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Free Claim Review

In Region 1, which comprises the New England States, we have the Decision Review Board (DRB) as a legacy of the DSI process. Most claims that are denied at the ALJ level are selected by the DRB for review. So instead of an Appeals Council appeal, we have the Decision Review Board. The DRB review takes 90 days. When the DRB selects the case for review, it is automatic. You don't have to do anything. In my recent experience almost all unfavorable decisions are selected for review. 

You have the option of submitting a written statement to the DRB within 10 days explaining why you disagree with the ALJ's decision. So you have to act pretty fast. Nevertheless, I almost always submit a detailed written statement. 

But here's the thing. The DRB process must be completed within 90 days. If 90 days go by, and the DRB doesn't get around to reviewing the claim, you get a letter saying sorry, we did not get around to reviewing the decision. As a result of that nonreview, the ALJ's decision becomes the final decision of the Social Security Administration.

So far, every claim I've had go to the DRB has resulted in a letter saying that the DRB did not conduct it's review within 90 days. Every one. It is very frustrating. Furthermore, you lose the option of going to the Appeals Council. The usual complaint about the Appeals Council, which is the next level of review after the ALJ for most of the country, is that the Appeals Council review takes a long time. I have had claims at the Appeals Council for well over a year. But at least they get around to conducting a review eventually, and almost a quarter of those claims are remanded or allowed.

When the DRB process is not completed within 90 days, it says to the claimant: "Your claim was not important enough for us to review." It is really a terrible message from a federal agency to a citizen requesting services.

I have a few decisions pending at the DRB that are particularly egregious ALJ decisions. The same person at SSA is in charge of the Appeals Council and the DRB. I have emailed her to ask (to beg, really) that the DRB review a each of these claims within the allotted 90 days. I have received no response.

A DRB 90-day non-review means that federal district court is now the de facto first level of appeal of the ALJ decision. The number of district court filings is increasing dramatically in New England, because obviously flawed decisions that would be routinely remanded by the Appeals Council are now being sent to the DRB and then not getting reviewed within 90 days. Making the U.S. District Court the the first level review of an ALJ's decision is a poor use of scarce federal judicial resources. Our district court judges and magistrates are going to see those 25% of cases that are usually sent back by the Appeals Council. 

While DSI process has been mostly abandoned, the DRB still lives on. One wonders whether the DRB has the resources it needs. Until it is dissolved, however, it is a cause for concern here in New England.