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Apr 3, 2017

"The Wheels Are Already Coming Off The Bus"

     From the Roanoke Times:
More than a million people, including 5,000 in Southwest Virginia, are trying to convince a skeptical federal disability program that they are too disabled to work. ...
Federal disability claimants who have been turned down for assistance, but who insist they deserve the aid, wait an average of a year and a half for a final decision from the Social Security Administration. ... 
People living in the Roanoke area wait nearly two years. The local office ranks 155th, or 10th from the bottom nationally, in average case processing time, according to agency data. 
A hiring freeze ordered by the Trump administration means there’s little to no chance for a substantial increase in staffing to address the problem, according to an association of judges who work in the system. 
“I shudder to think what will happen if we don’t get significant relief from the hiring freeze. We desperately need support staff,” said Administrative Law Judge Marilyn Zahm, president of the Association of Administrative Law Judges. 
“The wheels are already coming off the bus,” said Zahm, who hears Social Security cases in Buffalo, New York. ...  
One in three support jobs in the Roanoke office is vacant, according to association figures. One judge’s job is vacant as well. The backlog of disputed disability cases, which exceeds 5,600, isn’t large by national standards. But the office’s nine judges deal with above-average amounts of paperwork, which increases decision-making time. ... 
That’s especially true in Roanoke, where 29 percent of case files run more than 1,000 pages, above the national average of 22 percent. Small case files, those with fewer than 500 pages, make up 15 percent of Roanoke’s case load, well below the national average of 28 percent. A judge must read each file, including handwritten medical notes. ...

37 comments:

  1. "A judge must read each file, including handwritten medical notes." Fake news!

    I don't know any Judges in Roanoke but I would estimate from my 20+ years of experience with several ODARS in several states that somewhere from 25-33% of Judges don't read the entire file.

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  2. Actually, because of her position in the ALJ union, Judge Zahm spends very little of her time in the Buffalo ODAR office and holds only a few hearings a year. According to agency statistics, she conducted only 32 hearings in 2016.

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  3. @ 4:53pm - whether you like or not, it's not uncommon for union officials to spend considerable amounts of work time on "official time" handling union matters. Official time declined during the George W. Bush administration but rose again during the Obama era. I have observed no change since Trump took over.

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  4. C'mon who are you guys fooling? It is like saying the CEO of the hospital or the health plan read your hospital chart/medical records. Anyone really believes that these judges have medical knowledge of complex medical issues that an experienced medical doctor acquires? The whole premise is based on the fallacy that this layperson with no medical education or experience can decide the severity of complex medical disease. Many doctors do not have that level of competency. THE US Congress must take this into account if the disability system is to be overhauled. Otherwise we are rearranging the chairs on this Titanic.

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  5. Strange, I am a Judge and a doctor... How unusual? And the Agency won't allow me enough time to properly read the records in an attempt to hold a full and fair hearing...

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  6. The number of pages in a file is a silly metric for determining how much time is needed to deal with a case by an ALJ.

    First, half of the pages are jurisdictional consisting of notices that were sent and information as to work activity. Aside from verifying work history, how much time does a Judge need to spend on going over an earnings record?

    And reading every page of a medical record is not needed. The ALJ is not diagnosing medical problems. They only really need to know what the medical problem is and what treatment has been provided. They then need to compare what the claimant says are their abilities to that record to see if they are consistent. Reading an EKG, whether you can or cannot, is no job for an ALJ. Fifty pages of nurses notes from a hospitalization are irrelevant. Read the discharge summary if you must. The operative report describing just how many stitches were put in and the result of the equipment count don't impact the decision on w/m the claimant is disabled. The only thing needed is to know the surgery took place. Any Judge that feels the need to read every page of the medical record in exhaustive detail is wasting their time.

    Its meatball surgery. There is no time. Just get er done.

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  7. 9:11 gets it.

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    1. I disagree.

      9:03, the Dr./ALJ, gets it so much more and is SPOT-ON! KUDOS, 9:03!

      In recent years, I have noticed it is rare to find handwritten nurses notes and other non-substantive information in medical records from hospitalizations. Decades ago, when I started with the Agency, it was common to have such information in the file. Over the years, medical records clerks at hospitals began asking those requesting medical records if they wanted all the handwritten nurses notes, etc., so they began to be weeded out. If the weeding out was not done on the front end, it was done by claimants reps who submitted medical records, or by support staff. I do not believe we see as much of these records today, as we did years ago.

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  8. If he is a judge and a doctor he should be able to breeze through the record far quicker than his companions that are not dual qualified. Sounds like he is just taking up space for a retirement after not making it on the outside.

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  9. Maybe he's trying to be fair to to the claimants, not just finding enough to justify his decision?

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  10. Thank you Tim, as this has been the most frustrating job I have ever had. The Agency pays lip service to "World Class Service" but they could give a damn less about full and fair hearings. I will soon retire as I can no longer suffer the BS.

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  11. For the most part, 9:11 is correct about what is necessary information for the ALJ. However, NOT reading the entire operative report is an error! While social-science/law school-educated ALJs may have difficulties understanding the medical-surgical jargon, the operative reports often actually tell the truth about some unusual anatomical defects which were encountered or complications which developed during the surgery. The surgical problems caused by these defects/complications often establish the origin of the chronic pain and other medical conditions which bolster the credibility of the claimant.

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  12. I am sure he is doing it because he is moved to help the disabled. So instead of providing legal and healthcare services to the disabled, poor and aging, where they live and die, he takes a $100k plus job, works from home several days a week and runs up a nice TSP.

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  13. Well as a doctor, I know what seems to be a secret at SSA. Almost all conditions are progressive and degenerative and will lead to disability eventually, maybe not on the AOD, but along the line and often prior to the ALJ Hearing. Just sayin'.

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  14. And all life ends in death. No medical school needed.

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  15. The comments @ 9:11, 10:21, and 12:09 regarding the ALJ who is also a doctor are unnecessarily mean spirited, contrary to the mission of SSA, and obviously made by a pompous, narcissistic jerk. If these individual(s) are ALJ's or Agency employees, they are a disgrace to the Agency and it's mission. If anyone is, "Taking up space ....," I cans assure you it is NOT the ALJ/Physician, but those who made the comments @9:11, 10:21, and 12:09.

    You come across as pretentious, self-centered jerks. The last thing individuals like you should be doing is hearing or writing decisions in SSA Disability appeals cases, or even worse, being illogically promoted through Agency management ranks to one of the top officials who run SSA/ODAR, i.e., think Garmon, et.al

    Instead of seizing on such a wonderful opportunity to utilize the expertise of a combined ALJ/Physician, Senior Management shuns these individuals, subjects them to ridiculous quotas/production numbers in terms of decisions issued and hearings held, and treats them like third graders. A combined ALJ/Physician ought to be an immediate consultant on serious issues this Agency faces, and urged/pushed to become a top Agency official. But no, this Agency does NOT promote the best and brightest. In fact, they do the direct opposite, i.e., promote only favorites and like-minded individuals who will never question anything, and will support those in their inner circle regardless of the type or extent of misconduct or wrongdoing those individuals may have engaged.

    This perfectly describes why any positive changes to improve the SSA Disability process must start with the BLOATED top level officials and executives - Not the worker bees, ALJ's, Attorneys, support staff actually doing the work. So long as the Trump Administration gives Agency top officials the power to decide where cuts must be made, I can assure you they will never choose among themselves. Thus, their answer is to do more with markedly less, and enforce their mantra of punitive threats with quotas, numbers, etc. What is lost is due process for claimants, and full and fair hearings.

    I personally commend the ALJ/Physician for everything he has done for the Agency. Thank you, and I regret you got caught up in this bureaucratic nightmare of SSA Disability Management who has not treated you with the respect you deserve, or even bothered to seek your valued expertise. It is shameful. --SA-27.

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  16. what 11:49 and other purist ALJs miss is that:

    1) SSA will never get a budget sufficient to hire the number of ALJs and support staff it needs to timely process all applications while giving the level of detail and time they feel is necessary.

    2) spending so much time on cases like these purists do with insufficient staff creates huge backlogs that hurt people.

    This is a volume game and always will be. It's one of the largest bureaucratic institutions many Americans go through. Knowing we will never get the 1,500, 2,000, or however many ALJs we would need (and 4.0 - 4.5 times as many support staff to properly support the hearing process) and the increased DDS staff we could use for better initial and recon determinations, it is quite simply foolish to try and treat each case like a precedent-setting Federal appellate case. You are hurting more people by moving so slowly with so many waiting than the rare person here and there that might get an incorrect decision because you didn't fine-tooth-comb each and every record.

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  17. Duncan Sighting!!!

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  18. It's pretty clear from anyone that reads this blog regularly that many of the posters here just plain hate SSA and ALJs. It's sad, and I hope one day that they come to terms with their misguided anger and jealousy (lots of comments about $100k jobs and telework for some reason). In any case, it's truly a low point when people mock judges for wanting to review the whole record. In my office, the medical records (not the jurisdictional or earnings documents) average around 800 pages per case. I try my best to review all those records, and I find serious ailments that DDS overlooked, as well as provider notes about ongoing work, drug seeking behavior and other activities that help me understand what inquiries need to be made during the hearing. For people to complain about judges not earning their salaries, but then also complain about judges being diligent in their jobs is hypocrisy at best and sheer spite at worst. In any case, if I was a disabled individual appealing a denial, I would a judge to review every single piece of evidence in my case. People on this blog either don't want to understand that simple concept, or they just want another reason to gripe. My money's on the latter.

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  19. 2:26 PM Dunkin' Donuts? You must be from Boston... they're everywhere there. Seriously, just what are you refering to, TROLL?

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  20. Ignoring the ad hominin above (which makes reading this blog a lot more pleasant and productive), Zahm is half right. The front tires are bare and the rear tires just barely able to brake. But the program will continue to motor along. Most lawmakers and taxpayers don't know or care about disability. Until there is a real coalition (both sides - SSA and those who interact with SSA), ALJs will be required to make too many decisions with too few resources. Representatives will continue to be saddled with misguided restraints. I have been doing this for decades, on both sides. Most ALJs appear to make the best effort possible. Yes, there are criminals who deny 90+%, but they are the minority and (I believe) karma will catch up with them. As far as reading the op notes, waste of time in most cases. There are some exceptions such a GI bleeds, Hip disarticulation, some cancer cases. But the intake and discharge notes are usually sufficient. And, BTW I scan every page in the exhibit file and take notes. It can be done in an afternoon.

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  21. Duncan not Dunkin', reading skills like that can make you a senior attorney!

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  22. 2:20 - Generally speaking, you are correct. From the agency's standpoint it is a volume game. But various recommendations that I needn't go into have been made as to how to facilitate a quicker adjudication of the cases. But the agency keeps going to the same well - incentivizing judges to do more work. We all know how well that went last time we had a large backlog - with some judges issuing 1200+ decisions per year, not reading the record, and holding 10 minute hearings. If that's the world you want to live in, then I understand where you come from. But in my view, convenience and expediency do not trump what is legally and ethically the right thing to do.

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  23. Duncan, #1 in yo-yos!!

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  24. @ 1:11 you must be the village idiot. It is about living not about dying.

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  25. By far, SSA must be one of the worst federal agency in terms of quality hires and compassionate employees. It all goes back to the upper echelon and their HR departments which are full of biased bigots. Most had climbed their way up onto this agency's leading components by holding firm to these unethical human qualities. It's time that the agency should start hiring on-campus graduates with true-earned above average GPA, humane in nature, compassionate caring and do not tolerate bullying or harassment against any group of employees. Let's us all pray!!!!

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  26. My disability claim was approved after approximately 1 year and 4 months. Also I received a big check for 5 years of retroactive back pay as well as Medicare benefits. This was after the first time I filed.

    One of the reasons I may have been approved is because I genuinely tried to work. I've landed about 40 to 50 jobs, but due to my disability I cannot hold a job for long.

    Also I tried avenues such as Vocational Rehabilitation (Voc Rehab) at the VA, where the jobs lady helped me get 6 different jobs successfully. I just couldn't hold on to the jobs for very long due to various reasons.

    So, I was never discriminated against due to my mental illness, that I am aware of.

    My point is, even if you get approved, it is going to take awhile. Like I said, my case took a year and 4 months.

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  27. 9:31. THAT sure beats me waiting 2 years and two months and NOT receiving all of my retro. and put on SSI & not SSDI AND taking the word of a WC adjuster that claimed that the employer would be giving me WC and did not or medical care and did not How many times is there an OFFSET? AND ANOTHER woman taken off SSDI arbitrarily with not seeing a SS doctor until two years afterwards and then waiting another 8 years only to get SSI and NO retro. This is what disabled injured workers face time and time again for 3 decades in CA.CA. being the largest state of injured disabled workers. HR is nothing more than a non profit to hire poorly trained staff for any govt or corporate entity to sabotage real work needed.

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  28. Do the ALJs use software which enables key term searching v reading the entire file?

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  29. @ 5:05 our electronic documents can be OCR'd, which works pretty well depending on the clarity/formatting/etc. of the document.

    OCR is kind of slow, and like most everything else extra slow when connected via VPN on telework, so how many judges use it? Your guess is as good as mine.

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  30. 931 PM said "My disability claim was approved after approximately 1 year and 4 months. Also I received a big check for 5 years of retroactive back pay as well as Medicare benefits. This was after the first time I filed."

    SSA only pays back 12 months from the filing date so not sure how 5 years of retro benefits were paid.

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  31. SSA's first two letter stands for "Schutzstaffel". As history had shown, they did like the disabled...

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  32. They should just get rid of the judges. TOo many of them don't do their jobs. And taxpayers suffer because of it.

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