Monday, June 27, 2016

Madison, Wisconsin Social Security Judge Accused of "Highly Inappropriate" Comments

A Social Security Disability Administrative Law Judge appears to have been suspended in the wake of a scandal involving allegations so sexism and bigotry.  News reports indicate that the the Office of the Inspector General has begun an investigation into the Madison, Wisconsin Office of Disability Adjudication and Review, particularly of ALJ John Pleuss.  Judge Pleuss has allegedly engaged in a pattern of sexual harassment against his staff and made inappropriate comments about claimants who have appeared before him.
According to, in recent days, Judge Pleuss' hearings have been cancelled amid the Inspector General's Investigation.   See Sources: Social Security judge suspended in wake of Madison scandal By M.D. Kittle / June 16, 2016    Madison ODAR director Laura Hodorowicz has also been out of the office, fostering speculation that she has been suspended also.  
According to reports, employees at the Madison ODAR have blown the whistle at what they claim is a "culture of corruption and cover-up" at their office.  In fact, someone within the office has leaked some of the notes taken by Judge Pleuss during hearings.  These notes reveal a pattern of gender discrimination and bigotry against claimants.  Some of the notes allegedly written by Judge Pleuss state:
“Young, white (female); long brown hair; attractive; looks innocent,” the ALJ wrote.  He described another claimant as “buxom,” and noted that a “young, white (woman) looks like a man.”
“Obese, young, white (female) skimpy black top,” he wrote of another claimant.
Very black, African looking (female),” the ALJ wrote, and parenthetically he added,“(actually a gorilla-like appearance).”
In another document, Pleuss wrote, “I’ll pay this lady when hell freezes over!”  (See article from
U.S. Sen. Ron Johnson, R-Wis. has taken an active role in this controversy and has asked Social Security Commissioner, Carolyn Colvin for her agency's unfettered cooperation in this matter.

As this controversy escalates, one must wonder whether the SSA is going to follow the same hard line approach that it has used in cases of alleged corruption where claimants were granted benefits. For example, in cases involving alleged corruption in Kentucky and Puerto Rico, the SSA suspended benefits to claimants even before the allegations of corruption had been substantiated.   Eventually, claimants in Puerto Rico and Kentucky were required to go through a new hearing process in order to re-determine whether they could receive disability benefits.  In light of this harsh stance by the Agency, claimants who received unfavorable decisions from Judge Pleuss have every right to demand that they be given a new opportunity to present their case at a new hearing before a different Administrative Law Judge.   

Monday, June 20, 2016

Recent Connecticut Cases Regarding "The Treating Physician Rule"

The "treating physician rule" is a fundamental principle of Social Security disability law.  According to this rule, if an opinion comes from one of your own doctors, the SSA has to give that medical opinion "controlling weight".  An Administrative Law Judge can only disregard an opinion from a treating physicians if he or she finds that there are "good reasons" to disregard the opinion.
Unfortunately, for the past several years ALJ's in Connecticut have taken the habit of disregarding medical opinions from treating sources for practically any reason.  In fact, it appears that ALJ's have developed boiler plate phrases that they insert in unfavorable decisions when they want to disregard a treating physician's opinion.  
In response to this problem, the Federal Court in Connecticut has issued two recent decisions discussing the treating physician rule. Thornton v. Colvin, 2016 U.S. Dist. LEXIS 15504 (D. Conn. Feb. 9, 2016) and Stango v. Colvin, 2016 U.S. Dist. LEXIS 79096 (D. Conn. Jun, 17, 2016)  These decisions provide an excellent discussion of some of the typical excuses and boiler plate language used by ALJ's to disregard treating doctor's opinions.  Both of these cases provide great ammunition for anyone seeking to obtain a remand in a case where the ALJ gave less that controlling weight to a treating physician's opinion.   

Monday, June 13, 2016

Social Security Proposes Rule to Excluded Evidence from Providers Convicted of Felonies

As part of the bipartisan budget of 2015, Congress instructed the Social Security Administration to enact a rule excluding evidence from medical providers who have been convicted of fraud.  This mandate arose out of the concern that disability claimants could be gaining an unfair advantage by using medical opinions that had been obtain through dishonest means. 
Although this rule serves a good purpose, its strict application  could lead to unfair results.  In many cases involving fraud accusations, claimants were completely unaware  that their lawyers or medical experts were involved in fraud.  I have seen this in cases that I have worked on in Kentucky where some claimants were completely unaware of the fraud.  Unfortunately, when cases from claimants from Kentucky were re-opened during the course fraud investigations, it was extremely difficult to prove their cases without relying on evidence from sources who were implicated in the scandal.  It isn't fair to assume that all medical evidence produced by a doctor who was involved in fraud is unreliable.  Take the example of a case from Puerto Rico that I worked on.  In Puerto Rico, the same doctor who was involved in the fraud was also hired by the agency to perform consultative evaluations.  Under those circumstances, it wasn't fair to exclude the consultative evaluation from the review process.
The proposed regulation will allow the SSA to admit evidence otherwise excluded if there exists "good cause".  The proposed regulations lays out five circumstances under which good cause might exist.   For a copy of the proposed rule visit: 
Another important mandate of this new rule is that it requires medical providers to inform the SSA that they have been subject to penalties for fraudulent conduct.