Originally Posted by mastoidectomy

I have had several mastoidectomy procedures over the years (inner ear), and have been left with complications, pain, nausea, facial paralysis, infections. The infections over the years has burned a hole in my ear drum as well as dissolved inner ear bones etc... I'm 44, and the pain is just gotten really worse over the last 8 years or so. I filed in 2009, had a hearing recently 2013. The ALJ in her ruling stated that I went to a clinic several times were I received "cleanings" of debris. The clinic has no ENT'S, and provides no such services, they simply provide me with pain and anti swelling medication for said mastoidectomy complications. She stated I received "cleanings" there in an effort to show that my diagnosis of symptom of otitis media "infections" is unfounded as at these "cleanings" no infection was noted. The real reason no infection was noted is because it is beyond their medical scope to even look for it let alone detect it. She completely fabricated this idea of me getting "cleanings" there as part of her ruling, it just did not occur, and she states it happened, twice!
As I said the facility simply prescribes my meds and referrals FOR volunteer ENT services, which I get maybe once a year if lucky. The ENT states as have other ENT'S, that I must see ENT at least three times a year for debriment to prevent infection, for life, and this clinic does not do these procedures she states that I received there, she made it up, from thin air!
Is an ALJ's statement of treatment "cleanings", which did not occur grounds for a remand as it is clearly a complete fabrication by the ALJ of services rendered at the clinic in question. This ALJ has gone from 60% approval down to 30% in just the last two years, she is lying, lying, lying, and is obviously brazen about it to actually insert made up facts such as these. She is so emboldened that she does not even consider that the clinic in question might not even do the "cleanings" she said I got there, she feels she can do or say anything, can she?
Any help?

Originally Posted by Direwolf

I have no idea, what does it matter if its remand eligible anyway? To gain a remand you must either prevail at appeals council which is all but impossible, or pursue a civil lawsuit in a real courtroom, either way requires you to appeal the alj's decision, incidentally you must proceed through the appeals council if you wish to file a federal lawsuit anyway, a process that will likely eat up nine months more of your time.

Often as in both of my appeals council appeals, the council will just sit on your appeal for a year, then notify you that they will not review the decision no matter what, which is so outrageous it defies all rational response....

Bottom line, to garner a remand, you must proceed on through the system, a process that easily could tack on an additional 4-5 years of anguish and despair...

Originally Posted by LIT LOVE

When the Appeal's Council denies a request for review, this doesn't mean they didn't read your appeal and make a decision on it. It means they read the appeal, denied you, and will not review the entire case. http://www.ssa.gov/pubs/EN-05-10041.pdf

Originally Posted by Direwolf

Not according to my attorneys, they clearly stated that AC routinely refuses to even read the ALJ decision, which in my case they did twice!

Again, to be perfectly clear, the AC often simply refuses to even review the ALJ's decision, Daley Disability Law says its not at all uncommon...

Originally Posted by LIT LOVE

I think you're confusing my point. I stated the AC read your appeal--which they decided was without merit, and as a result you received a denial. I didn't state that they read every ALJ decision--in some cases it might not be necessary.

Over half of the applicants that file appeals will eventually be awarded benefits, so statistically it is not a waste of time for applicants to follow through.

Originally Posted by Direwolf

Thats just the point intended for the op, how is it possible to decide your appeal is without merit if they have not even read the decision? You are confusing him I think, its profoundly necessary that the OP understand just what they are up against here. Its both figuratively and literally impossible for AC to reject an appeal based on such outrageousness....Yet they do just that thousands of times each year.

The only chance the op has is in a federal courtroom, tacking on an easy extra 3-5 yrs to the process, that or he can file a new claim and hope for a different outcome. These people need to understand the truth, and that is that most of them are going to lose, and lose badly!

Originally Posted by LIT LOVE

Only 4% of the cases are given an outright approval at the Federal Court level. Most are either denied (40%) or simply remanded (47%) back to an ALJ.

http://www.ultimatedisabilityguide.c...ial_rates.html

I don't know how you came to the decision that Federal Court would give you, or anyone, a better opportunity for approval, but it just isn't true. It can give you another opportunity to keep your case alive and not lose backpay, so that new evidence can be presented to an ALJ--but that's generally what one is trying to accomplish with the AC as well.