Saturday, April 12, 2008

Attorney Adjudicator

One of the ways that the Social Security Administration (the “SSA”) is trying to reduce its backlog of disability claims is by allowing staff attorneys known as Attorney Adjudicators to issue on the record (“OTR”) requests for fully favorable decisions. An OTR is a submission that asks the SSA hearing office to approve disability benefits without the need for a hearing.

Establishing a rapport with the staff attorneys increases the chances of having an OTR approved. I represent a 37 year old woman whose past work included various sedentary, light and medium semiskilled positions. Her application was approved OTR today because of the dialogue that I had with the staff attorney who reviewed her file.

I had submitted supportive medical records, diagnostic tests and reports from the claimant’s orthopedist, neurosurgeon, internist, and pain management specialist. Nonetheless, the staff attorney called me because he felt the file was insufficient to support the OTR request that I had submitted. While I had submitted diagnostic tests with some of the medical reports several months earlier, the last report I submitted referred to updated diagnostic tests. After securing the recent MRI and EMG, which actually revealed some progression of the claimant’s condition, the staff attorney approved the OTR.

Because of my volume of cases at this particular hearing office, I know the staff attorneys there fairly well. At this point, they know that if there is a problem with a file, such as a gap in the record or stale records, that I will obtain the information they need quickly and with great alacrity. Similarly, if I call the staff attorneys they are also willing to tell me the reason why an OTR was not approved, which enables me to cure the perceived deficiency. The staff attorneys are happy because I make their job a little easier and help reduce their case load. I’m happy to help because it results in most OTRs being approved, which avoids the long wait for a hearing.

Even at a hearing office that is notorious for Judge’s who deny claims, because the staff attorneys know me, most of my OTRs are approved, which is due in part to my providing additional information based on discussing the OTR. Not only is it important to be aware of the OTR mechanism, but it is also important to know the players when navigating the process.

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