Systematic File review: an approach for efficiently managing a Social Security practice

To manage a Social Security practice effectively, it is essential to have a system in place for routinely reviewing cases in order to make important case decisions.  In order to win cases, you need to know what you have, what you need, and how you will get it.  To concentrate your efforts where they will be most fruitful, you should first have a system in place to identify and "sort" your cases. 

In a "volume business", cases will broadly fall into three categories.

Category 1 is the "Good" cases. In triage, these cases are not only meritorious on the asserted facts, but the evidence is well-developed. These cases need minimal attention. Proper diligence on a case like this is to quickly settle it. Get the client their money, get the firm their fee, and take it off the docket.

Category 3 is the "junk" cases. These are cases that either lack merit even on the alleged facts, have such significant evidentiary issues that the case is likely futile, or have client problems that merit cutting losses. All of these cases should be identified as soon as possible and jettisoned, generally by withdrawing the representation. Exit and don't look back.

That leaves category 2: the "work" cases. These should be the bulk of clients in the first place: claims which would be meritorious on the alleged facts, but which need work to complete the evidence. This is where an advocate gets to be really effective. In a "work" case, the advocate review identifies the strategy of the case, identifies the likely sources of evidence, and plans the timeline of the case.

Identifying the category of case is essentially step 0 to managing an effective volume practice. Knowing what you are working with will allow you to efficiently utilize your resources and effectively advocate for your clients.

So how do you identify the cases?  

It’s important to remember that these categories are somewhat fluid, except category 3.  2s become 3s if development reveals that the allegations will not be supported.  2s become 1s when development is completed and the facts and argument are supported. 1s become 2s if an unexpected problem develops, or if the firm fails to act before evidence gets stale.  

If a case is properly identified as a 3, then it should not be revisited.  The purpose of a “jettison” category is twofold.  First, it helps the client to guide their personal decision making.  When a client has a category 3 case, a good attorney enters the "counselor at law” role to advise the client that they do not have a viable claim, and should direct them to the appropriate alternative resource, whether that is a rehabilitation resource, an appropriate medical source, or a different type of claim.  Second, the jettison helps the firm to efficiently target resources where they are likely to be fruitful.  Attorney and paralegal time, as well as expense expenditures, are nominally scarce resources, and shouldn’t be squandered.  Every resource that is spent on a 3 raises the cost of the 2 and 1 cases, because those cases are now sharing resources with wasted efforts.  So keeping bad cases going is bad for the client and it’s bad for the firm.  It’s also a failure of several ethical duties.  

A case that is a 1 should be expedited.  The same reasoning applies here as in 3: it is good for the client, and good for the firm.  There can be no doubt that a client with a meritorious claim is better off the sooner they get paid.  Some firm managers may question whether it is good for the firm, though.  In contingency fee matters, resolving a matter quickly may actually result in a lower fee payment, and sometimes that fee reduction is disproportionate to the amount of effort saved.  But if they are not expedited, evidence goes stale, the client gets more frustrated, and the case is moved back to category 2.  

Arguably, expediting 1 cases might cost more resources, as the firm would need to invest a burst of attorney time on the motion for summary judgment; in social security hearings, this might actually take more attorney time than simply going to the hearing.  This is an area where a firm needs to consider other aspects of their practice model.  Does reputation matter?  Is there a possibility of client referrals coming from expedited cases?  Is ethical duty a priority over fee considerations?  If the answer to any of these is “yes”, then there’s not really a choice here.  Category 1 cases must be expedited.  It’s not optional.  

So that brings us to category two, which is worthy of its own articles.