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Jul 5, 2011

Congressional Hearing On Outlier ALJs

A press release from two Congressional subcommittees (emphasis in original):
U.S. Congressman Sam Johnson (R-TX), Chairman of the House Committee on Ways and Means Subcommittee on Social Security, and U.S. Congressman Howard Coble (R-NC), Chairman of the House Committee on the Judiciary Subcommittee on Courts, Commercial and Administrative Law, announced today that the Subcommittees will hold a joint oversight hearing on the role of Administrative Law Judges (ALJs) at the Social Security Administration (SSA).  The hearing will take place on Monday, July 11, 2011 in 2141 Rayburn House Office Building, beginning at 3:30 p.m. ...
ALJ productivity, award and denial rates can vary significantly.  Based on data provided by the SSA, in FY 2010 74 percent of ALJs met the requested threshold of 500 decisions, however 15 ALJs handled more than 1000 cases and 98 ALJs handled fewer than 100 cases.  Also, nationally, ALJs awarded benefits in 61 percent of cases and denied them in 26 percent of cases and dismissed the requests in 14 percent of cases; however, 54 ALJs consistently awarded benefits in 85 percent or more of their cases and 2 ALJs denied them in at least 80 percent of their cases.  The Social Security Subcommittee has requested that the SSA Office of Inspector General evaluate the most significant cases of variance to see what factors may explain it, and whether SSA is effectively using its management authority to ensure adherence to SSA policies and procedures. That review is now underway.
In announcing the hearing, Chairman Sam Johnson (R-TX) stated, “No one should have to wait months or even years for their hearing decision because of the office or the ALJ their case is assigned to. That’s just plain wrong.  All of us have a responsibility to make things right for workers who paid for and deserve far better service.  At the same time, Social Security must be able to call bad decision-makers and under-performers to account.  I am committed to exploring measures that can be taken to improve productivity, quality, and agency oversight without compromising the right of claimants to a fair and impartial decision on their case.”

14 comments:

  1. It's just political posturing...but let's hope that it goes somewhere. 85% favorable! What a joke.

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  2. Next thing you know, SSA will mandate that all ALJs must approve 65% of cases - no more, no less. Imagine that nightmare. Would that make you feel better, anon 1?

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  3. Anon 1, is an 80% denial rate any less of a joke?

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  4. @ Anon 2...no, that would not make me feel better. I would feel better if ALJ's consistently applied laws and SSA rules.

    @ Anon 3...yes, 80% denial is MUCH less of a joke. Claimant's at the ALJ hearing level have already been denied. I think that a 20% error rate at the field level is probably closer to a true measure of "disability", but still too high.

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  5. I hope they take a long hard look at the Chief ALJ in the Dover office. We'd like to get back to a decent success rate there. Instead, we find ourselves with Appeals Council and District Court remanding claims left and right...always back to the same ALJ, who then re-denies it. After the second remand, we usually win. It's gotten to the point where we tell clients that they are going to lose if they get that ALJ.

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  6. @ anon at 3:33...probably not a good idea to be advising claimant's of there probable success (or lack thereof) prior to the issuance of an ALJ decision.

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  7. Probably not. But if they ask their chances, we're not going to lie to them. An 18% approval rating is well outside the norm. All of the other ALJs in that office are at least willing to entertain the notion that the claimants might possibly be disabled.

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  8. 18%...seems like he is "at least willing to entertain the notion that the claimants might possibly be disabled"

    Unless his approval rate was 0%, he is "at least willing."

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  9. @Anon 1: The ALJ's are not conducting quality assurance reviews on the prior initial and reconsideration decisions but are engaging in new and independent decisions. Your suggestion that an 80% denial rate is much less of a joke is absurd. You clearly are on the dark side of this process and are pushing an agenda here.

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  10. OK,how about a little reality check:

    1. DDS is scrutinized on approvals; ALJs are scrutinized on denials.
    2. ALJ decisions come long after DDS decisions are made,and conditions tend to worsen as people get older.
    3. Along the same lines, by the the time claims get to an ALJ, many claimants will grid out.
    3. DDS does not have to contend with sworn,direct, and unrebutted testimony re: pain and functional limits.
    4. DDS will not have an attorney involved in the earlier process, b/c there is no financial incentive.
    5. Claimant reps get paid on back benefits, which is why the most probative evidence does not appear until later in the appeals process (very often, not until the day of or the day before the hearing).
    6. DDS applies a clear and convincing standard of evidence, whereas ALJs are legally required to apply a preponderance of the evidence standard(although many do not.)
    7. Court decisions, SSRs, aquiescence rulings, and the like are skewed towards favorable decisions at the ALJ level. The DDS doesn't have to contend with those.
    8. Many "favorable" decisions made by ALJs are either amended onset or closed period dates.
    9. ALJs are the only decision makers that actually speak to the claimants.
    10. DDS does not employ VE's, whose testimony often impels a favorable decision.
    11. DDS examiners are kept in employment b/c of their super-conservative evaluations. When the same examiner is hired by the claimant rep, all of a sudden they become very liberal. Seen this many times.
    12. Bottom line: any ALJ who approves less than 70% of claims is applying de facto a clear and convincing evidentiary standard. I have no problem w/that as far as it goes, but that is not the law that ALJs are supposed to follow.

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  11. Having been a trial attorney for many years with many jury trials on the books, I am somewhat perplexed by the belief that judges should all fit in a certain statistical range. Juries operate with specific instructions just as judges act with specific rules and regulations but are human beings just like MOST jurors. We cannot expect human beings with past life experiences to act/react the same. Jurors do not see evidence the same way and neither will judges. A statistical bell curve will always exist as long as humans are making decisions. Maybe things would be better if we just fed all the information into a computer in the DOs and out would pop a decision like the take-a-number system used in the lobbies for interview times. The current system works better than anything else that could be devised to provide due process. The problem areas are very insignificant in the grand scheme and there are ways to address those areas without demeaning the entire process.

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  12. Here is the latest TRAC Report which discusses disparities among ALJs within offices.
    http://trac.syr.edu/tracreports/ssa/254/

    *surprised that Charles Hall failed to find and post this link.

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  13. Hell, I'd be happy if they would just APPLY THE LAW!

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  14. Oops...forgot to mention that the favorable decisions were, with one or two exceptions, issued as soon as the claim got to the hearing office...not after a hearing.(knocking out Concerned ALJ's theory that reps withhold evidence until the last minute)

    One of our favorables went to District Court twice, and the claimant died, before we got a favorable.

    What would make the most sense to me, is if the Appeals Council would start taking a stand against that ALJ. They pass the buck and we end up in District Court, which means our claimants have to wait even longer. It's at the point that we have claimants file new applications as soon as we get the hearing denial. And probably 70% of those are approved before we even hear back from the AC.

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