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Post by montyburns on Feb 8, 2016 23:26:04 GMT -5
40 hours a day? You're an amazing woman!  And you thought you were tough sleeping on your couch! Why didn't you create 16 more hours in a day to work?  |
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Post by mamaru on Feb 9, 2016 5:27:58 GMT -5
40 hours a day? You're an amazing woman! No kidding. I caught that and couldn't edit - having trouble with the site. Then when I reread it I deleted the comment cause it sounded snarky. Again, I apologize for taking your comment at face value. i will admit that sometimes it felt like it was 40 hours in a day. |
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Post by catspaw on Feb 9, 2016 9:27:10 GMT -5
40 hours a day? You're an amazing woman! No kidding. I caught that and couldn't edit - having trouble with the site. Then when I reread it I deleted the comment cause it sounded snarky. Again, I apologize for taking your comment at face value. i will admit that sometimes it felt like it was 40 hours in a day. While inadvertent, working 40 hours a day brilliantly describes the life of a lawyer, IMHO. |
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Post by mamaru on Feb 9, 2016 10:39:25 GMT -5
40 hours a day? You're an amazing woman! And you thought you were tough sleeping on your couch! Why didn't you create 16 more hours in a day to work? For the record, my firm had "nap" rooms furnished with real beds. And I am not going to say anything more about those in a public forum. |
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Post by catspaw on Feb 9, 2016 11:08:46 GMT -5
And you thought you were tough sleeping on your couch! Why didn't you create 16 more hours in a day to work? For the record, my firm had "nap" rooms furnished with real beds. And I am not going to say anything more about those in a public forum. We may be missing our calling with this ALJ gig. We may need to become screenwriters and develop a new television show for Netflix or Hulu entitled "40 Hours" - it'll have everything. Drama, comedy, intrigue, suspense and a dose of raunchiness. |
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Post by lizdarcy on Feb 9, 2016 11:32:08 GMT -5
This study does not address the law that you will administer as an SSA ALJ. It does, however, very accurately describe how you will do the job. drive.google.com/file/d/0B2kAAfgH45ClZjRGejdwSkwyNXc/view?pli=1As a bonus, it documents some of the frustrations sitting SSA ALJs have voiced with their positions. Have fun. And be careful. You may get what you wish for. This study was paid for by the AALJ. Not sure of the value of union dues going to this study, but just so folks understand the real purpose of this paper is to push the AALJ agenda, so take it with a grain of salt. The purpose of the study is to present to an arbitrator facts about how long it takes an ALJ to complete each case. The arbitrator is going to decide whether the agency violated the collective bargaining agreement by unilaterally changing the terms and conditions of a mandatory subject of bargaining, that is, by unilaterally deciding that ALJs cannot telework unless they schedule at least 50 cases a month. I am an AALJ dues payer. I am happy the union used my dues money for this purpose. |
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Post by ba on Feb 9, 2016 11:57:12 GMT -5
This study was paid for by the AALJ. Not sure of the value of union dues going to this study, but just so folks understand the real purpose of this paper is to push the AALJ agenda, so take it with a grain of salt. The purpose of the study is to present to an arbitrator facts about how long it takes an ALJ to complete each case. The arbitrator is going to decide whether the agency violated the collective bargaining agreement by unilaterally changing the terms and conditions of a mandatory subject of bargaining, that is, by unilaterally deciding that ALJs cannot telework unless they schedule at least 50 cases a month. I am an AALJ dues payer. I am happy the union used my dues money for this purpose. I agree with Liz. This was a valuable use of union dues. I can't say that about some other things the union has done. |
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Post by mamaru on Feb 9, 2016 13:59:51 GMT -5
For the record, my firm had "nap" rooms furnished with real beds. And I am not going to say anything more about those in a public forum. We may be missing our calling with this ALJ gig. We may need to become screenwriters and develop a new television show for Netflix or Hulu entitled "40 Hours" - it'll have everything. Drama, comedy, intrigue, suspense and a dose of raunchiness. Gaiden does the soundtrack.
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Post by blondswede on Feb 9, 2016 19:00:09 GMT -5
No problem. That's the problem with writing vs. talking, e.g. texting, posting here: you lose the personality of the message, the non-verbal but physical cues left out of writing, especially when "talking" with a bunch of people you don't know. As long as we can laugh about the miscues, huh?
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Post by Propmaster on Feb 10, 2016 10:17:13 GMT -5
I wish I'd had something like that. I've had to learn the hard way, i.e. making a fool of myself trying to guess what a medical term meant [FYI: "facet" as a medical term is pronounced "fasétte" with the emphasis on the 2nd syllable (I don't have a "schwa" on my keyboard), I pronounced it " facette" with emphasis on 1st syllable, like the side of a diamond. The physician whose depo we were taking corrected my pronunciation, to my horror: I was green, but hoped the other attorney wouldn't know; he did after the correction]. I've had a tiny book called, Medical Abbreviations: 4200 Conveniences at the Expense of Communications and Safety, Neil M. Davis, 1987, ever since 1987 and it's been invaluable to me. It is now in its 15th edition, with 32,000 abbreviations. Mine is 4" x 6", the new one is 6" x 9".www.barnesandnoble.com/w/medical-abbreviations-davis/1101762753 ($22.43). www.amazon.com/Medical-Abbreviations-Conveniences-Expense-Communication/dp/0931431158 ($28.95 with Prime). It's made reading physicians'/nurses' hand-written notes actually bearable. Of course, years and years of doing this (28 for me) makes what is usually seen as chicken-scratch actually legible; but, without knowing what those letters/abbreviations mean won't help you at all. So, anyone having to read hand-written medical notes (e.g. ALJs in ODAR) will be totally lost without a source to decipher abbreviations. Not to mention learning medical shorthand yourself, which makes taking notes during testimony much easier. Thanks for the referral. I looked it up and purchased a used copy, and I look forward to no longer updating my personal list of abbreviations, which is far short of 32,000 (but better for my SSA purposes than most Internet references because I write down in it abbreviations I find or figure out in records so I do not have to look them up all the time). ...edit... Update to my ongoing saga with this resource: I got my book in the mail. It is FANTASTIC. It is a must for ALJs. It has medical abbreviations, but it also has a cross-reference of generic and name brand drugs, normal lab values for common lab tests, and a variety of helpful features that I am SOOOO pleased to have. The author indicates customized versions are available for institutions - ALJ training should COME with this book as a giveaway. I cannot praise it highly enough. That said, it did not contain the first thing I looked up in it, which I have decided must have been a typo in the examination (unless someone knows what "CA" means in a back examination that reads "No CA or tenderness"). |
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Post by Deleted on Feb 10, 2016 10:45:54 GMT -5
(unless someone knows what "CA" means in a back examination that reads "No CA or tenderness"). Cardiac arrest. So touching the claimant's back did not cause a cardiac arrest.
 haha
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Post by Deleted on Feb 10, 2016 10:50:15 GMT -5
No CA or tenderness in the back, if not a typo, could possibly be....
Costovertebral angle tenderness (CVAT), also known as Murphy's punch sign or the Pasternacki's Sign (Latin: succusio renalis), is a medical test in which pain is elicited by percussion of the area of the back overlying the kidney (the costovertebral angle, an angle made by the vertebral column and the costal margin). The test is positive in people with an infection around the kidney (perinephric abscess), pyelonephritis, hemorrhagic fever with renal syndrome or renal stone. Because the kidney lies directly below this area, known as the costovertebral angle, tapping disturbs the inflamed tissue, causing pain.
Just a shot in the dark... |
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Post by maquereau on Feb 10, 2016 17:15:39 GMT -5
I agree with Liz. As for the 40 hours a day thing - if I recall correctly, that's what Webb Hubbell tried, but it didn't work out so well for him.
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Post by blondswede on Feb 10, 2016 21:01:54 GMT -5
Update to my ongoing saga with this resource: I got my book in the mail. It is FANTASTIC. It is a must for ALJs. It has medical abbreviations, but it also has a cross-reference of generic and name brand drugs, normal lab values for common lab tests, and a variety of helpful features that I am SOOOO pleased to have. The author indicates customized versions are available for institutions - ALJ training should COME with this book as a giveaway. I cannot praise it highly enough. That said, it did not contain the first thing I looked up in it, which I have decided must have been a typo in the examination (unless someone knows what "CA" means in a back examination that reads "No CA or tenderness"). You're right. It must be a typo, because "CA" usually means cancer. Are you allowed to contact the physician to find out what it means? |
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Post by trickbag on Feb 10, 2016 21:02:33 GMT -5
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Post by montyburns on Feb 10, 2016 22:17:01 GMT -5
Update to my ongoing saga with this resource: I got my book in the mail. It is FANTASTIC. It is a must for ALJs. It has medical abbreviations, but it also has a cross-reference of generic and name brand drugs, normal lab values for common lab tests, and a variety of helpful features that I am SOOOO pleased to have. The author indicates customized versions are available for institutions - ALJ training should COME with this book as a giveaway. I cannot praise it highly enough. That said, it did not contain the first thing I looked up in it, which I have decided must have been a typo in the examination (unless someone knows what "CA" means in a back examination that reads "No CA or tenderness"). You're right. It must be a typo, because "CA" usually means cancer. Are you allowed to contact the physician to find out what it means? Since this notation came in the context of exam findings, and the system being examined is noted, the context will likely provide the answer. I am guessing Soldack is probably right in this case.
While I suppose we are not prohibited from contacting the physician for clarification, this has probably never happened in the history of ODAR. If the guy has cancer or cardiac arrest, he has hopefully provided more evidence than a mystical abbreviation to support the claim. I am not saying this to be glib, but if you have a case for more than the 7 days you are allowed to have a case (as a writer) you will be approached by management. I cannot imagine what their response would be if you told them you were waiting for a call back from the doctor to explain a single note in an exam.
As a former WC attorney myself, I can appreciate such attention to detail. You have doubtlessly spent many hours in any given case meticulously comparing medical records to make arguments about causation, apportionment, or the necessity/reasonable of a given course of treatment. Making a call to a doctor in this context may make sense; indeed, the answer might be crucial for proving your case. This level of detail and attention (along with likely countless depositions/cross-examinations of doctors) has provided you with very valuable insight into medical terminology, how certain conditions cause given limitations, and just general mastery of the most common disabling conditions. Far more than most ODAR ALJs and writers. However, this level of detail will absolutely impair your ability to be an "productive" (as management defines it) ODAR ALJ. You cannot get bogged down into detail of this level. The fact that Prop even looked this up (particularly since it said "no" CA, which probably supports the denial he was likely writing) shows that he goes beyond what most writers, myself included, would probably do (without context, I assume this is your typical lumbar spine/depression denial case, in which case "no finding = good evidence," even if you are not 100 on what that means). Not saying I would mention the finding if I didn't know what it meant, but if it's negative, well, honestly who cares, it's not going to hurt you. Indeed, Prop had probably already written the case and got it out before coming here to post the question/comment.
All of this not to knock you, who has, by virtue of your experience, superior knowledge on these subjects compared to I or most of ODAR. But just to reality check that you will not have the kind of time to maintain this level of detail orientation, and will never be calling doctors to ask about their notes when you become an ALJ (and I honestly hope you do, since you clearly know what you are doing) unless you really want to piss off management (which is fine with me!).
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Post by Pixie on Feb 11, 2016 0:23:47 GMT -5
I seldom get remands, especially after the AC got its new marching orders five or six years ago, but about 10 years ago I got a remand on an almost identical issue. Buried in one of the physician's notes was some minor but cryptic notation, made several years in the past.
Someone reviewing the case at the AC saw the note, noticed it wasn't discussed in the decision and remanded for the administrative law judge (me) to "seek clarification" from the physician. And, BTW, to give the claimant another hearing. To start all over from the beginning and do it all again.
I sent the physician a letter asking for clarification and made it clear that I had been ordered to send him the letter. Of course I didn't get a response from the physician, the case was reset for another hearing with the same result. Evidently the letter satisfied the AC as I never saw that case again. Even the claimant's attorney shook his head over this one. He had not raised that issue on appeal. The AC thought of it all on it's own.
If I had it to over again, would I have asked the physician what he meant by his notation in the old treatment notes? Nope, I would have done it all the same as I did initially. We don't have the luxury of burrowing into all of the rabbit holes we encounter on our journey through the medical records.
So, even though this appears to be a minor point, the AC has remanded on similar minor points in the past. Good luck. Pixie.
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Post by Propmaster on Feb 11, 2016 11:30:44 GMT -5
You're right. It must be a typo, because "CA" usually means cancer. Are you allowed to contact the physician to find out what it means? Since this notation came in the context of exam findings, and the system being examined is noted, the context will likely provide the answer. I am guessing Soldack is probably right in this case.
While I suppose we are not prohibited from contacting the physician for clarification, this has probably never happened in the history of ODAR. If the guy has cancer or cardiac arrest, he has hopefully provided more evidence than a mystical abbreviation to support the claim. I am not saying this to be glib, but if you have a case for more than the 7 days you are allowed to have a case (as a writer) you will be approached by management. I cannot imagine what their response would be if you told them you were waiting for a call back from the doctor to explain a single note in an exam.
As a former WC attorney myself, I can appreciate such attention to detail. You have doubtlessly spent many hours in any given case meticulously comparing medical records to make arguments about causation, apportionment, or the necessity/reasonable of a given course of treatment. Making a call to a doctor in this context may make sense; indeed, the answer might be crucial for proving your case. This level of detail and attention (along with likely countless depositions/cross-examinations of doctors) has provided you with very valuable insight into medical terminology, how certain conditions cause given limitations, and just general mastery of the most common disabling conditions. Far more than most ODAR ALJs and writers. However, this level of detail will absolutely impair your ability to be an "productive" (as management defines it) ODAR ALJ. You cannot get bogged down into detail of this level. The fact that Prop even looked this up (particularly since it said "no" CA, which probably supports the denial he was likely writing) shows that he goes beyond what most writers, myself included, would probably do (without context, I assume this is your typical lumbar spine/depression denial case, in which case "no finding = good evidence," even if you are not 100 on what that means). Not saying I would mention the finding if I didn't know what it meant, but if it's negative, well, honestly who cares, it's not going to hurt you. Indeed, Prop had probably already written the case and got it out before coming here to post the question/comment.
All of this not to knock you, who has, by virtue of your experience, superior knowledge on these subjects compared to I or most of ODAR. But just to reality check that you will not have the kind of time to maintain this level of detail orientation, and will never be calling doctors to ask about their notes when you become an ALJ (and I honestly hope you do, since you clearly know what you are doing) unless you really want to piss off management (which is fine with me!).
Absolutely correct. I phrased it as "no notable clinical abnormalities on physical examination" and the decision was out before I got the book. But having asked two nurses working as writers in my office and consulting online sites, it was the first thing I checked in the book. I agree with Soldack, too, if this is not a weird typo - or lately a dictation error. I thought it might mean costovertebral abnormalities or something, but really at that place in the exam I would have expected muscle spasms or something. Anyway, I agree with the above 100%. |
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Post by Propmaster on Feb 11, 2016 11:53:45 GMT -5
Thanks. I added it to my favorites. It did not help me with CA (although there were some phrases suggested with which I am not familiar), but it is a great-looking resource. |
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Post by anotherfed on Feb 11, 2016 13:01:46 GMT -5
If you trust your mentor ALJ, find out from them who the best attorneys in the office are. Pow wow with your fellow ALJs and those attorneys in random combinations regularly. Identify a good/competent GS and keep a line of communication open with them. HODs and HOCALJs are really busy if they're doing what they should and tend to focus on bigger picture stuff--trust me that your good GS will be much better equipped to help you with the day-to-day issues that crop up. GSs and HODs don't manage ALJs, but we manage everyone else in the building that do all the things you need done to hear and decide your cases Finally, pray you have a good computer assistant and, if you do, be that person's best friend. You'll be just fine  Sage advice. Take advantage of the collective experience in your office -- you can learn something from everyone. |
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haha
