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Post by nylawyer on Feb 22, 2023 12:55:01 GMT -5
Just venting here, but boy you gotta love a remand because you failed to do something that you were just told in an OCEP training that you are under no circumstances ever to do. (It was a District Court remand).
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Post by ok1956 on Mar 10, 2023 16:08:54 GMT -5
Reviewed an AC remand today. Fully favorable and remanded because the non-severe impairments weren’t “adequately” discussed. Um WHAT?
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Post by christina on Mar 10, 2023 16:51:18 GMT -5
Reviewed an AC remand today. Fully favorable and remanded because the non-severe impairments weren’t “adequately” discussed. Um WHAT? 😒 |
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Post by neufenland on Mar 10, 2023 19:22:17 GMT -5
Reviewed an AC remand today. Fully favorable and remanded because the non-severe impairments weren’t “adequately” discussed. Um WHAT? So, serious question from an outsider, but why would a fully favorable determination be appealed to the Appeals Council? I would imagine the claimant would be satisfied, and since there is no adverse party, it seems odd to see an appeal. Does the AC do sua sponte reviews? |
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Post by hopefalj on Mar 10, 2023 19:24:35 GMT -5
Reviewed an AC remand today. Fully favorable and remanded because the non-severe impairments weren’t “adequately” discussed. Um WHAT? So, serious question from an outsider, but why would a fully favorable determination be appealed to the Appeals Council? I would imagine the claimant would be satisfied, and since there is no adverse party, it seems odd to see an appeal. Does the AC do sua sponte reviews? Yes, they do. And they’re incredible at it. |
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Post by christina on Mar 10, 2023 21:07:13 GMT -5
Reviewed an AC remand today. Fully favorable and remanded because the non-severe impairments weren’t “adequately” discussed. Um WHAT? So, serious question from an outsider, but why would a fully favorable determination be appealed to the Appeals Council? I would imagine the claimant would be satisfied, and since there is no adverse party, it seems odd to see an appeal. Does the AC do sua sponte reviews? Unfortunately |
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Post by arkstfan on Mar 11, 2023 1:03:55 GMT -5
So, serious question from an outsider, but why would a fully favorable determination be appealed to the Appeals Council? I would imagine the claimant would be satisfied, and since there is no adverse party, it seems odd to see an appeal. Does the AC do sua sponte reviews? Unfortunately It's been more than a year since I had an own motion remand. The last one I had the RFC included restriction of "requires a cane in the dominant upper extremity to ambulate more than X feet from the duty station" Remand stated that the record did not support the restriction. Other than primary care physician prescribing the cane, the primary and a specialist noting antalgic gait and use of cane. Plus the claimant testifying did not need the cane for balance or walking short distances. Said could pick up a few items at the dollar store and not use cane but needed it at larger discount stores and grocery stores. Testified that used the cane in the dominant hand. |
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Post by rp on Mar 11, 2023 23:09:51 GMT -5
So, serious question from an outsider, but why would a fully favorable determination be appealed to the Appeals Council? I would imagine the claimant would be satisfied, and since there is no adverse party, it seems odd to see an appeal. Does the AC do sua sponte reviews? Yes, they do. And they’re incredible at it. Yes. With “incredible” - at least to me - meaning “ridiculous.” There is a lot of substitution of judgement going on in these own motion reviews. Not sure that it does anything at all. Most ALJs I know simply do the hearing again and grant the benefits - again. Last time I checked - AC doesn’t review them again. So my question is - what’s the point? I had one where an ME said a claimant equaled a listing for congestive heart failure. AC own motion review said “wrong! Do it again.” The claimant’s ejection fraction is less than 20% and frankly the claimant will likely not survive. If they simply thought it should have been step 5 instead of step 3, then why send it back?! Just issue a new decision. And by the way - continued the claimant’s benefits during the remand so you KNOW the AC believes the claimant is disabled. 🤦♂️ |
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Post by arkstfan on Mar 12, 2023 11:10:08 GMT -5
Yes, they do. And they’re incredible at it. Yes. With “incredible” - at least to me - meaning “ridiculous.” There is a lot of substitution of judgement going on in these own motion reviews. Not sure that it does anything at all. Most ALJs I know simply do the hearing again and grant the benefits - again. Last time I checked - AC doesn’t review them again. So my question is - what’s the point? I had one where an ME said a claimant equaled a listing for congestive heart failure. AC own motion review said “wrong! Do it again.” The claimant’s ejection fraction is less than 20% and frankly the claimant will likely not survive. If they simply thought it should have been step 5 instead of step 3, then why send it back?! Just issue a new decision. And by the way - continued the claimant’s benefits during the remand so you KNOW the AC believes the claimant is disabled. 🤦♂️ District Court is where the real, nah I disagree so do it again happens. |
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Post by rp on Mar 12, 2023 18:34:21 GMT -5
Yes. With “incredible” - at least to me - meaning “ridiculous.” There is a lot of substitution of judgement going on in these own motion reviews. Not sure that it does anything at all. Most ALJs I know simply do the hearing again and grant the benefits - again. Last time I checked - AC doesn’t review them again. So my question is - what’s the point? I had one where an ME said a claimant equaled a listing for congestive heart failure. AC own motion review said “wrong! Do it again.” The claimant’s ejection fraction is less than 20% and frankly the claimant will likely not survive. If they simply thought it should have been step 5 instead of step 3, then why send it back?! Just issue a new decision. And by the way - continued the claimant’s benefits during the remand so you KNOW the AC believes the claimant is disabled. 🤦♂️ District Court is where the real, nah I disagree so do it again happens. Well I don’t think it’s a competition. But perhaps the AC is gaining on the District Courts. And District Court remands don’t count against me. AC Remands do. So that’s one of the reasons why I care. Also - I just heard from a few practitioners in my neck of the woods. One stated: “ Out of 26 cases at the AC currently, 4 were FFD and are own motion review.” I think we are seeing a trend here. |
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Post by arkstfan on Mar 14, 2023 0:30:19 GMT -5
District Court is where the real, nah I disagree so do it again happens. Well I don’t think it’s a competition. But perhaps the AC is gaining on the District Courts. And District Court remands don’t count against me. AC Remands do. So that’s one of the reasons why I care. Also - I just heard from a few practitioners in my neck of the woods. One stated: “ Out of 26 cases at the AC currently, 4 were FFD and are own motion review.” I think we are seeing a trend here. Certainly not trying to sort it into a competition, just what I'm seeing. So many district court remands I see boil down to nah don't like that outcome, while what I see from AC tends to more to you didn't consider exhibit 33F even though it was marked exhibited and offered nothing not in other exhibits and such. |
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Post by nylawyer on Mar 14, 2023 8:18:14 GMT -5
I haven't seen any fully favorable remands in a while. I have had a couple of partial favorables that the rep appealed and the AC sent it back because they had a problem with the favorable portion of the decision, but that's not exactly the same thing.
(As a side note, it is appalling to me how many times I see either initial appeals or remands on partial favorables where the rep didn't tell the claimant that the favorable portion would also be reviewed).
I would agree that the District Court remands tend to be about disagreeing with the outcome while the AC tends to focus more on the technical issues. (And, boy do I wish the District Court would just reverse the decision and order the benefits instead of sending it back).
I recently had one of the dumbest AC remands I have ever seen (but not the all time worst). I can't give the details here as the facts are unique enough to be identifiable, but suffice to say the prior ALJ issued an unfavorable finding and the AC felt it wasn't unfavorable enough.
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Post by arkstfan on Mar 18, 2023 23:27:40 GMT -5
I haven't seen any fully favorable remands in a while. I have had a couple of partial favorables that the rep appealed and the AC sent it back because they had a problem with the favorable portion of the decision, but that's not exactly the same thing. (As a side note, it is appalling to me how many times I see either initial appeals or remands on partial favorables where the rep didn't tell the claimant that the favorable portion would also be reviewed). I would agree that the District Court remands tend to be about disagreeing with the outcome while the AC tends to focus more on the technical issues. (And, boy do I wish the District Court would just reverse the decision and order the benefits instead of sending it back). I recently had one of the dumbest AC remands I have ever seen (but not the all time worst). I can't give the details here as the facts are unique enough to be identifiable, but suffice to say the prior ALJ issued an unfavorable finding and the AC felt it wasn't unfavorable enough. Ha! Had that happen few years ago. Sedentary RFC with several restrictions. AC remanded noting record indicated light work and disagreed with couple restrictions. I’ve always been a give claimant benefit of the doubt on impairments if it doesn’t change outcome. Got a remand on return to past work where AC concluded VE didn’t mean the job claimant worked for roughly 1700 hours for about 29 months and instead meant the different occupation the claimant worked for 20 hours one week. AC rightly concluded 20 hour was insufficient to use as past relevant work and wrongly concluded VE had meant that occupation |
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