If anyone is curious, compared to 2024 the changes are:
-1% Initial +1% Recon +6% ALJ +3% AC +2% FDC
Also, for those figures I combined positive (Allow/Remand) and negative (Dismiss/Deny). Surprised ALJs ticked up, certainly doesn't feel like it on the ground.
The Federal Courts are being ttransformed by Trump Judges who never affirm Article I judges on ideological grounds, and by Obama/Biden Judges in 2nd Circuit who are still applying some version of the treating physician rule. What we don't win with ALJs we more than make up for in EAJA awards.
Those remand numbers speak for themselves for anyone viewing them objectively. Imagine an assembly line that has to send back 16% of the automobiles it produces (appeals council) or recalls 63% of its final product (federal courts). You hear many justifications for these numbers but the bottom line Is that our decisions are rife with problems, either outright errors or a failure to persuasively explain them.
Sounds better than the 9th. The vast majority of friendly judges have retired or died, and the treating physician rule has basically been entirely overturned. The new treating physician precedent is more admin-friendly than the actual regulation.
24% of ALJ determinations were dismissals last year (a very high rate compared to prior years--many had probably been pending throughout the pandemic and got dismissed when HALLEX changes made that easier). That presumably pushed the award rate in FY23 and then it rebounded as dismissals reverted to a more typical percentage.
I wonder how much of that was due to the 3+ months of the new PRW rule that 10:36 referenced. I think there is another year or two where you’ll see an uptick in favorable ALJ decisions solely applying DDS opinions to a case denied on past work outside the 5-year window. I’ve seen several OTRs on that basis.
15 of the 17 District Judges in NJ were appointed by Obama (5) and Biden (10) and to date none have demonstrated that they are particularly Claimant friendly in their Social Security decisions. It has been quite the opposite. Time will tell but you cannot assume anything from who appointed them in considering how they will approach these cases.
I'll bet you'd see more initial approvals if the big box reps would actually do a decent job on initial claims. Not enough money in getting people approved early though.
Not that I love the "big box reps" but it might be useful to consider the percentages of representation at each level. Latest figures I see are around 75% at hearing level and vastly lower at initial level. Hard to blame reps for not providing evidence before they are hired.
My case went to Federal Court and was remanded and approved. It's a shame that they ALJ couldn't interpret policy correctly, when they first had my case initially in front of them. How much time and money did it cost the SSA along with prolonged anxiety. Why doesn't the Federal Court and ALJ have a training to make ALJs more proficient in interpreting policy? To me, ALJs are like Physican assistants or Nurse Practitioners who have a limited scope of care. Sometimes they need to consult with the MD.
Voluntary remands initiated by OGC are at an all-time high, which explains the federal court remand rate. The remand rate for cases briefed by OGC is much lower.
12:45-that isn’t how the agency looks at it though. It isn’t 16% or 63% of the final product. It’s 16% of 16% (since only ~16% of the 289k cases are actually appealed to AC) and 63% of 5% of the final product (since only ~5% of the 289k cases are appealed to federal court).
While this is a yearly receipt snapshot, those percentages have been pretty consistent year over year, with about 16% of cases that make it to ALJ level getting appealed to AC and only about 5% to DC.
So, like it or not, the remands are a drop in the claims filed bucket and are within a totally acceptable margin of error for TPTB. So, when you look at this chart and wonder why nothing changes—this is why.
@5:27. That’s a very generous way of looking at it. It assumes that all of the decisions that weren’t appealed to the appeals council or federal courts were flawless. That’s a tenuous premise at best. For one, very few of the favorables are reviewed at all, yet those contain plenty of errors. Beyond that, there are many denials that aren’t appealed to the AC. And certainly the vast majority of cases denied at the AC are not appealed to federal courts. Also, the appeals council overlooks many demonstrable errors as apparently not rising to the level of their subjective “worth remanding” standard, which seems to drift from year to year, and focuses on different issues at different times. Many poor decisions are not remanded if they don’t happen to involve the current “issue du jour” receiving attention at the AC.
One illustration of the quality problem is the many voluntary remands OGC agrees to because it does not believe it can effectively defend the decision. These remands occur shortly after the decision has received the AC’s imprimatur as “A-OK.” I think you’d agree there is a problem with our process when our internal components are so often not on the same page. Also, there are many federal courts in particular districts or circuits that are conservative and affirm decisions that also have clear errors in them.
I agree that we can’t afford to remand every case with any error in it or the whole process would grind to a halt administratively. But rhat doesn’t mean we can’t acknowledge the errors and steadily try to eradicate them over the years. The OCEP training sessions, although a great improvement over the days when we had no formal refresher trainings, often simply address very basic, fundamental aspects of our law that are apparently still being widely misapplied. A lot of of those OCEP sessions have the intellectual rigor of traffic school. They don’t even get to the more complex issues
Also, It has always seemed very odd to me that there is no systematic communication between the hearing offices and OGC. You would think that a component (OGC) that had to defend the work product of another component (OHO) would be very proactive in creating multiple channels of communication in order to be more effective. But that is a very haphazard and ad hoc process in OGC/OHO, usually depending solely on the initiative of local hearing offices or regions to set up. Likewise, OHO has no user-friendly, intuitive online resource to stay abreast of what is taking place in the courts in an effective way.
The basic point I’m making is there is enormous room for improvement in the quality of our work product, yet we grade ourselves on a curve and are very slow to acknowledge & correct widespread misapplication of the law and regs.
Curious to know the portion of FDC remands that are voluntary remands. You know there is a problem with some of these high denier ALJs when their own agency can't even defend their garbage decisions in court.
The issue isn’t training. The issue is that YOUR congress and YOUR president don’t think it’s worth spending the money needed to hire enough judges to actually spend more than 15-20 minutes reviewing the medical records in your case. Instead, they‘ve decided it’s much more important to let Elon Musk and Jeff Bozo keep more of their easily and unfairly gained fortunes. And you and your fellow voters REFUSE to use your vote to demonstrate that you aren’t totally cool with this, because at least you get to dunk on trans kids or whatever.
That’s even worse then. OGC Is apparently concluding In more cases that there's not even a realistic chance to win so they don’t even bother defending it (assuming they aren’t gaming the situation to increase their winning percentage before the courts).
Or, more likely given the budget and staffing circumstances, the OGC attorneys aren’t given enough time to defend more than a small percentage of the decisions being appealed .
Why is there always a rationalization for SSA’s poor work? The very high court remand rate and the voluntary remand issue has been mentioned by management maybe twice in my decades long legal career in ssa. (Unlike the DWPI, mentioned weekly.) I get waaay more helpful info from this blog than I do from official sources within ssa.
We rarely have to really account for the quality of our work to outside sources. We are always grading our own homework. AC remands are easily shrugged off and court remands are rarely seen unless the case happens to be assigned to u. Even then it is usually years later. We r slow to react to our deficiencies. For example, it took about 5+ years after SSR 13-3p was issued for a large portion of writers and judges to “get the memo” that we are responsible for deciding disability thru the date of the decision in CDR cases. That was the cause of many remands. Likewise for ALJs still denying cases at step 1 on the basis that the claimant performed some SGA within 12 months of the decision date, as opposed to addressing the expected duration issue as of the date the work stopped. SSR 13-2 is rarely applied faithfully to this day, especially as reflected in ALJ instructions.
To the degree that time pressures influence the quality of our work, whose fault is that? As an organization we’ve done almost nothing to make file review more efficient at the hearing level (and OGC, I assume). Everybody slogs thru files like mules pulling a plough instead of risking a new-fangled tractor. IMAGEN began development about 7-8 years ago but still has not been implemented in OHO.
We ought to own up to our weaknesses and work steadily to address them. Our work basically stays the same year to year so any improvements to our process should pay benefits steadily into the future. But my personal experience is that while almost everyone works hard on individual cases day after day, very little is done or attempted systemically to make the legal aspects of our work more efficient and accurate and persuasive.
Of course, the cases being pursued to the federal district court level are likely to be the most contentious and remandable. This seems like much ado about nothing to me.
I don’t attacking writers and judges, or criticizing them for defending themselves against those personal attacks, is indicative of a lack of concern about the bigger picture. But carry on with your self-righteous crusade, bitter old timer.
@9:07 That's a good point. Reps don't get paid for a lot of work time if they lose at USDC. They have a financial incentive to carefully vet cases for merit.
24 comments:
I wonder how much this will change next year with the PRW rule change.
If anyone is curious, compared to 2024 the changes are:
-1% Initial
+1% Recon
+6% ALJ
+3% AC
+2% FDC
Also, for those figures I combined positive (Allow/Remand) and negative (Dismiss/Deny). Surprised ALJs ticked up, certainly doesn't feel like it on the ground.
The Federal Courts are being ttransformed by Trump Judges who never affirm Article I judges on ideological grounds, and by Obama/Biden Judges in 2nd Circuit who are still applying some version of the treating physician rule. What we don't win with ALJs we more than make up for in EAJA awards.
Those remand numbers speak for themselves for anyone viewing them objectively. Imagine an assembly line that has to send back 16% of the automobiles it produces (appeals council) or recalls 63% of its final product (federal courts). You hear many justifications for these numbers but the bottom line Is that our decisions are rife with problems, either outright errors or a failure to persuasively explain them.
@12:29
Sounds better than the 9th. The vast majority of friendly judges have retired or died, and the treating physician rule has basically been entirely overturned. The new treating physician precedent is more admin-friendly than the actual regulation.
24% of ALJ determinations were dismissals last year (a very high rate compared to prior years--many had probably been pending throughout the pandemic and got dismissed when HALLEX changes made that easier). That presumably pushed the award rate in FY23 and then it rebounded as dismissals reverted to a more typical percentage.
I wonder how much of that was due to the 3+ months of the new PRW rule that 10:36 referenced. I think there is another year or two where you’ll see an uptick in favorable ALJ decisions solely applying DDS opinions to a case denied on past work outside the 5-year window. I’ve seen several OTRs on that basis.
15 of the 17 District Judges in NJ were appointed by Obama (5) and Biden (10) and to date none have demonstrated that they are particularly Claimant friendly in their Social Security decisions. It has been quite the opposite. Time will tell but you cannot assume anything from who appointed them in considering how they will approach these cases.
Is there a waterfall chart that breaks out how many of the federal court remands that were voluntarily sought by the agency?
I'll bet you'd see more initial approvals if the big box reps would actually do a decent job on initial claims. Not enough money in getting people approved early though.
Not that I love the "big box reps" but it might be useful to consider the percentages of representation at each level. Latest figures I see are around 75% at hearing level and vastly lower at initial level. Hard to blame reps for not providing evidence before they are hired.
My case went to Federal Court and was remanded and approved. It's a shame that they ALJ couldn't interpret policy correctly, when they first had my case initially in front of them. How much time and money did it cost the SSA along with prolonged anxiety.
Why doesn't the Federal Court and ALJ have a training to make ALJs more proficient in interpreting policy? To me, ALJs are like Physican assistants or Nurse Practitioners who have a limited scope of care. Sometimes they need to consult with the MD.
Legit reps usually don't even take claims on the initial level. The big box reps do, that's part of their business model.
Voluntary remands initiated by OGC are at an all-time high, which explains the federal court remand rate. The remand rate for cases briefed by OGC is much lower.
12:45-that isn’t how the agency looks at it though. It isn’t 16% or 63% of the final product. It’s 16% of 16% (since only ~16% of the 289k cases are actually appealed to AC) and 63% of 5% of the final product (since only ~5% of the 289k cases are appealed to federal court).
While this is a yearly receipt snapshot, those percentages have been pretty consistent year over year, with about 16% of cases that make it to ALJ level getting appealed to AC and only about 5% to DC.
So, like it or not, the remands are a drop in the claims filed bucket and are within a totally acceptable margin of error for TPTB. So, when you look at this chart and wonder why nothing changes—this is why.
@5:27. That’s a very generous way of looking at it. It assumes that all of the decisions that weren’t appealed to the appeals council or federal courts were flawless. That’s a tenuous premise at best. For one, very few of the favorables are reviewed at all, yet those contain plenty of errors. Beyond that, there are many denials that aren’t appealed to the AC. And certainly the vast majority of cases denied at the AC are not appealed to federal courts. Also, the appeals council overlooks many demonstrable errors as apparently not rising to the level of their subjective “worth remanding” standard, which seems to drift from year to year, and focuses on different issues at different times. Many poor decisions are not remanded if they don’t happen to involve the current “issue du jour” receiving attention at the AC.
One illustration of the quality problem is the many voluntary remands OGC agrees to because it does not believe it can effectively defend the decision. These remands occur shortly after the decision has received the AC’s imprimatur as “A-OK.” I think you’d agree there is a problem with our process when our internal components are so often not on the same page. Also, there are many federal courts in particular districts or circuits that are conservative and affirm decisions that also have clear errors in them.
I agree that we can’t afford to remand every case with any error in it or the whole process would grind to a halt administratively. But rhat doesn’t mean we can’t acknowledge the errors and steadily try to eradicate them over the years. The OCEP training sessions, although a great improvement over the days when we had no formal refresher trainings, often simply address very basic, fundamental aspects of our law that are apparently still being widely misapplied. A lot of of those OCEP sessions have the intellectual rigor of traffic school. They don’t even get to the more complex issues
Also, It has always seemed very odd to me that there is no systematic communication between the hearing offices and OGC. You would think that a component (OGC) that had to defend the work product of another component (OHO) would be very proactive in creating multiple channels of communication in order to be more effective. But that is a very haphazard and ad hoc process in OGC/OHO, usually depending solely on the initiative of local hearing offices or regions to set up. Likewise, OHO has no user-friendly, intuitive online resource to stay abreast of what is taking place in the courts in an effective way.
The basic point I’m making is there is enormous room for improvement in the quality of our work product, yet we grade ourselves on a curve and are very slow to acknowledge & correct widespread misapplication of the law and regs.
Curious to know the portion of FDC remands that are voluntary remands. You know there is a problem with some of these high denier ALJs when their own agency can't even defend their garbage decisions in court.
The issue isn’t training. The issue is that YOUR congress and YOUR president don’t think it’s worth spending the money needed to hire enough judges to actually spend more than 15-20 minutes reviewing the medical records in your case. Instead, they‘ve decided it’s much more important to let Elon Musk and Jeff Bozo keep more of their easily and unfairly gained fortunes. And you and your fellow voters REFUSE to use your vote to demonstrate that you aren’t totally cool with this, because at least you get to dunk on trans kids or whatever.
That’s even worse then. OGC Is apparently concluding In more cases that there's not even a realistic chance to win so they don’t even bother defending it (assuming they aren’t gaming the situation to increase their winning percentage before the courts).
Or, more likely given the budget and staffing circumstances, the OGC attorneys aren’t given enough time to defend more than a small percentage of the decisions being appealed .
Why is there always a rationalization for SSA’s poor work? The very high court remand rate and the voluntary remand issue has been mentioned by management maybe twice in my decades long legal career in ssa. (Unlike the DWPI, mentioned weekly.) I get waaay more helpful info from this blog than I do from official sources within ssa.
We rarely have to really account for the quality of our work to outside sources. We are always grading our own homework. AC remands are easily shrugged off and court remands are rarely seen unless the case happens to be assigned to u. Even then it is usually years later. We r slow to react to our deficiencies. For example, it took about 5+ years after SSR 13-3p was issued for a large portion of writers and judges to “get the memo” that we are responsible for deciding disability thru the date of the decision in CDR cases. That was the cause of many remands. Likewise for ALJs still denying cases at step 1 on the basis that the claimant performed some SGA within 12 months of the decision date, as opposed to addressing the expected duration
issue as of the date the work
stopped. SSR 13-2 is rarely applied faithfully to this day, especially as reflected in ALJ instructions.
To the degree that time pressures influence the quality of our work, whose fault is that? As an organization we’ve done almost nothing to make file review more efficient at the hearing level (and OGC, I assume). Everybody slogs thru files like mules pulling a plough instead of risking a new-fangled tractor. IMAGEN began development about 7-8 years ago but still has not been implemented in OHO.
We ought to own up to our weaknesses and work steadily to address them. Our work basically stays the same year to year so any improvements to our process should pay benefits steadily into the future. But my personal experience is that while almost everyone works hard on individual cases day after day, very little is done or attempted systemically to make the legal aspects of our work more efficient and accurate and persuasive.
Of course, the cases being pursued to the federal district court level are likely to be the most contentious and remandable. This seems like much ado about nothing to me.
I don’t attacking writers and judges, or criticizing them for defending themselves against those personal attacks, is indicative of a lack of concern about the bigger picture. But carry on with your self-righteous crusade, bitter old timer.
@9:07 That's a good point. Reps don't get paid for a lot of work time if they lose at USDC. They have a financial incentive to carefully vet cases for merit.
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