Help! Decision Writing Advice

[christina]

Oct 22, 2020 5:25:39 GMT -5 Portulaca said:

Oct 18, 2020 22:29:36 GMT -5 jimmy224 said:

Keep in mind too, you do not need to cite all the evidence www.ssa.gov/OP_Home/hallex/I-03/I-3-3-4.html
When determining whether to recommend to the AC that an ALJ's decision is supported by substantial evidence, an Office of Appellate Operations analyst will consider the ALJ's action, findings, and conclusions as well as any evidence the ALJ cited in the decision. Additionally, the analyst will evaluate the entire record, including the evidence the ALJ did not cite in the decision.
www.casemine.com/judgement/us/5be3c1d0342cca4ce4b51c14
The commissioner's reliance on evidence of record not cited by an ALJ in support of the ALJ's stated rationale is not improper. "Evidence not cited by an [ALJ] may be relied upon as substantial evidence in support of his or her decision." Paquin v. Colvin, No. 1:13-cv-360-JDL, 2014 WL 6679123, at *4 n.5 (D. Me. Nov. 25, 2014) (citations omitted).

So, knowing that you don’t need to cite to all the evidence, you can use that to cut down on what you write and get faster at drafting decisions (the key is knowing what needs to be articulated in the decision, what is relevant and needs to be discussed, etc—and you get an understanding of that from reading hallex Poms ssrs etc

Before relying on the bolded advice above, I would recommend looking at Chenery v. SEC, 318 U.S. 80 (1943), an old US Supreme Court case that did not buy the use of post hoc rationale that was not relied on by an ALJ. While the AC may be okay with looking at the record to see whether the ALJ's decision is supported by substantial evidence, including evidence not clearly relied on, federal courts cannot be expected to do so.  There is obviously some gray area here, but I think the evidence cited needs to provide substantial evidence in support of the ALJ's findings.

Yeah I’d say this depends on where you are at. I know that is scotus case referenced above and am not ignoring this

In some district courts, the D. Court will only look at what AlJ cited to. Presumably the Court in Maine follows its own precedent and I’m sure OGC argues first case cited above. However, based on remands I’ve seen, not every D. Court follows the finding from this case so I’d ask how District Courts in your area handle this issue.

[lurkerbelow]

I tend to avoid using citations to anything not in our guidance. This is purely a matter of efficiency.

[statman]

I put in exhibit and page cites. District courts do what they want and frequently disregard the substantial evidence rule and all other rules. Besides that the AC nitpicks things to death when they want to remand. Full disclosure I have a terrible remand rate. However it only bothers me when I realize that I made a substantial mistake.

[christina]

Oct 18, 2020 13:05:19 GMT -5 willowby said:

Hi, I have been a decision writer for two years. I have definitely increased my drafting pace but I still have a very difficult time with case that have over 400 or so pages of medical records (and I realize that most cases have over that amount). I do not take notes. I draft as I go through the records. I have tried a few times to take notes and then summarize in my drafts instead of going through appointments but I can only do that for files with a limited amount of medical evidence. I would greatly appreciate advice on how to increase my speed in cases with a lot of medical evidence. Do you recommend taking notes? If so, how do you take notes? Do you use excel? Do you use some sort of table? Do you just do it freehand on the computer or paper? On the other hand, would you discourage taking notes because it is a sure way to slow myself down? I struggle to meet the 95% rate every month. I don't break for lunch. I work straight through the day except for bathroom breaks and grabbing stuff to eat from the kitchen. Every month, I seem to get cases that take me a lot more time that we are allotted to do certain cases and then I end up with some cases that take me less time so I can make up the difference (is this the same with other writers?) but, usually, only by the skin of my teeth. I have searched Sharepoint looking for some advice on this issue (getting through cases with lots of medical evidence) and have found very little. Does anyone know of any helpful SSA document on this issue? Thank you.

Do u type well? It’s been my informal observation that many who struggle type at mediocre speed. If you are under 50 to 60 wpm find a typing program that works best for u.

I still am not fast with uf or pf cases with a lot of pages either.

For ff cases as noted in previous posts, save time on them. Keep them as short and sweet as u can within judges’ preferences.

First thing I do is make sure there are no red flag issues eg evidence needs proffered, sga problems in ff. If prw case, I make sure job(s) are sga, within last 15 years, and performed long enough.

I’ve tried lots of methods over the years. One thing I’ve done recently is get myself in the mindset I’m working on a “final exam” when writing a longer case. I hyperfocus on decision only and on time I’m spending. Like when I took a final and had 5 questions in 2 hours. I can’t spend more than 40 minutes per question.

For years, I put Alj instructions into draft first. This keeps me from forgetting something ALJ considered important.

I will add additional comments at another time. I’m getting tired 😴

Good luck and keep hanging on! You got this.

[nappyloxs]

Autocorrect is still in current version. Autotext is now called building blocks and quick parts in word. I simply refer to autotext as any of the three functions (autocorrect, building blocks, quick parts). Once you start using it for common terms, you start using it for common paragraphs. I have talked with people who spend too much on parts of decisions. SGA for example. It is either iSGA, not SGA, give benefit of doubt and proceed, UWA, TWP/EPE. In a Step 4/5, SGA finding does not need a long detailed discussion citing positions, name of employers, dates of employment, and break down of earnings. Use autotext, insert facts, and get it done in a few minutes.

I used it for listings too. 1.01x, 1.03x, 11.04x etc... Yes, the finding was longer but to me, it made decision more legally sufficient. I don’t write anymore, but review remands and have seen too many remands that mention the physical listings were not adequately considered. Recently just dealt with a court remand on this issue. Not saying my method would have prevented remand, but ..remand orders mention problem with the other style. Sorry I erased original comment here since it is public forum and judges don’t want anymore remands.

Routine RFCs, procedural history info (CV hearing language), AR language, Rep names, Dr names, providers, exam findings, prw language, intro/conclusion sentences, consistency/supportability language, and so much more can be added to autotext. Just trying to give OP some ideas of how to use it.

Overall, it is a useful tool to insert common phrases, language, and template. It must still be tailored to facts and should be used to make draft more persuasive. More importantly, you still have to write most of the draft.

Anyone, feel free to pm me for more info.

[nappyloxs]

Oct 22, 2020 20:20:14 GMT -5 christina said:

Oct 18, 2020 13:05:19 GMT -5 willowby said:

Hi, I have been a decision writer for two years. I have definitely increased my drafting pace but I still have a very difficult time with case that have over 400 or so pages of medical records (and I realize that most cases have over that amount). I do not take notes. I draft as I go through the records. I have tried a few times to take notes and then summarize in my drafts instead of going through appointments but I can only do that for files with a limited amount of medical evidence. I would greatly appreciate advice on how to increase my speed in cases with a lot of medical evidence. Do you recommend taking notes? If so, how do you take notes? Do you use excel? Do you use some sort of table? Do you just do it freehand on the computer or paper? On the other hand, would you discourage taking notes because it is a sure way to slow myself down? I struggle to meet the 95% rate every month. I don't break for lunch. I work straight through the day except for bathroom breaks and grabbing stuff to eat from the kitchen. Every month, I seem to get cases that take me a lot more time that we are allotted to do certain cases and then I end up with some cases that take me less time so I can make up the difference (is this the same with other writers?) but, usually, only by the skin of my teeth. I have searched Sharepoint looking for some advice on this issue (getting through cases with lots of medical evidence) and have found very little. Does anyone know of any helpful SSA document on this issue? Thank you.

Do u type well? It’s been my informal observation that many who struggle type at mediocre speed. If you are under 50 to 60 wpm find a typing program that works best for u.

I still am not fast with uf or pf cases with a lot of pages either.

For ff cases as noted in previous posts, save time on them. Keep them as short and sweet as u can within judges’ preferences.

First thing I do is make sure there are no red flag issues eg evidence needs proffered, sga problems in ff. If prw case, I make sure job(s) are sga, within last 15 years, and performed long enough.

I’ve tried lots of methods over the years. One thing I’ve done recently is get myself in the mindset I’m working on a “final exam” when writing a longer case. I hyperfocus on decision only and on time I’m spending. Like when I took a final and had 5 questions in 2 hours. I can’t spend more than 40 minutes per question.

For years, I put Alj instructions into draft first. This keeps me from forgetting something ALJ considered important.

I will add additional comments at another time. I’m getting tired 😴

Good luck and keep hanging on! You got this.

Christina is correct about FFs. Keep them short and sweet. One tip with FFs, group opinions evidence and discuss together. If opinions support/consistent with disability, you may discuss them individually but have one s/c paragraph for them. Group all the unsupported/inconsistent opinions in one-two paragraphs.

[roymcavoy]

All of these tips are helpful—and I think the overarching thing is that whatever you choose for shortcuts, do them every time. I used to train decision writers and the one thing I tried to push across was doing the exact same thing every single time.

Repetition breeds speed.

[nylawyer]

Oct 23, 2020 1:05:34 GMT -5 nappyloxs said:

Oct 22, 2020 20:20:14 GMT -5 christina said:

Do u type well? It’s been my informal observation that many who struggle type at mediocre speed. If you are under 50 to 60 wpm find a typing program that works best for u.

I still am not fast with uf or pf cases with a lot of pages either.

For ff cases as noted in previous posts, save time on them. Keep them as short and sweet as u can within judges’ preferences.

First thing I do is make sure there are no red flag issues eg evidence needs proffered, sga problems in ff. If prw case, I make sure job(s) are sga, within last 15 years, and performed long enough.

I’ve tried lots of methods over the years. One thing I’ve done recently is get myself in the mindset I’m working on a “final exam” when writing a longer case. I hyperfocus on decision only and on time I’m spending. Like when I took a final and had 5 questions in 2 hours. I can’t spend more than 40 minutes per question.

For years, I put Alj instructions into draft first. This keeps me from forgetting something ALJ considered important.

I will add additional comments at another time. I’m getting tired 😴

Good luck and keep hanging on! You got this.

Christina is correct about FFs. Keep them short and sweet. One tip with FFs, group opinions evidence and discuss together. If opinions support/consistent with disability, you may discuss them individually but have one s/c paragraph for them. Group all the unsupported/inconsistent opinions in one-two paragraphs.

A little off topic (because I am not advising or suggesting anyone do anything with this), but I suspect we will start to see a lot more FFs coming back from the AC.

[superalj]

Wow I’m impressed with all the advice. I have a couple suggestions. First, find out who are the stronger DWs in your office and ask them for help. Second, review the record before drafting the decision. I would go most recent to most remote through the exhibits using Dragon dictation to identify by date and then exhibit so you can refer back when drafting the important evidence and opinions. Third, read the instructions again and do a brief outline as to why the claimant is not disabled. It usually comes down to the objective medical evidence not supporting the allegations and sometimes good ADLs. Fourth, draft the case analyzing not summarizing the important evidence while discounting but always dealing with adverse evidence. Do not use dragon when drafting as you will have too many typos.

Try to use the same format in every case which will take a while a first but make your drafting more efficient in the end. Obviously you will have to take shortcuts during file review but concentrate on CEs, imaging, specialists and fly thru hospital records looking only for the discharge summary. Simarly fly though the family dr as they contain duplicates. Always look for missed opinions. Lastly, it takes a while. It took me a year but once you develop a system it’s like making a car a Honda not a BMW. And almost forgot, make up your time on the FFs good DW doesn’t need 2-3 hours for a FF. Just support that RFC and the time saved on concise FF will give you more time on the UFs.

[Synik]

At the risk of repeating others, here's my two cents, as a former writer/trainer and now a judge/trainer, with more than 20 years of Agency experience:
(1) I mostly wrote decisions pre-FIT (WordPerfect, then Word). I wrote for just a short time after FIT was mandated. I still write my own decisions occasionally, but have not yet used HACPS to do so. I basically wrote as I reviewed, but it was essentially taking notes in narrative form, inserting and rearranging as I went along so that, when my review was finished, my draft was essentially finished, as well. My suggestion would be to outline the RFC: "The preponderance of the evidence supports a conclusion that he is able to stand and/or walk for up to about four hours, but no more than that. Specifically,...." Do the same for lift/carry, posturals, etc. That way, the judge's RFC is fully supported and nothing gets overlooked. You can incorporate the "consistency" elements in that discussion, or do a separate section addressing inconsistencies or lack of support for subjective allegations. Same with opinions. You know, you could do that in a Word doc and just plop it into the template once you're happy with the final product.
(2) Read through all of the judge's instructions, from beginning to end. Get a "feel" for how s/he reached the conclusion, if you are able. I know -- a lot of ALJs simply don't give you that. More often than not, I give the decision writers way more than they want or need. However, that's for ME, in case the draft is poorly written and I have to perform major rehabilitative surgery.
(3) My pet peeve about FIT/HACPS is the relative lack of flexibility. It marches the writer down a path that might not be the most efficient approach to a draft. Because of its structure, I see way too many decisions that start with a stream-of-consciousness recitation of the testimony that jumps all over the place, followed by a visit-by-visit medical history, capped off by conclusory statements without tying it all together. Notwithstanding my advice above, some decisions really lend themselves better to impairment-by-impairment analysis and others make more sense if the treatment history is addressed more chronologically. Be prepared to think outside the box.
(4) The claimant already knows his medical history. You only need to address in the draft information that is relevant to salient points, not every runny nose and skinned knee. BTW, PLEASE do not recite everything the claimant TELLS a CE provider. If the claimant says something inconsistent to one CE versus another or versus testimony, sure, point it out. But don't waste your time providing every detail. No one -- not the claimant/rep, not the ALJ, and not any reviewing body -- wants to slog through a 20- or 30-page decision!
(5) Read recent decisions written by others and cull out language that sounds good to you -- maybe run it by a Senior Attorney, GS or an ALJ. Tweak as you go along. Someone else pointed out that much of the WoW canned language is obsolete. I keep a OneNote Notebook with a page of my preferred canned language so that I can pop it into drafts as I wish, and I update it as necessary, e.g., the recent change as to how we handle inability to communicate effectively in English. (Of course, it helps if the writer pays attention to the fact that I ask for 1st-person drafting so that it matches.)

It comes down to this -- do what works for you and expect that to change frequently throughout the years.

Happy Writing!

[places2go]

I am former writer now ALJ.  I agree with a lot of the comments.  I still use quickparts for things I need to pop into deicsions (5-day rule language, proffer language, etc).  As a writer I found having language for common listings, obesity, whether fibromyalgia was medically determinable, etc was very helpful.  Pop it in, tweak the language, and add a couple cites.  Don't recreate the wheel every time.  

I also suggest, as others have stated, that you know what you are looking for.  So read the instructions and have an idea of what is important.  Don't reiterate every medical appointment and subjective complaint.  I had one decision that stated for every office visit that the claimant reported drinking two beers a day.  The beer drinking was not relevant to the issues at all.  Leave that stuff out unless it adds value.  

As for taking notes in general, I always did.  But know what you are looking for before you start.  And as tempting as it is to jump in, try scrolling through the exhibits first to get an idea what was going on, rather than just take notes on every single visit and then look back to see what you ended up with.  You might find that there are 15 PCP visits and most were due to strep throat or a cough that has nothing to do with the impairments.  Think about what you are looking for.  Ex for ortho/neuro look for tenderness, ROM, sensation, reflexes, gait, etc.  If it's an impairment that is demonstrated by subjective reports, what is important?  ex for fibromyalgia, reports of pain and fatigue, as well as tender points on exam are important; headaches:frequency, duration, severity, and response to medication are important.  If someone is treating for headaches, scroll through the neuro visits and get an idea of what happened over time, and summarize, rather than explain each visit.  Maybe it took 6 months, and 4-5 visits, but if after some trials they found something that worked, that's what's important, and you don't have to give all the details of each visit. 

I was able, after a couple years, to draft FF by taking the notes into the decision and drating as I went along. I never could for UF. For UF, I opened a blank doc and took notes and drafted into it at the same time. I generally organized by impairment, and was able to add citations and language as I went along, and tweak the language along the way, if necessary. But I could also take a random note that I thought might be relevant but was not sure.  Then, I could cut and paste chunks into the final decision template.  I always had the original to fall back on if I edited something out of the final draft and then regretted it later. (That is so frustrating and a huge time loss to recreate the lost language)



I agree with having a process and following it.  A routine helps you do it faster over time, and keeps you from missing things.  I agree with doing B criteria, and other listing paragraphs, last.  When I started, I would sit an stew over trying to figure out what to put in each B criteria and how to discuss the listings. Once you have done the RFC, you generally have all of the info and citations you need and can summarize into the listing language.  To keep myself from forgetting to go back, I would highligt the listing section, so it would catch my eye and I would know to go back.     

[nappyloxs]

Oct 23, 2020 16:18:53 GMT -5 Synik said:

At the risk of repeating others, here's my two cents, as a former writer/trainer and now a judge/trainer, with more than 20 years of Agency experience:
(1) I mostly wrote decisions pre-FIT (WordPerfect, then Word). I wrote for just a short time after FIT was mandated. I still write my own decisions occasionally, but have not yet used HACPS to do so. I basically wrote as I reviewed, but it was essentially taking notes in narrative form, inserting and rearranging as I went along so that, when my review was finished, my draft was essentially finished, as well. My suggestion would be to outline the RFC: "The preponderance of the evidence supports a conclusion that he is able to stand and/or walk for up to about four hours, but no more than that. Specifically,...." Do the same for lift/carry, posturals, etc. That way, the judge's RFC is fully supported and nothing gets overlooked. You can incorporate the "consistency" elements in that discussion, or do a separate section addressing inconsistencies or lack of support for subjective allegations. Same with opinions. You know, you could do that in a Word doc and just plop it into the template once you're happy with the final product.
(2) Read through all of the judge's instructions, from beginning to end. Get a "feel" for how s/he reached the conclusion, if you are able. I know -- a lot of ALJs simply don't give you that. More often than not, I give the decision writers way more than they want or need. However, that's for ME, in case the draft is poorly written and I have to perform major rehabilitative surgery.
(3) My pet peeve about FIT/HACPS is the relative lack of flexibility. It marches the writer down a path that might not be the most efficient approach to a draft. Because of its structure, I see way too many decisions that start with a stream-of-consciousness recitation of the testimony that jumps all over the place, followed by a visit-by-visit medical history, capped off by conclusory statements without tying it all together. Notwithstanding my advice above, some decisions really lend themselves better to impairment-by-impairment analysis and others make more sense if the treatment history is addressed more chronologically. Be prepared to think outside the box.
(4) The claimant already knows his medical history. You only need to address in the draft information that is relevant to salient points, not every runny nose and skinned knee. BTW, PLEASE do not recite everything the claimant TELLS a CE provider. If the claimant says something inconsistent to one CE versus another or versus testimony, sure, point it out. But don't waste your time providing every detail. No one -- not the claimant/rep, not the ALJ, and not any reviewing body -- wants to slog through a 20- or 30-page decision!
(5) Read recent decisions written by others and cull out language that sounds good to you -- maybe run it by a Senior Attorney, GS or an ALJ. Tweak as you go along. Someone else pointed out that much of the WoW canned language is obsolete. I keep a OneNote Notebook with a page of my preferred canned language so that I can pop it into drafts as I wish, and I update it as necessary, e.g., the recent change as to how we handle inability to communicate effectively in English. (Of course, it helps if the writer pays attention to the fact that I ask for 1st-person drafting so that it matches.)

It comes down to this -- do what works for you and expect that to change frequently throughout the years.

Happy Writing!

I was just about to post about OneNote! It is an awesome tool. I used tabs for each area/finding of decision for canned language and broke tabs down futher with sections for different issues/topics. Also, I have additional resource tabs by topics. I have encouraged an office version to no avail though. Maybe I will try again with new FY and recent changes.

Great point about reading others’ decisions, 1-2 a month is good start.

Lots of excellent info in last few posts.

[places2go]

I have encouraged an office version to no avail though. Maybe I will try again with new FY and recent changes.

Great point about reading others’ decisions, 1-2 a month is good start.

Lots of excellent info in last few posts. [/quote]


Having an office document or folder to share info is a great idea. My office, when I was a writer, did this. One of the GSs was a gatekeeper to make sure people were not adding language that was incorrect. It was a great resource for novel issues that could come up again and suggested language for new writers. I highly suggest this, if you have a supportive office.

[generalsherman]

Two things I do that make my life easier are autotexts in MS Word. I don’t know if that’s the right term, but I set it up where I type “ddd” and it changes it to degenerative disc disease, or I set up another one where I type a string of characters that autcorrects into a sentence about who the representative was at the hearing. It only saves a few minutes, probably, but it’s very good in reducing frustration because typing “so and so, an attorney, appeared at the hearing on the claimant’s behalf” is a hassle every time.

I also made an MS Word document for common listings that I can cut and paste into the decision. That’s helpful because the listings rarely change but some of them are quite lengthy. Again it only saves a few minutes or so but it’s much better than doing it new each time.

I’m probably one of the few people who takes notes by hand. That way I can look at them without having to switch back and forth between different tabs in the screen. It’s a system I used when I was a rep and I think it works well for DWing, but I am probably an outlier in that regard. I mainly don’t like switching screens/tabs and handwritten notes avoid that. And no, there’s no PII on them either

[places2go]

Oct 24, 2020 20:11:59 GMT -5 generalsherman said:

Two things I do that make my life easier are autotexts in MS Word. I don’t know if that’s the right term, but I set it up where I type “ddd” and it changes it to degenerative disc disease, or I set up another one where I type a string of characters that autcorrects into a sentence about who the representative was at the hearing. It only saves a few minutes, probably, but it’s very good in reducing frustration because typing “so and so, an attorney, appeared at the hearing on the claimant’s behalf” is a hassle every time.

I also made an MS Word document for common listings that I can cut and paste into the decision. That’s helpful because the listings rarely change but some of them are quite lengthy. Again it only saves a few minutes or so but it’s much better than doing it new each time.

I’m probably one of the few people who takes notes by hand. That way I can look at them without having to switch back and forth between different tabs in the screen. It’s a system I used when I was a rep and I think it works well for DWing, but I am probably an outlier in that regard. I mainly don’t like switching screens/tabs and handwritten notes avoid that. And no, there’s no PII on them either

I stopped hand writing notes pretty quickly when I realized it took me too long to type after, rather than cut and paste. But always do what works best for you. I also dislike clicking between tabs, as noted above. I got around this by using two monitors, both aligned horizontally and both split screen. This gives the ability to have 4 docs open at a time. (I am not a fan of a long vertical screen for the decision, which has always been popular with writers in my office.)