What is an Administrative Record?

According to the Supreme Court, the administrative record includes all materials compiled by the agency, which were before the agency at the time the decision was made. That definition is well settled. Nonetheless, even though they know that they are not agencies, disability insurance companies constantly argue that the claim file they compile is an administrative record in ERISA benefit actions. 

Disability insurers assert that their claim files are administrative records in order to evade discovery. For decades, disability insurers have filed motions “on the administrative record.” Courts regularly hold that no such thing exists, and treat the motions as motions for summary judgment. Insurers misname their motions because summary judgment specifically anticipates that the motion will follow the completion of discovery. 

Similarly, disability insurers assert that their claim files are administrative records in order to evade their initial disclosure obligations under Rule 26(1)(1). Unum made that argument in one of my pending cases, but Judge Abrams rejected it today. 

Judge Abrams explained that unlike a federal agency, which is statutorily bound to be neutral, insurance companies like Unum are not. As another Court reasoned: 

“In an agency proceeding, the court reviews the decision of a board or other agency tribunal that has been authorized by Congress to make such decisions after appropriate administrative proceedings. None of the neutrality or hearing-type protections in those cases is present here.”

Pain Medicine

According to the American Board of Pain Medicine, pain medicine is concerned with the prevention of pain, and the evaluation, treatment, and rehabilitation of persons in pain. The POMS says there is no specialty board for pain or certification program. The POMS is wrong because the following specialty boards have certifications for Pain Medicine: Anesthesiology, Emergency Medicine, Family Medicine, Physical Medicine and Rehabilitation, Neurology, and Radiology. 

I represent a 45 year old former nurse assistant whose application for Social Security Disability (“SSD”) benefits was approved today by an administrative law judge (“ALJ”) on-the-record (“OTR”) without a hearing. The claimant has neck and back problems that cause neck, back, leg, and hand pain, which have persisted despite treatment with the claimant’s board certified physiatrist who is certified in Pain Medicine. 

When making its initial SSD decision, the State agency, is supposed to follow the POMS. Perhaps if the POMS correctly recognized that numerous medical specialty boards, including physiatry, maintain certification programs for Pain Medicine, then the State agency would have approved the claimant’s SSD application. Considering that most claimants are disabled by pain, extra weight should be given to pain specialists, regardless of whether there is an independent medical board that is part of the American Board of Medical Specialities.