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Post by mytwocents on Feb 21, 2014 19:21:37 GMT -5
A little known secret. Most of the ODAR offices listed in various agency reports as being “the bottom performing offices,” in terms of productivity indexes tracked in such reports, have the distinction of being offices with the largest case files, and then some. These reports of the average size of files that are adjudicated in ODAR’s 160+ offices, which vary in extreme ways, calls into question all of the agency’s recent actions that relate to what seems to be the agency’s desire to impose quotas in a “one size fits” all approach. A review of all of the posts on this board regarding quotas/benchmarks/performance standards does not show that anyone wants to shine a bright light on the above-mentioned little known secret. The larger the case file, the more medical source opinions, etc. In light of recent announcements on this board that ALJs are told during recent training that they are supposed to the know “the file” better than anyone, attempts to impose quotas/benchmark/performance standards, etc., without taking into account things like the raw size of case files threatens, IMHO, things like quality and the ability to provide justice. That is to say that the private practice attorneys who practice in the offices described in agency reports as being “the bottom performing offices” but also the “offices with the largest case files,” on balance, whether they be attorneys right out of law school or attorneys who have spent a lifetime practicing in this arena, spend way more than the two or so hours that it has been reported that the agency expects the average ALJ to spend in this “one size fits all” environment that those at the top seem to be advancing.
How big are the ODAR case files you work? How big are the average ODAR case files in Fort Smith, as compared to Atlanta, as compared to Reno, as compared to Lexington, as compared to Los Angeles, as compared to Mount Pleasant, as compared to Tulsa, as compared to Augusta, as compared to Columbus? Should the average size of a case file adjudicated in various ODAR offices be taken into consideration when trying to compare the number of widgets an ALJ in Detroit produces each month with the number of widgets an ALJ in Sioux Falls produces each month?
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Post by Dark Lord of the Sith on Feb 21, 2014 21:15:53 GMT -5
Well I can tell you this...can't speak to the distribution across the nation.....but veteran files that include VA records can get pretty lengthy.....especially when vets have to document everything that has bothered then while on active duty in order to get a disability rating from the VA....this can result in hundreds if not a thousand pages....making this even more difficult is the arcane way the VA number there records....but don't let size fool you...some of the most difficult cases can be relatively small in proportion to large exhibit cases. Imho the better the alj is in writing their instructions combined with providing the precise exhibit number where they found information they want highlighted in the decision is key to turning these puppies out fast. Especially when the aljs handwriting is worse than a surgeon's.
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Post by niqueoftime on Feb 21, 2014 23:16:41 GMT -5
Well I can tell you this...can't speak to the distribution across the nation.....but veteran files that include VA records can get pretty lengthy.....especially when vets have to document everything that has bothered then while on active duty in order to get a disability rating from the VA....this can result in hundreds if not a thousand pages....making this even more difficult is the arcane way the VA number there records....but don't let size fool you...some of the most difficult cases can be relatively small in proportion to large exhibit cases. Imho the better the alj is in writing their instructions combined with providing the precise exhibit number where they found information they want highlighted in the decision is key to turning these puppies out fast. Especially when the aljs handwriting is worse than a surgeon's. Based upon the files and instructions I've encountered in the corner of my ODAR world, I agree with your assessment and opinion Dark Lord!
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Post by bartleby on Feb 21, 2014 23:44:01 GMT -5
I am not sure what is going on, but craziness abounds here. File size and preparation severely affect review time for judges. To somehow try to confuse the issue by noting how well a Judge writes instructions as being the "key to turning these puppies out fast" is ludicrous. The only way the Judge's instructional writing ability affects the speed of dispositions is how long it takes the writer to interpret them. Since when do Judicial candidates argue apples and oranges?? We are not concerned with the decision writing time, we are concerned with the difference of reviewing on the average 200-300 pages versus 700-1200 pages by a Judge. This is only one factor that makes it easy for some Judges to do 500 cases and not some other Judges. Another variable is the matter of whether the file has been properly pulled or not. There are many variables of which the Judge has no control, however, the problem is that the Agency has determined all are capable and will meet the same goals or be punished.
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Post by bartleby on Feb 21, 2014 23:57:17 GMT -5
I agree, it's not the sole measure, but it is one of them..
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Post by Dark Lord of the Sith on Feb 22, 2014 0:04:15 GMT -5
I am not sure what is going on, but craziness abounds here. File size and preparation severely affect review time for judges. To somehow try to confuse the issue by noting how well a Judge writes instructions as being the "key to turning these puppies out fast" is ludicrous. The only way the Judge's instructional writing ability affects the speed of dispositions is how long it takes the writer to interpret them. Since when do Judicial candidates argue apples and oranges?? We are not concerned with the decision writing time, we are concerned with the difference of reviewing on the average 200-300 pages versus 700-1200 pages by a Judge. This is only one factor that makes it easy for some Judges to do 500 cases and not some other Judges. Another variable is the matter of whether the file has been properly pulled or not. There are many variables of which the Judge has no control, however, the problem is that the Agency has determined all are capable and will meet the same goals or be punished. No need to get into a pissing contest....but I am a Sith Lord so I will....It does matter how well the instructions are done in getting these cases done. AN ALJ writes sloppy instructions or illegible ones the writer has to WASTE time trying to figure out what the hell is going on. That leaves several options: put the case at the bottom of the pile and move on to another one, try and track down the ALJ between hearings, lunch, or flexiplace, guess get it wrong and have to re-write it. Point is where ever and when ever a few minutes can be shaved off the process the faster a case can be turned around and placed on the ALJ's desk for signature. Now multiply that over the course of a year and it just might add up to a few extra cases completed. BTW you should be concerned with decision writing time after all you are a part of the team and the person waiting to get paid or denied would appreciate it. For what it is worth, good instructions has more to do with efficiency and quality than time anyway. Maybe if more cared there would not need to be this senseless show down. Who want's to wait and extra day or week for benefits or a denial simply because an ALJ refuses to write legible instructions, refuses to write any instructions, or refuses to use modern technology to speed up the process. Old timers...my word.... I just hope you are one of the considerate ones.
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Post by bartleby on Feb 22, 2014 0:41:36 GMT -5
Trust me Sith if you have followed my posts you would know I use FIT instructions and put my severe impairments, RFC, and DOT info into the format so it can be copied and pasted. If you think you are under pressure as a writer I pity when you become a Judge. Trust me, the best/easiest job I have had at ODAR was senior attorney and now that has gone to hell. For me to do my instructions properly for you, I must spend time the Agency doesn't want me to do. I am having a hard time doing what I think is proper in preparing for the hearing, having the hearing, doing proper instructions for you and editing cases from people that miss half of my RFC by typing it instead of copying and pasting.. Trust me, I can cut corners in many places and have little problem meeting the goals, but what does that do for my professionalism? The Agency doesn't care if I give you crap directions, but I do. They don't care how prepared I am for a hearing, but I do. All the Agency cares about is my numbers. What do you suggest I cut?? Who takes the hit? You, the claimant?
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Post by Dark Lord of the Sith on Feb 22, 2014 0:53:03 GMT -5
I am under no pressure as a writer...in fact it comes very easy for me...i used to be an editor in a past life....float like a butterfly and sting like a bee. I truly thank you for using FIT.....thank you for caring....and thank you for doing it the right way....if I am lucky enough to cross the Rubicon...maybe you could be my long distance mentor. I truly want to do it the right way too.
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Post by trekker on Feb 22, 2014 7:35:22 GMT -5
I have been reading medical records for about 35 years now, give or take a year or two. I was a research assistant in college and helped my spouse when he was doing research as a med student, resident, fellow, and now staff surgeon. (I was cheap and quick.). I also worked in a couple of cancer centers extrapolating data (subj & obj) for patients participating in clinical trials. The early years meant trying to decipher the chicken scratch of many doctors including my spouse. Then I became an attorney doing public benefits. More physician chicken scratch. I was so looking forward to electronic records and then they became reality. (I actually preferred reading VA records because most of them were typed. I was a medical transcriptionist when the children were little so I was familiar with the mistakes that were often made so it was no big deal.). I now hate the new electronic record keeping and feel sorry for the ALJ's who have to read through 1200 pages of records for my clients who actually are in therapy and complying with treatment. Every visit to a MH provider generates at least 3 pages of notes most of it just transferred from the last visit but you have to read it and look for the new info that may be in the record. Same is becoming true for medical records from health care systems that have made the transition to all electronic record keeping. Providers hate the new systems because they have to spend more time checking boxes than they get to spend with their patients. And when they add a note to the record that falls outside of the standardized record, it is usually about 8 point print. So yes I believe there may be a big difference in record size especially between rural and urban providers. But whether or not the new production rules will adjust for that is unclear.
I'm currently reading 12 Years A Slave. I only bring it up because it details the production requirements imposed on slaves for picking cotton or sugar cane. There was a minimum standard you had to meet or be subjected to a lashing. If you exceeded the limit, the next day you had to reproduce that figure or face a lashing. I'm over simplifying the description provided by the author but it is an interesting read given the posts on this thread and others. Given that one of my early jobs was working for a clothing manufacturer where we had to meet production standards and were paid by the piece, I usually hate preset goals because the harder you work, the higher the goal is set for the next year. And I remember one ALJ who set a time limit on hearings (this was in the 90's) at 15 minutes. No more. No less. Didn't matter if an interpreter was required or not. You knew you only had 15 minutes to make your case. He wasn't the worst ALJ in that hearing office but he was the fastest, including the writing of the decision. It will be interesting to see how the new rules outlined in the memo play out and whether or not claimants will be harmed. I just know that one size doesn't really fit all.
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Post by prescient on Feb 22, 2014 8:55:10 GMT -5
I think much of this is BS for a variety of reasons. Putting the toddler to bed now, so I'll just say that I don't see any difference in the size of the files in my office compared to the files we receive from other offices who can't finish their own work. I work in an office where the average case file is 250 to 300 pages. I previously worked in an office where the average case was 800 to 1000 pages. I would argue that the size of the medical records is by far the single most time limiting factor in processing a case. Of course how the file has been pulled and organized, quality of he instructions, and quality of he written draft all play roles in delaying completion of getting a case out the door, but all of these are minimal compared to the size of the file. I've long argued that the number of pages should be tracked and factored into the production quotas. It's ridiculous that it's completely ignored.
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Post by funkyodar on Feb 22, 2014 10:19:58 GMT -5
I can speak to this case file size issue a bit.
We recently had a writer from our office transfer to a neighboring office of similar size. Our office's production is routinely compared to this office as we are geographically close and essentially the same in staffing and pending cases (though our service area is larger and more rural while theirs is smaller but more populated and urban).
When compared to this office, ours is routinely noted to have less dispositions, average cases written per writer and in all the measured alj categories. Not once have we been offered any explanation other than we need to do more.
Then the writer transfer occurred. According to this writer, the other office has an average case file of only 10 to 12 exhibits and in several months working there they have had no files with more than 500 pages of med records. Our office, contrarily, has an average file size of 20 to 25 exhibits and usually 800 to 1200 pages of med.
Some investigation has revealed why this is and why they appear to be doing so much better than us in writing and alj measurables.
1. our claimants are generally more financially able to seek medical care versus their typical claimant resulting in more med ev.
2. our service area includes a large VA Med center and we get a ton of recs from them.
3. our judges order substantially more development than do their judges.
4. our case techs blow theirs away in all aspects of pulling and are encouraged to make efforts to secure med records and to suggest CEs when none are in the rec and it appears they would be helpful.
5. as a general rule, the reps in our area are better and submit substantially more ev than do the reps in the other area.
And 6. the other areas pay rate is higher leading to easier dispositions for both judges and writers.
We have also noted that, despite the fact the other office doesn't do anywhere near the development we do, their remand rates are no higher than ours.
Despite the fact that they work in apples while we labor under oranges, we continue to be compared to their output. Count me as on board with prescient's recommendation to somehow figure case size into the production mix.
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Post by maquereau on Feb 22, 2014 10:29:04 GMT -5
Funky touched on one point that I believe to be (or should be) perhaps the most important factor, the pay rate of the office. Some offices just have very high pay rates - some in PR, NY, ME, TN, AL, while other offices in places like AK, WI, LA, KS, DE have rather low pay rates. Now everybody who has worked at ODAR knows that a pay case TYPICALLY takes about 1/6 the amount of time to process as a denial. When I wrote decisions, I could easily spit out 6 favorables to 1 unfavorable. When it comes to dispositions, top mgmt is looking at raw numbers - how many widgets an office has produced. It doesn't matter to them if it is an unfavorable widget or a favorable widget. But it matters greatly to the processing times of individual offices. Those people in Falls Church need to start factoring that into their efficiency calculus. It SHOULD be easy for a high pay office to make their quotas while it would be much more difficult for a low pay office to do the same.
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Post by decadealj on Feb 22, 2014 12:30:50 GMT -5
My old office (and I) were right dab in the middle of pay rates, dispos, etc. We had a very large VA caseload and decent staff- outstanding to marginal case support and writing. We did a lot of other office caseloads via Video hearings primarily in the rural South and the rustbelt. The only way I could barely reach quota (and that is what is was) was to write all my own favorables and dismissals. They weren't pretty, barebones, but cited the exhibit numbers for my findings. I didn't spend any time discussing the evidence- if the AC wanted to question my findings they could read the evidence- i.e. treating source opinions at EX 5, 10 and 15, the listing, the RFC and the grid, or the reason for the dismissal. I probably wrote several thousand dispos and the only remands were for a couple of dismissals. I didn't cut the writers much slack with all partial or unfavorables but tried to make up for it with concise instructions and an open door for any questions or disagreement (which I sincerely invited- I didn't want anyone struggling to write what they believed to be an unsupportable decision). I rarely sent cases back for editing- I did that myself and wrote my own decisions on my one day a week workplace. It worked for me and I hope may be of some assistance to those like me that struggled to meet quota.
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MW2
Full Member
Posts: 49
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Post by MW2 on Feb 22, 2014 15:15:57 GMT -5
Based upon the instructions I've seen from various ALJs, the quality of the instructions does not have much of anything to do with the numbers of cases processed. Some spend a lot of time on their instructions and turn out a large number of cases, others not so many. Of the ALJs who don't appear to spend much time on the instructions some turn out a lot of cases, others do not.
The size case will generally dictate how much time it will take to draft a decision. Of course there will be exceptions. Doesn't mean the case size is irrelevant. In my experience, cases with 1,000+ pages of medical evidence will almost always take longer to review that cases in the range of 250.
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Post by sandiferhands (old) on Feb 22, 2014 15:28:35 GMT -5
My old office (and I) were right dab in the middle of pay rates, dispos, etc. We had a very large VA caseload and decent staff- outstanding to marginal case support and writing. We did a lot of other office caseloads via Video hearings primarily in the rural South and the rustbelt. The only way I could barely reach quota (and that is what is was) was to write all my own favorables and dismissals. They weren't pretty, barebones, but cited the exhibit numbers for my findings. I didn't spend any time discussing the evidence- if the AC wanted to question my findings they could read the evidence- i.e. treating source opinions at EX 5, 10 and 15, the listing, the RFC and the grid, or the reason for the dismissal. I probably wrote several thousand dispos and the only remands were for a couple of dismissals. I didn't cut the writers much slack with all partial or unfavorables but tried to make up for it with concise instructions and an open door for any questions or disagreement (which I sincerely invited- I didn't want anyone struggling to write what they believed to be an unsupportable decision). I rarely sent cases back for editing- I did that myself and wrote my own decisions on my one day a week workplace. It worked for me and I hope may be of some assistance to those like me that struggled to meet quota. Sounds eminently reasonable. Sometimes the quarterback has to run, sometimes the receiver has to block, to advance the ball for the team.
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Post by bartleby on Feb 22, 2014 17:35:38 GMT -5
May I add something that has been ignored or overlooked? I truly think one of the biggest assets a Judge can have is extreme typing skills. I do not. I have taken typing classes and just don't improve. I could never learn Morse code either. Whether there is a connection between the two or not I don't know, but suspect there is as I have spent money and effort on both and it doesn't happen. That said, someone with 90 words a minute typing skill that can type while listening to testimony has a real advantage over someone who can't. One of the new ALJ tools, eBB, electronic Bench Book, is designed with the typist in mind. If done properly, one can do their prehearing notes in eBB, type in information during the hearing and it will then import a lot of your information into the instructional portion. The goal of the program is to ultimately generate a simple decision. What impact this will have on the writers is unclear. Unfortunately, typing well has never been a requirement for this position and really should be for one to be ultimately successful.
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Post by cougarfan on Feb 22, 2014 18:02:22 GMT -5
May I add something that has been ignored or overlooked? I truly think one of the biggest assets a Judge can have is extreme typing skills. I do not. I have taken typing classes and just don't improve. I could never learn Morse code either. Whether there is a connection between the two or not I don't know, but suspect there is as I have spent money and effort on both and it doesn't happen. That said, someone with 90 words a minute typing skill that can type while listening to testimony has a real advantage over someone who can't. One of the new ALJ tools, eBB, electronic Bench Book, is designed with the typist in mind. If done properly, one can do their prehearing notes in eBB, type in information during the hearing and it will then import a lot of your information into the instructional portion. The goal of the program is to ultimately generate a simple decision. What impact this will have on the writers is unclear. Unfortunately, typing well has never been a requirement for this position and really should be for one to be ultimately successful. I agree with this. Fortunately, I am able to type while I'm listening to the hearing testimony and I have found EBB to be much quicker and more efficient, for me, for the reasons Bartleby put forth, than the FIT and enhanced FIT processes I used earlier. I am a big advocate for EBB and I especially like the ability to OCR the exhibits and then cut and paste language from the exhibit in word format into my notes and into my instructions. For those who find typing difficult I can see how that would be frustrating because a big part of the efficiency, for me, is typing notes during the hearing. There are judges in my office who aren't comfortable typing during the hearing and they are excellent judges, as I am sure Bartleby is.
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Post by mytwocents on Feb 22, 2014 18:45:49 GMT -5
Once upon a time not too long ago, an assistant United States attorney told me, during a conversation in a Social Security appeal in which we were joined, that she was given five full working days to prepare the equivalent of two and one-half briefs in support of ALJs denials that her office found to be denials that should be defended in federal court. This conversation grew out of my desire to gauge how much I should charge other attorneys who were retaining me to prosecute appeals for clients of theirs unhappy with an ALJ’s decision finding them not to be disabled. Thus, she was telling me that she was allotted two full weeks to draft five briefs that, on average, and including boilerplate, were in the 16+ page range. The region that I performed the above-described work includes an office which has, based on "historical data" that those at the top have recently referenced having access to in the memorandum regarding an ALJ's ability to work from home, been at the bottom of agency productivity indexes. At that time, I was spending an average of about 16 hours drafting a brief in support of a federal SSA appeal. As further background to the issues presented by this thread and the responses to it, I was successful, that is I was able to get a remand from a federal court, in more than 90 percent of the 100+ cases I prosecuted for myself or for other attorneys.
In reality, a federal court brief in a SSA appeal is the same as what all of the laws, regulations, rulings, and memorandums,etc., instruct should be in an ALJ decision whether the decision be favorable or unfavorable. That is the law does not really distinguish between a favorable or unfavorable decision. The law says that all decisions should be the same.
Today, I asked a colleague who practices in the above-described region how much time he spends, just before a hearing, reviewing a case file. He asked me how many pages, “500?” I said, no, “1,000 pages.” He responded, “about eight to 10 hours.”
Are there any assistant U.S. attorneys out there who defend ALJ denials? How much time are you currently allotted to prepare a brief in support of an ALJ denial? That is are you being pushed to draft more than 2.5 SSA briefs a week in a region like the region described above. What are the quotas/production standards for OGC attorneys?
On their face, all of the ODAR benchmarks are presuming that all ALJs in this country should be spending, on average, no more than five hours on any single case. Some of these ALJs are in offices where more than 60 percent of the case files contain more than 500 pages of records, thirty percent or more that contain more than 1,000 pages of records. Justice is threatened when an ALJ is threatened with punishment in a region like the one described above if said ALJ dares spend more time than the powers arbitrarily deem should be allotted in their “one size fits all” mentality. Again, IMHO.
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Post by JudgeRatty on Feb 22, 2014 18:56:38 GMT -5
Once upon a time not too long ago, an assistant United States attorney told me, during a conversation in a Social Security appeal in which we were joined, that she was given five full working days to prepare the equivalent of two and one-half briefs in support of ALJs denials that her office found to be denials that should be defended in federal court. This conversation grew out of my desire to gauge how much I should charge other attorneys who were retaining me to prosecute appeals for clients of theirs unhappy with an ALJ’s decision finding them not to be disabled. Thus, she was telling me that she was allotted two full weeks to draft five briefs that, on average, and including boilerplate, were in the 16+ page range. The region that I performed the above-described work includes an office which has, based on "historical data" that those at the top have recently referenced having access to in the memorandum regarding an ALJ's ability to work from home, been at the bottom of agency productivity indexes. At that time, I was spending an average of about 16 hours drafting a brief in support of a federal SSA appeal. As further background to the issues presented by this thread and the responses to it, I was successful, that is I was able to get a remand from a federal court, in more than 90 percent of the 100+ cases I prosecuted for myself or for other attorneys.
In reality, a federal court brief in a SSA appeal is the same as what all of the laws, regulations, rulings, and memorandums,etc., instruct should be in an ALJ decision whether the decision be favorable or unfavorable. That is the law does not really distinguish between a favorable or unfavorable decision. The law says that all decisions should be the same.
Today, I asked a colleague who practices in the above-described region how much time he spends, just before a hearing, reviewing a case file. He asked me how many pages, “500?” I said, no, “1,000 pages.” He responded, “about eight to 10 hours.”
Are there any assistant U.S. attorneys out there who defend ALJ denials? How much time are you currently allotted to prepare a brief in support of an ALJ denial? That is are you being pushed to brief more than 2.5 briefs a week in a region like the region described above. What are the quotas/production standards for OGC attorneys?
On their face, all of the ODAR benchmarks are presuming that all ALJs in this country should be spending, on average, no more than five hours on any single case. Some of these ALJs are in offices where more than 60 percent of the case files contain more than 500 pages of records, thirty percent or more that contain more than 1,000 pages of records. Justice is threatened when an ALJ is threatened with punishment in a region like the one described above if said ALJ dares spend more than the powers want deem should be allotted in their “one size fits all” mentality. Again, IMHO.
[ Good points. I say this after attempting to write a decision today on OT on a 3900 page evidence case. I did NOT get it completed and in light of the current QA reviews for writers, I will take as long as needed to do it the right way. Now I have always felt I did what was right but now I do not feel the stress of "hurry" since I feel the powers that be would rather they had an excellent product than mere numbers. But next week I have a few less intensive cases and will make up the time. It evens out in the long run over time. I guess it just depends on what the office average size case is and maybe they just "averaged" all the cases to get the goal/ whatever you want to call it number for the target. I can see that... But individual offices need to have allowances for their average size case before anyone is held to a "National" average. This seems to be the issue. There is a competing interest at present .... QA vs productivity and benchmarks. It's a tight balance for sure.
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Post by mytwocents on Feb 22, 2014 20:09:34 GMT -5
Hey OGC. Kindly, and respectively, please answer the question I posed earlier in this thread (see below). IMHO, justice will be protected/served by an honest response: Are there any assistant U.S. attorneys out there who defend ALJ denials? How much time are you currently allotted to prepare a brief in support of an ALJ denial? That is are you being pushed to draft more than 2.5 SSA briefs a week in a region like the region described above. What are the quotas/production standards for OGC attorneys in relation to SSA ALJ denials?
More specific to the issues raised in this thread to federal Odianaranwannabees, are the quotas/productions standards you are subject to in relation to defending ALJ denials applied in an “one size fits all” approach no matter the region in which you work? It seems strange to me, if I disagreeumptions are correct, that the agency gives OGC attorneys a much "lighter" workload (by the way, I sincerely believe OGC attorneys, on balance, are working hard/to capacity) than the agency wants to give its ALJs who are, as those at the top know, "United States Administrative Law Judges."
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