Saturday, May 21, 2011

Some Judges Can't Say No, but Others Can't Say Yes

According to the Wall Street Journal, one administrative law judge in West Virginia just can't say no to disability claims that come before him.  The attack on ALJ David Daugherty is simply poor journalism.  Now that the gantlet is on the ground, let's take a look at the numbers that the WSJ reproduced from the Social Security Administration web site.  

Does Judge Daugherty hear too many cases?  Apparently not.  Frederick McGrath heard cases in 9 different hearing offices during the same period.  ALJ McGrath decided procedurally or on the merits 1,749 cases during half the fiscal year.  

Does hearing a lot of cases mean that the ALJ is giving away the farm?  Apparently no.  ALJ McGrath has an allowance rate the fluctuates from office to office and has an allowance rate of only 69.5%.  So this ALJ is the tops in getting cases decided and right in the middle of the pack for percentage of cases in which he granted benefits.

Thomas Bundy has also heard cases in a number of hearing offices.  As the second most prolific ALJ in the system, he decided 763 cases on the merits and granted the claim in 23.3% of the cases.  If we assume for the sake of argument that people do sustain serious injuries and illnesses and that the presence of a disability system as part of the social safety net is a good thing, then administrative law judges must grant some claims.  The average allowance rate for ALJ's in the past 5 years has hovered around the mid-60's of cases decided on the merits.  This excludes dismissals for procedural errors, withdrawals of claims by people that change their minds, and other cases disposed of but not on the merits.  Assume the number is 65%, not as it should be but as it is.

According to the implication in the WSJ, ALJ Daugherty pays 35% too many cases.  Applying the dust that the WSJ throws at this judge,  that is 255 people.  

Now let's be fair and apply the same analysis to ALJ McGrath.  With a 69.5% allowance rate, he has no problem saying "no" to claimants.  If we use strict numbers though, that is 60 too many people.  

On the other end of the spectrum, ALJ Bundy decided 23.3% of cases favorably to people stating that their injuries or illnesses prevented them from working for 12 or more months.  At 42% below the magic number, that is 320 people that should have gotten benefits but did not.  

You decide.  Would you prefer that people that don't deserve benefits get some or would you prefer that people that deserve benefits get none.  For many people applying for benefits that have to go before an ALJ, it is a crap shoot.  While I can't defend Daugherty's numbers and find that judge's with McGrath's numbers look fantastic, I ache for the human beings that get stuck with someone like Bundy's numbers.  And it isn't just that he grants benefits to so very few people.  No, it is also that he is so damn prolific at the process of denying claims.  

That is the problem.  Figures lie and liars figure.  Without knowing how well the state agency's are at sorting out the claims before they get to the ALJ level, it is impossible to gauge the fairness of an ALJ.  The Social Security Advisory Board publishes data on claims and the report for 2006 (chart 69 on page 91) is readily available.  The Appeals Council reviews ALJ decisions and finds over 25% of the nearly 90,000 cases faulty.   The federal courts review another 12,000 of the cases that the Appeals Council did not send back to an ALJ for another hearing and reverses SSA in about half of those cases.  People that have to take a claim for disability through SSA, to the courts, and back to SSA ... well those people 5 years or more before they get the benefits that are eventually awarded.  Imagine every financial problem from loss of home, vehicles, savings; all of that happens to people that are subject to ALJs that can't find a way to say "yes" when benefits really are due.  

Perhaps Daugherty is too trusting.  He believes that people and doctors are basically honest.  He probably is too.  When an ALJ is basically untrusting, he says that he believes that people and doctors are dishonest and would and do lie to get benefits.  I don't expect an ALJ to be naive, but so assume that  most people have no integrity constitutes a pretty dim view of humanity.  

6 comments:

  1. For anyone outside of the legal profession (and, in light of the WSJ piece, within is well) many disability claims can be murky. If a worker loses his arm in a press or is blinded by toxic chemicals, it's very easy to conclude that he can no longer work, at least at his chosen profession.

    But some very real maladies, such as mental illness, nerve disorders, back problems and the like aren't as easy to see, and are probably more likely to arouse the suspicion of fraud because they're more difficult to prove.

    I think most people want to see disability $$$ get to the people who qualify for it, but don't want to see scammers abusing the system.

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  2. If we assume that any system involving people will have some errors, it is better or deprive some claims erroneously? In the criminal justice system, we prefer to find "not guilty" that that we are pretty sure did the deed in the hope that we will not erroneously convict the innocent.

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  3. Agreed. However, that doesn't obviate the need for scrutiny or for discussions about the issue. If, for example, it were determined that the majority or a large portion of people receiving disability funds (posed strictly for the sake of argument; I have no idea whatsoever what the actual data are)were not actually entitled to those payments, then while the benefits received by qualified applicants would be an unambiguously good thing, the system would still be flawed, and perhaps fatally so.

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  4. You are right but judges don't takes decisions on basis of emotions they go through the legal rules and if they find it correct they say yes and if find it wrong they say it no.

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  5. Interesting. But that does not explain the spread of decisional rates within the corps of ALJs, within Regions, and within offices. At least within offices served by the same DDS, the judges should receive approximately the same number and quality of cases.

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  6. But we have offices with allowance rates ranging from 80% to 25% in the same office. The variable is the identity of the ALJ. That is why SSA will hide the ID of the ALJ from the claimant and the bar until the day of hearing ... as of now.

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