Aug 20, 2017

Be Careful What You Ask For

     I heard recently from an attorney who requested some medical records on his client from a hospital. The hospital sent the attorney a good deal more than he requested but it was all on his client. It came to 12,000 pages. If we didn't have regulations requiring that EVERTHING be submitted, the attorney would have culled out the records than hadn't been requested, records that weren't material to the determination of disability such as nurses notes, medication records, endless lab tests, etc, but he can't do that now. He's submitting the whole thing.

18 comments:

Tim said...

Totally ABSURD!!! They are so afraid that you'll exclude opinions of doctors that don't fully support everything you claim. Well, that is often because doctors really have only a book knowledge of many medical conditions. My experiences have shown me that many don't really understand what some people have to live with. I have found this often to be true whether it was epilepsy, ankylosing spondylitis, fibromyalgia or dry eye syndrome. The doctors who have actually experienced or have a sibling who has are far more understanding! Maybe I've just had too many arrogant doctors that think they know it all! And too many that seem to not really care! Too many that treat you for a few years, then tell you,"Well, I don't believe in fibromyalgia!" I don't know what fibromyalgia is either, but SOMETHING is causing all this pain! And then there are the doctors that tell you they're trying to help you, but then won't, and tell you "I don't do that." I consider that dishonest, because they've known for 5 years that your ability to work has been greatly diminishing and that disability was inevitable. Here's a thought: let us bring these doctors in and crossexamine them. With a jury instead of an ALJ getting to decide your fate. And if it takes six months to get it right... After waiting 3 years for a hearing, is getting it RIGHT too much to ask?

Tim said...

I also think that one of the possible reasons for wanting to increase the backlogs is to increase the entire appeals process. If they can keep denying you long enough, eventually the claimants will be in a no win scenario: keep appealing your original case in the hope to preserve $30,000 or more of back benefits or file a new case to preserve SSDI instead of SSI (due to date of last insured). Either way, they can screw you out of what you paid the insurance for! The only way to stop this is to make the government pay. ALL lawyers fees paid by SS with no cap! New evidence can be entered and must be considered. No date of last insured for those who have been unable to do SGA since their initial application, especially if they haven't been able to work at all! You wouldn't let an insurance company get out of paying what all they owe just by running out the clock, would you? How about forcing an ALJ to reconsider his decision if evidence can be obtained after his decision that addresses his excuse for denial?

Anonymous said...

And what about the cost of 12,000 pages of records? That's obscene.

Anonymous said...

I can also imagine a few attorneys submitting all 12k pages without any attempt at redaction with a sadly familiar argument that their client must be disabled with all those medical records.

Anonymous said...

It is doubtful that these records don't contain thousands of pages that are not relevant and probably many that are remote. A professional would call OHO and ask for guidance. A cover letter explaining that records covering earlier periods are available and will be submitted would suffice. I would not tell OHO to stick it.

Anonymous said...

Contact the ALJ and see if he or she will allow culling of the documents.

Anonymous said...

@ 3:00, you're on the right track. a simple call to the hearing office to discuss with the assigned ALJ would probably result in a simple solution...submit what is relevant and briefly summarize the rest.

Anonymous said...

If I knew there were 12K pages I certainly would not ask for them all. As long as you tell the ALJ that your request was limited and inform of the source so he/she can get the extras if they want, my understanding is that you have complied with the new rule. Plus you have not incurred exorbitant costs.

Anonymous said...

ALJ denies the application because on page 9659 the patient told a nurse he was "doing great." Treating source given some weight because of apparent conflict between the medical source statement and the claimant's self-reported condition of "doing great." Significant weight given to non-examining physician who says the claimant can crawl frequently on his shiny new knees and hips.

Anonymous said...

It's often hard to cull records like this, because they all run together. If you take pages out, you're breaking up the flow of the record.

Anonymous said...

I do worker compensation also and we usually have over a thousand pages per case by the time there is a hearing. I have been chastised by judges for turning in so many records.

Anonymous said...

Just try and get life insurance with a medical diagnosis of fibromyalgia when they ask you if it is slight moderate or severe ( they, the insurer called it terminal) meaning fibro, takes completely over the whole body at some point. Being denied life insurance on that basis, means as always, the insurers, including the SSA/Medicare certainly knows more than what many of us do not and as usual, the deny all of it for whatever reason for insurer profitability.

I sure would like to know how the attorney got 12,000 pages when a self rep asks for their own records and the SSA either states, one has to identify a specific record ( how would one even know what to ask for what specific form) OR the SSA just flats out denies any request even under FOIA or the Privacy Act Request.
Getting 12,000 records is a tactic a corporate legal department would think of to muck up a legitimate claim.

Anonymous said...

@1:39

It is not optional.

@3:03

It is not a tactic to submit 12,000 pages. The regulations require it, unless you are certain the evidence does not relate to the claim or is duplicate. 20 CFR § 404.1512(c) states: "You must inform us about or submit all evidence known to you that relates to whether or not you are blind or disabled..." You also cannot be certain what evidence does not relate to the claim. You can reduce the records to a degree by culling out duplicate records, but that can only go so far. Submitting that much evidence could muck up a claim, but that's the requirement. The muck can be reduced with proper briefing.

Anonymous said...

It's one 12k-page file out of 650k+ hearing requests. That's not to say that there aren't other files of 10k or more pages, but frankly, it's a rarity. It's rarer than documented fraud, which is railed against on this blog time and time again as insignificant. It sucks for the judge, but that's why he/she gets paid the big bucks every two weeks.

Anonymous said...

We need to go to a national medical record database. Only accessible through HIPPA access and some kind of encryption. Then, doctors, patients, attorneys, etc., could access these medical records.

Tim said...

7:40 PM. Many medical places know give access to your own records and/or provide you a copy. However, that still doesn't prevent a doctor from telling you one thing and your records something else. Doctors often overstate the effectiveness of their treatments, don't put in a third of what you tell them and don't spell out how impactful the symptoms are. For example, my eyes have increasingly had irritations, which causes headaches, dizziness and migraines (3-5 a month, lasting hours: only relief was sleeping, usually 10-14 hours, meaning one migraine could cause up to 2 days of lost work). Doctor who "treated" me for 8 years wrote: has dry eye syndrome. Responded well to gell drops.

Anonymous said...

How much time would be saved by a universal medical record form. Everyone using the same form with the information in the same place every time. Not just for disability, but for medical case review by treating physicians. It would be handy for insurance, workers comp, all types of things and save companies money on forms. Instead we have a hodge podge of forms and records, no uniformity and plenty of space on forms and records to be ignored. Sloppy and stupid.

Anonymous said...

I thought computerized records was going to be helpful, but it's not. The judges I know do not want 12,000 pages. I always keep what I don't submit, so anyone who cares to can see that I didn't withhold relevant information. VA records and some of the records from our hospital are horrible. I know the judge doesn't need 6 pages explaining what nurse entered the information. I submit the doctor's statement of problems and any lab reports. I have told judges that there may be more visits but they repeat what is already there. Since my fax only likes to do 30 pages at a time, I am going to review what I fax. Particularly in VA records, I have found many single pages that simply state "end of report". Even with my editing, records submitted are more voluminous that in previous years, and I know that some records look like duplicates when they aren't, but I'm going to check records before I send them.