|
Post by blondswede on Feb 11, 2016 21:25:22 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!).
LOL! I usually try to hold off pissing off management until I've been working for a few months, at least. If that notation (CA) was in the medical records I was reviewing, I would spend a minute to figure out what it was, but generally, would not go so far as to call the physician. I was merely trying to be helpful to Propmaster by pointing out the resource I have used forever to figure out medical abbreviations, and asking whether calling a physician was even permitted at ODAR; but, I have to admit, that "CA" intrigued me, so I spent a few minutes trying to find it. One thing I am very capable of doing is reading through all medical records, and being able to quickly discern which ones to spend most time on, which ones to skim (e.g. nurses' notes, surgical nurses' notes, information which neither adds nor detracts from the diagnosis), etc. Litigating medical conditions and disability has been my entire career, and I would hope that I would be able to utilize what I already know, while learning new stuff, in my next position.
|
|
|
Post by montyburns on Feb 11, 2016 21:52:25 GMT -5
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!).
LOL! I usually try to hold off pissing off management until I've been working for a few months, at least. If that notation (CA) was in the medical records I was reviewing, I would spend a minute to figure out what it was, but generally, would not go so far as to call the physician. I was merely trying to be helpful to Propmaster by pointing out the resource I have used forever to figure out medical abbreviations, and asking whether calling a physician was even permitted at ODAR; but, I have to admit, that "CA" intrigued me, so I spent a few minutes trying to find it. One thing I am very capable of doing is reading through all medical records, and being able to quickly discern which ones to spend most time on, which ones to skim (e.g. nurses' notes, surgical nurses' notes, information which neither adds nor detracts from the diagnosis), etc. Litigating medical conditions and disability has been my entire career, and I would hope that I would be able to utilize what I already know, while learning new stuff, in my next position. Well if you are not pissing off management in the first few months, I dare say you are not fully exercising judicial independence and enjoying you APA protections! This coming from a career butt-kisser of course. . Recent news on ALJ hiring goals sounds very promising for you. Might take a while, but you'll be living it up in Middlesboro or Tupelo soon enough!
|
|
|
Post by blondswede on Feb 11, 2016 22:02:28 GMT -5
Well if you are not pissing off management in the first few months, I dare say you are not fully exercising judicial independence and enjoying you APA protections! This coming from a career butt-kisser of course. . Recent news on ALJ hiring goals sounds very promising for you. Might take a while, but you'll be living it up in Middlesboro or Tupelo soon enough! From your mouth to whomever makes the hiring decisions. BTW, what's wrong with Middlesboro or Tupelo? I've never been to either city, but I have seen mention of these two cities a couple of other times on this forum.
|
|
|
Post by gary on Feb 11, 2016 22:23:26 GMT -5
Well if you are not pissing off management in the first few months, I dare say you are not fully exercising judicial independence and enjoying you APA protections! This coming from a career butt-kisser of course. . Recent news on ALJ hiring goals sounds very promising for you. Might take a while, but you'll be living it up in Middlesboro or Tupelo soon enough! From your mouth to whomever makes the hiring decisions. BTW, what's wrong with Middlesboro or Tupelo? I've never been to either city, but I have seen mention of these two cities a couple of other times on this forum. Those are the two towns that have been graced by the presence of the Hon Funky Odar, ALJ Extraordinaire. They are geographically shunned by most applicants but, from the reports I have seen, are fine offices for a fledgling ALJ to start adjudicating in.
|
|
|
Post by blondswede on Feb 11, 2016 22:27:57 GMT -5
From your mouth to whomever makes the hiring decisions. BTW, what's wrong with Middlesboro or Tupelo? I've never been to either city, but I have seen mention of these two cities a couple of other times on this forum. Those are the two towns that have been graced by the presence of the Hon Funky Odar, ALJ Extraordinaire. They are geographically shunned by most applicants but, from the reports I have seen, are fine offices for a fledgling ALJ to start adjudicating in. Well, if nobody else will, I will take either Middlesboro or Tupelo. Assuming of course that I even get on the register. Wherever I needed, I'm ready to go. I got my FOAD letter two years ago, so at this point, I'm just excited I haven't gotten my second FOAD letter.
|
|
|
Post by montyburns on Feb 11, 2016 22:36:32 GMT -5
Those are the two towns that have been graced by the presence of the Hon Funky Odar, ALJ Extraordinaire. They are geographically shunned by most applicants but, from the reports I have seen, are fine offices for a fledgling ALJ to start adjudicating in. Well, if nobody else will, I will take either Middlesboro or Tupelo. Assuming of course that I even get on the register. Wherever I needed, I'm ready to go. I got my FOAD letter two years ago, so at this point, I'm just excited I haven't gotten my second FOAD letter. To be sure, these are fine locations where, for the price of a 1000 ft2 apartment on either coast, one can attain a house, 40 acres, a mule, and 2 cousins. Sorry, im just trying to bait funky and some of our recently departed.
|
|
|
Post by Gaidin on Feb 11, 2016 23:53:04 GMT -5
Well, if nobody else will, I will take either Middlesboro or Tupelo. Assuming of course that I even get on the register. Wherever I needed, I'm ready to go. I got my FOAD letter two years ago, so at this point, I'm just excited I haven't gotten my second FOAD letter. To be sure, these are fine locations where, for the price of a 1000 ft2 apartment on either coast, one can attain a house, 40 acres, a mule, and 2 cousins. Sorry, im just trying to bait funky and some of our recently departed. You're closer to the truth than you realize. I actually think Middlesboro is in a class by itself. It is extremely isolated even by small town standards. Its not just its size but the distance to anything else. I'm not saying no one should be willing to go there but I am saying its one of about a dozen locations that I would examine very closely before keeping it on my GAL.
|
|
|
Post by christina on Feb 12, 2016 5:40:22 GMT -5
iev wondered that about mboro myself too. looks like a lovely area but the remoteness might get to me.
|
|
|
Post by christina on Feb 12, 2016 5:41:44 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. AC New marching orders? Can you elaborate? i suspected this myself.
|
|
|
Post by Pixie on Feb 12, 2016 8:59:49 GMT -5
Basically, "Don't remand so many cases for silly reasons or no reason at all." The AC also has numbers to meet. In the last several years, the remands have been down. OCALJ gives the BS reason that the quality of the decisions has improved, thus the reduced number of remands. Pixie.
|
|
|
Post by christina on Feb 12, 2016 9:13:20 GMT -5
all i will respond is your post made me laugh, at least the last sentence. thanks for being so candid actually, i am going to bite. While quality on appealed cases improved, coincidentally, we all apparently became less capable of writing a proper FF. and thanks for info!!
|
|
|
Post by anotherfed on Feb 12, 2016 9:18:12 GMT -5
all i will respond is your post made me laugh, at least the last sentence. thanks for being so candid actually, i am going to bite. While quality on appealed cases improved, coincidentally, we all apparently became less capable of writing a proper FF. and thanks for info!! Twin! At least until you change your avatar again.
|
|
|
Post by christina on Feb 12, 2016 9:20:32 GMT -5
oh, i am Sorry. i don;t have lipstick on though!! and yeah, i'll be changing it again soon
|
|
|
Post by Propmaster on Feb 12, 2016 11:02:08 GMT -5
all i will respond is your post made me laugh, at least the last sentence. thanks for being so candid actually, i am going to bite. While quality on appealed cases improved, coincidentally, we all apparently became less capable of writing a proper FF. and thanks for info!! As another extraordinary coincidence, meeting a goal within the SSA budget became dependent on the agree rate of ALJs increasing about that time. Having perused a few budgets and revised budgets (it's a two-year process to develop a budget, with a bit of wiggle in the middle), it is amazing to me when fundamental changes in the method by which success will be measured (e.g., changing from an annual goal to a September-only goal for APT reduction) or the manipulation-potential for the metrics used does not affect the consistency of budget revisions with the original approved budget. But I've never stirred the sausage-pot; perhaps it makes perfect sense to budget people.
|
|
|
Post by christina on Feb 12, 2016 11:07:31 GMT -5
prop, sounds like we agree on some of the coincidences....
|
|
|
Post by anotherfed on Feb 13, 2016 23:41:02 GMT -5
oh, i am Sorry. i don;t have lipstick on though!! and yeah, i'll be changing it again soon Here...I'll let you borrow my lipstick ... It's called Judgy Passion. It will be the in color this summer, and will look FABulous on you.
|
|
|
Post by Propmaster on Feb 16, 2016 12:08:33 GMT -5
oh, i am Sorry. i don;t have lipstick on though!! and yeah, i'll be changing it again soon Here...I'll let you borrow my lipstick ... It's called Judgy Passion. It will be the in color this summer, and will look FABulous on you. I'm going to try some of that...
|
|
|
Post by mamaru on Feb 17, 2016 0:37:46 GMT -5
oh, i am Sorry. i don;t have lipstick on though!! and yeah, i'll be changing it again soon Here...I'll let you borrow my lipstick ... It's called Judgy Passion. It will be the in color this summer, and will look FABulous on you. Don't forget your manicure - I heard they are now doing After Dark in Orland Park.
|
|