C-Span video library link to today's Senate committee hrg

[Deleted]

I don't need to be taught one thing from a person who does 3,500 cases a year and I know that was a joke, but somewhere over 1,000 should of raised a few flags from everything that I have read on this board.

[workdrone]

Oct 7, 2013 16:05:37 GMT -5 bartleby said:

Outliers are not always an indication of trouble. One ALJ was doing 3,500 cases a year. His denial/pay rate was no different than anyone else. His remand rate was no different than anyone else (although 10% of 3,500 cases seems like a lot more than 10% of 500 cases a year, the percentages are the same). He was not receiving any kick back at all. He felt that his job was to move cases for the climants. Others were not so happy with his public service.. He has been limited to 840 cases this year. Why ride someone for doing 400 cases a year instead of 500 and then limit someone that can do 3,500 cases a year to 840. Is something wrong with this scenario??

Bart you're really being a hypocrite here. If my memory serves me, you have been whining forever about how hard it is to meet 500-700 and how the case files are so huge and the writers are so bad that it's all but impossible. And now you're blaming the Agency for reining in McGrath?

So what is it? If the process is so hard that 500 a year is unreasonable, why are you defending someone who was doing 3500? If his methodology is the way we're suppose to do case, we don't need ALJs. Flipping quarters would work just fine.

[Deleted]

Workdrone, I didn't want to go there, but that was my first thought also! But everyone says I am too blunt, drunk or stupid, so I was going to leave that one alone, but we are here anyway!

[Gaidin]

I won't comment on the appropriateness of a judge doing 3,500 a year. What I will say is that sometimes outliers are fine and don't represent problems. However, looking at your outliers will almost always get you to the bulk of your problems.

I have seen to many data analysts identify without my prompting identify the exact doctors I knew were over prescribing or committing fraud.

[bartleby]

My point is that there is no magic number that signifies problems and no one number fits everyone. If you read my post, you will see that I am not criticizing anyone, so why the ad hominien attacks? Some feel 3,500 is doable, some feel 500 is doable and others feel 350-400 is doable. We all have our own strengths and weaknesses. This does not require personal attacks from anyone. Workdrone, I don't know what your problem is with me personally, but I wish you would knock it off. I also don't know why you insist on dropping names and revealing people. The Judge with the 3,500 did not have to be named.

[Orly]

Oct 7, 2013 13:55:42 GMT -5 mcb said:

www.hsgac.senate.gov/hearings/social-security-disability-benefits-did-a-group-of-judges-doctors-and-lawyers-abuse-programs-for-the-countrys-most-vulnerable

Wow.

After reading the report, I realized that I haven't been this angry in a long while. Nothing like finding a breach of trust to get the blood boiling. If we're only as good as our weakest link, I'm going to find a hole and hide for a while.

Assuming the allegations therein can be proven beyond a reasonable doubt, I foresee a new beginning for Messrs. Daugherty and Conn.

[Deleted]

Oct 7, 2013 20:16:52 GMT -5 Orly said:

Oct 7, 2013 13:55:42 GMT -5 mcb said:

www.hsgac.senate.gov/hearings/social-security-disability-benefits-did-a-group-of-judges-doctors-and-lawyers-abuse-programs-for-the-countrys-most-vulnerable

Wow.

After reading the report, I realized that I haven't been this angry in a long while. Nothing like finding a breach of trust to get the blood boiling. If we're only as good as our weakest link, I'm going to find a hole and hide for a while.

Assuming the allegations therein can be proven beyond a reasonable doubt, I foresee a new beginning for Messrs. Daugherty and Conn.

Unfortunately, you do not need "beyond a reasonable doubt" in the Federal Courts, just the sheer weight of the Feds will force most Defendants to voluntarily spent time in Federal prison to avoid a trial and a much longer jail sentence. Conn and the ALJ will agree to time if the DOJ comes after them, I am willing to bet a few bucks on that issue.

[Orly]

Oct 7, 2013 21:52:09 GMT -5 @tigerlaw said:

Conn and the ALJ will agree to time if the DOJ comes after them, I am willing to bet a few bucks on that issue.

4.5 million dollars in attorney's fees from Daugherty's cases alone since 2006 is not chump change, not to mention the potential billions of dollars in lifetime benefits. If there are indeed money changing hands for this, then it's definitely criminal. In light of the severity of the allegations and the level of media attention, I would be shocked if the DOJ doesn't go after them.

Just for fun, I looked up the federal sentencing guideline for bribery:

No prior criminal history (I)

+14 pts for public official
+ 2 involving more than one bribe
+ 4 pts for public official in a high-level decision-making or sensitive position
+18 pts for loss to government exceeding $2.5 million based on attorney's fees alone (per table in §2B1.1)
+ 2 pts for abuse of trust

Total: 40 pts without any additional charges or other mitigating or aggravating factors.

This puts a hypothetical defendant in zone D at 292-365 months (24.3 - 30.4 years) range and a forfeiture of $25,000 - $250,000. For someone in their late 70s, this is basically a life sentence.

It will be very interesting to see what happens next, and I hope justice will be served.

[mcb]

Oct 7, 2013 22:35:47 GMT -5 Orly said:

It will be very interesting to see what happens next, and I hope justice will be served.

The ALJ is at least 75 years old (not that that should make any difference). Ask Bernie Maddow.

BTW, to say I was flabbergasted by this report is an understatement.

[eyre44]

Oct 7, 2013 19:28:54 GMT -5 bartleby said:

My point is that there is no magic number that signifies problems and no one number fits everyone. If you read my post, you will see that I am not criticizing anyone, so why the ad hominien attacks? Some feel 3,500 is doable, some feel 500 is doable and others feel 350-400 is doable. We all have our own strengths and weaknesses. This does not require personal attacks from anyone. Workdrone, I don't know what your problem is with me personally, but I wish you would knock it off. I also don't know why you insist on dropping names and revealing people. The Judge with the 3,500 did not have to be named.

I'm all for considering the individual situation and office when looking at the quotas being imposed on Judges at ODAR. I was the one harping on that in another thread. However, there is a point where that goes too far.  Is 1 decision a year enough? Are 3500 decisions too many? Most would agree that both these extremes are not appropriate for ODAR judges. To quote Justice Stewart, "I know it when I see it," and I know that 3500 cases a year is too many to give claimants a full and fair hearing where they believe they have truly been heard.

I agree with Gaidin that outliers should be scrutinized more closely. Unfortunately, in the past ODAR management has only wanted to put that scrutiny on the low end of the bell curve. They ignored the extremely high producers, because they were more concerned with getting cases off the books than giving claimants full and fair hearings. That's what led to Conn and Daughtery getting away with what they were doing for years.

I'd like to think that some good has come out of this event.  Management is at least playing lip service to the idea that quantity is only one part of the equation.  We'll see in the next year whether that's truly the case, or whether in the end, they still only care about the number of cases going out the door.

[moopigsdad]

Oct 7, 2013 16:04:43 GMT -5 mcb said:

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.

www.coburn.senate.gov/public/index.cfm?a=Files.Serve&File_id=0d1ad28a-fd8a-4aca-93bd-c7bf9543af36

I think a lot of the recommendations have some issues that aren't well thought out. Let me take just one of the recommendations and deal with it from an attorney representative's viewpoint. (See Bold Above) The problem with a lot of DDS physician reviews is they are made without a lot of the medical of the claimant in the file being reviewed. I know many DDS workers who admit that many times the files sent on to the DDS physicians for review are not fully complete. Hence, the physician (without a personal examination) of the claimant is making a decision based upon a less than full picture of the claimant's disabilities. So, to say the ALJ should give greater deference to those decision as insinuated by the recommendation is absurd.

A lot of intervening things could have occurred to the claimant, since that initial DDS decision, including a further full development of the record by an attorney representative. The claimant's treating physician(s) would know much more about a claimant's underlying issues of disability over a non-examining DDS physician reviewer of incomplete records. So, any additional narratives from a treating source, since the DDS decision could dramatically change the picture of the claim. Lastly, to have the ALJ have to contact the DDS physician at the hearing to determine why that decision was made the way it was is ludicrous. What more can the DDS physician add than what he already stated, considering he never examined the claimant or saw the latest medical records? I could go on and on, but I won't. Hence, the recommendations while an attempt to help the system, really only further burdens the system. Why didn't Senator Coburn just make the "real" recommendation he wanted to make, which is the SSA disability system should be dismantled and done away with in his opinion. Politicians attempt to speak in areas, in which they lack knowledge and skill as to what is truly happening on a daily basis in the system. Let's allow some existing ALJs make some sensible recommendations along with attorney representatives to improve the disability system for SSA to make it better.

[mcb]

Old habits die hard.

I don't know if anyone waded all the way through the 5 hour 26 minute hearing video yesterday, but ALJ Daugherty was AWOL from the proceedings, like he used to be at the Huntington, WVA ODAR. I wonder if he signed in ...and then disappeared.

[Legal Beagle]

Oct 8, 2013 10:40:17 GMT -5 mcb said:

Old habits die hard.

I don't know if anyone waded all the way through the 5 hour 26 minute hearing video yesterday, but ALJ Daugherty was AWOL from the proceedings, like he used to be at the Huntington, WVA ODAR. I wonder if he signed in ...and then disappeared.

He did. He was there the when the first panel testified, then left. He needs to find a lawyer and take the 5th himself.

SSA's last opportunity to try and resolve or at least save face, would have been to join the qui tam lawsuit. By dragging it's proverbial feet and letting it be un-sealed without that, the Agency looks like total idiots. IMHO. And has completely lost control of the situation - hence the Senate and House committees taking over the job.

[mcb]

Oct 9, 2013 19:41:29 GMT -5 Legal Beagle said:

Oct 8, 2013 10:40:17 GMT -5 mcb said:

Old habits die hard.

I don't know if anyone waded all the way through the 5 hour 26 minute hearing video yesterday, but ALJ Daugherty was AWOL from the proceedings, like he used to be at the Huntington, WVA ODAR. I wonder if he signed in ...and then disappeared.

He did. He was there the when the first panel testified, then left. He needs to find a lawyer and take the 5th himself.

SSA's last opportunity to try and resolve or at least save face, would have been to join the qui tam lawsuit. By dragging it's proverbial feet and letting it be un-sealed without that, the Agency looks like total idiots. IMHO. And has completely lost control of the situation - hence the Senate and House committees taking over the job.

Thanks for the information.

[moopigsdad]

Some of the testimony was bizarre without naming names and leads me to wonder why testify and not take the Fifth Amendment against self-incrimination instead?