Saturday, April 22, 2006

From the Final Rule on Social Security Disability and SSI "reform"

This is taken from the final rule which was posted online at

"While the administrative law judge will not consider the Federal reviewing official's decision to be evidence, the written decision will explain in detail why the administrative law judge agrees or disagrees with the substantive findings and overall rationale of the Federal reviewing official's decision."

Ok, what is this telling us? Well, let's say a disability claimant who gets denied at the new federal review level (which will replace reconsideration starting 8/1/06 in the boston region which is mainly new england) requests a hearing before an administrative law judge. The hearing is held and at some point a decision is made. Regardless of whether the judge's decision is an approval or a denial, the disability judge will be required to "explain in detail" (here's another translation: probable pain in the ass) why he/she disagrees with the denial that was issued by the federal reviewing official (essentially, the new replacement "cog" for the reconsideration examiner).

Now, what's the possible fallout from this? Perhaps none. But, consider: if a disability claimant gets denied by an FRO (federal reviewing official) and then gets denied by a judge, how hard is that to justify? It's not hard at all. But if a judge approves a claimant that an FRO previously denied, then the judge's writeup, which he will be required to do, will effectively amount to a justification as to why he is making a different decision.

In the present system, judges issue decisions. But they don't have to present a rationale as to why they are making them. In other words, "johnny doesn't have to write a report explaining why he did what he did".

Once again, considering human nature, you have to wonder if this is going to affect, in some subtle way, the decision-making process of disability judges. Perhaps a judge who, before, may have given a claimant with a borderline case the "benefit of the doubt"...won't be so likely to do that in the new system.

And perhaps the fallout will be that judges will be gently nudged toward making more denials on claims. That is, in fact, the effect that external review has had on DDS adjudications (a disability examiner does not like "returns" ----because his supervisor doesn't like them and won't like him if he gets too many returns...and the net effect is that examiners are pressured to make denials).

SSA management claims that the purpose of having a disability judge rationalize his agreement or disagreement with the FRO is so the FRO can benefit from the feedback and improve in his own decision making. I guess like OJT (funny thing, recon examiners are already trained and don't need on-the-job training). Personally, though, I don't buy it. I see it more as an attempt to reduce the independent decision-making of administrative law judges.

If I'm right, you gotta hand it to this administration. They're pretty slick.

Return to the Social Security Disability SSI Benefits Blog

Other Posts

Filing a disability claim - don't procrastinate, get it done ?
Apply for SSI
How to qualify for disability
Social Security Disability SSI Georgia


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9:24 AM  

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