Practicing in MI, a prototype state, I don't understand why reconsideration still exists in the non-prototype states. Given the ridiculous pay rates at recon, it appears to just be a waste of time and resources to just rubber stamp the initial denial. It makes sense to a claimant in MI when I explain to them that they get to see the Judge after the initial denial. Do enough claimants drop off at the recon level nationally to keep it as a cost-savings mechanism at the hearing level? If so, then why keep the prototype states after all this time? Makes no sense to me.
Personally,an opportunity for an Alj hearing is overated. Based on an evidentiary record that can support two conclusions,a sound decision rest on an alj who may bring bias and or predjudice into a decision based on a claimant's appearance.
I would trust DDS before i trust an alj to render a just decision. FYI,i was a claimant.
The variance in these statistics is often overlooked when discussing the variance in ALJ approval rates, but they have a significant impact. ALJ's in states like MS, GA, KY, IN, WV and TN may have higher approval rates due to their respective DDS's lower approval rates.
I guarantee the pay rate at ALL levels (initial/recon/ALJ) is significantly lower in WV than surrounding states in the Philadelphia region, due to fear of further investigation. So much for independent decisionmaking.
While I certainly agree that an ALJ can bring their personal bias to a case, the ALJ and DDS are not typically looking at the same evidentiary record. DDS development of medical evidence, at least in my state of Ohio, is horrible. They make no real effort to obtain records and often times screw up the requests they do send out so they end up with an incomplete record. Once the claimant finds there way to us, typically after 2 denials, our first job is correct all the development mistakes the DDS has made.
Remember, adjudicators are judged by their supervisors more on how quickly they process a claim than any other factor. As very few denials are selected for QA review, the DDS mistakes never get caught.
Practicing in MI, a prototype state, I don't understand why reconsideration still exists in the non-prototype states. Given the ridiculous pay rates at recon, it appears to just be a waste of time and resources to just rubber stamp the initial denial. It makes sense to a claimant in MI when I explain to them that they get to see the Judge after the initial denial. Do enough claimants drop off at the recon level nationally to keep it as a cost-savings mechanism at the hearing level? If so, then why keep the prototype states after all this time? Makes no sense to me.
ReplyDeletePersonally,an opportunity for an Alj hearing is overated. Based on an evidentiary record that can support two conclusions,a sound decision rest on an alj who may bring bias and or predjudice into a decision based on a claimant's appearance.
ReplyDeleteI would trust DDS before i trust an alj to render a just decision. FYI,i was a claimant.
The variance in these statistics is often overlooked when discussing the variance in ALJ approval rates, but they have a significant impact. ALJ's in states like MS, GA, KY, IN, WV and TN may have higher approval rates due to their respective DDS's lower approval rates.
ReplyDeleteI guarantee the pay rate at ALL levels (initial/recon/ALJ) is significantly lower in WV than surrounding states in the Philadelphia region, due to fear of further investigation. So much for independent decisionmaking.
ReplyDelete@4:23 PM, August 25, 2014
ReplyDeleteWhile I certainly agree that an ALJ can bring their personal bias to a case, the ALJ and DDS are not typically looking at the same evidentiary record. DDS development of medical evidence, at least in my state of Ohio, is horrible. They make no real effort to obtain records and often times screw up the requests they do send out so they end up with an incomplete record. Once the claimant finds there way to us, typically after 2 denials, our first job is correct all the development mistakes the DDS has made.
Remember, adjudicators are judged by their supervisors more on how quickly they process a claim than any other factor. As very few denials are selected for QA review, the DDS mistakes never get caught.