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Oct 26, 2006

Don't Know How To Make The DRB Work? -- Hire A Contractor

Under the Disability Service Improvement (DSI) experiment currently underway in Social Security's Boston Region, the Appeals Council is being replaced by a Disability Review Board (DRB). Claimants will no longer be able to request review by the Appeals Council after they are denied by an Administrative Law Judge (ALJ). This plan has been criticized on the grounds that it would lead to a dramatic rise in Social Security cases being appealed to the Federal Courts. Social Security's response has been that the agency would avoid such a dramatic effect upon the Federal Courts by having the DRB identify cases that are likely to be appealed to Federal Court and then reversed or remanded. The DRB would correct errors in those decisions without the claimant requesting review. When questions have been raised about how this could be done, Social Security's responses have been vague.

We now know why Social Security was so vague on how the DRB would prevent a huge increase in Federal Court filings in Social Security cases. They had nothing more than a vague notion of how they could do this. Social Security has issued a "presolicitation notice" indicating that the agency is seeking a contractor to develop a computer system to screen ALJ decisions for cases that are likely to be appealed to Federal Court and then reversed or remanded.

It is entirely possible that a contractor can develop a system that will work. It is also entirely possible that this will fail miserably, most likely because Social Security's databases do not contain enough data fields to predict results in such a complex situation and it would be too expensive to add those data fields. Even though there is no proof that this computer system will work, Social Security has already enshrined the DRB in regulations. All Social Security can do now is hope a contractor can pull a rabbit out of a hat.

Here is the text of the notice:
The purpose of this notice is to advise interested parties that the Social Security Administration (SSA) intends to release a Requests for Proposals (RFP) for the services of a contractor to develop an automated, Section 508 compliant, profiling/screening tool (software) for identifying Administrative Law Judge (ALJ) disability decisions to FedBizOpps and will upload the solicitation document when issued.

The Social Security Administration (SSA) has a requirement for the services of a contractor to develop an automated, Section 508 compliant*, profiling/screening tool (software) for identifying Administrative Law Judge (ALJ) disability decisions that are likely to be appealed to federal district court and remanded or reversed by the court. The contractor may also recommend the purchase and/or modification of an existing Commercial Off-the-Shelf (COTS) software package for the profiling/screening tool if an existing product can be identified.

On March 31, 2006, SSA published the final rules establishing a new disability determination and administrative appeals process effective August 1, 2006. Under the new rules SSA is gradually phasing out the Appeals Council?s review of disability claims and replacing it with a review by a Decision Review Board (DRB). The DRB will focus on identifying decision-making errors as well as policies and procedures that will improve decision-making at all levels of the disability determination process.

SSA intends to select ALJ decisions for review by the DRB in several different ways, including the use of computer-based predictive screening tools. It is envisioned that a sophisticated computer-based profiling/screening tool could be developed to help identify unfavorable ALJ decisions that contain characteristics associated with federal district court appeals and remands or reversals. The profiling model will be developed using data recorded at the time of the initial level determination, ALJ decision, Appeals Council review, and the court action. This information includes the applicant?s age, education years, primary impairment, reason for the court remand, etc. The methods for selecting cases for DRB review are expected to evolve over time as more data are available and SSA gains more experience and knowledge in the use of computer-based tools. Any software will make use of current SSA databases and systems architecture already available, if applicable.

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