
     At some point in the future, I can't say when, Democrats will control the House of Representatives.  Should they hold hearings then and browbeat ALJs with low reversal rates?

30 comments:

Anonymous said...

Just watched the ALJ testimony, andI know that these ALJs faced many hostile congresspersons today, but am really disappointed that not one ALJ mentioned the amount of evidence generated post-recon denial, including additional medical records, treating source medical source statements, that DDS never requests, durational denials reaching 12 months, worsening impairments, new diagnoses, etc., etc., etc. The uniformed individual watching these proceedings must think these ALJs are just reversing the DDS based on the same evidence DDS used. Disappointing.

Anonymous said...

and reps wonder why ALJ's are concerned with pay rate these days. One wrong move and a judge ends up in a congressional report or subpoena'd for a hearing.

Anonymous said...

Political bullying. Republicans targeting disabled people in order to create another diversion away from scrutiny of government policies and practices that benefit wealthy individuals and corporations. Looks like a lot of coercion to pressure more ALJs to deny more cases. And at tomorrow's hearing the SSA agency officials will be aflutter to show how they are willing to lean wherever the political winds are blowing in order to protect their own careers.

Anonymous said...

Let's rein in the hyperbole. It takes more than "one wrong move" to land an ALJ in front of Congress. It takes years of head-scratching numbers. I understand the outcry against low-paying ALJs, but that is not a license for other ALJs to level the field by paying virtually every claim. 95% pay rates might be defensible using the ADA definition of disability, but that's not the standard that Congress adopted.

Anonymous said...

Some of the questions by the Congressman

"What gives you the right to make a diagnosis?

Why do you only have medical witnesses 4% of the time?

Where did you get your medical degree?

reflect only a complete lack of understanding of what is being decided.

Hint. It is not about diagnosis. It is about the effect of medical conditions on the ability to function.

And asking the Judges (none of which demonstrated much understanding either) whether or not they liked being cross-examined was just rude and unprofessional.

A typical Issa led circus. Two hours I'll never get back.

Anonymous said...

In many cases they are...these guys are in the hot seat not because republicans are mean but because they are not applying the well established legal principles. Reviews of their decisions have not stood up to legal sufficiency review. Did you read the report at all? While ALJs are not bound to DDS determinations, there should be very good rationale in decisions to support the different outcome. These judges are severely lacking and do not apply the law. When you are finding someone disabled for jock itch there's a problem.

Anonymous said...

Here's the thing about the ALJs with low pay rates, their decisions get reviewed upon appeal to the Appeals Council or even Federal Court. The agency does not have the capacity to review all of the favorable decisions generated with erroneous rationale as with the four judges who testified yesterday. Reps and claimants can take issue with Judges with low pay rates, but if the higher levels are not seeing an issue with their application of the law then they will continue. Many people seem to be confused that because they have a limitation or they cannot work at a past job they are entitled to benefits. The standard is strict to protect the integrity of the program.

Anonymous said...

It's not a confusion. You have judges making their own assessment of the diagnosis in the record in finding severe impairments at step II. These judges are making inferences, based on what who knows, and then making other determinations in the remainder of the sequential evaluation process without proper objective evidence. Subjective complaints cannot be relied upon to establish severity and that is what is happening at am alarming rate. Go back and listen to prior testimony on this issue and read the report with citations. This is a real issue costing taxpayers billions.

Anonymous said...

ALJs are bound by agency regulations, rulings, and directives. They are not article III judges and do not have the same latitude enjoyed by their counterparts in the federal judiciary. There needs to be a balance between judicial autonomy and ensuring legal sufficiency at the hearing level. It is unacceptable for judges with long documented histories of poor decision-making and failure to follow the sequential evaluation process to still be in positions of authority. There needs to be an overhaul of ODAR and decisions writers and management need to be consulted in this process.

Anonymous said...

The only real solution is to get the staff from Rep. Issa and Coburn's offices to help write the correct decisions.

Anonymous said...

Wait, What??? "There needs to be an overhaul of ODAR and decisions writers and management need to be consulted in this process." A large problem at ODAR is the Decision Writers. Another part is that the Judges don't have enough time to adequately edit the decisions written by poor writers, especially the paralegals, who have no legal training..

Nastassia said...
This comment has been removed by the author.
Anonymous said...

To take this in a different direction, why does no one ever raise general issues regarding the incompetency of the DDS doctors whose opinions are used to deny initial and recon claims and relied on so heavily these days by ALJs to deny claims.

As a former disability adjudicator, I have first hand experience with these so called "experts in the Social Security disability programs" according to SSR 96-6p. While there are some very good and knowledgeable doctors in the State agencies, there are also a lot of not so good ones. My impression was that the good ones rose to management positions. The others where there because they either couldn't cut it in the real world of medicine or were in the sunset years of their careers and hadn't seen a real patient in ten years. Yet somehow these folks are considered "experts" just by the position they are given.

Anonymous said...

agree with 12:08 PM.
Ditto with 2:36 PM.

Anonymous said...

Extremes are to be questioned--someone who approves 95 percent of cases should be investigated to the same degree as someone who approves five percent of cases.

Anonymous said...

It's hard to argue in support of the four ALJs, but the motives of the guys holding the hearing are just as questionable. Rep Gozar, who was quick to say he was a dentist, had an awful lot to say and pretty much said that a person can always work no matter how disabled they are. He should stick to filling cavities, because he sure doesn't know a lick about disability. It's scary that he is the best his district can send to Washington.

Anonymous said...

But the problem, 3:22, is that they're not investigating the other side of the pay spectrum. I could understand it if both sides were questioned. This hearing will have a chilling effect on the higher paying ALJs while offering support/justification to the lower paying ALJs. This whole charade is despicable.

Anonymous said...

@9:14 am You are spot on. We have already seen a reduction in pay rates in the wake of the Wall Street journal articles and the Huntington fiasco. This hearing is going to further frighten ALJs regarding paying cases. There is no adverse feedback for denying claims, only for paying them. Add to this the recent changes to the ALJ position description and more management oversight and the message SSA and Congress is sending to ALJs is very clear, stop paying cases or we will come after you.

Anonymous said...

Remands from the AC or USDC have no impact on the low paying judges. They just keep on denying claims.

Anonymous said...

No ALJ is going to be afraid to go from 30s-40s pay rate to 50s pay rate since the ODAR average is 50-ish. Even paying in the 60s is not adding any heat to the ALJs in my office, assuming they are in the 500-700 range as strongly advised. You guys are just looking for excuses to say ALJs are told to not pay anyone, when in reality the Agency is only coming down hard on ALJs who: 1) dispose of way too many cases (no matter the disposition ratio, though usually the ones hearing a bunch of cases seem to pay a whole lot of them...); or, 2) have a pay or disallow rate more than 15-20 points either direction from the mean. Admittedly, more heat is on those who are outliers on the high end, mostly because of W.Va. and because the AC/Courts aren't dealing with them via appeals.

Come off it--if an ALJ wanted to pay 60-70% of her 500-700 cases, nobody would say anything.

Anonymous said...

If you draw a low paying ALJ you get two more bites at the apple. The AC and the court system. Except for a few cases, the taxpayer doesn't have anyone checking on the quality of a pay decision.

Anonymous said...

Yes You do get two more bites of the apple, Bite One, just takes 17 months to get an answer. The is you go the next step, your looking at another 12 months if you lucky and then it will take another 6 months to schedule a hearing with the same low paying ALJ you saw before. I have no issue in reviewing the ALJs over 80% but we should look also at those below 20%. when someone that may not deserve it gets approved some tax money is wasted. When a non payer refuses help for someone that needs that help they not only destroy a life but everyone that knows that person loses a little faith in a system that is here to help people.

Anonymous said...

8:54. But the majority of decisions by a low pay ALJ end up being reviewed. The agency knows what percentage of the decisions are being upheld. Whether the agency goes to them and says "Hey why can't you issue a decision that is likely to be upheld?" is another matter.

Anonymous said...

12:08 PM, June 11, 2014- It's not fair to put all problems on the writers, who have zero control of any decisons and are often charged with making an illogical outcome make sense on paper. There are of lot of good writers out there- I am in an ODAR office known for high quality. We are just the minions. In some offices, the writers probably stopped caring due to the lack of any real advising duties in their job.

Anonymous said...

The verbage in Charles' tagline for this post and previous posts about similar ALJs on the low end of the pay scale really make it appear as though he believes a very large percent of claimant's before ODAR are disabled. I would have to assume he thinks (at least publicly) 100% of his clients are disabled, as most reps do. But I have to ask the reps in the house--what percentage of claimants at the ODAR level do you believe are disabled as defined in the regs? 100% of them? 100% of the repped ones? 100% of the repped by non-crappy reps?

I honestly would like to know your take. Because if you honestly believe 100% or close to it of claimants getting to hearing are in fact disabled yet ODAR's pay rate is around 50%, that would be a huge problem. But I suspect you don't believe it's that high since so many are willing to call 80%+ payers outliers worthy of extra scrutiny.

Matt Berry said...

I can answer that...it is indeed 100%. It is really simple. If I don't believe that they are disabled AND that I can prove it, I simply won't take the case. If I am already down the road, I will encourage dismissal. The truth is, for a small to medium size practice, that actually serves its clients, you can't economically survive any other way. Remember, across the board the average fee on a case won is only about $3,100.00.

Anonymous said...

Why can't the Social Security Administration and Congress have the balls to simply state that AALJ's on a rolling 12-month basis cannot award more than 75% of cases nor deny more than 30% of cases?

No they can't do that or won't do that so they're trying to bully and intimidate ALJ's closer to the average. Never mind the facts in each case. It simply doesn't matter.

So 100 paraplegics come walking through the door, 25 are going to be denied in order to hit the target. Welcome to due process, SSA-style!

Anonymous said...

Um,11:03, the paraplegic would be approved by DDS and would not go through the ODAR door to see an ALJ.

Anonymous said...

"100 paraplegics come walking through the door"

"paraplegics come walking"

"walking"

obvious troll is obvious.

Anonymous said...

Were in not for the obvious transparency in political bullying from the right and the 'war on the poor', Issa would not be literally targeting these judges. It's yet another tactic by the right, to slow genocide of the masses.

If we are to bring in ALJ's with high approval rates, why are we not taking task those who are the DENIERS, and there are plenty of them. All one needs to do is check the statistics at an ODAR site of an ALJ's approval ratings, where most of them DENY claims at a 80-95% rate. Surely all of those denials are NOT legit.

Think about the reasons this is happening. Issa is as pathological and dysfunctional as it gets. NONE of his 'hearings' are more than the intentional targeting of other human beings, while just one more of the puppet master's of the wealthy and in doing their bidding.

I guarantee this would not have taken place, if we did not have a pathological oligarchy running our government.