Dec 4, 2013

Hearing Office Attorney Advisor Ability To Issue Favorable Decisions Diminished


     From a Bulletin issued by Social Security's Chief Administrative Law Judge:
In November 2013 we began a pilot: the National Screening Unit (NSU). The NSU Core Team will review and select cases eligible for the program and will distribute those cases to hearing office (HO) management for assignment to AAs.
AAs [Attorney Advisors] may review and sign fully favorable decisions only in cases selected by the NSU. AAs may screen other cases (i.e., those not selected by the NSU) at the direction of HO management, but they may only do so for the purposes of identifying potential Administrative Law Judge (ALJ) OTR [On The Record] decisions or assisting an ALJ with a hearing. ...
AAs can only issue a fully favorable decision when the case is referred by the NSU and the evidence supports the following:
    • A claimant’s condition meets a listing at Step 3;
    • A claimant’s condition medically equals a listing at Step 3, based on medical expert (ME) evidence;
    • Applying the “special” medical-vocational profiles showing an inability to make an adjustment to other work (see 20 CFR 404.1562 and 416.962; Social Security Ruling 82-63); or
    • Directly applying a grid rule in Appendix 2 to Subpart P of Part 404 (Medical-Vocational Guidelines) to find a claimant disabled at Step 5.
      This was issued to dramatically cut down on AAs issuing decisions approving disability claims. This also has the effect of reducing Social Security's ability to deal with the growing backlogs of claimants seeking a hearing before an ALJ. However, these AA decisions came to a complete where I am even before this directive.

13 comments:

Anonymous said...

The first thing that struck me about this authority was the restriction on AA's being able to locate favorable decisions in their own office and issue those decisions directly.

This type of restriction also applies to ALJ's who cannot directly pull cases from master docket that look like favorable.

This seems to be a reaction to the Conn situation to guard against perceptions of influence.

Anonymous said...

Like Charles, our office has seen all AA decisions stop, even before this directive. In addition, we have seen the issuance of all decisions slow down, especially from DDS. I'm assuming this is because DDS and ODAR staffs are still trying to catch up from the govt shutdown. But we're starting to be affected by the lack of decisions (and accompanying attorney fees), especially at year's end. Anyone else having the same experience? When can we expect decision issuances to return to pre-govt shutdown levels?

Anonymous said...

I am glad to see that the backlog has started to reappear.

Anonymous said...

@10:26

not unless/until OT returns

Anonymous said...

10:26 is right. And I haven't heard even a whisper of it being made available again anytime soon. Then again, we work-a-day folks aren't exactly kept in the loop on these things...

Anonymous said...

The reduced authority is a reaction to misuse of SSR 96-8p by SAAs and ALJs; it is targeted at the SAAs first because they are much easier to limit.

Internal audits show an error rate around 25% for favorables -- i.e., the decision either lacks the proper rationale to support the pay or it should not have been a pay to begin with.

Anonymous said...

@ 10:26 with regard to slowing of decisions...there are many reasons. Here are some:

- no more OT
- no more awards for performance (i.e. no motivation to actually write decisions for AA)
- furlough
- general malaise among employees...no COLA increase in 3 years, no promotion or hiring due to budget, no OT, no awards

Yes, it's easy to argue, just do your job. I think most people are doing their job. However, where before, high performers had some motivation to work hard, now there is none. Over time, this erodes morale and performance suffers. Among my co-workers, I know that we all work to meet our goals, but no longer try to exceed them.

Anonymous said...

Thanks for the input, 1:35. I didn't realize that OT and performance awards had been taken away. I can certainly understand the malaise you describe. Everyone that I and my staff speaks with @ SSA and DDS all seem to be trying to work harder with less. From our point of view, the cases are on the shelves and, yes, this growing backlog will eventually increase our fees. However, we're anxiously waiting for the "stream" of decisions/fees to resume because for the last month or so, that "stream" has considerably slowed.

Anonymous said...

@ 2:29.

We were notified earlier this year (maybe Feb) that performance based incentives are indefinitely on hold during the so-called sequester.

To my knowledge, the legislation that put in place sequester cuts is scheduled to last until 2021. Thereofre, I don't see any annual bonus/incentives returning anytime soon. Coupled with no COLA, this makes motivating employees difficult.

For information, most bonuses/awards were in the range of 1-2% of total salary, with most being much closer to 1% (if not less). So it's not necessarily a huge financial boost. However, my management also told me that they won't do non-financial awards for fears that the union will protest such awards.

Anonymous said...

Amen, 1:35. No overtime, no awards, no cola, no hiring. Just lectures about doing more with less. Then management wonders why the office doesn't meet their "goals" i.e., numbers. Why make yourself sick with stress just to meet numbers for management? Better just to focus on getting through the day and doing a good job for the people I have time to help.

Anonymous said...

@12:59

There's a bit more to the story. SAA here--at the recent SA training in St. Louis, we were told by Sklar and Bice that the difference in SAA FF agreement rate changed drastically (from mid-to-high 90s down to where it is now) due to a change in evaluation criteria. The new, much lower number is due to one of these various sets of evaluation criteria tracking many more (including "harmless") decisional errors. Basically, the agree rate was 95+% under one standard (that apparently only/primarily centered on if the ultimate decision was correct), they changed the standard on which they measured SAA decision agreement rates, and now the agreement rate is much lower.

There are multiple components of SSA reviewing decisions--OQP, the AC, and now each Region has a group of AAs doing a new quality check. And each reviewing body has differing standards by which it determines whether it agrees with a decision. I have no idea which standard is used for any one report, etc. regarding SAA agreement rates. It's a mess. I am not saying one set of criteria is better than any other, but I am saying they vary widely (there is no way the agreement rate could dip so significantly so quickly unless the evaluating criteria changed dramatically).

To address Charles' contention that SAA decisions had stopped already, I don't know why he's seen that. I and my fellow SAAs were always reviewing OTR requests, though their numbers had decreased and the percentage (at least I) paid has gone down. Informal remands, the effects of 11-1p, and some other recent changes have reduced the number of likely-favorables coming to ODAR. Plus, ODAR as a whole is issuing a smaller percentage of favorable decisions--not just the SAAs.

Anonymous said...

"There are multiple components of SSA reviewing decisions--OQP, the AC, and now each Region has a group of AAs doing a new quality check. And each reviewing body has differing standards by which it determines whether it agrees with a decision. I have no idea which standard is used for any one report, etc. regarding SAA agreement rates. It's a mess. "

Absolutely true. OQP is supposed to be the centralized component with the mission to ensure quality and uniformity. The current mish mash is just confusing in the field.

Anonymous said...

funny thing awards
The unions asked about non-monetary awards in the absence of monetary awards and were told "no"