Social Security's Office of Inspector General (OIG) has issued a report on Agency Actions After the Huntington Fraud Scheme. This refers to the agency's hearing office in Huntington, WV. That office has jurisdiction over the area in Kentucky where Eric Conn practiced. The report talks about efforts made to make sure there were no other such schemes. Spoiler alert, there weren't any others. They found some things going on in Ft. Lauderdale and Harrisburg that shouldn't have been going on but those were management issues, not anything criminal. In fact, the bizarrely exceptional nature of what Conn did was one of the reasons the scheme went on as long as it did. No one in management could believe that such a preposterous scheme would be attempted.
Social Security went well beyond making sure there were no other such schemes. The agency made a deliberate attempt to influence Administrative Law Judge decision. Here are some excerpts from the report concerning those efforts -- footnotes omitted:
... In our FY 2012 report, we identified the 12 ALJs who had the highest allowance rates and the 12 who had the lowest allowance rates. The majority of the staff we interviewed attributed the variance in allowance rates to ALJs’ decisional independence and discretion when interpreting the law, as well as the demographics of the populations in the hearing offices’ service areas. In a FY 2017 we found the majority of the 24 outlier ALJs who had the highest and lowest allowance rates were no longer among the outlier ALJs because they were no longer working at the Agency or their allowance rates changed. ...
In a November 2014 report, we identified 44 outlier ALJs (about 4 percent of the average number of ALJs available in the Agency) who had 700 or more dispositions and had allowance rates of 85 percent or higher in any 2 FYs between 2007 and 2013. We conducted a sample review of favorable decisions issued by the 44 ALJs and concluded they improperly allowed disability benefits in some cases. SSA took administrative action on 15 of the 44 ALJs. ...
According to SSA, “ . . . [when] identifying outlier ALJs, OHO management (at all levels) use internal [management information] MI reports to review trends in Appeals Council remand rates, hearings held per month, hearings scheduled/hearings held, anomalous rates of favorable/unfavorable dispositions, length of time in certain docket statuses, and whether there has been a focused review for policy compliance."
When OHO managers identify an outlier ALJ, local hearing office managers may address issues with the ALJ to resolve performance. At any time, the HOCALJ may request support from regional and Headquarters ALJ performance teams for guidance, including receiving support from a Triage Assessment Group. The Group meets bi-weekly to evaluate the facts of each ALJ performance situation, including relevant management information and other documentation. The Group provides guidance for the Regional Chief ALJ and HOCALJ to take action regarding an outlier ALJ. The HOCALJ may assign an ALJ a mentor, require that an ALJ take additional training, or issue directives to correct performance. If the outlier ALJ continues having performance issues, OHO'S Office of Chief ALJ considers further action in consultation with SSA's Office of General Counsel. ...
FY 2011, the Division of Quality began conducting pre-effectuation reviews of randomly selected favorable hearing decisions before SSA made any payments to claimants. ...
SSA regional office employees conduct in-line quality reviews on a sample of hearing draft decisions to ensure the draft decisions are both policy-compliant and legally sufficient before employees submit the drafts to ALJs for signature. In-line quality review findings allow managers to provide feedback to ALJs when their decision writing instructions affect, contribute to, or cause legal sufficiency, quality, or policy-compliance errors. If hearing office managers begin to see recurring errors, they may determine training is needed for some or all of the hearing office staff and ALJs on those issues. SSA developed the in-line quality review program in 2009. Initially, SSA implemented the program in a limited number of regions because of hiring restrictions. However, in FY 2014, the Agency officially launched the program nationwide. In February 2017, SSA’s Office of the Chief ALJ informed us that the regional in-line quality reviews were temporarily suspended because of other critical work. ...
One of the CARES initiatives is Updating Decision Writing Tools and Templates, which SSA developed as part of its approach to ensuring policy compliance and national consistency in the tools its employees use to make and prepare draft decisions. Another quality assurance initiative in the CARES plan the Agency-developed is the Insight program. SSA uses Insight to identify policy compliance and internal consistency errors in hearing decisions to improve the consistency and timeliness of the disability adjudication process.45 In response to our April 2019 report,46 SSA developed metrics to conduct an analysis that showed a 31-percent reduction in quality flags for decisions where employees used Insight compared to when they did not. ...
OHO managers began monitoring national and individual ALJ agree ratesin FY 2011 to assess the level of policy-compliant, legally sufficient decisions. However, it did not set a goal until FY 2013 when OHO management established an 85-percent quality expectation goal for decisions and a 65-percent goal for dismissals.47 The decision agree rate represents the extent to which the Appeals Council concludes the ALJ decisions were supported by substantial evidence and contained no error of law or abuse that would justify a remand or reversal. ALJs who have below average agree rates may receive additional training, mentoring, and counseling and, in some cases, may be subject to further review. ... [footnotes omitted]
I know that some of this was directed at reducing the number of technical mistakes made and that's a good thing. However, it's been obvious that the whole process has been strongly tilted towards reviewing the decisions of ALJs who approve more claims than most. ALJs who approve only very few claims have drawn little or no attention. I'm not sure that the agency has even tried hard to reduce the number of technical mistakes. To give an example, if a claimant fails to appear for the hearing (in normal times) but the attorney does, the ALJ has some options but dismissing the request for hearing isn't one of them. However, ALJs commonly do dismiss in this situation. The Appeals Council will quickly remand these cases but they shouldn't happen. The regulations are clear. How much attention has Social Security paid to preventing mistakes like this? Not much that I can tell but they've sure succeeded in convincing ALJs that something bad will happen to them if they approve too many claims.