The Coburn Report makes the following recommendations:
ALJ Consideration of Prior Agency Decision. Judge Daugherty ignored information
provided in prior decisions denying benefits and overturned those decisions by relying on
information provided by Mr. Conn and his network of doctors that the claimant was disabled.
The agency should ensure initial decisions made by the Department of Disability Services
(“DDS”) to deny benefits are well documented, with specific evidence on why the claimant
did not meet the agency’s definition of disability. The agency should consider allowing the
ALJ to contact the DDS examiner who made the prior decision in the presence of the
claimant’s representative to ask about the reasons for the prior denial. The ALJ would
remain responsible for providing a de novo review of the claim.
Strengthen ALJ Quality Review Process. Judge Daugherty’s approved decisions were not
subject to further review or the scrutiny of the appellate process, since his awards of benefits
were not appealed by the claimant. It is important the agency strengthen and expand the
review of ALJ award decisions by the Quality Division of the Office of Appellate
Operations, and that Congress provide adequate funding for that effort. The agency should
conduct more reviews during the year and improve ways of measuring the quality of
disability decisions. Such information should be made available to Congress.
Reform the Medical-Vocational Guidelines. Almost all of Judge Daugherty’s cases
reviewed by the Committee were decided based on the outdated medical-vocational
guidelines, which have not been changed since 1980. Those guidelines should be reviewed
to determine the reforms needed to update the guidelines to reflect current life expectancy
and related ability. Additional studies should be conducted to evaluate whether the current
guidelines utilize the proper factors and if they appropriately reflect a person’s ability to
work.
Prohibit Claimant Use of Doctors with Revoked or Suspended Licenses. In some cases,
the Conn law firm provided medical opinions from a doctor whose licenses had been
suspended or revoked in another state. The agency should prohibit claimants from
submitting opinions by doctors whose services, under its existing rules, the agency itself
could not accept.
Strengthen ALJ Analysis of Medical Opinions. Almost all of Judge Daugherty’s decisions
were based on a medical opinion provided by an attorney-procured medical professional.
Many times those opinions were in direct conflict with other evidence in the claimants’ files.
SSA should provide specific training with regard to how ALJs should use these types of
opinions.
Focused Training for ALJs. The Office of Appellate Operations, Quality Division, should
provide training to all ALJs regarding adequate articulation in opinions of legal
determinations. This training should emphasize the proper way to analyze and address these
issues as required by law, regulation and agency guidance, including how to address obesity
and drug and alcohol abuse.
OIG Review of Top Attorney Fee Awards. The SSA Inspector General should conduct an
annual review of the practices of the law firms earning the most attorney fees from
processing disability cases to detect any abusive conduct. The review could include
examining a sample of RFC forms from the firm’s claimants to detect repetitive language,
reviewing the licensing history of the doctors used by the law firm to provide medical
opinions, and seeing if a disproportionate number of the claimants represented by the firm
had their cases decided by a particular judge.
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