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Social Security Scandal Averted In Charleston WV Appeals Office

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Huntington SSA Source Says Their Media Scandal Overshadowed Problems In Charleston Office

All of America is aware of the ongoing financial problems within the Social Security Administration and how politicians claim funds for SSA will be gone by 2030. But, the majority of Americans are unaware of the Social Security Administration's Appeals process for those people who apply for disability benefits and are denied them. The government entity that oversees an appeal of such a denial is known as the Office of Disability Adjudication and Review (ODAR).  ODAR functions through 169 hearing offices located across the US.

Each appeal is brought in the ODAR hearing office with jurisdiction in front of an Administrative Law Judge (ALJ) who examines medical evidence in support of the claimant's appeal. The ALJ then makes a determination based on the information on hand within the case file, expert witnesses, and supplemental arguments of the  lawyers that represent the claimant. Over the past year, evidence surfaced at the Huntington, West Virginia, ODAR office that shows the ODAR system is not working as intended:  enough so that Congress is investigating that office for numerous improprieties, some potentially felonious,  including alleged collusion between at least one former ALJ and an attorney in a case-fixing scandal that awarded 98% of that attorney's cases in the claimant's favor.  Claimants' attorneys frequently work for contingency fees in the types of cases heard before the ODAR courts. 

It now appears that the ongoing scandal within the Huntington SSA Appeals office overshadowed problems in another West Virginia ODAR office. According to one of our sources inside the Huntington office, their media scandal and congressional investigation kept the heat off serious issues being exposed in the ODAR office of Charleston, West Virginia--problems that include reports of management mishandling evidence; failure to mail out ALJ decisions timely, thereby denying futher appeal; and condoning questionable decisions by two judges.

With the national media attention focusing on Huntington ALJ David Daugherty's high appeal awards and alleged case-fixing ties with attorney Eric Conn, upper management in Charleston had the opportunity to fix their potential scandal without anyone finding out. Until now anyway. At first, most people felt that the problems in the Huntington office were isolated. However, according to that inside source and available records, SSA mismanagement extends also to Charleston, which had issues just as damaging to the SSA if found out.

Over a 3-year period of time, hundreds of ALJ case decisions were never mailed out until the 60-day time limit for claimants to appeal was about to expire. That in itself is a serious issue because once that deadline is up, a claimant may never be able to re-address their case again. SSA "recommends" that all decisions be mailed within one day of being prepared. And, if that were not trouble enough, management also knew that stacks of mail containing doctors reports or other evidence relevant to pending cases that ALJ's never saw before making some of their decisions on those cases were routinely left unopened in the office .

This unrevealed evidence, if timely made available, may have been the deciding factor to grant or deny a claim. The combination of both problems:  that of the ALJ decisions not being mailed out timely, and the unopened mail containing evidence, caused the appeal process to be defective. Eventually all of the mail was opened and placed into files, but once a case is decided and closed, there is little to no reason for a judge to re-open or change a previous decision.

One excuse given was that there was a lack of adequate staffing in the office. Bottom line, there is no excuse for either problem to have occurred. And there is no way to know the number of people who were denied equal access to the courts because of what happened. Reportedly, the problems have now been corrected, partly because of electronic filings and adequate staffing. During this same time period, Hearing Officer Chief Administrator Law Judge (HOCAL) Theodore Burock and Office Supervisor Teresa Bowen were transferred and new upper management was brought in. Correspondence we obtained  between employees in both offices verifies the problems existed.

One ALJ's High Number Of Decisions And Another's Low Rate Of Denials

As with the Huntington SSA scandal that instigated congressional hearings over higher than normal ALJ caseload decisions and/or lower than normal denial ratios, we found two ALJ's in Charleston whose statistics raise the same questions if not more. How did one judge manage to decide twice the number of cases as his counterparts while another averaged only a 1.5% denial rate in a 4 year consecutive period?

According to online reports linked below from 2005 to 2008, Charleston ALJ Harry Taylor decided twice the number of cases compared to his counterpart judges. And, many of his decisions were made without ever conducting hearings. Taylor decided a total of 4,091 cases over the 4-year consecutive time period noted above. Out of that, he only denied 173 of those appeals or 4.25%.  Now, in the most recent published ALJ Disposition Data from October 1, 2011 to March 30, 2012 (6 months) Taylor has already decided twice the caseload as any other Charleston ALJ. He has rendered 428 decisions and denied 34 or 8%.

Reportedly, like former ALJ Daugherty's SSA high approval ratings now being questioned, Charleston management allegedly condoned Taylor's high caseload decisions because his totals made the overall office numbers look good. Also, after the Huntington SSA scandal was exposed in 2011, Taylor was reportedly instructed to hold a minimum of 40 hearings each month.

Then there is the 1.5% denial ratios by ALJ Toby Buel for the same 4 year time period. He decided a total of 1,535 cases. Out of that, he only denied 23 of those appeals. Now, in the latest published ALJ Disposition Data from October 1, 2011 to March 30, 2012 (6 months) Buel has rendered 333 decisions and denied 60 or 18%. Judge Buel is now listed as working from the Huntington WV Office.

Remaining Charleston ALJ Judges Caseloads From 2005 to 2008

1. Judge Valerie Bawolek

Bawolek decided a total of 1,799 cases over the 4-year consecutive time period. Out of that, she denied 369 of those appeals or 18.5%. In the latest published ALJ Disposition Data from October 1, 2011 to March 30, 2012 (6 months) Bawolek has rendered 200 decisions and has denied 47 or 23%.

2. Theodore Burock

Burock decided a total of 1,877 cases over the 4-year consecutive time period. Out of that, he denied 532 of those appeals or 25.5%. In the latest published ALJ Disposition Data from October 1, 2011 to March 30, 2012 (6 months) Burock rendered 166 decisions and has denied 76 or 46%. Judge Burock is now assigned to the Harrisburg PA Office.

3. Ronald Chapman

Chapman decided a total of 2008 cases over the 4-year consecutive time period. Out of that, he denied 104 of those appeals or 5%. There are no recent records for Judge Chapman.

4. Jon K Johnson

Johnson decided a total of 1,505 cases over the 4-year consecutive time period. Out of that, he denied 152 of those appeals or 10.1%. Now, in the latest published ALJ Disposition Data from October 1, 2011 to March 30, 2012 (6 months) Johnson has rendered 221 decisions and denied 45 or 20%.

5. James P. Toschi

Toschi decided a total of 1,337 cases over the 4-year consecutive time period. Out of that, he denied 257 of those appeals or 19%. Now, in the latest published ALJ Disposition Data from October 1, 2011 to March 30, 2012 (6 months) Toschi has rendered 259 decisions and denied 72 or 28%.

In Closing

If there is any silver lining in the Huntington SSA Appeals Office scandal, it would be a wake up call to other offices across the country to get their departments up to standards. SSA Commissioner Michael Astrue stated back in February that there is "no silver bullet" that is going to fix all of the problems the Social Security Administration is facing. He admits that job related stress, higher workloads and pay issues equal an unhappy workforce.

"I know that fiscal shortfalls create stress in our offices, especially when there are fewer of you to handle more work. Our inability to timely handle work makes the public more frustrated, and you endure that frustration. I also know that outcomes like pay freezes may cause you to question your career choice."

But, there is no excuse for office managers to knowingly let mail sit around "unopened" that contains doctor's reports and other evidence that could be the silver bullet that either determines or denies a claimant's appeal. Nor is there any excuse for hundreds of ALJ decisions to have been sent out late or possibly not at all. Its good that they finally fixed the problems, but its sad for those who were denied access to the courts because of these manager's negligence in the performance of their duties.

Its possible that the Office Of Inspector General (OIG) is already investigating the problems in Charleston, including the high caseload decisions of Judge Taylor and the very low denial rates of Judge Buel from 2005 to 2008. Ironically, since the Huntington scandal broke, statistics for the judges who were in the Charleston office from 2005 to 2008, now have decision stats more in line with other offices in their regions.

By and large, ALJ hearings have the highest approval rate, with about two thirds of all disability applicants winning their disability claims. These are national averages, which means there are some states or regions that have much lower disability claim approval rates while others have higher approval rates

The Office of Disability Adjudication and Review (ODAR) has over 1600 Administrative Law Judges (ALJs) that conduct hearings and issue decisions for the Social Security Administration (SSA). There are over 160 ODAR hearing offices in the country.

End Of Story

Jack Swint-Publisher
West Virginia News
Website: http://WVNewsOnline.com
Blog: http://WestVirginiaNews.blogspot.com
Twitter:  @WVNewsOnline
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http://WVNewsOnline.com

I am the publisher of an online news website and blog covering local, state and national news since 2007. Author of 4 cold-case murder books in the "Who Killed?" series published by Rooftop Publishing Company. Retired from mainstream media in 2007 (more...)
 
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It appears that the SSA Appeals system needs to be... by Jack Swint on Sunday, May 20, 2012 at 9:29:09 PM
into a world most of us never know exists. I am at... by John Reed on Sunday, May 20, 2012 at 9:35:08 PM