Your source for news affecting the U.S. Social Security Administration/© Charles T. Hall
as noted in the comments to your original post, just submit the records and let SSA worry about going through them. This is designed to stop reps from withholding evidence and then using it as "new" evidence when appealing to the AC. Yes it happens.I still can't understand how an attorney can make an argument that having less than all the evidence is a good idea. Put it all on the table and let a decision be made.
Let the age of the 4000 page file begin!
We fill up a 50 gallon trash can for shredding monthly with duplicate records from providers who send us 3rd party records already in the file or records we have previously been advised by our ODAR not to submit (i.e. nursing notes from hospitalizations, lab results in cases where labs are not important,etc.) It would appear that we will no longer to able to remove these from the records we submit. I am curious to see if ODAR will in fact exhibit all of the materials we are asked to submit or if they will have case technicians cull through them before exhibiting the file. If its the later, they better appropriate funds to hire more case techs.
@ 11:56 we already choose what to exhibit and not and cull out duplicates
1:04 we know ODAR does this but up til now as attys we have already culled duplicates if they appear in multiple Md's records and have not, for instance, submitted gynecological records if it is back case. However as I understand it we now must submit all records from all sources whether relevant or not and Charles is suggesting it will mean much larger and harder to digest exhibit files and/or more culling work for ODAR employees.
Despite requesting the "Abstract" which includes ER records, History and physical on admission, consultations, lab reports, and discharge summaries, we often are sent "all" of the file and fight with the copying services which often demand "prepayment." Because the copying services which hospitals use pay the copying employee by the page, they have an incentive to include "all" the file, including property inventories, miscellaneous admitting paperwork of no medical relevance, etc. When I read comments by SSA employees such as by 9:57, it is obvious that they either are operating without any clue as to what goes on in any honest rep's office or they want to inflate the costs to such an extent that no rep will be able to make enough net profit to stay in business. With ALJs forcing amended onset dates to make miserly amounts of past-due benefits, 25% won't provide enough cash flow so small practitioners can stay in business. But, that seems to be the basis of many SSA/ODAR recent policies. And, despite the naïve comments by some SSA employees who comment on this blog, we don't get $6,000 per case--in our low-wage, semi-rural area, $1,500-$2,500 is probably more realistic. That won't go far when you're for paying inflated record prices. Dealing with SSA for years has made me the Social Security curmudgeon.
What it means is that I will be expecting a good brief with every file...
No one at ODAR is happy about sorting through more irrelevant evidence, trust us we don't want to read 4000 pages of gyno records either. Blame the Republicans in Congress pushing SSA into this rule as a way to show the agency is fighting the good fight against the always, ever-present "waste, fraud and abuse" by somehow combating nefarious tactics by reps which may or may not exist. Any money this rule saves through eliminating a tiny percentage of dirty tricks by a handful of reps will be canceled out fivefold by the increased overtime and hiring required to deal with bloated medical records. Although who are we kidding, there won't be any increased hiring, just more cases added to the backlog while line employees waste time sorting through 1000s of dups.
Reps, blame yourselves.There are only 10% of reps who honestly submit all relevant evidence regardless of whether it helps or harms their case. Everyone else has decided that relevant means only submitting those records which help the claim, while holding back the damaging treating source statements that call out the claimant for being a malingerer. Bring it on. More OT for me!
I think there's some nuance missing here.The rule, as I read it anyway, says that reps/claimants must submit all evidence they receive. So yeah, there may be the obnoxious lengthy files with all nurses' notes, etc.But what the rule does not say is that you must track down and get and then submit all possible MER there is ever.The way I see SSA wanting this rule to work is in a way to prevent the case(s) that brought about the change in the first place. It seems to me more that SSA wants reps who get an MSS or piece of evidence from Tx'ing Dr. Such and Such that says/suggests "you know what, Cl isn't that limited and is not disabled" to submit it to us and not sit on or bury it.I don't see this rule as imposing some requirement that you reps track down every scrap of paper related to any and all treatment of your client since forever. And the way I read it, I think it's totally reasonable. If you ask for records and, whoops, they aren't good for your case, you should still have to submit them to us. With this being a nonadversarial process and all, it would only seem right that you have to (unless you just expect SSA to come behind and do 100% of all development itself after the rep does to make sure it gets all the evidence, which I'll go ahead and let you know is absurd).
I agree with 5:43 PM. I'm an attorney and I don't think this will be so bad. There will be no change in our office procedure in terms of obtaining relevant evidence. We will have a form letter informing the ALJ of other evidence and ODAR can obtain it if they think it is relevant. We have no intention of paying for 100 pages of gyno records in a bad back case.If you are a local attorney, and not a national social security claim mill, your job is the deal with adverse evidence. It's called advocacy. The poster above who stated that he/she was expecting good brief with every file is probably right unless they are dealing with one of these mills. I have seen some of their hearing memos and, in my humble opinion, they were inadequate.
8:55 is onto something, and I'll chime in with a theme I've riffed on before.These ALJs have some pretty tough productivity standards. What do you think they will be inclined to do with well-written, well-reasoned persuasive legal arguments in a pre-hearing brief that lend themselves to being easily dropped into a (favorable) decision...
"What do you think they will be inclined to do with well-written, well-reasoned persuasive legal arguments in a pre-hearing brief that lend themselves to being easily dropped into a (favorable) decision..."I can't speak for other ALJs, but if I saw such a thing, I'd faint dead away. The sad fact of this business is that 90% of the reps we see are absolutely incapable of submitting such a brief and 99% of them are unwilling to do so.
"The sad fact of this business is that 90% of the reps we see are absolutely incapable of submitting such a brief and 99% of them are unwilling to do so."Sure. Something tells me that you also believe that 90% of claimants are capable of working and 99% of them are just exaggerating their symptoms. As an attorney rep, I can tell you that while almost all ALJs require prehearing briefs, many don't read them. It doesn't matter if we compose a 10 page treatise or a 2 paragraph synopsis, the low paying ALJs will just cherry pick the file to work backwards to justify their denials. So why knock yourself out preparing a detailed brief if ALJ is just going to ignore it and deny the case? Recall that we don't get paid by the hour. So if you as an ALJ are receiving what you perceive to be substandard briefs, perhaps the reason lies with you and not the reps.
Our ODAR started requesting briefs in every case and it soon become clear why. The ALJs wanted to know what our argument was going to be so they could manipulate the hearing to produce a record to defeat it. I have now tailored the majority of my briefs to deal with this issue.
So in the "non-adversarial" land of SSA, filing a thorough, well-argued brief jeopardizes your case? Orwellian?
As an ODAR senior attorney, I can tell you that since Case Techs were instructed NOT to cull duplicates from the file, in fact my time to go through all that medical (a lot of which is dupes)has increased three-fold. While I certainly don't mind doing so, I question the economic wisdom of paying me $50 an hour to do what a $20-per-hour employee could do (and did, in the past). Also, it just increases case processing time on my end and results in fewer cases written over a given period of time.
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