DECISION AT ISSUE CONTAINS OR DOES NOT CONTAIN
1. Findings of fact that have a plausible basis in the record.
2. Consistent with the available evidence.
3. Applicable statutes
4. Regulaitng provisions
5. Contains clearly states reasons and bases for the decision.
6. Whenever facts are in dispute or the evidence is such that fair-minded men may draw different conclusions, a measure of speculation and conjecture is required on the part of those whose duty it is to settel the dispute by choosing what seems to them to be the most reasonable conclusion. ONLY when there is a complete absence of probative facts to support the conclusion reached does a reversible error appear. But where as here, there is an evidentiary basis for the SSA's decision, the SSA is free to discard or disbelieve whatever facts are inconsistent with its conclusion. And the claimant may request a reconsideration if she or he feels there was a clear unmistakable error [CUE] or the wrong evidentiary standard was applied resulting in a flawed decision.
7. Furthermore, different examiners, at different times, will not describe the same disability in the same language. Features of the disability which must be persisted unchanged may be overlooked or a change for the better or worse may not be accurately appreciated or described. It is the responsibility of the disability specialist to interpret reports of examination in light of the whole recorded history, reconciling the various reports into a consistent picture so that the current rating may accurately reflect the elements of disability present. If a finding is not supported on the examination or the medical opinion or if the report does not contain sufficient detail, it is incumbent upon the disability specialist to return the report or medical opinion as inadequate for evaluation purposes.
8. The decision was "arbitrary and capricious, an abuse of discretion, or not in accordance with the law.
9. Misinterpreted the governing statue and applied an incorrect and prejudicial evidentiary standard in denying the claim.
10. By definition, every claimant seeking benefits under 20 C.F.R. receives medical care or services from private physicians. In order to determine whether the SSA physician exercised sound medical judgment, the disability specialist, need not accept the physician's decision as conclusive. Rather, the disability specialist may determine the SSA physician did not exercise sound medical judgment because he or she failed to consider certain evidence, or otherwise failed to account for why his or her opinion was contrary to overwhelming evidence that might have lead to another conclusion.
11. At the administrative adjudication level, is by design a non-adversarial process. It does not, set the claimant against the Secretary. There are no "parties" prior to the litigation phase of the process. SSA physicians have no personal interest, pecuniary or otherwise, in whether particular claimants receive benefits under title 20 of the U.S. Code. They are, thus, simply "neutral" gatekeepers whose purpose is to render objective medical opinions. To permit diverse private physicians who provided the care and services at issue, and who might have a vested interest in the determinaiton, to make that ultimate determination, would not be appropriate and would lead to dissimilar results in similar cases. Requiring that the decision be make by a neutral individual capable of making such medical determination, as the regulation does, is an appropriate exercise of the Secretary's rulemaking power. Additionally, by requiring that the ultimate decision be made by SSA physicians as to whether particular claimants receive benefits under the statute.
12. The agency can bring its expertise to bear upon the matter; it can evaluate the evidence; it can make an initial determination; and, in doing so, it can, through informed discussion and analysis, help a court later determine whether its decision exceeds the leeway that the law provides. If the record before the agency does not support the agency action, if the agency has not considered all relevant factors, or if the basis of the record before it, the proper course, remand to the agency for additional investigation or explanation. There is nothing in the principles governing review of administrative action, which precludes the court from giving an administrative body an opportunity to meet objections to its order by correcting irregularities in procedure, or supplying deficiencies in its record, or making additional findings where these are necessary or supplying findings validly made in the place of those attacked as invalid.
2. Consistent with the available evidence.
3. Applicable statutes
4. Regulaitng provisions
5. Contains clearly states reasons and bases for the decision.
6. Whenever facts are in dispute or the evidence is such that fair-minded men may draw different conclusions, a measure of speculation and conjecture is required on the part of those whose duty it is to settel the dispute by choosing what seems to them to be the most reasonable conclusion. ONLY when there is a complete absence of probative facts to support the conclusion reached does a reversible error appear. But where as here, there is an evidentiary basis for the SSA's decision, the SSA is free to discard or disbelieve whatever facts are inconsistent with its conclusion. And the claimant may request a reconsideration if she or he feels there was a clear unmistakable error [CUE] or the wrong evidentiary standard was applied resulting in a flawed decision.
7. Furthermore, different examiners, at different times, will not describe the same disability in the same language. Features of the disability which must be persisted unchanged may be overlooked or a change for the better or worse may not be accurately appreciated or described. It is the responsibility of the disability specialist to interpret reports of examination in light of the whole recorded history, reconciling the various reports into a consistent picture so that the current rating may accurately reflect the elements of disability present. If a finding is not supported on the examination or the medical opinion or if the report does not contain sufficient detail, it is incumbent upon the disability specialist to return the report or medical opinion as inadequate for evaluation purposes.
8. The decision was "arbitrary and capricious, an abuse of discretion, or not in accordance with the law.
9. Misinterpreted the governing statue and applied an incorrect and prejudicial evidentiary standard in denying the claim.
10. By definition, every claimant seeking benefits under 20 C.F.R. receives medical care or services from private physicians. In order to determine whether the SSA physician exercised sound medical judgment, the disability specialist, need not accept the physician's decision as conclusive. Rather, the disability specialist may determine the SSA physician did not exercise sound medical judgment because he or she failed to consider certain evidence, or otherwise failed to account for why his or her opinion was contrary to overwhelming evidence that might have lead to another conclusion.
11. At the administrative adjudication level, is by design a non-adversarial process. It does not, set the claimant against the Secretary. There are no "parties" prior to the litigation phase of the process. SSA physicians have no personal interest, pecuniary or otherwise, in whether particular claimants receive benefits under title 20 of the U.S. Code. They are, thus, simply "neutral" gatekeepers whose purpose is to render objective medical opinions. To permit diverse private physicians who provided the care and services at issue, and who might have a vested interest in the determinaiton, to make that ultimate determination, would not be appropriate and would lead to dissimilar results in similar cases. Requiring that the decision be make by a neutral individual capable of making such medical determination, as the regulation does, is an appropriate exercise of the Secretary's rulemaking power. Additionally, by requiring that the ultimate decision be made by SSA physicians as to whether particular claimants receive benefits under the statute.
12. The agency can bring its expertise to bear upon the matter; it can evaluate the evidence; it can make an initial determination; and, in doing so, it can, through informed discussion and analysis, help a court later determine whether its decision exceeds the leeway that the law provides. If the record before the agency does not support the agency action, if the agency has not considered all relevant factors, or if the basis of the record before it, the proper course, remand to the agency for additional investigation or explanation. There is nothing in the principles governing review of administrative action, which precludes the court from giving an administrative body an opportunity to meet objections to its order by correcting irregularities in procedure, or supplying deficiencies in its record, or making additional findings where these are necessary or supplying findings validly made in the place of those attacked as invalid.
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