The second meeting took place in the Washington DC office with the new Commissioner, Michael Astrue.

We had opportunities to discuss various issues raised by NADR members as well as the Agency’s future plans and direction. It was our intent to introduce ourselves to the Commissioner and offer “from the weeds” input whenever deemed to be helpful.

• DSI - Issues surrounding the new DSI program and various initiatives found within. It appears that this program is not the success that many had hoped although components of it are successful.
  
• Quick Decision Determination (QDD) - This is presently occurring in the DSI project in Region 1 and apparently is a successful component whereby claimants with significant diseases or impairments are “fast tracked” and can be found eligible within 20 days. This is “working well” and the model is expected to be rolled out across the country in the future.
  
• Federal Reviewing Official (FedRO) - This program, centered in the Appeals Council at Falls Church, has replaced the reconsideration level in DSI. Apparently, the costs were greater than anticipated with no overwhelming benefit to the process identified. Continuation of this program appears questionable at best.
  
• Office of Medical and Vocational Experts (OMVE) - There is recognition that better qualified experts are required across the board but given the financial remuneration they currently receive, there is little likelihood of having quality personnel. Social Security will be looking at this issue and opening a national registry for ME’s and VE’s. Remuneration for them is expected to be increased and tied to COLA’s in the future.
  
• Decision Review Board (DRB) - It appears that the DRB which has (or eventually would have) taken the place of the Appeals Council in DSI will be modified and there will be various aspects taken from both to create the new entity. The positive news is that there are expected to be rights of appeal similar to those we presently have at the AC whereas claimants going to the DRB had limited, if any, rights of appeal.
  
• Setting Hearings & Evidence Submission - The good news is that they are looking to eventually set hearings 75 days in advance versus the current 20 days. The bad news that goes along with this will be a greater expectation for timely submission of evidence and adverse consequences should that not occur. Submission of post hearing evidence is expected to be significantly restricted.
  
• Physician concerns regarding HIPAA Releases - SSA has received concerns about physicians not honoring various releases due to questions about HIPAA compliance. This is being investigated and will be dealt with.
  
• ALJ’s - The current number of ALJ’s is 1102. The goal is to increase that to 1250. Late last week a call for applications to those interested in becoming an ALJ was made. It is also understood that there are several ALJ’s whose production rates are inconsistent with most. They are expected to be reviewed.
  
• Compassionate Allowances - Mr. Astrue was very informed about issues surrounding listings. He discussed various rare genetic diseases and focused, via example, about boys with Hunter Syndrome. Given his background as President and CEO of Transkaryotic Therapies, a company that produces pharmaceuticals, he was able to provide specifics regarding pharmaceutical interventions which may now exist that previously did not and how persons with various impairments should be granted benefits at the earliest opportunity using “Compassionate Allowances.” This would occur even though they may not meet nor equal a listing because the disease itself has specific known mortality, impairment, or progression rates.
  
• Communication Forums - Finally, Mr. Astrue discussed how important he felt it was to obtain communication from various entities involved with the process. He hopes to institute public “hearings” on a quarterly basis. These would be two day events for small groups of various stakeholders in the disability process with the first day being focused issues and the second day being more “freeform.”

• NADR’s listing on the Handouts - Many of our members are not getting any referrals from the Telephone Referral Service (TRS) hotline because NADR may not be listed in the sheets which are given to claimants seeking representation. We have, for several years, asked that NADR be included and that improper persons and organizations be removed from these. We were told that this would be acted upon in the near future and that we will be given a copy of what is sent to both the FO and ODAR personnel.
  
• Problem ALJ’s - It is understood that there are ALJ’s within the system who are acting inappropriately. This is an issue that is on the radar of these folks and we have been instructed to notify them if/when issues occur. Ms. de Soto recommended using the current format for lodging complaints. She felt contacting your Regional CALJ is the first logical step. If you are dissatisfied with action (or inaction) taken at this level, you can bring the issue, with all supporting evidence, to the attention of the Legislative Committee and when appropriate, complaints will be submitted directly to Ms. de Soto from NADR President Chris Marois (lucky him!).