tag:blogger.com,1999:blog-19246708.post94095572767681070..comments2024-03-28T18:46:20.316-04:00Comments on Social Security News: Hearing Backlog BalloonsUnknownnoreply@blogger.comBlogger35125tag:blogger.com,1999:blog-19246708.post-56632005779460131272016-03-28T23:25:37.166-04:002016-03-28T23:25:37.166-04:00Yes it's been a "fun" year... with h...Yes it's been a "fun" year... with help from my attorney I finally got to the point where I'm waiting for a hearing with an ALJ. I was diagnosed with relapsing multiple sclerosis in 2007 and continued working until the spring of 2015 when my symptoms effected my ability to do my job. I've been told by everyone EXCEPT for the social security office that I should have been approved already. Instead, they have denied me twice and now I'm waiting for this hearing. I'm hoping that it gets approved prior to the hearing as finances are obviously tight. Hopefully they can find a way to speed up the process for people in the future... especially people like myself who would prefer to be working if they could...Mr. Nerve Damagehttps://www.blogger.com/profile/14109290094295928656noreply@blogger.comtag:blogger.com,1999:blog-19246708.post-48386629592443936052015-07-27T15:34:26.899-04:002015-07-27T15:34:26.899-04:00Took only 7 months for a favorable AC appeal recen...Took only 7 months for a favorable AC appeal recently (and boy did they school the ALJ who was wrong on all facets of law). Still, I been waiting since 1995 even though have 6 doctors and MRI's that say I neurologically disabled from genetic birth defects since age 15.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19246708.post-44515338623130201782015-07-23T17:00:22.246-04:002015-07-23T17:00:22.246-04:00So you are a DDS worker. You have a case that shou...So you are a DDS worker. You have a case that should be a approved, but according to the documents below, you know that your approvals will be audited. You also know that if they audit your approval<br /><br />-one THEY believe should be a denial, <br /><br />you will be subject to corrective action as punishment for approving a claim. (keep in mind that They NEVER audit denials.) So it doesn't take rocket science to pick what you will do with each file that comes across your desk. It much easier to say "not my problem, let the ALJ figure it out".<br /><br />2009<br />https://web.archive.org/web/20111020141626/http://ssa.gov/legislation/PER%20fy09.pdf<br /><br />2013<br />http://www.ssa.gov/legislation/PER%20fy13.pdf<br /><br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19246708.post-40888093857354421492015-07-23T12:14:23.514-04:002015-07-23T12:14:23.514-04:00http://www.latimes.com/nation/la-na-social-securit...http://www.latimes.com/nation/la-na-social-security-disability-20150722-story.html<br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19246708.post-84365564539527033462015-07-23T11:44:11.241-04:002015-07-23T11:44:11.241-04:00Thanks, 11:03! I've long suspected that to be...Thanks, 11:03! I've long suspected that to be the case. <br />--5:42<br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19246708.post-38540639919308568742015-07-22T23:03:47.463-04:002015-07-22T23:03:47.463-04:00@ 5:42 anon, the reason DDS does not grant a vast ...@ 5:42 anon, the reason DDS does not grant a vast majority of multiple sclerosis cases is because they know that approvals will be audited, and denials are never audited. So to avoid the dreadful "quality review", they feel safer denying a legitimate claim and letting the ALJ handle it. Its a big giant "hot potato" game.<br /><br />There is some fraud issues going on with Social Security, such as denying legit claims. DDS will be exposed, just as the VA was exposed. Veterans have died because of the VA scandal, just as Social Security claimants are dying as they appeal their denials. One whistle blower will bring the house down.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19246708.post-37684055357048646932015-07-22T17:42:32.505-04:002015-07-22T17:42:32.505-04:00I am always amazed by comments of SSA employees su...I am always amazed by comments of SSA employees such as 8:34 who seem to give full credibility to DDS Agency Reviewers who have never examined the claimant and who even attack the credibility of the very rare consultative examiner whose physical or mental exam strongly supports disability, along with treating records. What I cannot understand is why DDS cannot grant disability to the multiple sclerosis claimants whose physical exams show definitive dysfunctional symptoms of MS and are accompanied by MRIs of the brain and/or cervical spinal cord which provide clear "objective" evidence of lesions in the white matter. I've had ALJs scratch their heads after 5 minutes into the hearing and state, "Why didn't DDS grant this obvious case?" I've always regarded these cases as "easy" wins. I suppose I should be grateful that DDS denies such obvious cases, so I can make a living by doing hearings. However, because of the 2-3 year wait, at least 50% of my clients have lost their homes before finally getting a bit of relief.<br /><br />By the way, very few ALJs at the ODAR where 95% of my hearings are done will even consider an AOD that leaves the claimant with more than 6-12 months of past-due benefits after the waiting period. In 75-80% of the cases, they "force" an amended onset date which guts benefits--and the amended onset dates seldom make any sense from a medially objective perspective. Of course, my now destitute client jumps for any financial relief whatsoever. I've had cases that I was itching to resist modifying the onset date and appeal (even with the lousy percentage chance of prevailing at the Appeals Council), but the case belongs to the claimant--not to me, and they are just tired of fighting.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19246708.post-4896118124220811982015-07-21T16:38:15.089-04:002015-07-21T16:38:15.089-04:00Or implies that the claimant meets a listing and t...Or implies that the claimant meets a listing and they are not even close. One needs to read the introductory to the Listing to obtain all of the necessary info for meeting a listing in that category. Being blind in one eye does not meet a listing. Using a cane does not meet a listing. Having problems with a non-weight bearing joint does not meet a listing. Another good one is to bring in a foreigner that has been here 20 years, has worked as a taxi driver or had their own auto mechanic shop and then try to convince us that they are illiterate. If the Reps would spend half the time preparing for cases as they do trying to confuse the issues, they would win more. And has anyone ever gotten anywhere attacking VE numbers? I had one the other day where I gave a deny RFC and the rep attacked the VE for 10 minutes about numbers, finally saying, "Ok if I had 100 cars in a parking lot and they were red, white, blue and yellow, would you say 25%.." That is where I stopped him. I asked if there was anywhere in the records that supported stricter limitations than I had used in my RFC. He said no. He never asked the VE a hypo. Malpractice the way I see it...Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19246708.post-21010658776259149602015-07-21T12:27:13.355-04:002015-07-21T12:27:13.355-04:00The sad fact is that,in my experience as an ALJ,th...The sad fact is that,in my experience as an ALJ,the vast majority of reps are incapable of writing a persuasive OTR request that addresses all of the issues that need to be addressed before an OTR can be issued. Whenever I have said something similar in the past, several commenters got upset, so let me say this: if you care enough about your practice to frequent this site, I am probably not talking about you. But here is the problem: I hold 50 hearings a month, sometimes more. I spend a great deal of time preparing for those hearings. If I get an OTR request that is half baked, lazy, and clearly does not address the issues that need to be addressed, I am not going to take time out from getting ready for scheduled hearings to review the file in the case that has not yet been scheduled. This is especially true if the F section is of typical size, over 500 pages. I just don't have the time. I will look at that case when it is scheduled. I am not going to grant an OTR request without reviewing the file to determine whether the assertions of the rep are accurate or supported. The biggest issues I see that are not addressed in OTR requests are: onset; earnings after onset; transferability of skills; step 4 issues; DAA issues; compliance issues; credibility issues. No rep has ever addressed the state agency opinions or rationales or argued why they should be accorded little weight; generally they are simply ignored. Way too often, the OTR request consists of little more than a citation to a ridiculously completed checkbox physical abilities questionnaire and an unsupported, lazy argument that it should be accorded controlling weight.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19246708.post-44286600094392777782015-07-21T11:39:12.892-04:002015-07-21T11:39:12.892-04:00@11:22AM. Have you ever tried to get an employer t...@11:22AM. Have you ever tried to get an employer to make a statement about why an employee was fired or quit? Employers, particularly those with legal departments, won't offer up any such statements for fear of ADA suits or other problems. I would venture to guess that the 1% of cases you see those statements in are from mom and pop family run businesses. Those are the only people I have had any success getting anything more than start and stop date and earnings info from. <br />Anonymoushttps://www.blogger.com/profile/07593661368002260111noreply@blogger.comtag:blogger.com,1999:blog-19246708.post-3222368545527901882015-07-21T11:22:27.524-04:002015-07-21T11:22:27.524-04:00An area that I find reps do any extremely poor job...An area that I find reps do any extremely poor job on, which would greatly improve the chances of having a case paid from the AOD: contacting the claimant's last employer, and getting a certified statement from this employer attesting to functional limitations which resulted in the claimant's firing/quitting. <br /><br />I would estimate that less than 1% of cases have any type of documentation from the claimant's former boss. <br /><br />Have fun screaming 83-20 all you want, but if there's no treatment note anywhere near the AOD, you're getting a later onset. Burden is on the claimant do prove disability during the entire time period alleged. 404.1512(c)Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19246708.post-7938259633378753102015-07-21T10:17:11.842-04:002015-07-21T10:17:11.842-04:00Ok guys, I don't by the crap about "not w...Ok guys, I don't by the crap about "not wanting their decisions to be reviewed". It's all about numbers. If a case of mine comes back from the AC, it is another number for the books. As far as amended onset dates, after the testimony and the Rep has made his spiel, I will say, Counselor, the problem I see with your case is that there is no supporting documentation until... Have you discussed an amended onset date with the claimant? Would you care to step out for a minute? Further, a lot, and I do mean lot of AOD's are based upon the day the factory closed, the day I was laid off, the day I went to jail, it goes on and on. Very seldom do we have catastrophic disease process cases. When was the last time you had a listing case? They are in front of us because they are not clear cut cases. It is your job to show us the smoking gun and when it was severe enough to warrant disability, not discomfort. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19246708.post-35710949484553724482015-07-21T09:25:31.317-04:002015-07-21T09:25:31.317-04:008:51: "Read it and weep?" This isn't...8:51: "Read it and weep?" This isn't a game we attorney reps are playing: these are real peoples' lives. We're not arguing the 32 yr old with a bad back and headaches (which, by the way, no credible rep would take such a case to hearing). We're talking the cancer, dialysis, or back fusion cases that are only being paid as of a definitive diagnosis or MRI, not when the problem existed much earlier. In the cancer case I described above, when I explained to my client that the ALJ will only allow an award starting the month prior when she was diagnosed, instead of a year back when she left work due to the complaints that led to the cancer diagnosis, she tearfully told me to accept it. However, she said that she was going to be evicted for she was counting on that back pay to catch up on the back rent she owed that wasn't paid because she wasn't working. When I tried to explain this fact to the ALJ, he wouldn't budge saying that he didn't want his decision to be reviewed. Don't forget that there are real people being affected by these decisions.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19246708.post-76903243124054158962015-07-21T09:23:29.555-04:002015-07-21T09:23:29.555-04:00Anon 7:01
You seem to have missed this part
&q...Anon 7:01 <br /><br />You seem to have missed this part <br /><br />"Precise Evidence Not Available -- Need for Inferences<br /><br />In some cases, it may be possible, based on the medical evidence to reasonably infer that the onset of a disabling impairment(s) occurred some time prior to the date of the first recorded medical examination"<br /><br />There are other suggestions too. Over reliance on when a medical report is written, or an MRI is done, is just a failure to fully understand what evidence means. <br /><br />And, I am not upset when your imaginary 32 year old with three kids with complaints and no medical treatment is denied. I am upset when ALJ's make foolish statements that reflect a lack of understanding of SS Rulings assuming that they can make assumptions on arbitrary cut offs like " 6 months at the most and usually closer to 2-3 months prior to the date of a firm diagnosis". 83-20 also discusses getting a medical opinion as to onset in such cases. It does not suggest ALJ's make it up as they go along.<br /><br />I do my job. I want you to do yours according to your own rules.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19246708.post-25376420535860308092015-07-21T08:51:45.364-04:002015-07-21T08:51:45.364-04:007:01, here ya go: SSR83-20 "POLICY STATEMENT...7:01, here ya go: SSR83-20 "POLICY STATEMENT: The onset date of disability is the first day an individual is disabled as defined in the Act and the regulations. Factors relevant to the determination of disability onset include the individual's allegation, the work history, and the medical evidence. These factors are often evaluated together to arrive at the onset date. However, the individual's allegation or the date of work stoppage is significant in determining onset only if it is consistent with the severity of the condition(s) shown by the medical evidence." Notice "by the medical evidence"?? Read it and weep. Another thing, I don't think any ALJ is going to reasonably assume more than 6 months at the most and usually closer to 2-3 months prior to the date of a firm diagnosis. I am telling you what it takes to get a case paid, why argue with me? Do a brief, know your stuff, amend the onset date if needed, and don't get your feelings hurt when you don't get paid on a 32 year old that has 3 kids at home they need to take care of with a bad back and headaches and no supporting documentation. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19246708.post-90245040766194867392015-07-21T08:34:20.975-04:002015-07-21T08:34:20.975-04:00for those complaining about OTR's not being gr...for those complaining about OTR's not being granted, remember, at least one person has already denied your case (DDS) based on the record. While it is possible that the evidence does support a FF decision, it is more likely that the facts are in the "gray" area and require a hearing/credibility analysis to flush out. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19246708.post-2022646722578198472015-07-21T07:47:38.160-04:002015-07-21T07:47:38.160-04:005:25pm You are delusional. 4:24 is right on point....5:25pm You are delusional. 4:24 is right on point.<br /><br />9:19 pm, judges like you crack me up. You need supporting documentation that makes the claimant's allegations credible, to read the regs any other way is specious at best. If a claimant has been complaining of fatigue, headaches, minor infections as well as general malaise and then is diagnosed with cancer at some relevant point thereafter, you have your supporting documentation back to the time of the originating complaints. "It is reasonable to assume ..."<br /><br />I suppose you are also the same the judge who will find a claimant disabled as of the date of a confirming MRI rather than the date that the credible complaints of back pain or whatever began.<br /><br />I hope that I misunderstood your post, and if I did, I apologize. However, if I didn't, then you are missing the forest for the trees and harming a lot of people in the process.<br /><br />To you Madam, I say, Do YOUR job.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19246708.post-60326605529531656192015-07-21T07:01:22.908-04:002015-07-21T07:01:22.908-04:00Anon 8-13
83-20 Read it. Learn itAnon 8-13<br /><br />83-20 Read it. Learn itAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-19246708.post-18114165088395194172015-07-20T21:19:27.560-04:002015-07-20T21:19:27.560-04:008:13, we are given the file about a week prior to ...8:13, we are given the file about a week prior to the hearing to review. If an OTR request comes in and support staff brings it to my attention I will certainly look at it immediately. As far as amended onset dates? That is where I get over 50% of my pay cases. Why would I pay a case that was turned down twice already because the medical evidence didn't support it? Regulations require that we have to have SUPPORTING documentation to pay a case. If the first supporting documentation is a dx of cancer, so be it. Prior to that the record supports fatigue and achiness and headaches. Trust me, there are enough people trying to scam the system and we are not allowed to pay a case on testimony alone. Severe impairments must be established by authorized medical sources. I find a lot of the Reps haven't looked at the record as much as I have. Read your record and submit a brief. Don't blame the Judge. The burden of proof is on the claimant. Do your job. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19246708.post-50977313553347407122015-07-20T20:13:56.670-04:002015-07-20T20:13:56.670-04:00Agree w/ Anon 2:04: Most ALJs do not seem to look ...Agree w/ Anon 2:04: Most ALJs do not seem to look at the file until the hearing. This would work if most of the cases are not OTR worthy. I still draft cases that are OTR worthy knowing full well they will not be granted prior to a hearing. But they are just that, worthy of being granted prior to the hearing.<br /><br />Like the argument about looking at claimants over 50 first. This would help a lot w/ the backlog if ODARs just had the guts to grant these cases.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19246708.post-81298312343614152202015-07-20T17:45:39.043-04:002015-07-20T17:45:39.043-04:00I am the 4:34 poster and what I said is absolutely...I am the 4:34 poster and what I said is absolutely correct. So, I did not go into more detail about how the Senior Attorney's working under the umbrella of the NHC's were selected. Duh...Where else do would any reasonable person think they came from? Moreover, that has nothing to do with the substance of what I said. I hope you cry yourself a good one idiot. I am LMAO.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19246708.post-24164307077546489592015-07-20T17:25:07.144-04:002015-07-20T17:25:07.144-04:004:34's post is so full of misinformation I'...4:34's post is so full of misinformation I'm crying over here. For starters, the few SAAs doing the year long detail for OTRs are not at or from the NHCs (I suppose if there are SAAs at the NHCs, one or more could have been selected for the detail)--the detail picked up folks from odar offices across the nation. Second, like it's been noted over and over again, SAA adjudicatory authority was curtailed because our agree rate is bad and the chief actuary got antsy that we were paying tons of folks who shouldn't be paid and imperiling the trust fund. Trust and believe the top brass would love nothing more than anyone issuing more (quality) decisions and they wouldn't let some crybaby ALJs feeling like their turf was being encroached upon change their course of action.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19246708.post-73650330210523444352015-07-20T17:14:32.233-04:002015-07-20T17:14:32.233-04:00Thanks for the inside scoop, 4:34. What you say is...Thanks for the inside scoop, 4:34. What you say is sad, but all your points make total sense. I especially can see, from the claimant attorney perspective, that ALJs wouldn't want to relinquish the "easy cases" that help pad their numbers. It's also sickening to think that Conn and his ilk have damaged the SAP program.<br /><br />By the way, it's comments like 4:34 that keep me reading this blog every day.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19246708.post-62496227647023323552015-07-20T17:14:29.344-04:002015-07-20T17:14:29.344-04:00Does nobody read these boards? Senior attorneys a...Does nobody read these boards? Senior attorneys aren't dissuaded from issuing OTRs--we are absolutely prohibited from doing so. Have been for a few months. The year before that change, we could only pay meets/equals or if the claimant would grid at the full range of an exertional level (even if we had nonexertional lims) considering PRW and transferrable skills. So essentially we haven't been paying for a year plus now.<br /><br />As to the "ALJs won't issue OTRs even for my dying clients on dialysis (which so easily meets a Listing the substantive discussion takes two lines)," the only time I've seen SAAs and ALJs not willing to do OTRs is when the AOD (or DLI in Title II cases...) is a million years before dialysis started and there was nothing significant until shortly before the renal function completely tanked and required dialysis. I find it really, really hard to believe that ALJs are en masse not OTR'ing claimants undergoing chronic dialysis absent those or similar situations since kidney disease only gets worse and a meets 6.03 decision is about the easiest decision there is to write.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19246708.post-70332408916484259912015-07-20T16:34:35.452-04:002015-07-20T16:34:35.452-04:00The Senior Attorney Program is no longer the terif...The Senior Attorney Program is no longer the teriffic program it was when it originally began in 1995 and immediately achieved success in reducing the backlog. Recently, the top brass gutted the original intent and purpose of the Senior Attorney Program, which was to allow experienced Senior Attorneys to screen cases for potential O-T-R decisions, negotiate obvious settlements with counsel over onset dates, etc., and accept calls from counsel seeking to settle potential O-T-R cases in an effort to reduce the backlog while at the same time providing necessary exprience for Senior Attorney's who wish to become ALJ's. I have been a Senior Attorney since its original inception in 1995 and speak with first hand knowledge. <br /><br />Senior Attorneys in the ODAR offices are no longer supposed to issue O-T-R decisions. Rather, they are to concentrate on writing more complex ALJ decisions and performing research requested by ALJ's. A SMALL group of Senior Attorneys has been established in the newer National Hearing Centers (NHC) to exclusively perform the original intent and purpose of the Senior Attorney Program, i.e., screen cases for potential O-T-R's, write brief reviews of the cases that cannot be paid O-T-R, and negotiate with counsel on cases which have the potential to be decided O-T-R. The NCH Senior Attorneys are few in number and as a result, unable to make a dent in the backog.<br /><br />Another reason the Senior Attorney Program has been substantially curtailed is because it was not traditionally well supported by the ALJ's or the AALJ's. This is nothing more than a power thing, however, i.e., many ALJ's simply could not stand the fact that Senior Attorney's were allowed to issue O-T-R decisions and felt their authority was somehow being usurped. It was also a "numbers" issue insofar as many ALJ's believed the easiest cases they could process were taken from them by the Senior Attorney's, and the Agency's sweatshop production mentality and unrealistic numerical goals certainly did not help. In addition, many ALJ's were upset the most experienced and talented Attorneys were not writing more decisions for them because of the Senior Attorney work they performed. Unfortunately, ALJ's who were former Senior Attorneys have not proven to be assertive advocates on behalf of the Senior Attorney Program once they become ALJ's. <br /><br />Finally, the Senior Attorney Program has also been gutted in response to the recent scandals and Republicans in Congress who are far too concerned that many SSA disability applicants are being paid who should not.Anonymousnoreply@blogger.com