May as well just start issuing proposed remand order and $7,000+ checks for EAJA fees along with every denial. This is what a decade of management failures and inertia has brought us.
I think it's generally true that a federal court remand demonstrates a failure of the Appeals Council. And it's less often--but still frequently--true that an ALJ award demonstrates a failure of the DDS. I cut the DDS some slack though: they don't have VEs and their job is really just to make decisions fast and award the obvious yeses. Plus a lot of claimants don't get represented until the ALJ level and don't fill out the forms well or track down the medical records when the providers don't respond to a DDS request.
Pretty amazing to see almost a quarter of ALJ dispos were dismissals and they still didn't hit a quarter million. There is such a buildup at initial and recon, and when the dam breaks it's going to flood OHO.
The high rate of federal court remands is a direct consequence of the decision to plow ahead with implementation of DWPI during the last decade, and leadership’s stubborn refusal to acknowledge reality and make adjustments to the productivity standards commensurate with increases in file sizes. Any competent leader would’ve seen this coming from the get-go. But it’s been a long time since OHO had one of those.
11:31, if that were true, wouldn't we see federal court remand rates going down over the past couple years with ALJs making far fewer decisions than they used to?
Part of me always wonders at the reporting of these numbers with the remand percentages based on the appeal number & not the total applications filed. So, at AC, remands are 13% compared to the 49000 appealed, but if you crunch the number against the 1.9M filed, it’s 2%. 61% at DC of the 15000 appealed, but less than 1% of applications filed.
Even saying something to the effect of, of 1.9M applications filed only about 13% are get appealed to an ALJ puts the numbers in a light more favorable to SSA.
Not saying massaging the numbers like that would be the right thing to do, but you could provide all of the same information used here AND that information. Seems that would be information SSA could use to crow about their workload volumes and success at a macro level, which they seem happy to do in most other situations.
No. DWPI is wholly unrelated to the number of dispositions issued by ALJs. It dictates the speed at which writers must review the files and write the decisions, and the lack of adequate time for that process is the primary cause of court remands. (AC remands are simply random and occur at a predetermined rate according to OAO’s quotas)
It’s a tool prepared to serve as an indicator of accuracy and legal sufficiency, and I think most reasonable people realize that the rate at which claims are appealed has little to do with either of those things, and more to do with luck, tenacity and financial circumstances.
I think the problem of tracking these numbers is these are not the same claims from the same year. So it would not be accurate to say of these 1.9 million filed, x% were appealed because it is not all from this year's 1.9 million but includes an earlier x millions. So the percent of whatever is handled at each step is the best you can show.
It’s interesting when I see these numbers. A lot of commenters on this blog in other posts seem to believe that the high number of court remands occur because ALJs are clearly getting the decisions wrong. If that were actually true, the reversal rate would be far higher than 1%.
The number of remands is directly related to the number of legal errors committed which occur in the majority of cases, not the minority. The overall remand rate at the AC changes based on management priorities and policy clarifications from circuit trends and press, but denials are presumed to be the majority of outcomes using post hoc rationalization to support the concept of "harmless error" because no one has the time or inclination to appropriately articulate their conclusions and/or that articulation would inevitably reveal flawed logic or a misunderstanding of medicine.
99% of ALJ decisions contain some legal error, and yet the remand rate is this small. It's because of production quotas, duh.
11 comments:
May as well just start issuing proposed remand order and $7,000+ checks for EAJA fees along with every denial. This is what a decade of management failures and inertia has brought us.
I think it's generally true that a federal court remand demonstrates a failure of the Appeals Council. And it's less often--but still frequently--true that an ALJ award demonstrates a failure of the DDS. I cut the DDS some slack though: they don't have VEs and their job is really just to make decisions fast and award the obvious yeses. Plus a lot of claimants don't get represented until the ALJ level and don't fill out the forms well or track down the medical records when the providers don't respond to a DDS request.
Pretty amazing to see almost a quarter of ALJ dispos were dismissals and they still didn't hit a quarter million. There is such a buildup at initial and recon, and when the dam breaks it's going to flood OHO.
The high rate of federal court remands is a direct consequence of the decision to plow ahead with implementation of DWPI during the last decade, and leadership’s stubborn refusal to acknowledge reality and make adjustments to the productivity standards commensurate with increases in file sizes. Any competent leader would’ve seen this coming from the get-go. But it’s been a long time since OHO had one of those.
11:31, if that were true, wouldn't we see federal court remand rates going down over the past couple years with ALJs making far fewer decisions than they used to?
Part of me always wonders at the reporting of these numbers with the remand percentages based on the appeal number & not the total applications filed. So, at AC, remands are 13% compared to the 49000 appealed, but if you crunch the number against the 1.9M filed, it’s 2%. 61% at DC of the 15000 appealed, but less than 1% of applications filed.
Even saying something to the effect of, of 1.9M applications filed only about 13% are get appealed to an ALJ puts the numbers in a light more favorable to SSA.
Not saying massaging the numbers like that would be the right thing to do, but you could provide all of the same information used here AND that information. Seems that would be information SSA could use to crow about their workload volumes and success at a macro level, which they seem happy to do in most other situations.
No. DWPI is wholly unrelated to the number of dispositions issued by ALJs. It dictates the speed at which writers must review the files and write the decisions, and the lack of adequate time for that process is the primary cause of court remands. (AC remands are simply random and occur at a predetermined rate according to OAO’s quotas)
It’s a tool prepared to serve as an indicator of accuracy and legal sufficiency, and I think most reasonable people realize that the rate at which claims are appealed has little to do with either of those things, and more to do with luck, tenacity and financial circumstances.
I think the problem of tracking these numbers is these are not the same claims from the same year. So it would not be accurate to say of these 1.9 million filed, x% were appealed because it is not all from this year's 1.9 million but includes an earlier x millions. So the percent of whatever is handled at each step is the best you can show.
It’s interesting when I see these numbers. A lot of commenters on this blog in other posts seem to believe that the high number of court remands occur because ALJs are clearly getting the decisions wrong. If that were actually true, the reversal rate would be far higher than 1%.
The number of remands is directly related to the number of legal errors committed which occur in the majority of cases, not the minority. The overall remand rate at the AC changes based on management priorities and policy clarifications from circuit trends and press, but denials are presumed to be the majority of outcomes using post hoc rationalization to support the concept of "harmless error" because no one has the time or inclination to appropriately articulate their conclusions and/or that articulation would inevitably reveal flawed logic or a misunderstanding of medicine.
99% of ALJ decisions contain some legal error, and yet the remand rate is this small. It's because of production quotas, duh.
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