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OIG Studies ALJ Productivity and Allowance Rates

October 31, 2017

Two recent reports by the Social Security Administration’s (SSA) Office of the Inspector General (OIG) studied trends in ALJ productivity and allowance rates. Thanks to Keith Jensen of the Empire Justice Center for summarizing them.

OIG A-12-18-50289, published in September 2017, examined factors that have led to a decrease in administrative law judge (ALJ) productivity. In FY 2011, ODAR had 705,367 pending cases and an average processing time of 426 days. By the end of FY 2016, the number of cases pending had increased to over 1.1 million, and the average processing time has worsened to 543 days. During this time, ALJ productivity decreased by about 21 percent. ODAR measures ALJ productivity by dispositions per day per available ALJ. In FY 2011, ALJs produced an average of 2.42 dispositions per day; in FY 2016, this number decreased to 1.9 dispositions per day.

Two main factors related to decreasing ALJ productivity include decreased staffing ratios and a renewed focus on quality. By the end of April 2017, decision writer-to-ALJ ratios had decreased 22 percent from FY 2011 levels, and hearing office staff-to-ALJ ratios had decreased by 22 percent. During the same period, ALJ productivity has decreased 22 percent as well. Other factors related to decreased ALJ productivity were (a) a change in regulations that increase the medical evidence claimants must submit for their hearings and (b) an increase in the number of denied cases at the hearing level since denial decisions typically take longer to process.

According to the OIG, SSA had used its scarce resources in recent years to continue hiring ALJs to address a growing hearings backlog. But while the number of new ALJs hired has increased, ALJ productivity has decreased. SSA developed the Compassionate and Responsive Service (CARES) plan in 2016 to address the hearings backlog, but the plan depends on funding to hire a sufficient number of support staff. The OIG recommended that SSA needs to continue balancing productivity with quality.

OIG A-12-17-50247, also published in September 2017, found that ALJs with the most experience, had, on average, higher allowance rates than ALJs with fewer years of experience

Allowance rates reflect the number of favorable Administrative Law Judge (ALJ) decisions as a percentage of the number of requests for a hearing in a given year. The ALJ decisional allowance rate had fluctuated from a high of 75.2 percent in FY 1994 to a low of 53.5 percent in FY 2015. The 53.5 percent decisional average allowance rate in FY 2015 was the lowest rate in 23 years.

In FY 2013, ODAR began calculating a quality measure on appealed ALJ denial and dismissal decisions- known as the “agree rate.” The agree rate represents the extent to which the Appeals Council (AC) concludes the ALJ’s decisions were supported by substantial evidence and contained no error of law or abuse of discretion justifying a remand or reversal. SSA’s national goal for agree rate is 85 percent.  ALJs with the most experience had, on average, lower agree rates than ALJs with fewer years of experience.

The Office of Inspector General (OIG) was not able to determine why these trends were occurring.  And the Agency had no information on any pattern regarding a relationship between an ALJ’s years of service and his/her quality.

Individual allowance rates ranged from 19.9 percent to 90.0 percent, and the average national decisional allowance rate was about 53.5 percent. ALJs in the most experienced group had an average allowance rate of 57.74 percent, or 4.2 percent about the average. ALJs in the least experienced group had an average allowance rate of 48.8 percent, or 4.5 percent  below the average.  The allowance rate of ALJs in the most experienced group was nine percent above the ALJs who had fewer than five years of experience.

ALJ agree rates ranged from 59.3 percent to 100 percent. The OIG’s review showed that ALJs who had more than 14 years of service had, on average, lower agree rates than all the other groups. The most experienced ALJs had average agree rates of about 84 percent, which was six percent below the average of ALJs with fewer than five years’ experience.

The OIG also reviewed ALJ training information to determine whether it could be a factor in the high allowance and low agree rate pattern as ALJs gain more experience. It could not, however, determine why these trends were occurring, nor did it find a link between the amount or type of training an ALJ received and the high allowance rate and low agree rate pattern.

When the OIG examined SSA’s judicial training attendance records, it initially identified 16 ALJs who had not attended any judicial training over the last seven years.  The OIG presented this information to SSA, which argued that some of these ALJs watch a taped version of judicial training.  After accounting for these ALJs, the OIG found that seven of the more experienced ALJs had not received judicial training over the last seven years; and four of these seven ALJs had agree rates that were below the 85-percent national goal.  SSA informed OIG that one of the seven ALJs was scheduled for this year’s virtual judicial training.

 





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