From the Wall Street Journal:
A large number of Social Security disability cases approved by certain judges lacked “a well-supported rationale” for awarding benefits, the agency’s inspector general will say in a new report, potentially drawing renewed scrutiny to a program that grew sharply during the economic downturn.
The Social Security Administration’s inspector general plans next week to issue a report that looks at benefits paid by administrative law judges who had both decided an unusually large number of cases and awarded an unusually high number of benefits.The agency determined there were 44 judges over seven years who met that criteria, a number that represented just 4% of the agency’s judicial corps. ...
It examined 275 instances when those judges awarded benefits and found that just 31 of the cases were “properly processed.” Another 216 of the cases “had quality issues,” and 28 “had missing information that prevented us from reviewing the file,” according to the report.
The inspector general concluded that 38 of the 275 cases should have ultimately been denied. It used these findings to determine that the agency “improperly allowed disability benefits on approximately 24,900 cases, resulting in questionable costs of about $2 billion.”
Could someone explain to me how Social Security's Office of Inspector General came by the gold standard for judging who is and who isn't disabled? I know that the rest of Social Security would love to see that gold standard. They've been looking for it for more than 60 years but they just can't seem to find it.
13 comments:
when you read the actual report you will see that the cases the IG questioned were also subsecuently reviewed by the AC quality staff.....and that's how they found that so many Judges' decisions are not supported by actual evidence, the law is not followed or the decision makes no sense. It's long overdue that Congress should reform this system - the ALJs are out of control.....and SSA can't or perhaps won't try to control them.
“AC Quality staff” ha ha ha ha ha ha ha ha oh ha ha!! There is no AC “quality” staff. There is an unchecked star chamber of bureaucrats with undisclosed credentials who have increasingly denied review of all decisions - now denying around 90 percent of the decisions they review. They do not have “quality” standards and are not required to release workload specifics.
There are some ALJs out of control, (many federal agencies have components out of control, see the AC above) - I would suggest more ALJs who deny cases have abandoned their charge. But I doubt the forthcoming report will focus on those outliers. It is not in the republicans’ or WSJ’s political agenda. So the result will be more fodder for the shills on the hill. Meanwhile the law, the criteria for disability has not changed. But reports and publicity such as these have allowed all adjudicators to deny 20 percent more claims, increase review on the weakest – SSI recipients who are more often than not unable to respond to notices and subsequently are ceased, and conspired to steal back pay with unfavorable onsets.
The Inspector General report will likely contribute to this despicable chapter of SSA disability history.
Oh, and the "quality staff" used what standard to make those determinations? Substantial evidence? Jusk asking.
The AC is a large waste of federal funding if they do not provide a substantive reasoning for agreeing with an ALJ decision.
It should be eliminated or substantially reduced allowing for a faster track to federal judicial review and cost savings.
My office has tried sending an AC request to Falls Church since 2008! It is still not loaded in the ARPS system. We have event sent the request via certified mail twice in the past 2 years. When the claimant visits our FO, I really do not know what to tell her other than that we will send the request again. The case is not even loaded onto the system, much less being processed. I have no idea what they do down there but it is purely a joke and waste of agency resources.
This report shows that a number of claimants were improperly awarded disability benefits. But the report is also probably extrapolating their findings to the entire universe basically finding that about 14% of all the decisions by these 44 ALJs were incorrect. I'd like for a statistician to review OIGs work in this regard. Also, we should remember the number of ALJ denials overturned by the AC and by the Federal courts, either directly or by remand, which would indicate claims perhaps improperly denied.
The federal courts would have something to say about eliminating the AC, I can guarantee you they do not want that entire workload of 100,000+ cases in their courtrooms.
And do you really want to give Obama a few hundred more lifetime appointed Article III judges to manage the increase?
Either way i suspect the majority of appeals to the AC will eventually be before the district court. And the uneeded delay at the appeals council harms the claimant and add an uneeded layer of administrative bureaucracy.
Better mr obama appoint more judges than have a conservative court reducing rights of americans.
Anon 4:06 11/16 - Faulty logic. At current denial of review probably higher than 90% , the increase in subsequent review would be less than 9 percent. Significant number of applicants give up their appeal, rather than wait more years. Where do you get 100,000 + cases if AC was removed? So far this year the AC has managed about 8600 remands. The federal courts want cases adjudicated accurately. When the agency allows a 20% increase in denials and the AC (and reconsideration) rubber stamp, the federal courts are left with a significant increase in workload. SSA is funding a review that supports 9 out of 10 decisions -such a review is statistically meaningless.
I want to see a review of the decisions made by "outliers" on the other end--ALJs who award benefits in less than 20% of their cases. And, many of those "fully favorable" decisions are deceiving--they include amended onset dates that were crammed down the throats of desperate, destitute claimants who've waited 2-3 years since applying for benefits.
There goes that old "judicial independence" that the Judges are supposed to have. The Reg's, Rules, POMS, Hallex, daily directive, SSR's, etc., are all conflicting and contradictory. Every Judge has to interpret and apply what he/she believes the "rules" are that apply to each case. It may not be rocket science, but each case has a nuance that must be addressed. Since the "rules" are so screwed up, it makes it easy for some moron to look at the case and pick which rule is contrary to the ones used. Perhaps better "rules" and more than 4 weeks of training might help. Further, perhaps hiring Judges with some knowledge about the system and impairments or illnesses/diseases/injuries?? Why hire a patent attorney to do this work? Why hire a tax attorney to do this work? Why hire a prosecutor or criminal defense attorney to do this work?
@ 3:17 PM, November 15, 2014
Send it to the AC certified, RRR. Send a copy to the DO, certified at least.
"In another 28 cases [out of the 275], we were unable to review the ALJ’s decision because SSA could not locate case folders, hearing transcripts, and/or the ALJ’s decision."
So in ten percent of the cases, they lost the case folder, transcript, or Decision.
Justin
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