Aug 5, 2022

Such Careful Reviews

     Social Security's Office of Inspector General (OIG) has belatedly posted four reports for the time period of June and July. I had written recently about the lack of reports for that time period. Four is still far below what OIG had been averaging but better than nothing,

    Here's a quote from one of those newly posted reports, The Social Security Administration’s Appeals Council Workloads:

In FY 2020, 76 AAJs [Administrative Appeals Judges] issued approximately 85,000 total dispositions. While 22 AAJs issued fewer than 500 dispositions, 4 issued more than 2,500, see Figure 6. The number of dispositions per AAJ ranged from 3 to 3,731, and the median number was 1,064 dispositions.

    These files probably average around 1,000 pages now but one AAJ is carefully reviewing 3,731 of them a year? Yes, they have help but 3,731 in a year? Calling the Appeals Council a rubber stamp is an insult to rubber stamps.

16 comments:

Anonymous said...

Same level of care and scrutiny they give everything.

James Roy Williams said...

If the Appeals Council has already predetermined that they will deny 85-86% of the appeals regardless of the facts of each case, as they have done for some years now, why devote much time to looking at the files? After all, the net result is the same--a denial in 6 out of 7 appeals! Why spend hours looking at 1000 pages of medical records when it is easier to just use a boilerplate denial form? Just look for the one appeal out of seven to remand and say "next" to the rest of the appeals. After all, it is easier to look at the medical records for the first time when an appeal if filed in the federal court than bothering doing this at the Appeals Council level--let the Civil Actions Branch do this.

Anonymous said...

For the AAJ who issued 3,731, that's nearly 2 per hour working a 40 hour week with no time off.

Anonymous said...

If there is one thing that is consistent about social security, its inconsistency. Multiple I've seen cases remanded for a particular reason while many other cases with the same issue were simply rubberstamped.

Anonymous said...

My initial thought was maybe the person who did 3731 handled the ones that were easy dismissals, like untimely filing, appeals of fully favorable decisions, or appeals filed based on initial and recon denials before the case went to an ALJ? But with only 7% of AC dispositions in FY20 being dismissals, that is just over 1200 dismissals across the whole AC.

Anonymous said...

Many of these they never look at the medical. Look at the decision see if you can find something that doesn’t sound right, like an odd RFC restriction. Make a snide comment and send it back.
Stage 2 look at the list of exhibits is there anything new not exhibited? Send it back. Is there newer evidence exhibited? Look to see if the exhibit is referenced? It’s not? Look at the exhibit? Is likely relevant? Then send it back. The ALJ obviously didn’t consider it.

Anonymous said...

It’s a skin deep review at the AC, though I have trouble blaming the people there given the staffing levels vs. the work load. If you have a good case with a bad ALJ decision plan on going to Federal Court. It was interesting for SSA to have a 7% error rate on internal substantive review, while the Courts are finding 50%. Claimant attorneys are merit reviewing the AC denials and presumably appealing the better cases, but a 43% swing is a big difference.

Anonymous said...

My understanding is that there is an analyst that reviews every case and prepares a one ofr two page summary of the case that is transmitted to the AAJ with a recommendation. If an AAJ is not particularly interested in the cases, then it would not be particularly hard to issue two cases per hour.

The only reason they even bother to have an AAJ is that they think they need someone of at least equivalent rank to an ALJ to review the cases. Otherwise, the person drafting the summary could just do the job themselves.

This is not unlike the process at the State Agency where an Adjudicator drafts the summary for the "Doctor" who review and signs off on the result.

Simply, if the ostensible decision maker doesn't really give a sh88 quite a lot of work can be churned out

Anonymous said...

One, I agree that it is absurd that some AAJs are pumping out such ridiculous numbers. Unless you’re doing SVP 2 production work, it’s hard to imagine one person putting out 3,700 of anything.

Two, it’s interesting that I’m guessing a lot of the same people jeering the AC for rubber stamping an inordinate amount of denials were cheering the ALJs in the 2000s and early 2010s that issued 1,000-2,000+ decisions, the vast majority of which were favorable. My guess is that if the AAJs were reversing (not remanding) 3,700 decisions a year, you’d be talking about how much better they are than the ALJs and begging to let them do hearings.

Anonymous said...

I was on the AC from 82 to 87. When I arrived, one of the members (as we were called then) told me "the secret is don't take the rubber bands off the files"

In practice, we had a several page form filled out by an analyst with checkmark analysis, as well as spaces for comments at different steps. Also, in practice, the people who held the analyst job were extremely well-versed in the program, diligent and professional, and tended to take an attitude of benefit of the doubt to the claimant. The AC members, despite gallows humor about the workload, also worked hard and were conscientious in performing their work.

There is no excuse whatever for the workload the government inflicts on its workers.

Anonymous said...

As with all parts of the Agency, there are varying levels of competence or care about the quality of the cases versus quantity. What is good public service? That the agency take the time to fully develop files and issue the correct decision at the earliest point in the process, right? Why isn’t that happening? A truly meritorious case should really never get to the AC or federal court, but the volume and disincentive built into each level to actually spend the necessary time on each case, coupled by the varying degrees of competence and availability of staff and adjudicators, leads to the situation we have, where mistakes are made. Managers think hitting the numbers (x numbers of cases done per year, regardless of quality or correctness) is good public service. If you have adjudicators who think the same (“we’re making Chevys not Cadillacs”) because performance is measured by how many cases get done within a certain timeframe for everyone “on production”, then you get the cases (real people) falling through the cracks. If you have a system that treats people like widgets and widget makers, the person behind the file, i.e., the claimant or beneficiary, gets lost, because the attorney/analyst, appeals officer, administrative law judge or appeals judge does not have infinite time to review every page of every medical record or correct every error in a decision before it must go out the door - it’s a “case count” not a person who I need to care about and deciding their case correctly. The reality is that we accept a system where people fall through the cracks and some people cheat because Congress is not willing to pay for better. Within the system, there are people who take their duties seriously and some who don’t. The pressure to produce certainly makes it easier to justify quantity over quality.

Anonymous said...

People are literally just numbers

Anonymous said...

Well said 5:06.

Anonymous said...

Congress demanded metrics for every single employee, and then demanded that every employee be rated on productivity every month. Managers spend their time evaluating metrics and running analysts out the door in as near a state of at will employment as they could get to. This evolved out of the constant attacks and erosion of respect for federal workers. You try getting through a 3000 document case in 4 hours, and them preparing an order. SSA is top down managed organization which has been eroding the autonomy of its professional workforce for many years now. The result is progression to telling AAJ’s they need permission from their DCAAJ to spend more than a maximum of about 55 minutes cumulatively to finally adjudicate a case. Don’t blame the people trying to do a complex job under this type of micromanagement. Blame who you voted for in Congress who oversees SSA.

Anonymous said...

The AC behind the scenes receives communications about the expected percentage of remands. It has generally been between 85 and 90 percent — and an important reason for keeping the remand rate
low is to avoid any data suggesting that the hearing offices/overpaid-ALJs are not doing a good job. The AC is a colossal waste of the public funds. Barnhart almost succeeded in kicking it to the dustbin, but Astrue took over and got starry-eyed over Gerald Ray, who, with his amateur math skills became a Svengali-like figure convincing Astrue that the AC was the key to transforming the system. A snake oil salesman if there ever was one.

Anonymous said...

Correction- expected percentage of RR denials - aka “rubber stamps” - 85 to 90 %. Expected remand rate 10-15%