Something that seemed innocuous at the time. SSA started stuffing Falls Church and the HOs with DO management officials. Thus, the culture of denial and disdain for the claimants infected the hearing process. Obama did not pay attention because he let CC run everything and CC was an operations girl. I don't think her intentions were to negatively impact the claimants but as they say "the road to hell is paved with good intentions" and now the hearings process has been completely infected with the DO mindset.
I live/practice in Ohio and Appalachia. For me, the biggest catalyst for change was Huntington. EVERYTHING in the region tightened up almost immediately after that 5/2011 Wall St Journal article.
I seem to remember a right wing extremist congressman from California subpoenaing a few ALJ's he thought were too easy in front of his committee and publicly humiliating them in a kangaroo show trial type proceeding. Bet nobody else in the ALJ Corp wanted to make an appearance after that. Tea Party extremist republicans put the fear of god in them much like our current immigrant political environment today. As an aside I've seen more of my people die going through the process than ever before this period we are talking about. Opiate crisis was also being misunderstood and was raging during this period making for a perfect storm for sick claimants. The key to being a first class economic competitor is to have a population that is allowed to get dumber and sicker.
I'd have no problem explaining myself to a congressional committee if I were asked to address my decisions. Admittedly, it might be easier for me than the five buffoons they paraded out there in 2014 because I know what the hell I'm doing and know how to apply the law with some semblance of competence. I'm not blindly awarding or denying benefits without being able to provide a simple explanation beyond "Credibility!"
Anyone that thinks those five were doing their job correctly and had any idea how to correctly apply the rules is either kidding themselves or doesn't know how to apply the regs/rulings themselves. I've seen CDRs from one of them and other judges with similar favorable rates, and their original decisions are regularly unsupportable.
And yes, I know the other side of the coin are the judges that are high deniers, and they likely won't face the same scrutiny these five did. But if you think competent judges would be afraid of Congress, then you're mistaken.
@11:51 am. The problem with OHO is there are now way too many district office folks who have no clue how to do anything but refers to POMS. And they don't even do that well. Hopefully, the new commissioner will correct the numerous upon numerous mistakes the prior acting commissioner made during her useless tenure as commissioner, including getting rid of the useless GS and HOD's at OHO who came from district/field offices.
2010, two years after the market crash, a huge recession, high unemployment. States scrambled and extended unemployment to periods as long as a year or more. Those caught in the early wave exhausted all forms of income, then filed a last ditch Hail Mary disability claims in mass, old shoulder injuries from high school, seizure conditions long treated with medication, naturally low back pain and depression. Lacking any real evidence other than regular doctor visits that noted the conditions being controlled by medication, the claims were denied.
The backlog trickles along with those less than significant cases, as the economy recovers, slowly over a decade, they return to work, conditions get treated under ACA with some Medicaid assistance in states that havent returned to the dark ages. Public sentiment shifts, there is a feeling that DIB has become a lifeboat, an extension of UE and the overall feeling that someone is getting something for free that I have to work for every day. Stories like Conn and a string of major newspaper stories help support that feeling that the system is being abused. In the end, 5% of the entire working population in the country is getting benefits, the trust funds are in danger, and here we sit with no solutions, little hope, and a looming feeling that we are going to get screwed when they do something.
Been an ALJ for more than a decade. I'm not sure what "oversight" has been imposed. The computers now generate a please move it along email if a case is getting stale. The HOCALJ or HOD every few months will send an email saying we are close to some goal of some sort and need cases signed that week.
I've never been told to pay more cases nor pay fewer cases, just keep 'em moving.
We do have solutions to protect the trust fund. First, remove or lift the cap on what can be taxed for social security. Second, step up immigration. There are immigrants who will do the work we won't and pay taxes. We need workers in some fields, and we can get those workers.
One word, Huntington. That certainly started the decline which was further exacerbated by the hiring of ALJs who were just happy to have a long term job in a difficult economy for lawyers generally. A large percentage were willing to drink the kool-aid they were taught in training and fostered in the ODAR/OHO offices about how most claimants are trying to cheat the system. While no one told ALJs to deny more, they were certainly massaged in that direction.
No one seems to have mentioned that more and more unemployed people apply for benefits during a recession. 2010 was the year those denials finally started arriving in ODAR. Unemployment does not equate to disability. Nevertheless, the comments regarding Huntington, WV, and not mentioned: Ponce, PR; Queens, NY, etc., all contributed to a management focus on reestablishing a QA/QR program at the Regional Level and Own Motion Review program at the Appeals Council that focused the agency on quality decisions rather than quantity. The ALJ error rate for favorable reversals was over 22% in the early days of 2010, but within a year rose to less than 10%. Moreover, the agency all but cancelled its Senior Attorney adjudication program-- centralizing it into a National Adjudication Team to have better control and oversight of FREVs. There were many factors that led to the decrease in favorable reversals, and it is not as simple as any one answer may provide.
It really was a confluence of events. Some have already been mentioned: 1. End of Recession. As one poster noted, 2010 saw the nation beginning to emerge from the great recession. With UE benefits expiring but jobs in short supply, many were filing for DIB in hopes of some income before they could secure a job. I saw the quality of applications go down around that time. 1. Huntington. The fall out can't be understated. The agency was under incredible scrutiny, given the publicity of Huntington and other less publicized articles about ALJs paying lots of cases (Harrisburg and Pittsburgh are two I can recall). The agency was obsessed with this issue, and in my opinion, swung the pendulum to the other side. When I was Chief Judge in 2006, we instituted a few initiatives to not only eat at the back end of the backlog (oldest first) but also to triage the front end and pay those folks quickly who were obviously disabled. An example of this was the durational denial intiative, where we culled all the cases pending at the hearings level that had been denied by DDS based on duration (person was disabled but not expected to last 12 months). The allowance rate on those cases was incredible - I believe it was over 80%. We also looked at certain impairments that had historically high allowance rates, which was a precursor to the compassionate allowance program started by the next Commissioner, Mike Astrue. I also initiated an expedited fully favorable template from my FIT (findings integrated template) system. This was a template designed to allow the ALJs to convert their notes into a favorable decision format. The beauty of this was that it was designed for legal sufficency and saved resources and time. Decision writers could focus on the unfavorable drafts, and folks who were allowed would not have their cases languish in writing but instead get their benefits faster. It was a win-win. As an ALJ I wrote almost all of my favorables with this template. These kinds of initiatives were halted after Huntington, as the agency did not want to be criticized by a hard right Congress that was micromanaging any move that would pay claimants. Quality units were installed at the Regional level overseeing ALJ cases before they were finalized, and the AC began to require robust favorable decisions that mirrored unfavorables (e.g., all opinions, pro and con, needed to be addressed, along with a detailed credibility analysis). 3. The 2010 Congress. With the republicans regaining control of the House, oversight hearings dealt almost exclusively with fraud and then the fall out of Huntington. Congress was obsessed with the high paying ALJs. Focus was on the hearing level. The backlog took a backseat, with the Agency taking marching orders to focus on "quality". I am sure there are other variables that contributed to the allowance rate drop.
The 2009 recession could be a reason. Many filed disability claims simply because they could not get a job. But those trickled away around the mid 2010s as unemployment went down.
Around maybe 2014-15, I did see a trend of most new ALJs coming out of the box denying. When I first started in this business around 2005, most new ALJs came out of the box granting too much. Most eventually settled into what they were destined to grant.
I figured there was some tweak in training from Astrue with the newer ALJs. I remember an ALJ who was a writer become an ALJ and grant like 30 percent. But he eventually went up to around normal 40-50 percent. He is a good ALJ and just seemed to be trained to deny.
The other perspective seldom mentioned on this blog is that SSA hired new judges that correctly interpreted and applied the law rather than just assuming everyone who applies must be disabled or simply going with their gut based on hearing testimony without concern for any evidentiary standards.
8:06 I disagree. The more experienced judges I appear in front of start a hearing with an open mind looking to answer the question: "Is this person disabled?"
The newer judges assume the person is not disabled, and look for evidence that will support their position. I am tired of walking into the hearing room and having a Judge focus on one mention of cocaine use in 1998 or that my client went to their son's wedding in 2017 in another state as proof that the claimant is obviously not disabled.
Well, 1:01, hopefully those new judges eventually learn that there's a presumption of disability unless SSA can overcome its burden of proof with clear and convincing evidence. Then they can learn that testimony can replace medical evidence, that if you like someone you can find them disabled, that if someone has a 100% rating from the VA this other government program should simply accept and adopt it, and that if it's a T2 case, you should probably just give the people their money since it is their money. It would certainly make things easier for those new judges if they could figure these things out.
We have very few real fair hearings now, but I've had a few where the judge really looks at the claimant and notes that this person really appears disabled. They usually will send this person out tor a CE to see what the person can and cannot do.
3:30 PM. ..."where the judge really looks at the claimant and notes that this person really appears disabled." Do you understand the fallacy of your point? You normally can't SEE disability. Sure, you can see that someone is missing a limb, but that doesn't necessarily translate into disability (in terms of the ability to achieve SGA). Have you heard of Jim Abbott? Naturally, he was the exception. However, for the most part, you can't see pain or mental illness. You can't see heart disease. Unlessntheybarevhaving a migraine or seizure during the hearing, you cant see those either. This is why witness statements need to be given more weight. Only SSA disregards the testimony of witnesses. Many legal cases are decided SOLELY on the testimony of witnesses.
Something that seemed innocuous at the time. SSA started stuffing Falls Church and the HOs with DO management officials. Thus, the culture of denial and disdain for the claimants infected the hearing process. Obama did not pay attention because he let CC run everything and CC was an operations girl. I don't think her intentions were to negatively impact the claimants but as they say "the road to hell is paved with good intentions" and now the hearings process has been completely infected with the DO mindset.
ReplyDeletePatient Protection and Affordable Care Act.
ReplyDeleteThe claimant no longer came in with a couple ER visits and one or two charitable clinic visits. Claimants now had medical visits and treatment.
Uncontrolled hypertension that resulted in strokes or TIA's or kidney complications became controlled.
Orthopedic issues managed with a cane and occasional pain meds received physical therapy and or surgery.
I live/practice in Ohio and Appalachia. For me, the biggest catalyst for change was Huntington. EVERYTHING in the region tightened up almost immediately after that 5/2011 Wall St Journal article.
ReplyDeleteI seem to remember a right wing extremist congressman from California subpoenaing a few ALJ's he thought were too easy in front of his committee and publicly humiliating them in a kangaroo show trial type proceeding. Bet nobody else in the ALJ Corp wanted to make an appearance after that. Tea Party extremist republicans put the fear of god in them much like our current immigrant political environment today. As an aside I've seen more of my people die going through the process than ever before this period we are talking about. Opiate crisis was also being misunderstood and was raging during this period making for a perfect storm for sick claimants. The key to being a first class economic competitor is to have a population that is allowed to get dumber and sicker.
ReplyDelete@2:06
ReplyDeleteI'd have no problem explaining myself to a congressional committee if I were asked to address my decisions. Admittedly, it might be easier for me than the five buffoons they paraded out there in 2014 because I know what the hell I'm doing and know how to apply the law with some semblance of competence. I'm not blindly awarding or denying benefits without being able to provide a simple explanation beyond "Credibility!"
Anyone that thinks those five were doing their job correctly and had any idea how to correctly apply the rules is either kidding themselves or doesn't know how to apply the regs/rulings themselves. I've seen CDRs from one of them and other judges with similar favorable rates, and their original decisions are regularly unsupportable.
And yes, I know the other side of the coin are the judges that are high deniers, and they likely won't face the same scrutiny these five did. But if you think competent judges would be afraid of Congress, then you're mistaken.
@11:51 am. The problem with OHO is there are now way too many district office folks who have no clue how to do anything but refers to POMS. And they don't even do that well. Hopefully, the new commissioner will correct the numerous upon numerous mistakes the prior acting commissioner made during her useless tenure as commissioner, including getting rid of the useless GS and HOD's at OHO who came from district/field offices.
ReplyDelete2010, two years after the market crash, a huge recession, high unemployment. States scrambled and extended unemployment to periods as long as a year or more. Those caught in the early wave exhausted all forms of income, then filed a last ditch Hail Mary disability claims in mass, old shoulder injuries from high school, seizure conditions long treated with medication, naturally low back pain and depression. Lacking any real evidence other than regular doctor visits that noted the conditions being controlled by medication, the claims were denied.
ReplyDeleteThe backlog trickles along with those less than significant cases, as the economy recovers, slowly over a decade, they return to work, conditions get treated under ACA with some Medicaid assistance in states that havent returned to the dark ages. Public sentiment shifts, there is a feeling that DIB has become a lifeboat, an extension of UE and the overall feeling that someone is getting something for free that I have to work for every day. Stories like Conn and a string of major newspaper stories help support that feeling that the system is being abused. In the end, 5% of the entire working population in the country is getting benefits, the trust funds are in danger, and here we sit with no solutions, little hope, and a looming feeling that we are going to get screwed when they do something.
https://www.cbpp.org/blog/disability-allowance-rates-fall-as-social-security-strengthens-oversight-of-hearings
ReplyDeleteBeen an ALJ for more than a decade. I'm not sure what "oversight" has been imposed. The computers now generate a please move it along email if a case is getting stale. The HOCALJ or HOD every few months will send an email saying we are close to some goal of some sort and need cases signed that week.
ReplyDeleteI've never been told to pay more cases nor pay fewer cases, just keep 'em moving.
We do have solutions to protect the trust fund. First, remove or lift the cap on what can be taxed for social security. Second, step up immigration. There are immigrants who will do the work we won't and pay taxes. We need workers in some fields, and we can get those workers.
ReplyDeleteOne word, Huntington. That certainly started the decline which was further exacerbated by the hiring of ALJs who were just happy to have a long term job in a difficult economy for lawyers generally. A large percentage were willing to drink the kool-aid they were taught in training and fostered in the ODAR/OHO offices about how most claimants are trying to cheat the system. While no one told ALJs to deny more, they were certainly massaged in that direction.
ReplyDeleteNo one seems to have mentioned that more and more unemployed people apply for benefits during a recession. 2010 was the year those denials finally started arriving in ODAR. Unemployment does not equate to disability. Nevertheless, the comments regarding Huntington, WV, and not mentioned: Ponce, PR; Queens, NY, etc., all contributed to a management focus on reestablishing a QA/QR program at the Regional Level and Own Motion Review program at the Appeals Council that focused the agency on quality decisions rather than quantity. The ALJ error rate for favorable reversals was over 22% in the early days of 2010, but within a year rose to less than 10%. Moreover, the agency all but cancelled its Senior Attorney adjudication program-- centralizing it into a National Adjudication Team to have better control and oversight of FREVs. There were many factors that led to the decrease in favorable reversals, and it is not as simple as any one answer may provide.
ReplyDeleteIt really was a confluence of events. Some have already been mentioned:
ReplyDelete1. End of Recession. As one poster noted, 2010 saw the nation beginning to emerge from the great recession. With UE benefits expiring but jobs in short supply, many were filing for DIB in hopes of some income before they could secure a job. I saw the quality of applications go down around that time.
1. Huntington. The fall out can't be understated. The agency was under incredible scrutiny, given the publicity of Huntington and other less publicized articles about ALJs paying lots of cases (Harrisburg and Pittsburgh are two I can recall). The agency was obsessed with this issue, and in my opinion, swung the pendulum to the other side. When I was Chief Judge in 2006, we instituted a few initiatives to not only eat at the back end of the backlog (oldest first) but also to triage the front end and pay those folks quickly who were obviously disabled. An example of this was the durational denial intiative, where we culled all the cases pending at the hearings level that had been denied by DDS based on duration (person was disabled but not expected to last 12 months). The allowance rate on those cases was incredible - I believe it was over 80%. We also looked at certain impairments that had historically high allowance rates, which was a precursor to the compassionate allowance program started by the next Commissioner, Mike Astrue. I also initiated an expedited fully favorable template from my FIT (findings integrated template) system. This was a template designed to allow the ALJs to convert their notes into a favorable decision format. The beauty of this was that it was designed for legal sufficency and saved resources and time. Decision writers could focus on the unfavorable drafts, and folks who were allowed would not have their cases languish in writing but instead get their benefits faster. It was a win-win. As an ALJ I wrote almost all of my favorables with this template. These kinds of initiatives were halted after Huntington, as the agency did not want to be criticized by a hard right Congress that was micromanaging any move that would pay claimants. Quality units were installed at the Regional level overseeing ALJ cases before they were finalized, and the AC began to require robust favorable decisions that mirrored unfavorables (e.g., all opinions, pro and con, needed to be addressed, along with a detailed credibility analysis).
3. The 2010 Congress. With the republicans regaining control of the House, oversight hearings dealt almost exclusively with fraud and then the fall out of Huntington. Congress was obsessed with the high paying ALJs. Focus was on the hearing level. The backlog took a backseat, with the Agency taking marching orders to focus on "quality".
I am sure there are other variables that contributed to the allowance rate drop.
The 2009 recession could be a reason. Many filed disability claims simply because they could not get a job. But those trickled away around the mid 2010s as unemployment went down.
ReplyDeleteAround maybe 2014-15, I did see a trend of most new ALJs coming out of the box denying. When I first started in this business around 2005, most new ALJs came out of the box granting too much. Most eventually settled into what they were destined to grant.
I figured there was some tweak in training from Astrue with the newer ALJs. I remember an ALJ who was a writer become an ALJ and grant like 30 percent. But he eventually went up to around normal 40-50 percent. He is a good ALJ and just seemed to be trained to deny.
@10:07
ReplyDeleteThe other perspective seldom mentioned on this blog is that SSA hired new judges that correctly interpreted and applied the law rather than just assuming everyone who applies must be disabled or simply going with their gut based on hearing testimony without concern for any evidentiary standards.
8:06 I disagree. The more experienced judges I appear in front of start a hearing with an open mind looking to answer the question: "Is this person disabled?"
ReplyDeleteThe newer judges assume the person is not disabled, and look for evidence that will support their position. I am tired of walking into the hearing room and having a Judge focus on one mention of cocaine use in 1998 or that my client went to their son's wedding in 2017 in another state as proof that the claimant is obviously not disabled.
Well, 1:01, hopefully those new judges eventually learn that there's a presumption of disability unless SSA can overcome its burden of proof with clear and convincing evidence. Then they can learn that testimony can replace medical evidence, that if you like someone you can find them disabled, that if someone has a 100% rating from the VA this other government program should simply accept and adopt it, and that if it's a T2 case, you should probably just give the people their money since it is their money. It would certainly make things easier for those new judges if they could figure these things out.
ReplyDeleteWe have very few real fair hearings now, but I've had a few where the judge really looks at the claimant and notes that this person really appears disabled. They usually will send this person out tor a CE to see what the person can and cannot do.
ReplyDelete3:30 PM. ..."where the judge really looks at the claimant and notes that this person really appears disabled." Do you understand the fallacy of your point? You normally can't SEE disability. Sure, you can see that someone is missing a limb, but that doesn't necessarily translate into disability (in terms of the ability to achieve SGA). Have you heard of Jim Abbott? Naturally, he was the exception. However, for the most part, you can't see pain or mental illness. You can't see heart disease. Unlessntheybarevhaving a migraine or seizure during the hearing, you cant see those either. This is why witness statements need to be given more weight. Only SSA disregards the testimony of witnesses. Many legal cases are decided SOLELY on the testimony of witnesses.
ReplyDelete