type: other

jurisdiction: US

text: b' SOCIAL SECURITY\n October 27, 2008\n\nThe Honorable Wayne T. Gilchrest\n2245 Rayburn House Office Building\nHouse of Representatives\nWashington, D.C. 20515\n\nDear Mr. Gilchrest:\n\nIn a June 22, 2007 letter, you asked that we review issues relating to constituent\nconcerns at the Dover Hearing Office, including\n\n 1. requests for excessive and redundant medical evidence;\n 2. unwarranted dismissals;\n 3. improper handling of terminal illness, medically critical, and dire need claims; and\n 4. inappropriate comments at hearings.\n\nTo assess these issues, we obtained copies of the allegations, reviewed the Social\nSecurity Administration\xe2\x80\x99s (SSA) processes that address such allegations, obtained\nextracts from Agency systems related to the claims and prior allegations, and spoke to\nSSA staff at the Headquarters, regional, and hearing office level, as well as claimant\nrepresentatives associated with these allegations.\n\nThank you for bringing your concerns to my attention. My office is committed to\ncombating fraud, waste, and abuse in SSA\xe2\x80\x99s operations and programs. This report\nhighlights various facts pertaining to the issues raised in your letter. To ensure SSA is\naware of the information provided to your office, we are forwarding a copy of this report\nto the Agency.\n\nIf you have any questions concerning this matter, please call me or have your staff\ncontact Jonathan Lasher, Acting Assistant Inspector General for External Relations, at\n(410) 965-7178.\n\n Sincerely,\n\n\n S\n Patrick P. O\xe2\x80\x99Carroll, Jr.\n Inspector General\nEnclosure\ncc: Michael J. Astrue\n\n\n\n SOCIAL SECURITY ADMINISTRATION BALTIMORE MD 21235-0001\n\x0cCONGRESSIONAL RESPONSE\n REPORT\n\n Customer Service Issues at\n the Dover Hearing Office\n\n A-12-08-28080\n\n\n\n\n October 2008\n\x0c Mission\nBy conducting independent and objective audits, evaluations and investigations,\nwe inspire public confidence in the integrity and security of SSA\xe2\x80\x99s programs and\noperations and protect them against fraud, waste and abuse. We provide timely,\nuseful and reliable information and advice to Administration officials, Congress\nand the public.\n\n Authority\nThe Inspector General Act created independent audit and investigative units,\ncalled the Office of Inspector General (OIG). The mission of the OIG, as spelled\nout in the Act, is to:\n\n \xef\x81\xad Conduct and supervise independent and objective audits and\n investigations relating to agency programs and operations.\n \xef\x81\xad Promote economy, effectiveness, and efficiency within the agency.\n \xef\x81\xad Prevent and detect fraud, waste, and abuse in agency programs and\n operations.\n \xef\x81\xad Review and make recommendations regarding existing and proposed\n legislation and regulations relating to agency programs and operations.\n \xef\x81\xad Keep the agency head and the Congress fully and currently informed of\n problems in agency programs and operations.\n\n To ensure objectivity, the IG Act empowers the IG with:\n\n \xef\x81\xad Independence to determine what reviews to perform.\n \xef\x81\xad Access to all information necessary for the reviews.\n \xef\x81\xad Authority to publish findings and recommendations based on the reviews.\n\n Vision\nWe strive for continual improvement in SSA\xe2\x80\x99s programs, operations and\nmanagement by proactively seeking new ways to prevent and deter fraud, waste\nand abuse. We commit to integrity and excellence by supporting an environment\nthat provides a valuable public service while encouraging employee development\nand retention and fostering diversity and innovation.\n\x0c Executive Summary\nOBJECTIVE\n\nThe objective of this review was to address the request of Congressman Wayne T.\nGilchrest regarding claimant complaints of poor customer service and improper handling\nof claims at the Dover Hearing Office. Specifically, the Congressman requested\ninformation on complaints related to (1) requests for excessive and redundant medical\nevidence; (2) unwarranted dismissals; (3) improper handling of terminal illness,\nmedically critical, and dire need claims; and (4) inappropriate comments at hearings.\n\nBACKGROUND\nTo remedy public complaints of alleged unfair treatment at hearing offices, all Social\nSecurity Administration (SSA) claimants have the right to (1) request a review by the\nAppeals Council (AC) and/or (2) file an Unfair Treatment Complaint with the Office of\nthe Chief Administrative Law Judge (OCALJ).\n\nRESULTS OF REVIEW\nThe Office of Disability Adjudication and Review (ODAR) has been aware of complaints\nabout unsatisfactory service at the Dover Hearing Office for at least 2 years. In our\nreview, rather than investigating the merits of each allegation, we focused on the status\nof the complaints at ODAR since many of the claims in question had been appealed or\na second request for hearing had been filed and we did not want to interfere with this\nprocess. To address the issue of improper handling of terminal illness, we performed a\ncomparison of terminal illness claims at the Dover and Baltimore Hearing Offices, both\nof which serve the Congressman\xe2\x80\x99s constituents. While our review of the terminal illness\nclaims did not find a significant variance between the Dover and Baltimore Hearing\nOffices, we did find it was taking the Dover Hearing Office more time to process such\nclaims.\n\nAlthough not a part of initial communications with SSA, the Congressman\xe2\x80\x99s office sent\nODAR the names and Social Security numbers of 111 constituents with complaints\nrelated to Dover Hearing Office. While SSA was not provided the requisite information\nto support a full review of each allegation, we believe ODAR could have been more\nproactive, such as providing the Congressman\xe2\x80\x99s office with basic information regarding\nthe status of each claim. We reviewed the status of these 111 claims and found that\n53 had been appealed or a second request for hearing had been filed.\n\nThe Congressman\xe2\x80\x99s office also provided us with an additional 49 allegations, and we\nfound that 39 of the allegations related to medical, credibility and procedural issues,\nwhich would normally be addressed under the AC process. The remaining\n10 allegations related to bias or misconduct, which would normally be referred to\n\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080) i\n\x0cOCALJ\xe2\x80\x99s Unfair Treatment Complaint process. We found 43 of the 49 claims had been\nappealed or a second request for hearing had been filed. As such, it appeared the\nmerits of some of the allegations had been or were still being determined.\n\nTo address the Congressman\xe2\x80\x99s concerns, ODAR requested a review of a sample of\ndispositions at the Dover Hearing Office. This review found that about 96 percent of\ndispositions were accurately processed. While the OQP review addressed many of the\ntypes of complaints we cited earlier as medical, credibility and procedural, it would not\nnecessarily detect instances of administrative law judge misconduct. Such cases may\nrequire a more detailed review of the hearing documents as well as statements from the\nclaimants and their representatives.\n\nWe also found that SSA did not adequately track the Unfair Treatment Complaints and,\nas a result, could not determine relevant trends, such as repeated bias complaints\nassociated with an administrative law judge. Moreover, the complaint process could be\ntimelier in acknowledging the receipts of complaints. In addition, until recently,\ninformation regarding the complaint process was inaccurate and not always publicized\nin hearing offices. The Commissioner and ODAR have stated the Agency is committed\nto improving the Unfair Treatment Complaint process and a number of improvements\nhave occurred or are underway.\n\nCONCLUSIONS\nMost of the claims related to the allegations have been reviewed or are still undergoing\nadditional review by ODAR, indicating the claimants have taken additional actions and\nthe Agency is reviewing the underlying concerns. However, ODAR needs to ensure all\nthe claimants\xe2\x80\x99 concerns are appropriately addressed, the Congressman\xe2\x80\x99s concerns are\ntimely addressed by the AC or the Unfair Treatment Complaint process and the status\nof this process is shared with the Congressman\xe2\x80\x99s office. To assist with this process, we\nhave shared information related to the 49 claims in our possession with ODAR. We\nunderstand that approximately 200 allegations related to the Dover Hearing Office were\nawaiting resolution. Moreover, ODAR needs to ensure that continued improvements to\nthe Unfair Treatment Complaint process allow the Agency to track pending and\ncompleted reviews, timely notify parties about the status of their complaints, and provide\nthe public with accurate information on how to file a complaint.\n\n\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080) ii\n\x0c Table of Contents\n Page\n\nBACKGROUND ......................................................................................................1\n\nRESULTS OF REVIEW ..........................................................................................4\n\n RECEIPT OF COMPLAINTS ..............................................................................4\n\n STATUS OF CONSTITUENT COMPLAINTS .....................................................6\n\n UNFAIR TREATMENT COMPLAINT PROCESS ...............................................9\n\nCONCLUSIONS....................................................................................................14\n\nAPPENDICES\nAPPENDIX A \xe2\x80\x93 Acronyms\nAPPENDIX B \xe2\x80\x93 Scope and Methodology\nAPPENDIX C \xe2\x80\x93 Workload Statistics for Hearing Offices Serving Congressman\n Gilchrest\xe2\x80\x99s Constituents\nAPPENDIX D \xe2\x80\x93 Unfair Treatment Complaint Process\nAPPENDIX E \xe2\x80\x93 How to File an Unfair Treatment Complaint\nAPPENDIX F \xe2\x80\x93 Congressional Response Process at the Office of Disability Adjudication\n and Review\nAPPENDIX G \xe2\x80\x93 Selected Correspondence Between Congressman Gilchrest and the\n Office of Disability Adjudication and Review\nAPPENDIX H \xe2\x80\x93 Status of 111 Hearing Claims Referred by Congressman Gilchrest\xe2\x80\x99s\n Office\nAPPENDIX I \xe2\x80\x93 Unfair Treatment Complaints Provided by the Office of the Chief\n Administrative Law Judge\n\n\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080)\n\x0c Background\nOBJECTIVE\n\nThe objective of this review was to address the request of Congressman Wayne T.\nGilchrest 1 regarding claimant complaints of poor customer service and improper\nhandling of claims at the Dover Hearing Office. Specifically, the Congressman\nrequested information on complaints related to (1) requests for excessive and\nredundant medical evidence; (2) unwarranted dismissals; (3) improper handling of\nterminal illness, medically critical, and dire need claims; and (4) inappropriate comments\nat hearings.\n\nBACKGROUND\nThe Office of Disability Adjudication and Review (ODAR) administers the hearings and\nappeals program for the Social Security Administration (SSA). The hearing process\nbegins after an applicant for benefits is denied at the initial and reconsideration levels.\nAt the next step in the appeals process, an administrative law judge (ALJ) conducts a\nhearing and issues a decision. Claimants who are dissatisfied with an ALJ\xe2\x80\x99s decision\non their cases may request that SSA\xe2\x80\x99s Appeals Council (AC) review the decision. If the\nclaimant is dissatisfied with the AC action, the claimant may appeal the case to a\nFederal district court. When the court remands (or returns) a case to the Commissioner\nof Social Security, the remand is sent to the AC. The AC remands the case to an ALJ.\n\nCLAIMANT COMPLAINTS\n\nTo remedy complaints of alleged unfair treatment at hearing offices, all SSA claimants\nhave the right to (1) request a review by the AC and/or (2) file an Unfair Treatment\nComplaint with the Office of the Chief Administrative Law Judge (OCALJ) (see\nAppendix D).\n\n\n\n\n1\n Congressman Gilchrest represents the First Congressional District of Maryland, which encompasses the\nEastern Shore of Maryland, as well as parts of Anne Arundel, Baltimore and Harford Counties. Four\nhearing offices serve Congressman Gilchrest\xe2\x80\x99s constituents in Baltimore, Maryland; Dover, Delaware;\nNorfolk, Virginia; and Washington, DC. According to Congressman Gilchrest\xe2\x80\x99s staff, most of the\nCongressman\xe2\x80\x99s constituents attend hearings at the Dover, Delaware, office. See Appendix C for general\nworkload statistics associated with these four hearing offices.\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080) 1\n\x0cAC Process\n\nODAR staff informed us that the majority of allegations of unfair treatment are submitted\nby claimants or their representatives in connection with a request for an AC review. The\nAC process is to be used when a party to the hearing disagrees with the hearing\ndecision or with the dismissal of the hearing request. 2 The AC will generally review a\ncase if it determines\n\n\xef\x82\xb7 it appears the ALJ abused his/her discretion;\n\xef\x82\xb7 there is an error of law;\n\xef\x82\xb7 the ALJ\xe2\x80\x99s actions, findings, or conclusions are not supported by substantial\n evidence;\n\xef\x82\xb7 there is a broad policy or procedural issue that may affect the general public interest;\n and/or\n\xef\x82\xb7 new material evidence is submitted, the evidence submitted relates to the period on\n or before the date of the ALJ\xe2\x80\x99s decision, and the AC finds that the ALJ\xe2\x80\x99s actions,\n findings, or conclusion is/are contrary to the weight of the evidence in the records. 3\n\nUnder the AC process, when a pending appeal indicates possible improper conduct by\nthe ALJ, the case is sent to OCALJ for a separate review pertaining to the ALJ.\nHowever, the AC will continue to process the claimant\xe2\x80\x99s appeal based on the merits of\nevidence and legal proceedings and make a determination on the allegation as part of\nthe administrative record in the decision on the case. 4\n\nPublic ALJ Misconduct Complaint Process\n\nSince 1992, ODAR has offered a second method to voice complaints about ALJ bias,\nmisconduct or unfair treatment\xe2\x80\x94the Public ALJ Misconduct Complaint Process. This\ncomplaint procedure does not provide an additional or alternative means of appealing\nunfavorable decisions, but it is another method to address any public perception of bias,\nor misconduct in the adjudicative process. The public is informed and instructed in\nnotices posted in hearing offices and on SSA\xe2\x80\x99s website about \xe2\x80\x9cHow to File an Unfair\nTreatment Complaint.\xe2\x80\x9d Specifically, the notices state \xe2\x80\x9c[SSA] wants to treat fairly and\nequally all claimants and their representatives\xe2\x80\xa6If you think any ALJ treated you\nunfairly, you should tell us about it and ask us to look into it. You can ask even while we\nare deciding your claims for benefits.\xe2\x80\x9d 5\n\n\n2\n The claimant is expected to file a Request for Review of Decision/Order (Form HA-520) within 60 days\nof the date he/she received the hearing decision or order.\n3\n SSA, Online Social Security Handbook, Chapter 20: Determinations and the Administrative Review\nProcess, Section 2013.6 \xe2\x80\x93 When Does the Appeals Council Review a Case?\n4\n SSA, Hearings, Appeals and Litigation Law manual (HALLEX) I-3-1-25\xe2\x80\x94Unfair Hearing Allegations.\n5\n See Appendix E.\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080) 2\n\x0cWritten complaints are to be addressed to OCALJ in Falls Church, Virginia. The notice\nstates that the Agency will inform the sender that OCALJ received the complaint, assign\nthe issue to someone who has not handled the claim in question, and share the final\nresults. If the claimant is also filing an appeal with the AC, the AC will look into the\ncomplaint as part of the appeal, and this additional review will be part of the final\ndecision on the appeal.\n\nIn May 2007, the Commissioner published a number of initiatives to eliminate the\nhearings backlog, 6 including being more proactive in investigating alleged ALJ\nmisconduct complaints. In the Summary of Initiatives to Eliminate the SSA Hearings\nBacklog, the Commissioner noted\n\n The process to handle public complaints against ALJs was adopted as\n an interim process in 1992. It was intended as a short-term process\n until the permanent process could be adopted. Fifteen years later, the\n permanent process has still not been adopted. We continue to handle\n public complaints but are working on developing a permanent process\n that results in consistent, timely action.\n\nCONGRESSIONAL INQUIRIES AT HEARING OFFICES\n\nClaimants via their Members of Congress can also inquire on their claims and monitor\nODAR\xe2\x80\x99s processing of their claims. 7 According to ODAR\xe2\x80\x99s policy, 8 hearing offices are\nexpected to (1) give high priority to congressional inquiries; (2) respond to\ncongressional inquiries promptly, accurately and courteously; and (3) communicate any\nconcerns about a particular inquiry to the congressional office that made the inquiry as\nwell as the Office of the Regional Chief ALJ and OCALJ.\n\nCurrent policy also provides for some flexibility in how a hearing office responds to a\ncongressional inquiry. For example, some hearing offices have made arrangements\nwith congressional staff to send monthly status reports using mutually agreed-upon\nmodes of responses, for example, sending printouts generated from the Case\nProcessing and Management System (CPMS) in lieu of letters. The policy notes that\nhearing office management should document any such agreements in the hearing\noffice\xe2\x80\x99s administrative records. 9\n\n\n\n\n6\n Statement of Michael J. Astrue, Commissioner of Social Security, Testimony before the Senate Finance\nCommittee, May 23, 2007.\n7\n See Appendix F for more information on ODAR\xe2\x80\x99s congressional response process.\n8\n SSA, HALLEX I-1-6-1.A\xe2\x80\x94Congressional Inquiries at Hearing Offices.\n9\n Id.\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080) 3\n\x0c Results of Review\nODAR has been aware of complaints about unsatisfactory service at the Dover Hearing\nOffice for at least 2 years, and details of some of these cases have been shared with\nthe Agency. While SSA was not provided the requisite information to support a full\nreview of each allegation, we believe ODAR could have been more proactive in\nproviding the Congressman\xe2\x80\x99s office with basic information regarding the status of each\nclaim. Of the 49 allegations we examined, we found that 80 percent of the complaints\nrelated to issues normally handled by the AC. The remaining 20 percent of the\ncomplaints related to bias or misconduct, which would normally be referred to OCALJ\xe2\x80\x99s\nUnfair Treatment Complaint process. In addition, 43 of these 49 claimants had\nrequested new hearings, submitted their cases to the AC, or were pursuing remedy\nthrough the Federal courts. As such, it appeared the merits of some of the allegations\nhad been or were still being determined. ODAR requested a review of the dispositions\nof the Dover Hearing Office, and this review found that about 96 percent of dispositions\nwere accurately processed. Our own review of the processing time for terminal illness\nclaims at the Dover Hearing Office found some delays. We also found that SSA was\nnot adequately tracking the Unfair Treatment Complaints and, as a result, could not\ndetermine relevant trends, such as repeated bias complaints associated with an ALJ.\nMoreover, the complaint process could be timelier in acknowledging the receipts of\ncomplaints. In addition, until recently, public information on the process was inaccurate\nand not always available at hearing offices. The Commissioner and ODAR have stated\nthe Agency is committed to improving the Unfair Treatment Complaint process and a\nnumber of improvements have occurred or are underway.\n\nRECEIPT OF COMPLAINTS\nODAR has been aware of complaints about unsatisfactory service at the Dover Hearing\nOffice for approximately 2 years (see Figure 1 and Appendix G). We found that\nCongressman Gilchrest\xe2\x80\x99s office first notified ODAR of constituent complaints associated\nwith the Dover Hearing Office in August 2006, citing a number of concerns, such as\nprocedures for hearing notifications, scheduling delays, the integrity of the hearings\nprocess, response time on inquiries and allegations of retaliation against claimants for\nmaking such inquiries. 10\n\n\n\n\n10\n In our review, rather than investigating the merits of each allegation, we focused on the status of the\ncomplaints at ODAR since many of the claims in question had been appealed or a second request for\nhearing had been filed and we did not want to interfere with this process.\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080) 4\n\x0c Figure 1: Timeline of Correspondence Regarding Issues\n at the Dover Hearing Office\n\n\n\n\n August 2006 November 2006 March 2007 December 2007 April 2008 ODAR April 2008\n Congressman ODAR w rites Congressman says Congressman w rites Congressman and\n w rites to SSA Congressman for he has 200 sends ODAR 111 Congressman ODAR meet to\n name and SSNs complaints SSNs and names committing to a discuss status of\n review of a sample the allegations\n of decisions\n\n\nIn subsequent letters, SSA addressed some of the higher-level issues but not the\nspecific allegations. In a November 2006 letter, ODAR noted that \xe2\x80\x9c. . . without having\ncase-specific information (Social Security Number or names), we are not able to provide\na more detailed response.\xe2\x80\x9d\n\nIn March 2007, Congressman Gilchrest wrote to ODAR noting that the number of\nconstituent complaints exceeded 200 claims. In December 2007, the Congressman\xe2\x80\x99s\noffice sent the names and Social Security numbers (SSN) of 111 constituents with\ncomplaints related to the Dover Hearing Office. Although the list contained the\nclaimant\xe2\x80\x99s name and SSN, the list did not contain specific allegations related to each\nclaim. As a result, ODAR informed the Congressman that ODAR needed specific\nallegations for each claim to investigate the issues.\n\nWhile we agree that the correspondence sent by the Congressman\xe2\x80\x99s office was not\nsufficient to initiate the Unfair Treatment Complaint process, the list provided enough\ninformation for ODAR staff to query their systems to determine the status of these\nclaims, such as whether appeals had been filed. We performed such an analysis and\nfound that 53 of these cases had been appealed or a second request for hearing had\nbeen filed as of September 2008 (see Appendix H). The Agency could have shared this\ninformation with the Congressman to demonstrate continued Agency activity with these\nclaimants. The December 2007 list also contained the names of the claimants\xe2\x80\x99\nrepresentatives and the ALJs hearing the cases. ODAR management has stated that\ncurrent procedures require that the Agency deal directly with the person making the\ncomplaint (the Congressman) rather than the claimants and their representatives.\nNonetheless, given the continued correspondence between the Congressman and\nODAR, as well as the Commissioner\xe2\x80\x99s statements regarding an improved ALJ complaint\nprocess, we believe ODAR could have been more proactive with these complaints.\n\n\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080) 5\n\x0cSTATUS OF CONSTITUENT COMPLAINTS\nOur review of an additional 49 constituent complaints related to the Dover Hearing\nOffice found that most related to medical, credibility and procedural issues, though\n10 alleged bias or misconduct. Most of these cases were still pending and the\nclaimants had requested new hearings, submitted their cases to the AC, or were\npursuing remedy through the Federal courts. ODAR requested a review of the\ndispositions at the Dover Hearing Office to address some of these issues, and the\nreview found that the Hearing Office had adequate support for its decisions. While our\nown review of terminal illness claims did not find a significant variance between the\nDover Hearing Office and another hearing office serving the same constituents, we did\nfind it was taking the Dover Hearing Office more time to process such claims.\n\nCLASSIFICATION OF COMPLAINTS\n\nWe reviewed 49 constituent complaints provided by Congressman Gilchrest\xe2\x80\x99s office to\nbetter understand the type of complaints being filed. 11 All of the complaints were\nassociated with ALJs at the Dover Hearing Office. We found that the majority of the\ncomplaints related to medical or credibility issues, followed by alleged bias or\nmisconduct on the part of the ALJ and finally procedural irregularities (see Figure 2).\n\n Figure 2: Types of Constituent Complaints\n (49 Claims)\n Procedural\n Issues\n 16%\n\n Bias or\n Misconduct\n Issues\n 20%\n\n\n Medical or\n Credibility\n Issues\n 64%\n\n\n\n\nWe classified a case as \xe2\x80\x9cmedical or credibility issues\xe2\x80\x9d where, for example, complaints\nrelated to a questionable disability onset date or an ALJ not considering specific\nevidence. We classified a case as \xe2\x80\x9cprocedural issues\xe2\x80\x9d where, for instance, complaints\nrelated to an inappropriate hearing location or an unwarranted dismissal of a case. We\n\n\n\n11\n We received 51 complaints from Congressman Gilchrest\xe2\x80\x99s office, but 2 lacked the claimants\xe2\x80\x99 SSNs.\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080) 6\n\x0cconsidered a case to have \xe2\x80\x9cbias or misconduct issues\xe2\x80\x9d if the allegation related to an\ninappropriate statement by the ALJ or improper treatment due to someone\xe2\x80\x99s age or\nillness.\n\nWe found that 39 complaints, or 80 percent, related to medical, credibility and\nprocedural issues and could normally be addressed through the AC process. The\nremaining 10 complaints, or 20 percent, related to bias or misconduct and would be\nbest suited for the Unfair Treatment Complaint process. For example, in one case, the\nclaimant alleged the ALJ \xe2\x80\x9cwould cut me off\xe2\x80\x9d and \xe2\x80\x9cyelled\xe2\x80\x9d when a witness was\nintroduced, noting the ALJ \xe2\x80\x9c\xe2\x80\xa6did not want to hear any things [sic] he had to say, and\ncontinually interrupted his testimony as well.\xe2\x80\x9d However, we later reviewed the digital\nrecording associated with this hearing and found no evidence that the ALJ had yelled at\nor been rude to the claimant.\n\nWe also spoke to AC staff concerning the allegations and were told that the medical,\ncredibility and procedural complaints were common reasons for an appeal. However,\nthe Administrative Appeals Judge we spoke to said that the allegations of bias or\nmisconduct we shared were not common. These cases included alleged discrimination\nagainst a person under age 50 and misconduct by an ALJ who was rude to the\nclaimant. She said these are not routine allegations in an appeal, and her office would\nnormally review the matter to determine whether the allegations had merit and advise\nOCALJ\xe2\x80\x99s Division of Quality Services (DQS) regarding the findings.\n\nODAR PROCESSING OF DISABILITY CLAIMS\n\nAs of August 2008, 43 of the 49 claimants had taken action on their claims by pursuing\ndisability benefits through the AC or Federal court process or by filing a new request for\na hearing (see Table 2). 12 In our review of the appeal documentation, we found that\nmany of the claimants reaffirmed their position while seeking appeal. Hence, many of\nthe issues identified by Congressman Gilchrest had been or were still being reviewed by\nthe Agency at the time of our audit. Of the 43 claims undergoing additional review,\n11 had favorable new decisions, 8 had unfavorable new decisions, and 24 were still\npending a new decision.\n Table 2: Status of 49 Constituent Claims\n (As of August 2008)\n No New Appeals 2nd Reopen/\n Action on Council Federal Hearing Hearing\n Category Case Review Court Review Request Level Total\nNumber of 6 25 14 1 3 49\nClaims\n\n\n\n12\n A claimant representative we interviewed told us that considering it currently takes over 2 years from\nthe time a claim is filed until a hearing decision is rendered, starting the claims process again from the\nbeginning is not an efficient option for most disability claimants. However, some claimants choose this\noption with the expectation that the disability will be adjudicated differently at the second hearing.\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080) 7\n\x0cWhile the AC can refer cases of potential bias or misconduct to OCALJ as part of its\nreview, it is possible these claims could have been processed more timely under the\nUnfair Treatment Complaint process. In fact, we found that 4 of the 49 complaints were\nbeing treated as Unfair Treatment Complaints. At the time of our review, three of the\ncomplaints were pending and one had been closed as unsupported.\n\nAs noted earlier, ODAR could have provided the Congressman the information we\nprovide in Table 2 to demonstrate that the claims were being reviewed. We provided\nour analysis of these 49 claims to ODAR for further review.\n\nOFFICE OF QUALITY PERFORMANCE\n\nAs a result of Congressman Gilchrest\xe2\x80\x99s inquiries into the performance of the Dover\nHearing Office, ODAR decided to review a sample of completed cases. The Office of\nQuality Performance (OQP) randomly selected 90 favorable and 90 unfavorable\ndecisions issued by the Dover Hearing Office after September 30, 2006. 13 OQP\nexaminers found that 86 of the 90 allowance decisions were supported by a\npreponderance of the evidence, which represents a 96 percent agreement rate. The\nexaminers agreed with 48 of 49 denials 14 they reviewed for an agreement rate of\n98 percent. For allowances and denials combined, the agreement rate was 96 percent.\nThe report also noted that the examiners reviewed hearing recordings and all written\ndecisions and did not uncover any evidence that Dover ALJs were trying to persuade\nclaimants to either amend their onset date or request a closed period of disability. 15\n\nIn the case of the four allowances where there was disagreement, the examiners\nconcluded that three cases contained decisional errors and the remaining case did not\ncontain sufficient documentation to support any decision. The one denial with a\ndisagreement related to insufficient evidence in the record to make any decision.\n\nWhile the OQP review addressed many of the types of complaints we cited earlier as\nmedical, credibility and procedural, it would not necessarily detect cases of ALJ\nmisconduct. Such cases may require a more detailed review of the hearing documents\nas well as statements from the claimants and their representatives.\n\n\n\n13\n According to OQP\xe2\x80\x99s report methodology, unfavorable decisions with a pending AC request for review or\npreviously receiving an AC review were excluded from the sample. However, OQP explained that since\nthese ALJ decisions were evaluated by the AC, an additional review would not be necessary inasmuch as\nthe AC findings could be used by OCALJ to supplement the OQP findings.\n14\n Only 49 of the 90 unfavorable decisions were identified for review, primarily due to appeals pending at\nthe AC as well as the inability to obtain some paper folders. No other denials were available within the\nsampling timeframe.\n15\n A closed period of disability occurs when (1) an impairment prevented substantial gainful activity at\nleast 12 months; (2) prior to the date of adjudication, the individual was no longer disabled; and (3) the\n\xe2\x80\x9cdisability\xe2\x80\x9d ceased no earlier than 14 months before the month of filing. See SSA, POMS DI 25510.010\nTitle II - Closed Period.\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080) 8\n\x0cCRITICAL CASES\n\nOne of the concerns cited by Congressman Gilchrest involved improper handling of\ncritical cases at the Dover Hearing Office. 16 ODAR provided us with a list of terminal\nillness claims 17 for the four hearing offices serving the Congressman\xe2\x80\x99s constituents.\nTerminal illness claims require additional special handling by hearing offices. We\nreviewed claims from the Dover and Baltimore Hearing Offices during Fiscal Years (FY)\n2004 to 2007 to identify any problematic trends, 18 such as processing delays and/or\nindividuals dying before their cases were decided. While our review of the terminal\nillness claims did not find a significant variance between the Dover and Baltimore\nHearing Offices, we did find it was taking the Dover Hearing Office more time to process\nsuch claims.\n\nFor the 13 terminal illness claims at the Dover Hearing Office, we found the average\nprocessing time was 92 days, with the quickest review being 1 day and the longest\nreview being 544 days. 19 We also found one case where the decision was issued\n79 days after the death of the claimant. 20\n\nFor the 45 terminal illness claims at the Baltimore Hearing Office, we found the average\nprocessing time was 85 days, with the quickest review being 1 day and the longest\nreview being 348 days. We also found four cases where the beneficiaries died before\nthe decisions were issued. These decisions were issued between 69 and 248 days\nafter the claimants\xe2\x80\x99 deaths. 21\n\nUNFAIR TREATMENT COMPLAINT PROCESS\nOur review found that ODAR lacked an automated database to track Unfair Treatment\nComplaint allegations and produce management information on trends in ALJ bias or\nmisconduct. Moreover, the complaint process could be timelier in acknowledging the\nreceipts of complaints. In addition, until recently, information regarding the complaint\n\n16\n ODAR designates a claim for expedited processing based on one of three criteria: (1) terminal illness,\n(2) dire need, and (3) threatening behavior to themselves or others. For more information on Critical\nCases, see HALLEX I-2-1-40 \xe2\x80\x93 Critical Cases.\n17\n Terminal illness claims include disability claims for any military service personnel, regardless of where\nthe disability occurred (that is, in the United States or on foreign soil) during military service in the line of\nduty October 1, 2001, or later.\n18\n We provide additional workload statistics on the four hearing offices serving Congressman Gilchrest\xe2\x80\x99s\nconstituents in Appendix C.\n\n19\n We calculated the timeliness from the date the case was classified as a terminal illness claim in CPMS\nto the date of the decision. As a result, the average processing time for these claims was longer than\n92 days.\n20\n The median processing time for Dover Hearing Office terminal illness claims was 65 days.\n21\n The median processing time for Baltimore Hearing Office terminal illness claims was 37 days.\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080) 9\n\x0cprocess was inaccurate and not always publicized in hearing offices. The\nCommissioner and ODAR have stated the Agency is committed to improving the Unfair\nTreatment Complaint process and a number of improvements have been made or are\nunderway.\n\nUNFAIR TREATMENT COMPLAINT MANAGEMENT INFORMATION\n\nThe system to process Unfair Treatment Complaints is complex 22 and involves\ncoordination and exchange of documents and information between OCALJ, regional\noffices 23 and the AC (see Appendix D for a flowchart of the responsibilities of the\nentities involved in the Unfair Treatment Complaint process). Currently, the\ncomponents exchange paper documents as the complaint moves through the process.\n\nUnfair Treatment Complaints are processed through a number of venues, including the\nhearing office, regional office, Congressman\xe2\x80\x99s office, as part of an AC appeal, or directly\nto OCALJ. OCALJ\xe2\x80\x99s DQS shares the complaint information with the appropriate\nregional office. The regional office investigates the complaint by interviewing the ALJ\ninvolved and reporting the results to DQS. At the end of the investigation, the regional\noffice submits a recommendation that may involve a personnel action against the ALJ.\nThe Director of DQS told us that the office usually agrees with the regional office\xe2\x80\x99s\nrecommended course of action. Regardless of where the complaint was filed or which\noffice reviewed the complaint, DQS is to be notified of all claims and any\nrecommendations from either the AC or Regional Chief ALJ.\n\nThe Unfair Treatment Complaint process supplements, and is coordinated with, the AC\nprocess. When a pending appeal indicates possible improper conduct by the ALJ, the\nAC sends the case to DQS for a separate review. Under the AC process, the AC must\nrespond to the allegation of bias or an unfair hearing in the AC decision if an allegation\nor complaint has been filed with the appeal. However, the AC will continue to process\nthe claimant\xe2\x80\x99s appeal based on the merits of evidence and legal proceedings and make\na determination responding to the allegation of bias in the AC administrative record or\ndecision. In addition, misconduct can be identified by the AC on its own without a\ncomplaint as part of the review of the hearing decision.\n\nOCALJ and Region III Data\n\nIn our interviews and review of the Unfair Treatment Complaint process, we found that\nODAR did not have a centralized electronic database for tracking and reporting on\nthese complaints. Instead, ODAR maintains paper documents in a filing cabinet\narranged by hearing office. As a result, ODAR could not provide us with management\ninformation on the number of Unfair Treatment Complaints that were filed, the number\n\n22\n Complaints may be filed at any time in the process up to and including the time the claim is filed at the\nFederal court level. Complaints that are mailed by the public to SSA may be received by hearing offices,\nfield offices, the AC, any regional office, OCALJ or the Office of General Counsel.\n23\n By \xe2\x80\x9cregional office,\xe2\x80\x9d we mean the Office of the Regional Chief ALJ.\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080) 10\n\x0cof complaints that had merit and the action taken on such cases, or the trends in\nmisconduct or bias among its ALJs. While OCALJ staff provided us 20 Unfair\nTreatment Complaints received in Calendar Year (CY) 2007 24 relating to the 4 hearing\noffices serving Congressman Gilchrest\xe2\x80\x99s District, 25 we could not be certain that we were\nprovided with all the complaints for this period.\n\nWe reviewed the process for tracking Unfair Treatment Complaints at Region III\xe2\x80\x99s 26\nOffice of the Regional Chief ALJ and found the office had its own control system to track\ncomplaints. However, this regional system did not electronically interface with OCALJ\xe2\x80\x99s\nsystem. According to the regional staff, they confer weekly with DQS regarding their\nongoing investigations into Unfair Treatment Complaints. However, we reviewed a list\nof 20 Unfair Treatment Complaints from the region\xe2\x80\x99s control system for the hearing\noffices in Congressman Gilchrest\xe2\x80\x99s District and found 5 Unfair Treatment Complaints\nthat were in the Region\xe2\x80\x99s control system but not on OCALJ\xe2\x80\x99s list. OCALJ staff informed\nus that two of these should have been included as part of their files. We could not get\nadequate clarification from ODAR regarding the other three Unfair Treatment\nComplaints and could not determine why they were not on OCALJ\xe2\x80\x99s list.\n\nThe lack of a central control for tracking and resolving these complaints has been a\nlongstanding concern. In a 2002 report, 27 the Government Accountability Office (GAO)\nrecommended that SSA (1) adopt a method for summarizing key information on each\nALJ complaint, including the type of allegation; (2) place the complaint information in an\nelectronic format; (3) periodically analyze this information and report the results to the\nCommissioner; and (4) develop necessary action plans. While SSA concurred with\nGAO\xe2\x80\x99s findings, we found no evidence the Agency took timely action on these\nrecommendations. ODAR management told us that DQS is taking steps to create a\nsystem of records that will lead to the development of an electronic database to track\nrelevant trends.\n\nAcknowledging Receipt of Complaints\n\nSSA had informed the public that parties filing complaints will be promptly notified about\nthe receipt of their complaint as well as the subsequent results of the investigation. 28 Of\nthe 20 Unfair Treatment Complaint folders we reviewed, we found that 13 were sent as\n\n24\n In fact, one complaint was related to late CY 2006 and another to early CY 2008.\n\n25\n Of the 20 complaints, 11 related to the Dover Hearing Office, 5 related to the Washington, DC Hearing\nOffice, and the Baltimore and Norfolk hearing offices each had 2 complaints. See Appendix I for\ninformation on these complaints.\n26\n Region III includes Delaware, Maryland, Pennsylvania, Virginia, Washington, DC, and West Virginia.\n\n27\n Government Accountability Office, SSA Disability Decision Making: Additional Measures Would\nEnhance Agency\xe2\x80\x99s Ability to Determine Whether Racial Bias Exists (GAO-02-831), September 2002.\n28\n In the updated version of the website, the word \xe2\x80\x9cpromptly\xe2\x80\x9d was removed in relation to OCALJ\xe2\x80\x99s\nresponse time to complaints.\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080) 11\n\x0cpart of an appeal to the AC. Per AC policy, claimants are informed about the receipt of\nthe complaint in a notice from the AC. Of the seven remaining complaints, five had\nacknowledgment letters in their files, and the median processing time from receipt of\ncomplaint to its acknowledgment was 60 days. The remaining two files had a complaint\nletter but no acknowledgment letter. ODAR informed us that one acknowledgment letter\nhad been sent after we were provided with our data. Congressman Gilchrest forwarded\nthe complaint in question July 2007, and the acknowledgment letter provided to us by\nODAR was sent in April 2008, approximately 9 months after the original complaint.\n\nUnfair Treatment Complaint Public Material\n\nSSA\xe2\x80\x99s website instructs individuals with complaints about the hearing process to write a\nletter to the Agency (Appendix E provides a copy of the updated information from the\nwebsite). However, at the time of our review, the information on this site had not been\nupdated since 2004. As a result, instead of listing ODAR, the site was still using the\nformer name\xe2\x80\x94the \xe2\x80\x9cOffice of Hearings and Appeals.\xe2\x80\x9d SSA further instructed the\nclaimant to send a letter to the Office of Special Counsel if they believed they were not\ngetting an adequate response from OCALJ. However, the Office of Special Counsel\nhad not existed since 2003. According to ODAR\xe2\x80\x99s mailroom supervisor, all mail\naddressed to the Office of Special Counsel was opened and reviewed, and the Unfair\nTreatment Complaint letters were forwarded to OCALJ.\n\nODAR staff told us posters in hearing office reception areas contained information on\nhow to file Unfair Treatment Complaints. However, in our visits to two hearing offices in\nRegion III we did not see these posters in the reception areas. ODAR staff told us they\nwere aware that SSA\xe2\x80\x99s website and its hearing office posters had out-of-date\ninformation. As a result, the website was updated in August 2008. According to ODAR,\nupdated posters were also being distributed to all hearing and regional offices.\n\nComments from Law Firms\n\nWe interviewed attorneys at three law firms representing individuals in the\nCongressman\xe2\x80\x99s district who filed complaints with ODAR regarding the Dover Hearing\nOffice. We found that they either had problems with the Unfair Treatment Complaint\nprocess or were not confident about how it worked. An attorney from one law firm\nstated that one of his claimants had used the Unfair Treatment Complaint process, but\nhe never received an acknowledgment letter nor was he informed of the outcome of the\ncomplaint. As a result, the attorney decided the process was not effective. An attorney\nfrom a different law firm only filed requests for appeals to the AC because he said the\nUnfair Treatment Complaint process was ineffective. In addition, he sent a letter to\nCongressman Gilchrest\xe2\x80\x99s office noting several claimants\xe2\x80\x99 complaints.\n\n\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080) 12\n\x0cCommissioner Initiative to Improve the Process\n\nODAR management said the Agency is committed to improving the Unfair Treatment\nComplaint process and implementing the Commissioner\xe2\x80\x99s initiative in this area. As\nnoted earlier, steps are being taken to better track complaint processing, the Unfair\nTreatment Complaint website was recently updated, and new posters have been\ncreated for the hearing offices. According to ODAR management, staffing has also\nbeen increased in DQS to address the growing workload of Unfair Treatment\nComplaints and related matters. In addition, an inter-component workgroup was\nestablished to update and finalize the Unfair Treatment Complaint regulations. 29\n\n\n\n\n29\n The parties involved include OCALJ as well as the Offices of General Counsel, Appellate Operations,\nand Labor Management and Employee Relations.\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080) 13\n\x0c Conclusions\nFor more than 2 years ODAR has been aware of allegations related to the Dover\nHearing Office. While it appears that some of these cases have undergone subsequent\nreview by ODAR, other allegations remain outstanding and await review. We believe\nODAR had enough facts from the correspondence to provide, at a minimum, status\ninformation to Congressman Gilchrist. Of the 49 allegations we examined, 43 of the\nclaimants had requested new hearings, submitted their cases to the AC, or were\npursing remedy through the Federal courts. We understand that about 150 additional\nallegations related to the Dover Hearing Office may also be awaiting resolution.\n\nWhile ODAR reviewed the performance of the Dover Hearing Office and did not find any\nissues, we believe ODAR needs to ensure these allegations are timely reviewed by the\nAC or the Unfair Treatment Complaint process. To assist with this process, we have\nshared information related to the 49 claims with ODAR.\n\nFinally, we found that ODAR did not have a centralized electronic database to track\nUnfair Treatment Complaints and, as a result, lacks an easy means to determine\nrelevant trends, such as repeated bias complaints associated with an ALJ. Moreover,\nuntil recently, public information regarding the complaint process was inaccurate and\nnot always posted at hearing offices.\n\nThe Commissioner and ODAR have stated the Agency is committed to improving the\nUnfair Treatment Complaint process and a number of improvements have been made\nor are underway. ODAR needs to ensure that continued improvements to the Unfair\nTreatment Complaint process allow the Agency to appropriately track pending and\ncompleted reviews, timely notify parties about the status of their complaints, and provide\nthe public with accurate information on how to file a complaint.\n\n\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080) 14\n\x0c Appendices\n\n\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080)\n\x0c Appendix A\n\nAcronyms\n AC Appeals Council\n\n ALJ Administrative Law Judge\n\n CPAB Congressional and Public Affairs Branch\n\n CPMS Case Processing and Management System\n\n CY Calendar Year\n\n DEO Division of Executive Operations\n\n DQS Division of Quality Services\n\n ECB Executive Communications Branch\n\n FY Fiscal Year\n\n GAO Government Accountability Office\n\n OAO Office of Appellate Operations\n\n OCALJ Office of the Chief Administrative Law Judge\n\n ODAR Office of Disability Adjudication and Review\n\n OQP Office of Quality Performance\n\n RCALJ Regional Chief Administrative Law Judge\n\n SSA Social Security Administration\n SSN Social Security Number\n\n Form\n HA-520 Request for Review of Decision/Order\n\n\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080)\n\x0c Appendix B\n\nScope and Methodology\nTo complete our objective, we:\n\n \xef\x82\xb7 Reviewed applicable Federal laws and regulations, as well as Social Security\n Administration (SSA) policies and procedures pertaining to SSA\xe2\x80\x99s disability review\n process.\n\n \xef\x82\xb7 Reviewed Office of Disability Adjudication and Review (ODAR) criteria and\n procedures for processing Unfair Hearing Allegations in the Appeals Council and\n complaints via the Public Administrative Law Judge Misconduct Complaint\n Process.\n\n \xef\x82\xb7 Reviewed workload data, including remand statistics, for the hearing offices in\n Norfolk, Virginia; Washington DC; Dover, Delaware; and Baltimore, Maryland, for\n 2005, 2006 and 2007.\n\n \xef\x82\xb7 Analyzed the Unfair Treatment Complaints in the four hearing offices for Calendar\n Year 2007.\n\n \xef\x82\xb7 Compiled, reviewed and summarized constituent complaints from source\n documents provided by the Congressman\xe2\x80\x99s office.\n\n \xef\x82\xb7 Reviewed personnel actions that had been taken against administrative law\n judges (ALJ) in the four hearing offices for the previous 3 years.\n\n \xef\x82\xb7 Reviewed congressional inquiries and correspondence pertaining to issues in the\n four hearing offices for the previous 3 years.\n\n \xef\x82\xb7 Reviewed incident reports and/or harassment complaints filed in the four hearing\n offices in the previous 3 years.\n\n \xef\x82\xb7 Interviewed staff and senior management in the Office of the Chief ALJ, the Office\n of the Regional Chief ALJ, Hearing Office Directors in the four hearing offices and\n the Hearing Office Chief Administrative Law Judge in the Dover Hearing Office.\n\n \xef\x82\xb7 Interviewed attorneys from law firms who represented Congressman Gilchrest\xe2\x80\x99s\n constituents in hearings before ALJs in the Dover Hearing Office.\n\nThe SSA entity reviewed was ODAR under the Deputy Commissioner for Disability\nAdjudication and Review. The electronic data used for this audit were sufficiently\nreliable to meet our audit objectives. Our tests of internal controls were limited to\ngaining an understanding of the laws, regulations and policies that govern the\nprocessing of claimant complaints and performing the audit steps identified above. We\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080) B-1\n\x0cconducted our audit from December 2007 to September 2008 in Falls Church, Virginia.\nWe conducted this performance audit in accordance with generally accepted\ngovernment auditing standards. Those standards require that we plan and perform the\naudit to obtain sufficient, appropriate evidence to provide a reasonable basis for our\nfindings and conclusions based on our audit objectives. We believe the evidence\nobtained provides a reasonable basis for our findings and conclusions based on our\naudit objectives.\n\n\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080) B-2\n\x0c Appendix C\n\nWorkload Statistics for Hearing Offices Serving\nCongressman Gilchrest\xe2\x80\x99s Constituents\nUsing Case Processing and Management System data for Fiscal Years (FY) 2005\nthrough 2007, we analyzed workload statistics for the four hearing offices serving\nCongressman Gilchrest\xe2\x80\x99s constituents. 1 The four hearing offices are located in\nBaltimore, Maryland; Dover, Delaware; Norfolk, Virginia; and Washington, DC.\nAccording to Congressman Gilchrest\xe2\x80\x99s staff, the majority of the Congressman\xe2\x80\x99s\nconstituents attend hearings at the Dover, Delaware office.\n\n Table C-1: Eastern Maryland Hearing Offices Dispositions\n and Average Processing Time\n FY 2005 FY 2006 FY 2007\n Average Average Average\n Processing Processing Processing\n Hearing Time in Time in Time in\n Office Dispositions Days Dispositions Days Dispositions Days\nDover 1,768 306 2,009 459 1,620 490\nBaltimore 5,231 388 5,543 484 5,575 560\nWashington,\nDC 3,056 463 3,496 513 2,791 502\nNorfolk 2,989 393 3,373 420 3,005 379\n\n Table C-2: Number of ALJs in each Hearing Office\n FY 2005 FY 2006 FY 2007\n Hearing Office Number of ALJs Number of ALJs Number of ALJs\n Dover 5 4 3\n Baltimore 11 12 11\n Washington, DC 7 6 6\n Norfolk 6 7 6\n Note: Our ALJ counts were determined by the number of ALJs making decisions on cases\n during the time period in question. As a result, our count may vary with the Office of Disability\n Adjudication and Review\xe2\x80\x99s staffing reports, which determine ALJ counts at a specific point in time.\n\n Table C-3: Dover Hearing Office Disposition Results\n FY 2005 FY 2006 FY 2007\n Decision Title II Title XVI Title II Title XVI Title II Title XVI\nFavorable 49% 47% 50% 38% 51% 44%\nUnfavorable 35% 35% 35% 40% 32% 37%\nDismissals 13% 19% 15% 22% 17% 20%\n\n\n\n\n1\n Congressman Gilchrest represents the First Congressional District of Maryland, which encompasses the\nentire Eastern Shore of Maryland, as well as parts of Anne Arundel, Baltimore and Harford Counties.\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080) C-1\n\x0c Table C-4: Baltimore Hearing Office Disposition Results\n FY 2005 FY 2006 FY 2007\n Decision Title II Title XVI Title II Title XVI Title II Title XVI\nFavorable 74% 65% 71% 63% 67% 60%\nUnfavorable 13% 14% 12% 14% 13% 16%\nDismissals 14% 21% 17% 23% 20% 25%\n\n Table C-5: Washington, DC Hearing Office Disposition Results\n FY 2005 FY 2006 FY 2007\n Decision Title II Title XVI Title II Title XVI Title II Title XVI\nFavorable 63% 55% 68% 61% 60% 56%\nUnfavorable 27% 27% 19% 21% 25% 25%\nDismissals 10% 19% 13% 18% 16% 19%\n\n Table C-6: Norfolk Hearing Office Disposition Results\n FY 2005 FY 2006 FY 2007\n Decision Title II Title XVI Title II Title XVI Title II Title XVI\nFavorable 51% 42% 49% 37% 47% 39%\nUnfavorable 37% 44% 38% 44% 40% 45%\nDismissals 12% 14% 13% 19% 13% 16%\n\n Table C-7: Appeals Council Remands as a Percent of\n Total Dispositions for FY 2007\n Remands as a Percent\n Hearing Office Number of Remands Total Dispositions of Dispositions\nDover 107 1,646 6.50%\nBaltimore 211 5,486 3.85%\nWashington, DC 167 2,796 5.97%\nNorfolk 95 2,957 3.21%\n\n Table C-8: Court Remands as a Percent of\n Total Dispositions for FY 2007\n Remands as a Percent\n Hearing Office Number of Remands Total Dispositions of Dispositions\nDover 62 1,646 3.77%\nBaltimore 73 5,486 1.33%\nWashington, DC 117 2,796 4.18%\nNorfolk 14 2,957 0.47%\n\n\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080) C-2\n\x0c Appendix D\nUnfair Treatment Complaint Process\n Regional Office (RO) Office of the Chief Administrative Law Judge Appeals Council (AC) decides\n investigates (OCALJ) monitors complaints to identify if hearing was unfair because\n ALJ misconduct issues. occurrences of bias and misconduct. of misconduct or bias.\n\n RO Claimant Office of Appellate\n Complaint Operations (OAO)\n Coordinate Coordinate\n complaint complaint\n information information\n Begins investigation when The AC considers the\n the complaint is received OCALJ complaint in conjunction\n notified of all with the existing record,\n hearing testimony (if any),\n complaints, and and ALJ decision or\n Informs Administrative Law sends an dismissal order in\n Judge (ALJ) about the acknowledgement determining whether the\n complaint after hearing letter to the party request for review should\n decision is issued making the be granted\n complaint.\n Informs OCALJ of the\n investigation results, OCALJ sends AC addresses the\n provides conclusion as to complaint to complaint in its final\n findings of investigation, Regional Office to document\n and recommends action or begin\n no action is necessary\n investigation.\n OAO provides a\n OCALJ memorandum to\n communicates OCALJ with a copy of\n with the RO OCALJ determines appropriate pertinent documents\n concurrence with and a copy of the AC\xe2\x80\x99s\n recommended\n action on misconduct\n final action document\n action regarding ALJ after RO addressing the\n investigation and AC complaint.\n consideration (and considers\n RO performs action only if it recommendation from RO)\n is counseling and informs\n OCALJ action has been\n taken. If action to be taken\n is more than counseling,\n then Chief ALJ takes\n appropriate action Informs claimant of the results\n\n\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080)\n\x0c Appendix E\nHow to File an Unfair Treatment Complaint\n\n\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080)\n\x0c Appendix F\n\nCongressional Response Process at the Office\nof Disability Adjudication and Review\nThe Office of Disability Adjudication and Review (ODAR) has two Headquarters\ncomponents that respond to congressional inquiries. These components are in the\nDivision of Executive Operations (DEO), which serves as the liaison and the primary\npoint of coordination for the exchange of information and direction between the Deputy\nCommissioner and other ODAR executives.\n\nTHE EXECUTIVE COMMUNICATIONS BRANCH\n\nThe Executive Communications Branch (ECB) uses the standards in the Congressional\nInquiries Guide, a document issued by the Office of the Deputy Commissioner for\nLegislation and Congressional Affairs. ECB responds to congressional inquiries on\nbehalf of the Commissioner and Deputy Commissioner. ECB does not respond to\nUnfair Treatment Complaints but instead refers them to the Office of the Chief\nAdministrative Law Judge (OCALJ). The ECB provides an interim response to the\ncongressional office if a final reply cannot be made within 12 working days after the\nreceipt of an inquiry. Generally, subsequent interim responses (providing up-to-date\nstatus) are sent every 22 workdays until final resolution. When ECB expects it will be\nsome time before there will be any change in status, it will provide an interim response\nindicating what stage of the process the claim is in (for example, pending in the Appeals\nCouncil) and explain that the office will notify the congressional office once subsequent\naction has been taken.\n\nCONGRESSIONAL AND PUBLIC AFFAIRS BRANCH\n\nThe Congressional and Public Affairs Branch (CPAB) procedures require that a\nresponse to a new inquiry be provided to congressional staff within 5 1 working days\nfrom the date the inquiry is received. A 20-day due date will be assigned if the last\nresponse was a routine interim reply. A 90-day due date will be assigned if the last\nresponse was a substantial interim reply. According to CPAB staff, between January\nand June 2008, CPAB processed 1,874 written responses and 67,018 telephone\ninquiries.\n\nOFFICE OF THE CHIEF ADMINISTRATIVE LAW JUDGE\n\nAll Congressional inquiries that involve an Unfair Treatment Complaint are referred to\nOCALJ. OCALJ acknowledges receipt of the complaint and notifies the congressional\noffice of the result.\n1\n During the first quarter of 2008, following our audit review period, CPAB increased the amount of time a\nnew inquiry should be provided to congressional staff from 3 to 5 working days.\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080)\n\x0c Appendix G\n\nSelected Correspondence Between\nCongressman Gilchrest and the Office of\nDisability Adjudication and Review1\nAn August 26, 2006 letter from Congressman Gilchrest\xe2\x80\x99s office to the Regional Chief\nAdministrative Law Judge (RCALJ) in Region III 2 expressed concerns about procedures\nfor hearing notifications, scheduling delays, the integrity of the hearings process,\nresponse time on inquiries and allegations of retaliation against claimants for making\nsuch inquiries\n\nIn an October 20, 2006 letter to the Congressman, the Deputy Commissioner for\nDisability Adjudication and Review noted that new procedures were being implemented\nto improve the disability determination process. The letter also stated, \xe2\x80\x9cI have directed\nmembers of my management team in the Dover Office of Disability Adjudication and\nReview to respond to the serious matters involving poor service.\xe2\x80\x9d\n\nOn November 9, 2006, the Hearing Office Chief ALJ (HOCALJ) wrote to Congressman\nGilchrest addressing some of the timeliness issues and noting that \xe2\x80\x9cwithout having\ncase-specific information (Social Security Number or names), we are not able to provide\na more detailed response.\xe2\x80\x9d\n\nOn March 13, 2007, Congressman Gilchrest noted \xe2\x80\x9cThe sheer volume of the complaint\ncompilation now exceeds assessments of more than two-hundred disability cases\xe2\x80\x9d and\nnoted he had received complaints from five law firms. The letter also noted concerns\nabout a \xe2\x80\x9c\xe2\x80\xa6pattern of bias demonstrated in these cases reflects disdain for the\npermanently disabled on a scale that borders if not exceeds the federal law on\ndiscrimination against a protected class of people.\xe2\x80\xa6\xe2\x80\x9d Congressman Gilchrest also\nrequested a formal investigation of these complaints.\n\nOn March 29, 2007, the RCALJ for Region III wrote to Congressmen Gilchrest\nrequesting specific information on the cases \xe2\x80\x9cso that we have all of the facts and can\nfully address each of [the] concerns.\xe2\x80\x9d\n\nOn December 12, 2007, the Congressman\xe2\x80\x99s office sent the names and Social Security\nnumbers (SSN) of 111 constituents with complaints about their hearings at the Dover\nHearing Office. The list was broken down into three listings\xe2\x80\x94one for each of three\n\n1\n This is not an exhaustive list of all correspondence that took place between Congressman Gilchrest\xe2\x80\x99s\noffice and OCALJ, which included other e-mails, additional written correspondence, and phone\nconversations.\n2\n Region III includes Delaware, Maryland, Pennsylvania, Virginia, Washington, DC, and West Virginia.\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080) G-1\n\x0cALJs in the hearing office. The largest group involved 61 cases related to the HOCALJ.\nEach listing contained the claimant\xe2\x80\x99s name, SSN, claimant\xe2\x80\x99s representative, decision\ndate, and hearing decision.\n\nOn December 19, 2007, the RCALJ wrote to Congressmen Gilchrest noting \xe2\x80\x9c\xe2\x80\xa6we need\nto have a specific allegation tied to each case.\xe2\x80\x9d The RCALJ also noted that the Office of\nDisability Adjudication and Review (ODAR) had received more information on two of the\ncases and an investigation would take place.\n\nOn April 1, 2008, the Chief ALJ wrote to Congressman Gilchrest and noted \xe2\x80\x9cBecause of\nthe number of general complaints we have received from your office about the Dover\nHearing Office, we are in the process of conducting an audit of sample decisions issued\nby the Dover Hearing Office. This review will provide us with an objective assessment\nof the quality of the work in the Dover hearing Office\xe2\x80\xa6If allegations are found to be\nsubstantiated, appropriate action will be taken.\xe2\x80\x9d\n\nOn April 7, 2008, a meeting was held between Congressman Gilchrest, other\ncongressional staff, claimant representative attorneys, and the RCALJ. At the meeting\nODAR advised the representatives and the congressional staff to send the complaints\nto them so that they could be reviewed by ODAR.\n\n\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080) G-2\n\x0c Appendix H\n\nStatus of 111 Hearing Claims Referred by\nCongressman Gilchrest\xe2\x80\x99s Office\nCongressman Gilchrest\xe2\x80\x99s office sent the Office of Disability Adjudication and Review (ODAR)\na list of 111 alleged complaints in December 2007 identifying the claimants\xe2\x80\x99 names, Social\nSecurity numbers and the administrative law judges (ALJ) who presided at the hearings.\nAlthough the claimants did not describe in their own words how they were treated unfairly,\nODAR received sufficient information in each ALJ complaint for ODAR staff to query their\nsystems to determine whether appeals had been filed. Many of these complaints have\nundergone further review, as shown below, demonstrating that a more detailed response\ncould have been provided to the Congressman to indicate the status of the claims in\nquestion.\n\nWe found that as of September 2008, 53 of these claims had been appealed or a second\nrequest for hearing had been filed. Another 56 claims did not appear to have gone through\nadditional review and 2 claims were not in the Case Processing and Management System.\nWe also found that of the 53 cases undergoing additional review, 16 decisions were\nfavorable, 19 decisions were unfavorable, and 18 were pending a decision.\n\n Table H-1: Status of 111 Constituent Claims\n (As of September 2008)\n No New Appeals\n Action on Council Court 2nd Hearing No Records\n Case Review Remand Request found Total\nNumber of\n 56 36 4 13 2 111\nClaims\n\n\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080)\n\x0c Appendix I\n\nUnfair Treatment Complaints Provided by the\nOffice of the Chief Administrative Law Judge\nThe Office of the Chief Administrative Law Judge (OCALJ) provided us with 20 Unfair\nTreatment Complaints received in Calendar Year (CY) 2007 1 and related to the 4 hearing\noffices serving Congressman Gilchrest\xe2\x80\x99s district. 2 We found the majority of the complaints\nrelated to the Dover Hearing Office.\n\n Figure I-1: CY 2007 Unfair Treatment Complaints by Hearing Office\n\n 10%\n 10%\n\n\n\n 55%\n 25%\n\n\n Dover Washington, DC Norfolk Baltimore\n\n\n\n\nAt the time of our review, 13 of these complaints had been closed and 7 were still pending.\nODAR determined all 13 of the closed complaints to be unsubstantiated. We also found that\nit took ODAR an average of 5 months to review the 13 closed complaints, while the 7 pending\ncomplaints had been awaiting action for an average of 8 months. Moreover, 17 of the\n20 individuals filing the complaints, or 85 percent, had also appealed their cases to the\nAppeals Council.\n\n\n\n\n1\n In fact, one complaint was related to late CY 2006 and another to early CY 2008.\n2\n The four hearing offices are located in Baltimore, Maryland; Dover, Delaware; Norfolk, Virginia; and\nWashington, DC.\n\n\n\n\nCustomer Service Issues at the Dover Hearing Office (A-12-08-28080)\n\x0c DISTRIBUTION SCHEDULE\n\nCommissioner of Social Security\nOffice of Management and Budget, Income Maintenance Branch\nChairman and Ranking Member, Committee on Ways and Means\nChief of Staff, Committee on Ways and Means\nChairman and Ranking Minority Member, Subcommittee on Social Security\nMajority and Minority Staff Director, Subcommittee on Social Security\nChairman and Ranking Minority Member, Committee on the Budget, House of\nRepresentatives\nChairman and Ranking Minority Member, Committee on Oversight and Government Reform\nChairman and Ranking Minority Member, Committee on Appropriations, House of\nRepresentatives\nChairman and Ranking Minority, Subcommittee on Labor, Health and Human Services,\nEducation and Related Agencies, Committee on Appropriations,\n House of Representatives\nChairman and Ranking Minority Member, Committee on Appropriations, U.S. Senate\nChairman and Ranking Minority Member, Subcommittee on Labor, Health and Human\nServices, Education and Related Agencies, Committee on Appropriations, U.S. Senate\nChairman and Ranking Minority Member, Committee on Finance\nChairman and Ranking Minority Member, Subcommittee on Social Security Pensions and\nFamily Policy\nChairman and Ranking Minority Member, Senate Special Committee on Aging\nSocial Security Advisory Board\n\x0c Overview of the Office of the Inspector General\nThe Office of the Inspector General (OIG) is comprised of an Office of Audit (OA), Office of Investigations\n(OI), Office of the Counsel to the Inspector General (OCIG), Office of External Relations (OER), and Office of\nTechnology and Resource Management (OTRM). To ensure compliance with policies and procedures, internal\ncontrols, and professional standards, the OIG also has a comprehensive Professional Responsibility and Quality\nAssurance program.\n Office of Audit\nOA conducts financial and performance audits of the Social Security Administration\xe2\x80\x99s (SSA) programs and\noperations and makes recommendations to ensure program objectives are achieved effectively and efficiently.\nFinancial audits assess whether SSA\xe2\x80\x99s financial statements fairly present SSA\xe2\x80\x99s financial position, results of\noperations, and cash flow. Performance audits review the economy, efficiency, and effectiveness of SSA\xe2\x80\x99s\nprograms and operations. OA also conducts short-term management reviews and program evaluations on issues\nof concern to SSA, Congress, and the general public.\n Office of Investigations\nOI conducts investigations related to fraud, waste, abuse, and mismanagement in SSA programs and operations.\nThis includes wrongdoing by applicants, beneficiaries, contractors, third parties, or SSA employees performing\ntheir official duties. This office serves as liaison to the Department of Justice on all matters relating to the\ninvestigation of SSA programs and personnel. OI also conducts joint investigations with other Federal, State,\nand local law enforcement agencies.\n Office of the Counsel to the Inspector General\nOCIG provides independent legal advice and counsel to the IG on various matters, including statutes,\nregulations, legislation, and policy directives. OCIG also advises the IG on investigative procedures and\ntechniques, as well as on legal implications and conclusions to be drawn from audit and investigative material.\nAlso, OCIG administers the Civil Monetary Penalty program.\n Office of External Relations\nOER manages OIG\xe2\x80\x99s external and public affairs programs, and serves as the principal advisor on news releases\nand in providing information to the various news reporting services. OER develops OIG\xe2\x80\x99s media and public\ninformation policies, directs OIG\xe2\x80\x99s external and public affairs programs, and serves as the primary contact for\nthose seeking information about OIG. OER prepares OIG publications, speeches, and presentations to internal\nand external organizations, and responds to Congressional correspondence.\n Office of Technology and Resource Management\nOTRM supports OIG by providing information management and systems security. OTRM also coordinates\nOIG\xe2\x80\x99s budget, procurement, telecommunications, facilities, and human resources. In addition, OTRM is the\nfocal point for OIG\xe2\x80\x99s strategic planning function, and the development and monitoring of performance\nmeasures. In addition, OTRM receives and assigns for action allegations of criminal and administrative\nviolations of Social Security laws, identifies fugitives receiving benefit payments from SSA, and provides\ntechnological assistance to investigations.\n\x0c'


type: contracts

jurisdiction: EU

text:
Svarbus teisinis pranešimas
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 22003D0023
 Oficialusis leidinys L 137 , 05/06/2003 p. 0005 - 0008
 EEE jungtinio komiteto sprendimasNr. 23/20032003 m. kovo 14 d.iš dalies keičiantis EEE susitarimo I priedą (Veterinarijos ir fitosanitarijos klausimai)EEE JUNGTINIS KOMITETAS,Atsižvelgdamas į Europos ekonominės erdvės susitarimą, patikslintą Protokolu, patikslinančiu Europos ekonominės erdvės susitarimą, toliau — Susitarimas, ypač į jo 98 straipsnį,kadangi:(1) Susitarimo I priedas buvo iš dalies pakeistas 2002 m. gruodžio 6 d. EEE jungtinio komiteto sprendimu Nr. 157/2002 [1].(2) 2002 m. birželio 4 d. Komisijos sprendimas 2002/459/EB, pateikiantis ANIMO kompiuterių tinklo vienetų sąrašą ir panaikinantis Sprendimą 2000/287/EB [2], turi būti įtrauktas į Susitarimą.(3) Šis sprendimas netaikomas Lichtenšteinui,NUSPRENDĖ:1 straipsnisSusitarimo I priedo I skyriaus 1.2 dalis iš dalies pakeičiama taip, kaip nurodyta šio sprendimo priede.2 straipsnisSprendimo 2002/459/EB tekstas islandų ir norvegų kalbomis, kuris turi būti paskelbtas Europos Sąjungos oficialiojo leidinio EEE priede, yra autentiškas.3 straipsnisŠis sprendimas įsigalioja 2003 m. kovo 15 d., jei EEE jungtiniam komitetui buvo pateikti visi pranešimai pagal Susitarimo 103 straipsnio 1 dalį [3].4 straipsnisŠis sprendimas skelbiamas Europos Sąjungos oficialiojo leidinio EEE dalyje ir EEE priede.Priimta Briuselyje, 2003 m. kovo 14 d.EEE jungtinio komiteto varduPirmininkasP. Westerlund[1] OL L 38, 2003 2 13, p. 3.[2] OL L 159, 2002 6 17, p. 27.[3] Konstituciniai reikalavimai nenurodyti.--------------------------------------------------EEE JUNGTINIO KOMITETO SPRENDIMO Nr. 23/2003 PRIEDASSusitarimo I priedo I skyriaus 1.2 dalis iš dalies pakeičiama taip, kaip nurodyta toliau:46 punkto tekstas (Tarybos sprendimas 2000/287/EB) pakeičiamas taip:"32002 D 0459: 2002 m. birželio 4 d. Komisijos sprendimu 2002/459/EB, pateikiančiu ANIMO kompiuterių tinklo vienetų sąrašą ir panaikinančiu Sprendimą 2000/287/EB (OL L 159, 2002 6 17, p. 27).Šis aktas taip pat taikomas Islandijai tose srityse, kuriose taikomi konkretūs įžanginės dalies 2 punkte nurodyti aktai."Šio sprendimo nuostatos šio Susitarimo tikslais adaptuojamos taip:Priedas papildomas taip:"Šalis IslandijaPagrindinis vienetas1700000 | Fiskistofa |Pasienio kontrolės postai1700199 | P | Reykjavík |1700299 | P | Hafnarfjörður |1700399 | P | Isafjörður |1700499 | P | Akureyri |1700599 | P | Eskifjörður |1700799 | A | Keflavík Airport |1701399 | P | Husavik |1701899 | P | þorlákshöfn |1701999 | P | Njarðvík |1702199 | P | Siglufjörður |Šalis: NorvegijaPagrindinis vienetas1500000 | Statens Dyrehelsetilsyn |Vietiniai vienetai1500101 | Oslo, Akershus og Østfold |1500201 | Hedmark og Oppland |1500301 | Buskerud, Vestfold og Telemark |1500401 | Rogaland, Aust-Agder og Vestagder |1500501 | Hordaland og Sogn- og Fjordane |1500601 | Møre og Romsdal |1500701 | Sør-Trøndelag og Nord-Trøndelag |1500801 | Nordland |1500901 | Troms og Finnmark |Pasienio kontrolės postai1500199 | P | Oslo |1500299 | P | Kristiansund |1500399 | P | Stavanger |1500599 | P | Måløy |1500699 | P | Ålesund |1500799 | P | Trondheim |1500999 | P | Tromsø |1501099 | P | Hammerfest |1501199 | P | Båtsfjord |1501299 | R | Storskog |1501399 | A | Oslo Lufthavn |1501499 | P | Borg |1501599 | P | Vadsø |1501699 | P | Sortland |1501799 | P | Honningsvåg |1502099 | P | Skjervøy |1502199 | P | Kirkenes" |--------------------------------------------------