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Post by redsox1 on Jan 25, 2017 17:12:44 GMT -5
I think the issue of telework is being a little overblown here. I believe it is still 45-50 scheduled. Also, if there are good reasons why an ALJ can't make 45 one or two months the HOCALJ can still allow telework. The key, to me, is communication. If both sides are willing to work together, maybe the ALJ does an extra day of unrepresented claimants one month if the HOCALJ lets 40 in August slide, there should be few issues.
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Post by victor31 on Jan 25, 2017 20:19:43 GMT -5
At 12.5 hearing per week, if you have an average of 400 pages in a file, that's 5,000 pages a week.
Does an experienced ALJ actually read everything on every page of the medical? |
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Post by saaao on Jan 25, 2017 21:03:23 GMT -5
At 12.5 hearing per week, if you have an average of 400 pages in a file, that's 5,000 pages a week.
Does an experienced ALJ actually read everything on every page of the medical? The disability files are a bit different because rather than having to track the course of a single traumatic injury and subsequent improvement, you are often dealing with multiple chronic conditions in multiple specialty areas, and the interaction of these conditions and their treatment. Most of the time it still doesn't require reading every treatment note from beginning to end but most require a closer reading than a typical personal injury case, just because there are usually a lot more things going on. I started in personal injury before going to ODAR, and while I came in comfortable with Orthopedic and Neurology, notes I had to learn a ton about Rheumatology, Cardiology, Pulmonology,etc., etc. and those types of notes aren't nearly as neat and easy to digest as broken bones. Also claimant's tend to give their doctor's a more forthright answer of what they are doing with their spare time than they will in a disability report or disability hearing, so scanning the PCP notes for what the claimant is telling their doctor is a good practice. |
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Post by hopefalj on Jan 26, 2017 10:41:00 GMT -5
There is nothing, and I mean nothing, that eats up my time like editing. The quality of writing varies greatly from office to office. In good offices, I can get my editing and other functions done in something like, oh, a 50-hour workweek. In a bad office .... it's tough to even talk about it. I hate to say it but I think ALJs are going to spend a lot more time in EDIT with implementation of DWPI and the "race to the bottom" in terms of quality that it surely entails. A GS showed me the index and credit (I guess?) for each type of decision. Granted, I merely glanced at it, but it seemed a little more lenient than the old 4/8. Again, I just briefly looked at it, so it's likely I'm way off and would also hate it if I were still an AA. |
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Post by christina on Jan 26, 2017 11:27:04 GMT -5
I hate to say it but I think ALJs are going to spend a lot more time in EDIT with implementation of DWPI and the "race to the bottom" in terms of quality that it surely entails. A GS showed me the index and credit (I guess?) for each type of decision. Granted, I merely glanced at it, but it seemed a little more lenient than the old 4/8. Again, I just briefly looked at it, so it's likely I'm way off and would also hate it if I were still an AA. it is considerably better. the downside is AA's can be penalized for not meeting it and it does not address things such as 1500 page files, judges like hopefalj instructions (messing with you there bud  ) and the like. thanks for the post though. |
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Post by thankful1 on Jan 26, 2017 11:58:13 GMT -5
At 12.5 hearing per week, if you have an average of 400 pages in a file, that's 5,000 pages a week.
Does an experienced ALJ actually read everything on every page of the medical? If I were applying for disability, I'd want the person deciding the case to read everything I gave her or him |
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Post by montyburns on Jan 26, 2017 12:01:59 GMT -5
I hate to say it but I think ALJs are going to spend a lot more time in EDIT with implementation of DWPI and the "race to the bottom" in terms of quality that it surely entails. A GS showed me the index and credit (I guess?) for each type of decision. Granted, I merely glanced at it, but it seemed a little more lenient than the old 4/8. Again, I just briefly looked at it, so it's likely I'm way off and would also hate it if I were still an AA. I've seen the numbers for 13 different decision types they outlined, and the hours allotted for PF or DAA cases was more than the old 8 hours we used to have. But here's the thing- those aren't static numbers. Rather the DWPI is recalculated every month to see what those averages are for that month and where you fall relative to everyone else. Therefore there is constant pressure to work faster, because everyone else will be, and if you don't improve your time every month you will fall behind. Conversely there are not a lot of reliable metrics to quantify quality and let's face it, numbers will always trump quality in our environment. This is what I meant by a race to the bottom - everyone writing faster and faster with an inevitable drop in quality. |
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Post by montyburns on Jan 26, 2017 12:03:46 GMT -5
I used to handle personal injury work exclusively. It was never necessary to read every word or even every page of medical. The hospital discharge summary and the last 6-ish lines of the office visit notes contain the legally salient facts of the patient's condition.
Does an experienced ALJ actually read everything on every page of the medical? If I were applying for disability, I'd want the person deciding the case to read everything I gave her or him Yep. That's the problem with all this OCR/ computer review/summary of the evidence - you still have to read the entire file. Can you really say you did that if all you read was some eBB summary of the evidence? |
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Post by hopefalj on Jan 26, 2017 12:14:29 GMT -5
If I were applying for disability, I'd want the person deciding the case to read everything I gave her or him Yep. That's the problem with all this OCR/ computer review/summary of the evidence - you still have to read the entire file. Can you really say you did that of all you read was some eBB summary of the evidence? I get your meaning as I wrote for judges that just read the DDE for all of the records prior to their evaluation and started after that (and some taking even shorter cuts), but it really depends on the records in front of you. Do you really need to thoroughly review 34 straight pages of hospital orders or vitals? The page in every one of the claimant's PCP records that has unchanged social history and past medical history? The 50 pages of women's health records in a case not involving women's health issues? Some of that can have useful information, but as you grow accustomed to the local healthcare providers and their records, it becomes far easier to mine the gold needed to make a decision in an efficient manner. |
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Post by thankful1 on Jan 26, 2017 12:30:15 GMT -5
I agree. A literal top to bottom read of every single page is not necessary, in my opinion. Additionally, if there is overwhelming evidence of disability, I'm not going to exhaustively search for contrary evidence. But it's hard to know if page 112 of exhibit 17F contains relevant information without knowing what's on it, and typically, to know what's on it, I've had to see it, even if it is to only scan it.
I find it challenging to do that with 45 cases scheduled per month. I find that it can't be done in 40 hours per week. Obviously, some people are quicker than others.
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Post by montyburns on Jan 26, 2017 12:30:32 GMT -5
Yep. That's the problem with all this OCR/ computer review/summary of the evidence - you still have to read the entire file. Can you really say you did that of all you read was some eBB summary of the evidence? I get your meaning as I wrote for judges that just read the DDE for all of the records prior to their evaluation and started after that (and some taking even shorter cuts), but it really depends on the records in front of you. Do you really need to thoroughly review 34 straight pages of hospital orders or vitals? The page in every one of the claimant's PCP records that has unchanged social history and past medical history? The 50 pages of women's health records in a case not involving women's health issues? Some of that can have useful information, but as you grow accustomed to the local healthcare providers and their records, it becomes far easier to mine the gold needed to make a decision in an efficient manner. Oh I hear ya, but you you at least glanced over the records and rendered your own judgment about the materiality/relevance of the evidence. And who knows, the on/gyn records may contain the claimants shocking admission that they are planning to defraud SSA (hasn't happened yet, but who knows). And that ALJ who only reads the A section - I know that guy/gal! |
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Post by montyburns on Jan 26, 2017 12:37:09 GMT -5
At 12.5 hearing per week, if you have an average of 400 pages in a file, that's 5,000 pages a week.
Does an experienced ALJ actually read everything on every page of the medical? Really? I fInd you need to be less thorough than in PI/WC because you are not dealing with causation/relatedness of treatment/ necessity of treatment. Nor are we concerned as much with BS impeachment/"gotcha" moments (e.g. -you said on this form you had seizures since June but later said May - LIAR!). Also, you must have had some great clients, because a lot of mine would usually provide some damning admissions/omissions in the intake forms and subjective complaint part of the SOAP notes. |
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Post by Reverend Geek on Jan 26, 2017 12:43:22 GMT -5
Oh I hear ya, but you you at least glanced over the records and rendered your own judgment about the materiality/relevance of the evidence. And who knows, the on/gyn records may contain the claimants shocking admission that they are planning to defraud SSA (hasn't happened yet, but who knows). It happens. A cardiologist once scrawled, "Patient is applying for disability but secretly works as a bodyguard." I've also seen a "GOMER" (Get Out of My Emergency Room) once or twice, as well as "frequent E.D. visitor because crazy." |
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Post by aa7 on Jan 26, 2017 12:54:01 GMT -5
I hate to say it but I think ALJs are going to spend a lot more time in EDIT with implementation of DWPI and the "race to the bottom" in terms of quality that it surely entails. A GS showed me the index and credit (I guess?) for each type of decision. Granted, I merely glanced at it, but it seemed a little more lenient than the old 4/8. Again, I just briefly looked at it, so it's likely I'm way off and would also hate it if I were still an AA. The biggest problem is that a writer's time for training, research, or mentoring is not subtracted from their time in the DWPI. The old 4/8 system allowed that time for these activities to be removed from the calculation. The shift is dramatic. At least for me, who used to do a lot of research and mentoring. It's depressing and demoralizing to be judged now solely on the number of widgets I produce.
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Post by Pixie on Jan 26, 2017 13:01:13 GMT -5
A GS showed me the index and credit (I guess?) for each type of decision. Granted, I merely glanced at it, but it seemed a little more lenient than the old 4/8. Again, I just briefly looked at it, so it's likely I'm way off and would also hate it if I were still an AA. The biggest problem is that a writer's time for training, research, or mentoring is not subtracted from their time in the DWPI. The old 4/8 system allowed that time for these activities to be removed from the calculation. The shift is dramatic. At least for me, who used to do a lot of research and mentoring. It's depressing and demoralizing to be judged now solely on the number of widgets I produce.
Yes, there is a great deal of satisfaction, at least for me, in being a successful mentor. |
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Post by numbersix on Jan 26, 2017 13:03:43 GMT -5
A GS showed me the index and credit (I guess?) for each type of decision. Granted, I merely glanced at it, but it seemed a little more lenient than the old 4/8. Again, I just briefly looked at it, so it's likely I'm way off and would also hate it if I were still an AA. The biggest problem is that a writer's time for training, research, or mentoring is not subtracted from their time in the DWPI. The old 4/8 system allowed that time for these activities to be removed from the calculation. The shift is dramatic. At least for me, who used to do a lot of research and mentoring. It's depressing and demoralizing to be judged now solely on the number of widgets I produce.
What was the old 4/8 system? |
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Post by Pixie on Jan 26, 2017 13:07:57 GMT -5
8 hours for an unfavorable and 4 hours for a favorable.
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Post by hopefalj on Jan 26, 2017 14:07:05 GMT -5
A GS showed me the index and credit (I guess?) for each type of decision. Granted, I merely glanced at it, but it seemed a little more lenient than the old 4/8. Again, I just briefly looked at it, so it's likely I'm way off and would also hate it if I were still an AA. The biggest problem is that a writer's time for training, research, or mentoring is not subtracted from their time in the DWPI. The old 4/8 system allowed that time for these activities to be removed from the calculation. The shift is dramatic. At least for me, who used to do a lot of research and mentoring. It's depressing and demoralizing to be judged now solely on the number of widgets I produce.
Thank you to you and Monty for explaining it a little better for me. I was just glad I never had to deal with a PACS review, and this sounds like even more fun. |
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Post by bowser on Jan 26, 2017 18:27:57 GMT -5
Strikes me as harebrained to apply any specific scheduling expectation to any ALJ who is exceeding 500 dispositions annually and meeting the affirmance expectations. If you don't postpone a ton of hearings and hold a ton of supplementals, scheduling 50 a month will result in far more than 500 cases ready for disposition. And, if you don't have the staff to work them up PRE and POST and draft decent decisions, that ALJ is going to end up with a huge pile of cases aging in his/her ALPO/EDIT, along with the stress of juggling that workload.
If they are going to threaten telework for someone who is exceeding 500, why oughtn't such an ALJ just come into the office and reduce his/her dispositions to 450, or even 400? Might be the result management gets if they apply a hardline on this...
Use all of your leave. Take advantage of credit hours. Come in late/leave early. Take the time to edit the lousy drafts. Sounds like a less stressful existence than continually jumping through hoops.
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Post by monday on Jan 26, 2017 20:15:49 GMT -5
It happens. A cardiologist once scrawled, "Patient is applying for disability but secretly works as a bodyguard." I've also seen a "GOMER" (Get Out of My Emergency Room) once or twice, as well as "frequent E.D. visitor because crazy." I've certainly seen a claimant who testified he couldn't do sedentary work tell the doctor how often he plays basketball or the guy who had a hard time getting to the doctor because it was his busy season at work. |
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) and the like. thanks for the post though. 
