Mar 1, 2012

Delaware ALJs Draw Media Attention

Delaware's federal legislators are asking the Social Security Administration to explain why disability cases heard by Dover judges are consistently denied at some of the highest rates in the country.
The agency's administrative law judges in Dover have denied 57 percent of the cases they've heard since October, compared to a national average of 41 percent, statistics show. It was the fifth-highest denial rate among the agency's 170 hearing offices. ...

Carol Moore, 57, of Bear, worked for more than 25 years as an administrative assistant before developing scleroderma, an autoimmune disorder, and Raynaud's phenomenon, a condition in which blood-vessel spasms block blood flow to the fingers, toes, ears and nose. Moore said she experiences swelling, joint pain and feelings of extreme cold. ...

After she was initially denied benefits six years ago, Moore appealed, and her case was heard by Dover Administrative Law Judge Judith Showalter, who dismissed her claims, Moore said. Showalter has denied 72 percent of the cases she's heard since October, the 27th-highest rate among the nation's 1,123 Social Security judges.

"She had no idea what the diseases were and didn't want to hear it," Moore said. "Nobody can stop her. She's not a doctor, but she can go beyond a doctor's diagnosis. How is one allowed to get away with that?"
Showalter did not respond to a request seeking comment for this story.
     If you think that scleroderma is just some trivial skin disease, think again. Scleroderma is also known as Progressive Systemic Sclerosis. Sclerosis means hardening, so the name means progressive systemic hardening -- and we're talking not just about hardening of the skin but of internal organs, like the heart, liver, lungs, kidneys, etc.and we're talking about real hardness, the kind of hardness that would shut down one of these organs. That doesn't sound like some minor skin disease, does it? Scleroderma is a very serious rheumatic condition that is often fatal. I've represented a number of clients with scleroderma over the years. I don't think I've ever lost one of these cases. A 57 year old claimant with scleroderma gets denied by an ALJ? That raises both of my eyebrows.


Anonymous said...

They have to justify their $162,000 salary somehow during this economic downturn. Denials seem to be a good way.

Anonymous said...

The denial of the woman with scleroderma may seem strange to you, Charles, but none of us know what symptoms she is actually experiencing, what the medical findings are, how effective treatment has been, or what her past work has been. Just because the person sounds sympathetic in the newspaper article does not mean the ALJ was wrong to deny the case -- do not forget that the ALJ was the third person to say "NO". Maybe SSA got it wrong, but without more details, we do not know.

The young lady with seizures and depression, two conditions that are very treatable, is not particularly sympathetic.

Moreover, a 70% denial rate is not unrealistic. The claimant has already been denied twice by DDS before reaching the hearing level. Also, with the expansive use of senior attorneys, many of the clearly favorable or even borderline cases are paid on-the-record, leaving fewer possible pays for the ALJs to find.

Instead of wondering why an ALJ only pays 3 out of every 10 cases, the more concerning question is how any ALJ is able to pay 7, 8, or 9 out of every 10 cases he/she hears.

Anonymous said...

These stats are very old. 1132 ALJ's? End of last year there were somethinbg like 1435 ALJ's. Last year, ALJ Showalter ran at something like 3% to 5% fully favorable. She was about the lowest in the country.

Anonymous said...

Nobody is not making up their illness or sickness I think it will be very hard to do that.when we get our paycheck money comes out before we even see our check.They take our money when they need it,so when we get sick why can't we get help when we need it.