ISSUED: July 19, 1999
I. Purpose
This Temporary Instruction (TI) sets forth procedures for implementing the
Final Order entered by the United States District Court for the District
of Utah on July 30, 1998, approving the parties' settlement agreement in
the Goodnight v. Apfel class action. The
Goodnight class action was principally oriented
toward alleged deficiencies in Utah Disability Determination Services
(DDS) actions and procedures.
Adjudicators throughout the country must be familiar with this TI because
of case transfers and because Goodnight class
members who now reside outside of Utah must have their cases processed in
accordance with the requirements of the Final Order and settlement
agreement.
II. Background
On March 27, 1992, the named plaintiffs filed a class action law suit
against the Secretary of Health and Human Services and three Utah DDS
officials. Plaintiffs alleged that the defendants have established a
system of policies, practices, procedures and standards to illegally deny
initial claims for title II and title XVI disability benefits.
Specifically, plaintiffs alleged that the Utah DDS failed to: 1) obtain
medical assessments; 2) develop a complete previous 12-month history; 3)
properly apply step three of the sequential evaluation process; 4)
consider the effect of a combination of impairments; 5) properly determine
the duration of impairment; 6) properly apply the medical-vocational
guidelines for individuals of advanced age; 7) obtain residual functional
capacity assessments from physicians; and 8) give proper notice of
unfavorable determinations.
On October 27, 1993, the district court denied the Federal and State
defendants' motions to dismiss and granted plaintiffs' motion for class
certification. Plaintiffs then proceeded with discovery and identified two
Utah DDS medical advisers who were signing decisional documents prepared
by disability examiners without having reviewed the claim files between
1991 and 1993. Following restrictions on funding to the Legal Services
Corporation, plaintiffs' counsel removed themselves from the case and
plaintiffs secured representation from a private practitioner.
On October 30, 1996, plaintiffs filed a motion for partial summary
judgment and the Federal and State defendants filed oppositions to
plaintiffs' motion. On January 28, 1997, the court held a hearing on the
parties' cross-motions for summary judgment. On April 14, 1997, the court
issued a memorandum decision and order which denied plaintiffs' motion for
partial summary judgment and denied in part and granted in part
defendants' cross-motion for partial summary judgment. The court held that
a Program Operations Manual System (POMS) instruction which permits
disability examiners to assist in completion of residual functional
capacity (RFC) assessment forms was consistent with the Social Security
Act and regulations and not subject to the notice and comment provisions
of the Administrative Procedure Act. However, the court found that an
issue of material fact existed as to whether defendants violated
plaintiffs' civil rights by processing certain claims without an
independent physician's assessment.
Following the Supreme Court's decision in Blessing v.
Firestone, 117 S. Ct. 1353 (1997), the defendant filed a brief
for the purpose of prompting the court to reconsider its prior denial of
its motion to dismiss plaintiffs' claim under 42 U.S.C. § 1983
against the State defendants. (In Blessing, the
Supreme Court held that a plaintiff cannot bring an action under §
1983 and sue a State defendant for its systematic failure to apply the
Federal regulations and laws of a Federally funded program.) On March 10,
1998, the court denied defendant's motion to reconsider.
On June 9, 1998, the parties filed notice of a proposed settlement
agreement, and, on June 10, 1998, the court gave its preliminary approval
of the settlement agreement. On June 26, 1998, July 3, 1998 and July 10,
1998, notice of the public hearing regarding the settlement proposal
appeared in four Utah newspapers. On July 29, 1998, following the
conclusion of the fairness hearing, the court approved the parties'
jointly negotiated settlement proposal, and, on July 30, 1998, the court
entered the order (see Attachment 1).
III. Guiding Principles
Under the Goodnight settlement, the Utah DDS (and
the Commissioner) will readjudicate the claims of those persons who: 1)
respond to notice informing them of the opportunity for review (see
Part V. A. 1. below); and 2) are
determined, after screening, to be class members entitled to relief (see
Part V. B. 3. below). Regardless of the
state of the claimant's current residence, the Utah DDS will, in most
cases, perform the agreed-upon readjudications. OHA will screen cases and
perform readjudications under limited circumstances (see
Parts V. and VI. below).
The type of readjudication will be a
“redetermination.” A
redetermination consists of a
de
novo evaluation of the class member's
eligibility for benefits based on all evidence in his or her file,
including newly obtained evidence, relevant to the period that was at
issue in the administrative determination(s) that forms the basis for the
claimant's class membership. If the redetermination results in a favorable
decision, the adjudicator must also determine whether the class member's
disability and eligibility has been continuous through the date of the
readjudication, i.e., through the current date or the date of the most
recent allowance. The adjudicator will also assess disability through the
current date if a class member claim is consolidated with a common-issue
current claim.
Cases readjudicated by the Utah DDS will be processed at the
reconsideration level regardless of the final level at which the claim was
previously decided. The class member claim(s) will be adjudicated under
current policies and procedures.
IV. Definition of Class
Except as noted below, the Goodnight class members
eligible to request relief are those persons:
•
who had a claim for title II and/or title XVI disability benefits denied
at steps two, four or five of the sequential evaluation process by the
Utah DDS at the initial or reconsideration levels between January 1, 1991,
and February 20, 1994, inclusive; and
•
whose determinations for disability benefits were based in whole or in
part on a mental impairment as indicated in primary or secondary
diagnostic blocks 16A or 16B on Form SSA-831-U3/C3 (the Disability
Determination and Transmittal); or
•
whose Form SSA-831-U3/C3 was signed by Utah DDS employees Doctor Manya
Atiya or Doctor Rebecca Dalisay.
A person is not a Goodnight class member eligible
to request relief if he or she:
•
received a subsequent award of benefits with respect to the same period of
time at issue in the class claim (Although the period at issue in the
class claim can be prior to January 1, 1991, the adjudication of the claim
only had to occur between January 1, 1991 and February 20, 1994,
inclusive); or
•
appealed the denial of his or her class claim to an Administrative Law
Judge (ALJ), the Appeals Council (AC) or to Federal court;
or
•
received a subsequent disability determination after February 20, 1994,
that adjudicated the same time period covered by the class claim;
or
•
has in his or her claim file a Psychiatric Review Technique Form (PRTF)
and Mental Residual Functional Capacity (MRFC) form each completed in its
entirety by a Utah DDS psychiatrist or psychologist employed by the Utah
DDS between January 1, 1991, and February 20, 1994, inclusive;
or
•
failed, without good cause, to timely request a redetermination by
responding to the notice requirements.
V. Determination of Class Membership and Preadjudication
Actions
A. Pre-Screening Actions - General
1.
Identification, Notification and Routing
In April 1999, SSA by means of its data processing systems identified the
names, social security numbers (SSNs) and last known addresses of
potentially eligible Goodnight class members and
sent these individuals notices. On June 3, 1999, because of problems with
the mailing, SSA sent a second notice to all potential class members
except those who responded to the first mailing and whose earlier notice
was returned as undeliverable. Potential class members have 90 days from
the receipt of the notice to return a reply form to the Office of Central
Operations (OCO)(formerly known as the Office of Disability and
International Operations) requesting that SSA readjudicate their claims
under the terms of the Goodnight settlement order.
Undeliverable notices returned to OCO will be used to update the Civil
Action Tracking System (CATS). Litigation Staff will then attempt to
obtain updated addresses by providing the Utah DDS with a computer tape of
those otentially eligible class members whose notices were returned as
undeliverable. The Utah DDS will then attempt to provide Litigation Staff
with a computer tape of updated addresses. Within 60 days of receiving the
updated addresses from the Utah DDS, Litigation Staff will make a good
faith effort to resend the notice by first class mail. If the second
notice is returned as undeliverable, Litigation Staff will then provide
the Utah DDS with a computer tape of those second mailed notices that were
returned as undeliverable. Within 120 days of receiving the computer tape
of undeliverable notices from the Utah DDS, plaintiffs' representative may
attempt to provide notice to those potentially eligible class members
whose second notice was returned as undeliverable.
Following issuance of the POMS instructions, SSA will also display posters
in all of its Utah field offices (FOs) for a period of 180 days from
posting. Absent a finding of good cause, potential class members will have
90 days after the poster display period has ended in which to respond.
However, individuals who receive a mailed notice will not be eligible to
have the time period extended within which they must respond to the mailed
notice by responding to the poster notice.
Individuals can also request review in person by visiting any FO. If the
individual has the Goodnight reply form, the FO
will instruct the potential class member to return the reply form to OCO
in the postage-paid, pre-addressed envelope. If the claimant lost or never
received one or is requesting review based on the poster display, the FO
will assist the claimant in completing an SSA-795 (Statement of Claimant).
The SSA-795 should state that the claimant is requesting review of his or
her disability claim based on the Goodnight court
case and include the claimant's name, SSN, current address and telephone
number. The claimant or representative payee should sign the
SSA-795.
Individuals can also request review by contacting any FO by telephone or
in writing. If the individual contacts the FO by telephone and the
individual has the reply form, the FO should instruct the individual to
return it to OCO. If the potential class member lost or never received a
reply form, the FO should complete an SSA-5002 (Report of Contact). The
report of contact should state that the claimant requested a review of his
disability claim based on the Goodnight court case
and include his or her name, SSN, current address and telephone number.
Any written requests for review and completed SSA-795 and SSA-5002 forms
should be forwarded to the Regional Office, Center for Disability, Federal
Building, 1961 Stout Street, Room 834, Denver, CO 80294, Attention:
Goodnight Coordinator.
2.
Alert and Folder Retrieval Process
OCO will enter the reply form information into the CATS, and CATS will
generate court case folder alerts (see Attachment 2 for a sample
Goodnight Court Case Flag/Alert). The alerts and
appropriate systems queries will be used to locate and retrieve the
Goodnight claim file(s).
OCO will associate the computer-generated alerts and query package (which
consists of a CATS alert cover sheet, SSIRD, AR-25, MBR FACT, OHAQ, DDBQ,
DDSQ and SEQY queries) and forward them to the appropriate component for
folder retrieval. OCO will be responsible for retrieving OCO jurisdiction
title II only and concurrent title II and title XVI potential class member
claims. The PSCs will be responsible for retrieving PSC jurisdiction title
II only and concurrent title II and title XVI potential class member
claims. The Wilkes-Barre Folder Servicing Operations (FSO) and the FOs
will be responsible for retrieving title XVI claims. OCO, the PSCs, the
FSO and the FOs will forward retrieved claim files to the Utah DDS for
class membership screening.
3.
Alerts Sent to OHA
If OCO, the PSCs, the FSO or the FOs determine that a current claim, i.e.,
either a potential class member claim or a subsequent claim, is pending
appeal or stored at OHA, it will forward the alert to OHA, along with any
prior claim file(s) not in OHA's possession, for screening, consolidation
consideration and readjudication (if consolidated).
If a claim is located in an OHA hearing office (HO), OCO, the PSCs, the
FSO or the FOs will forward the alert and query package and claim file(s),
if any, directly to the HO for processing. If the claim is pending or
stored at OHA Headquarters, OCO, the PSCs, the FSO or the FOs will forward
the alert and query package and claim file(s), if any, to the Office of
Appellate Operations (OAO), at the following address (case locator code
5007):
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Office of Hearings and Appeals
Office
of Appellate Operations
One Skyline Tower, Suite 701
5107
Leesburg Pike
Falls Church, VA 22041-3200
ATTN:
OAO Class Action Coordinator
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The OAO Class Action Coordinator is responsible for controlling and
reconciling the disposition of class alerts shipped to OHA Headquarters
for association with pending or stored claims. The Coordinator should
maintain a record of all alerts received and the location, if any, to
which they are transferred. SSA needs this information to do the final
class membership reconciliation.
4.
Folder Reconstruction
In general, OCO, the PSCs, or FOs will coordinate any necessary
reconstruction of prior claim files. OHA requests for reconstruction of
potential Goodnight cases should be rare. Prior to
requesting reconstruction, OHA will determine whether available systems
data or other information provides satisfactory proof that the particular
claim would not confer class membership. OHA (the HO or the OAO branch)
will direct any necessary reconstruction requests to the servicing FO. The
request will be made by memorandum and will include the alert and any
accompanying claim file(s) (if the claim file(s) is not needed for
adjudication purposes) as attachments. The request will also include
documentation of the attempts to locate the file. The memorandum will
request the FO to send the reconstructed file to OHA after it completes
its reconstruction action. HOs will route any reconstruction requests
directly to the servicing FOs. The OAO branch will also route
reconstruction requests directly to the servicing FO and will send a copy
of the request to the OAO Class Action Coordinator. For CATS purposes, HO
personnel and the OAO Class Action Coordinator will forward a copy of the
reconstruction request memorandum to Litigation Staff at the following
address:
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Office of Program Benefits
Litigation
Staff
3-K-26 Operations Building
6401 Security
Boulevard
Baltimore, MD 21235-6401
Attn: Goodnight Coordinator
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HO personnel and the OAO branch will identify in the reconstruction
request the OHA location of any existing claim file(s) being retained for
adjudication purposes, and the date(s) of the claim(s) involved.
The HO or OAO will not delay action on a pending claim when a prior claim
is being reconstructed for screening purposes, unless the prior claim is
needed for the adjudication of the pending claim. If OHA completes action
on the pending claim prior to receipt of the reconstructed folder, the HO
or OAO, as appropriate, will forward the class action material, including
the alert, if still in its possession, unneeded claim files, if any, and a
copy of the reconstruction request directly to the servicing FO using
Attachment 3. The HO or OAO will send a copy of the covering attachment to
the OAO Class Action Coordinator, along with a copy of the action taken on
the pending claim. For additional information on reconstruction
procedures, see Generic Class Action Implementation instructions in
HALLEX
HA 01170.005 C.
Occasionally, the situation may arise where OHA is in possession of a
Goodnight alert, and is ready to take action on a
pending, non-Goodnight claim, but the
Goodnight file has not been located and
reconstruction appears necessary but has not yet been requested. In this
situation, OHA will not delay its action on the pending claim. OHA will
proceed with its action on the pending claim and concurrently send the
Goodnight alert and a reconstruction request to the
servicing FO using Attachment 3, modified to fit the circumstances of the
case.
1.
Determining Jurisdiction for Screening
a.
Current Claim Pending or Stored in OHA
As provided in Part V. A. 3. above, if
there is a current claim pending or stored at OHA Headquarters, the OAO
Class Action Coordinator will receive the alert and related
Goodnight claim file(s). The OAO Class Action
Coordinator will determine OHA jurisdiction for screening and forward as
follows.
•
If the current claim is in an HO, the Coordinator will forward the alert
and any prior claim file(s) to the HO for screening using Attachment 4.
(Part V. B. 3. a. below provides
instructions to HOs regarding the action to be taken if they receive an
alert package but no longer have a current claim pending.)
•
If the current claim is pending before the Appeals Council, or is located
in an OAO branch mini-docket or in the OAO Docket and Files Branch (DFB),
the Coordinator will forward the alert and any prior claim file(s) to the
appropriate OAO branch for screening using Attachment 4.
(Part V. B. 3. a. below provides
instructions to the OAO branches regarding the action to be taken if they
receive an alert package but no longer have a current claim
pending.)
If the Coordinator (or designee) is unable to locate the current claim
file within OHA, the Coordinator (or designee) will broaden the claim file
search and arrange for alert transfer or folder reconstruction, as
necessary.
Do not screen pending cases unless an alert has been received. The
presence of an alert is evidence that the claimant has responded to notice
of potential class membership and that his or her case is ready for
review. However, if a claimant with a non-alerted pending case should
allege class membership, contact the Goodnight
coordinator in the Division of Litigation Analysis and Implementation
(DLAI) for assistance in determining the claimant's status. DLAI's address
is
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Division of Litigation Analysis
and Implementation
Office of Hearings and Appeals
One
Skyline Tower, Suite 1605
5107 Leesburg Pike
Falls
Church, VA 22041-3255
ATTN: Goodnight Coordinator
Telephone Number: (703) 605-8278
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b.
Current Claim Pending in Court
If the OAO Class Action Coordinator receives an alert for a claimant who
has a civil action pending, either on the alerted case or a subsequent or
prior claim, the Coordinator will forward the alert and any accompanying
claim file(s) to the appropriate OAO Court Case Preparation and Review
Branch (CCPRB) for screening, using Attachment 4. See
Part V. B. 3. b. below for special
screening instructions when a civil action is involved.
2.
Pre-Screening Procedures
Prior to screening an individual case, the screening component will obtain
appropriate systems information to determine whether:
•
there is a subsequent claim pending at any other administrative level or
in court;
•
there are additional claims within the class dates which have not been
associated;
•
the claimant has received a determination/decision on a subsequent claim
with respect to the time period at issue in the potential class member
claim, thus providing a basis for determining that the claimant is not a
class member eligible for relief.
The screening component will also:
•
obtain the files for all unassociated claims that fall within the class
dates, as well as the files for any inactive claims that postdate the
class period (which potentially provide a basis for screen-out or for
limiting class relief); and
•
if necessary, request reconstruction of any potential class member claim
files that cannot be located, unless available systems data or other
information provides satisfactory proof that the particular claim would
not confer class membership.
3.
Screening
a.
General Instructions
The screening component will associate the alert and any prior claim
file(s) with the claim file(s) in its possession and then complete a
screening sheet (see Attachment 5) as follows.
•
Consider all applications denied during the
Goodnight timeframe;
•
Follow all instructions on the screening sheet and the screening sheet
instructions (Attachment 5);
•
Sign and date the original screening sheet, place it in the claim file (on
the top right side of the file); and
•
If the screening component is an OHA Headquarters component or an HO,
forward a copy of the screening sheet to the OAO Class Action Coordinator
at the address in Part V. A. 3. above.
(The Coordinator will enter information from the screening sheet into a
database and will forward the screening sheet to DLAI.) HO personnel may
also forward material by telefax to DLAI at (703) 605-8251. (DLAI will
retain a copy of each screening sheet, share a copy with the OAO Class
Action Coordinator and forward a copy to Litigation Staff.)
If the case contains a PRTF and MRFC form each completed in its entirety
by a Utah DDS psychiatrist or psychologist employed by the Utah DDS
between January 1, 1991 and February 20, 1994, inclusive, and it is
possible that the case will be screened out using screenout code
“11,” do not proceed with any further screening. Instead,
send the claim file to the Utah DDS using Attachment 6. Do not send the
claimant a notice of denial of class membership. Any notice to be sent to
the claimant concerning class membership status will be taken by the DDS
following the results of a “double screening.”
If the HO receives an alert only, or an alert associated with a prior
claim file(s), for screening, and no longer has the current claim file, it
will return or forward the alert and any prior claim file(s) to the OAO
Class Action Coordinator (see address in
Part V. A. 3. above) and advise the
Coordinator of the action taken on the current claim and its destination.
The Coordinator will determine the current claim file location and, if it
is located in OHA Headquarters, will forward the alert and any
accompanying claim file(s) to the responsible OAO branch for screening,
using Attachment 4. If the file(s) is no longer in OHA, the Coordinator
will use Attachment 7 to send the alert and any accompanying claim file(s)
to the non-OHA location.
If an OAO branch receives an alert only, or an alert associated with a
prior claim file(s), and no longer has the current claim file (and it is
not located in mini-dockets or the OAO DFB), it will determine the
location of the current claim file. If the current claim file is located
within OHA, the OAO branch will use Attachment 4 to forward the material
to the OHA location. If the file(s) is no longer in OHA, the OAO branch
will use Attachment 7 to forward the material to the non-OHA location. The
OAO branch will also advise the OAO Class Action Coordinator of its
actions.
b.
Special OAO Screening Instructions if a Civil Action Is Involved
As noted in Part V. B. 1. b. above, the
CCPRB will screen for Goodnight class
membership/eligibility for relief when a civil action is involved. The
CCPRB's class membership/eligibility for relief determination will dictate
the appropriate post-screening action.
•
If the claimant is a class member eligible for relief, the CCPRB will
immediately notify the Regional OGC so that the Regional OGC can take
appropriate action. The Regional OGC will advise the CCPRB of the action
to be taken.
•
If the claimant is not a class member eligible for relief, the CCPRB will
follow the instructions in 4. a. below.
4.
Post-Screening Actions
a.
Screened Out Cases
If the screening component determines that the individual is not a class
member eligible for relief, the component will:
•
notify the individual, and representative, if any, of that determination
using Attachment 8 (modified as necessary to fit the circumstances and
posture of the case when there is a current claim); and
•
retain a copy of the notice in the claim file;
•
send a copy of the notice to:
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Brent V. Manning
Manning
Curtis Bradshaw & Bednar, LLC
370 E. South Temple,
Suite 200
Salt Lake City, UT 84111
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•
The Utah DDS or OHA, as appropriate, will hold for 65 days all claim files
of individuals to whom SSA sends notice of non-class membership or
ineligibility for relief pending a dispute by class counsel. Upon timely
request by class counsel, send the claim the claim file(s) to:
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Utah Disability Determination
Services
P.O. Box 144032
Salt Lake, City UT
84114-4032
Attn: Goodnight Coordinator
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•
If after 65 days no review is requested, return the file(s) to the
appropriate storage location if not otherwise needed.
b.
Cases Determined to be Class Members
If the screening component determines that the individual is a class
member eligible for relief, it will proceed with processing and
adjudication in accordance with the instructions in
Part VI. below.
Class membership will be presumed in reconstructed
Goodnight cases if the queries indicate a medical
denial between January 1, 1991 and February 20, 1994, inclusive.
VI. Processing and Adjudication
A. Cases Reviewed by the DDS
The Utah DDS will usually conduct the Goodnight
review. An exception will apply for cases consolidated at the OHA level
(see Part VI. D.). The DDS determination
will be a reconsideration determination, regardless of the administrative
level at which the class member claim(s) was previously decided and the
claimant will be entitled to appeal rights (i.e., ALJ hearing, Appeals
Council and judicial review.) However, the following processing and
adjudication procedures will apply when OHA has responsibility for
screening, i.e., when a potential class member claim or another claim is
pending or stored in OHA, and when the claimant is a class member.
B. OHA Adjudication of Class Member Claims
The following instructions apply to consolidation cases (see
Part D. below) in which the ALJ or
Appeals Council conducts the Goodnight
readjudication and to DDS readjudication cases in which the claimant
requests, and is eligible for, a hearing or Appeals Council review. Except
as noted herein, HOs and OHA Headquarters will process
Goodnight class member cases according to all other
current practices and procedures including coding, developing evidence,
routing, etc.
1.
Type of Review and Period to Be Considered
a.
Pursuant to the Goodnight Order, the type of review
to be conducted is a redetermination. The
redetermination consists of a de
novo evaluation of the class member's
eligibility for benefits based on all evidence in his or her file,
including newly obtained evidence, relevant to the period that was at
issue in the administrative determination or decision(s) that forms the
basis for Goodnight class membership. Because any
new evidence must relate to the time period that was at issue in the
administrative determination(s) forming the basis for the claimant's class
membership, ordering consultative examinations should be done only
rarely.
b.
If the redetermination results in a favorable decision, the adjudicator
will determine whether the individual's disability has been continuous
through the date of the redetermination or to the date of the most recent
allowance.
c.
If the evidence establishes that disability began only at some point
after the administrative
determination(s) that forms the basis for Goodnight
class membership, the class member must file a new application to
establish eligibility.
2.
Disability Evaluation Standards
Adjudicators must use the disability evaluation standards contained in the
statute, regulations and Rulings.
3.
Class Member Is Deceased
If a class member is deceased, the usual survivor and substitute party
provisions and existing procedures for determining distribution of any
potential underpayment apply.
C. Claim at OHA But No Current Action Pending
If a claim file (either a class member or another disability claim) is
located in OHA Headquarters but there is no claim actively pending
administrative review, e.g., Headquarters is holding the file awaiting
potential receipt of a request for review or notification that a civil
action has been filed, OAO branches will associate the alert with the file
and screen for class membership. (The OAO Class Action Coordinator will
coordinate the necessary actions, as explained in
Part V.). (See
Part V. B. 4., above, for non-class
member processing instructions.)
•
Whether the 120-day retention period for holding a claim file after an ALJ
decision or Appeals Council action has expired or not, OAO will attach a
Goodnight class member flag (see Attachment 9), to
the outside of the file and immediately forward the original or
photocopies (if less than 120 days) of the claim file(s) pertaining to the
Goodnight claim(s) to the Utah DDS for review of
the Goodnight class member claim.
D. Processing and Adjudicating Class Member Claims in Conjunction with
Current Claims (Consolidation Procedures)
1.
General
If a class member has a current claim pending at any administrative level
and consolidation is warranted according to the guidelines below, the
appropriate component will consolidate all
Goodnight class member claims with the current
claim at the level at which the current claim is pending.
2.
Current Claim Pending in the Hearing Office
Except as noted below, if a Goodnight class member
has a request for hearing pending on a current claim, and in all remand
cases, including court remands, the ALJ will consolidate the
Goodnight case with the appeal on the current
claim.
The ALJ will not consolidate the claims if
•
the current claim and the Goodnight claim do not
have any issues in common, or
•
a court remand contains a court-ordered time limit, and it will not be
possible to meet the time limit if the claims are consolidated, or
•
a consolidation will unreasonably delay action on either the current claim
or the Goodnight claim.
If the claims are consolidated, follow
Part VI. E. 2. a. below. If the claims
are not consolidated, follow
Part VI. E. 2. b. below.
a.
Actions if Claims Consolidated
When consolidating a Goodnight claim with any
current claim, and when the two claims involve overlapping periods at
issue, the issue is whether the claimant was disabled at any time from the
earliest alleged onset date through the present or to the date of the most
recent allowance (or through the claimant's date last insured or the date
the claimant last met prescribed period requirements, if applicable and
earlier). Accordingly, consolidation will result in a reopening of the
Goodnight claim through the time period at issue in
the current claim. However, if the period to be adjudicated in the current
claim does not overlap the period to be adjudicated in the
Goodnight claim, the two claims should be
considered separately.
Nevertheless, if the claimant is found to be disabled within the timeframe
of the Goodnight claim, the claim will be reopened
through the date at issue in the current claim. If the current claim and
the Goodnight claim are consolidated, the HO
will:
•
give proper notice of any new issue(s) as required by
20 CFR §§
404.946(b) and
416.1446(b), if
the Goodnight claim raises any additional issue(s)
not raised by the current claim;
•
offer the claimant a supplemental hearing if the ALJ has already held a
hearing and the Goodnight claim raises an
additional issue(s), unless the ALJ is prepared to issue a fully favorable
decision with respect to the Goodnight claim;
and;
•
issue one decision that addresses both the issues raised by the current
request for hearing and those raised by the
Goodnight claim (the ALJ's decision will clearly
indicate that the ALJ considered the Goodnight
claim pursuant to the Goodnight order);
•
forward a copy of the decision directly to DLAI at the address in
Part V. B. 1. a. above.
b.
Action if Claims Not Consolidated
If the ALJ decides not to consolidate the current claim with the
Goodnight claim because: 1) the claims do not have
any issues in common, or 2) there is a court-ordered time limit, or 3)
consolidation would unreasonably delay action on either the current claim
or the Goodnight claim, the ALJ will:
•
flag the Goodnight claim for DDS review using
Attachment 10; immediately route it to the Utah DDS for readjudication
(photocopies of any relevant material from either file should be made and
placed in the other file before shipping) and retain a copy of Attachment
10 in the current claim file;
•
take the necessary action to complete the record and issue a decision on
the current claim.
3.
Current Claim Pending at the Appeals Council
The action the Appeals Council takes on the current claim determines the
disposition of the Goodnight claim. Therefore, OAO
must keep the claim files together until the Appeals Council completes its
action on the current claim. The following sections identify possible
Appeals Council actions on the current claim and the corresponding action
on the Goodnight claim.
a.
Appeals Council Intends to Dismiss, Deny Review or Issue a Denial Decision
on the Current Claim
In this instance, the Appeals Council will proceed with its intended
action on the current claim. OAO staff will attach a
Goodnight case flag (Attachment 10; appropriately
modified) to the Goodnight claim, immediately
forward the Goodnight claim to the Utah DDS for
adjudication, and retain a copy of Attachment 10 in the current claim
file. OAO staff will include copies of the ALJ's or Appeals Council's
decision or order or notice of denial of request for review on the current
claim and the exhibit list used for the ALJ's or Appeals Council's
decision.
b.
Appeals Council Intends to Issue a Favorable Decision on the Unresolved
Claim — No Goodnight Issue(s) Will Remain
Unresolved
If the Appeals Council intends to issue a fully favorable decision on a
current claim, and this decision would be fully favorable with respect to
all issues raised by the application that makes the claimant a
Goodnight class member, the Appeals Council should
proceed with its intended action. In this instance, the Appeals Council
will consolidate the claims, reopen the final determination or decision on
the Goodnight claim and issue a decision that
adjudicates both applications. OAO staff will forward a copy of the
decision, for coordination with DLAI, to the OAO Class Action Coordinator
at the address in Part V. A. 3.
above.
c.
Appeals Council Intends to Issue a Favorable Decision on the Current Claim
— Goodnight Issue(s) Will Remain
Unresolved
If the Appeals Council intends to issue a fully favorable decision on a
current claim and this decision would not be fully favorable with respect
to all issues raised by the Goodnight claim, the
Appeals Council will proceed with its intended action. OAO staff will flag
the Goodnight claim for DDS review using Attachment
9 and immediately route it to the Utah DDS for redjudication (OAO staff
will make photocopies of any relevant material from either file and place
in the other file before shipping) and will retain a copy of Attachment 9
in the current claim file.
d.
Appeals Council Intends to Remand the Current Claim to an Administrative
Law Judge
If the Appeals Council intends to remand the current claim to an ALJ, it
will proceed with its intended action unless one of the exceptions below
applies.
In its remand order, the Appeals Council will direct the ALJ to
consolidate the Goodnight claim with the action on
the current claim pursuant to the instructions in
Part VI. E. 2. above.
The Appeals Council will not direct the ALJ to consolidate the claim
if
•
the current claim and the Goodnight claim do not
have any issues in common, or
•
a court remand contains a court-ordered time limit and it will not be
possible to meet the time limit if the claims are consolidated, or
•
consolidation would unreasonably delay action on either the current claim
or the Goodnight claim.
If any of the above-listed exceptions apply, OAO will immediately forward
the Goodnight class member claim to the Utah DDS,
for separate review. The case flag in Attachment 10 should be modified to
indicate that the Appeals Council, rather than the ALJ, is forwarding the
Goodnight class member claim for separate
processing.
VII. Case Coding
HO personnel will code prior claims into the Hearing Office Tracking
System (HOTS) as “reopenings.” If the prior claim is
consolidated with a current claim already pending at the hearing level
(see Part VI. D. above), HO personnel
will not code the prior claim as a separate hearing request. Instead, HO
personnel will change the hearing type on the current claim to a
“reopening,” i.e., “20.” If the conditions
described in Part VI. E. 2. b. above
apply, the ALJ should dismiss the request for hearing on the current claim
and HO personnel should enter “OTDI” in the
“DSP” field.
To identify class member cases in HOTS, HO personnel will code
“GN” in the “Class Action” field. No special
identification codes will be used in the OHA CCS.
VIII. Reconciliation of Implementation
At an appropriate time, Litigation Staff will request SSA components to
reconcile their screening activity and disposition of class member claims
with information available on CATS. Within OHA, the OAO Class Action
Coordinator is responsible for maintaining a personal computer-based
record of OHA implementation activity (i.e., a record of alerts processed
by OHA, and a record of cases screened and consolidated by OHA), as
reported by HOs and OAO.
IX. Inquiries
HO personnel should direct any questions to their Regional Office.
Regional Office personnel should contact the Division of Field Practices
and Procedures in the Office of the Chief Administrative Law Judge at
(703) 605-8530. OHA headquarters personnel should contact the Division of
Litigation Analysis and Implementation at 605-8278.
Attachment 1. Final Order Approving Settlement; Entered by the United States
District Court for the District of Utah on July 30, 1998.
DAVID L. GOODNIGHT, et. al. v. KENNETH S. APFEL, Commissioner
Of Social Security, et. al.
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[DATE FILED: July 30, 1998] |
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IN THE UNITED STATES DISTRICT COURT |
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FOR THE DISTRICT OF UTAH, CENTRAL DIVISION |
______________________________________________________________________
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DAVID L. GOODNIGHT, et. al. |
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JUDGMENT IN A CIVIL CASE |
Plaintiffs,
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v. |
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KENNETH S. APFEL, Commissioner |
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Of Social Security, et. al. |
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Defendants.
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______________________________________________________________________
This action came for hearing before the Court. The issues have been heard
and a decision has been rendered.
IT IS HEREBY ORDERED AND ADJUDGED
that there being no just reason for delay, that a final judgment pursuant
to Rule 54(b) of the Federal Rules of Civil Procedure be entered approving
the Settlement Agreement as to all class members and dismissing the
Complaint and all claims contained therein in accordance with the
provisions of the Court approved Settlement Agreement.
Dated this 29 day of July, 1998. Clerk: Markus B. Zimmer
By: /s/
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_________________________ |
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U. S. District Judge |
US DEPARTMENT OF JUSTICE
CIVIL
DIVISION
RM# 954
901 E Street, NW
WASHINGTON,
DC 20044Aaron K. Kann, Esq.
US DEPARTMENT OF JUSTICE
CIVIL
DIVISION
901 E ST NW
WASHINGTON, DC 20044Ms. Carlie Christensen, Esq.
US ATTORNEYS OFFICE
- UTAH
PFAX 9,5245985Ms. Maureen L. Cleary, Esq.
ST SCHOLASTICA PRIORY
PO
BOX 606
PETERSHAM, MA 01366Kay Kosow-Fox, Esq.
764 S 200 W
SALT
LAKE CITY, UT 84101Mr. Michael E. Bulson, Esq.
UTAH LEGAL SERVICES
INC
550 24TH ST, SUITE 300
OGDEN, UT 84401Brent V. Manning, Esq.
MANNING CURTIS BRADSHAW & BEDNAR
LLC
370 E S TEMPLE STE 200
SALT LAKE CITY, UT
84111
FAX 9,3645678
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THE UNITED STATES DISTRICT COURT |
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FOR THE DISTRICT OF UTAH |
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CENTRAL DIVISION |
_________________________________
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DAVID L. GOODNIGHT, et. al. |
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Plaintiffs,
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v. |
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Civil Action No. 92-C-279C |
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KENNETH S. APFEL, Commissioner |
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Of Social Security, et. al. |
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Defendants.
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_________________________________
WHEREAS, on October 27, 1993, the Court certified a class in this action
defined as “[a]ll persons who applied for and were denied the
receipt of Title II or Title XVI disability benefits by the [Utah
Disability Determination Services (”Utah DDS“)] since October
9, 1984. The class excludes persons who appealed the [Utah DDS's]
determinations beyond the [Utah DDS], persons who were denied benefits
because they have returned to substantial gainful activity, and persons
who are not eligible for disability benefits for reasons not related to
disability[.]”
WHEREAS, the parties wish to avoid further litigation and wish amicably,
fully, and finally to resolve all disputes that have been asserted in this
action,
THEREFORE, all parties in this civil action, by their undersigned counsel,
hereby agree, subject to approval by the Court, to the settlement of the
plaintiffs' claims in accordance with the following terms and
conditions:
1.
ELIGIBILITY FOR RELIEF: The class
members who shall be entitled to seek relief under this Agreement
(“potentially eligible plaintiffs”) include, subject to the
exclusions provided in paragraph 3, potentially eligible plaintiffs whose
claims for disability benefits under titles II and/or XVI of the Social
Security Act were finally1 denied at steps two, four or five of the
sequential evaluation process by the Utah DDS between January 1, 1991, and
February 20, 1994, inclusive (“class claims”) and (a) whose
determinations for disability benefits were based in whole or in part on a
mental impairment as indicated in primary or secondary diagnostic blocks
16A or 16B on SSA Form 831-U3/C3; or (b) whose SSA Form 831-U3/C3 was
signed by Utah DDS employees Doctor Monya Atiya or Doctor Rebecca
Dalisay.
2.
REDETERMINATIONS: Defendants will
not review any class claims until final instructions are issued in the
form of a Program Operations Manual System (“Instructional
POMS”) update to Social Security Administration
(“SSA”) offices in Utah and the Utah DDS. Such instructions
shall be submitted to plaintiffs' representative designated in paragraph
14, 120 days after the Court approves of this Agreement and enters an
order and final judgment to that effect as provided in paragraph 19.
Plaintiffs' representative shall review the Instructional POMS for
conformity with this Agreement within twenty days of receipt. If
plaintiffs' representative objects to the Instructional POMS he shall
provide comments to defendants within thirty days of receipt. Plaintiffs
and defendants shall attempt to resolve any objection plaintiffs'
representative may have. Those potentially eligible plaintiffs who are
found to be entitled to relief under this Agreement shall receive from
defendants a redetermination conducted at the reconsideration level of
administrative review which consists of a review of the evidence of record
to determine if they were disabled during the period covered by the class
claim. 20 C.F.R.
§§ 404.907 and
416.1407.
Defendants shall conduct such redeterminations in accordance with the
statutes, regulations and instructions in effect at the time of the
redetermination. If the claim file evidence is inadequate to assess the
potentially eligible plaintiff's impairments during the time period
covered by the class claim, defendants shall attempt to secure and/or
develop any further evidence that may be necessary, in accordance with
normal claims development procedures. In addition, a potentially eligible
plaintiff will be permitted to submit any additional evidence relevant to
the time period being redetermined in the class claim, and such evidence
will be considered by defendants in making the redetermination. If the
redetermination results in a finding that the potentially eligible
plaintiff was disabled, the claim of such potentially eligible plaintiff
will be reopened and the potentially eligible plaintiff's continuing
disability will be determined through the date of the new determination
rendered or the onset date of a more recent allowance. Upon such
reopening, defendants shall attempt to obtain updated medical records and
the potentially eligible plaintiff shall cooperate in this regard in
accordance with the requirements of
20 C.F.R. §§
404.1512-1519p and 416.912-919p. At the option of defendants,
potentially eligible plaintiffs with subsequent disability claims active
and simultaneously pending at any administrative level of review at the
time their class claim is being evaluated may have all their claims
consolidated and reviewed simultaneously. Defendants will use their best
efforts to ensure that adjudication of the current claim is not delayed by
such consolidation. Potentially eligible plaintiffs shall retain all
rights to seek further administrative and judicial review of
redeterminations conducted under this Agreement in accordance with 42
U.S.C. § 405(g) and 20 C.F.R. Parts 404 and 416.
3.
EXCLUSIONS: No potentially eligible
plaintiff shall be entitled to relief under this Agreement if that
potentially eligible plaintiff (a) has already received a subsequent award
of benefits with respect to the same period of time at issue in the class
claim; or (b) appealed the denial of his or her class claim to an
administrative law judge or higher levels of administrative or judicial
review; or (c) received a subsequent disability determination after
February 20, 1994, that adjudicated the same time period covered by the
class claim; or (d) the potentially eligible plaintiff's disability claim
file contains a Psychiatric Review Technique Form (“PRTF”)
and Mental Residual Functional Capacity (“MRFC”) form each
completed in its entirety by a Utah DDS psychiatrist or psychologist as
determined by the procedures set forth at paragraph 6; or (e) the
potentially eligible plaintiff fails, without good cause, to timely
request redetermination by responding to the notice requirements set forth
in paragraphs 4 and 5.
4.
IDENTIFICATION AND NOTIFICATION BY MAIL OF POTENTIALLY ELIGIBLE PLAINTIFFS:
For the purpose of this Agreement, defendants shall identify and provide
notice to the potentially eligible plaintiffs as follows:
1.
Within forty-five days after the Instructional POMS have been issued,
federal defendant will make a good faith effort, by means of its data
processing systems, to identify the names, Social Security numbers, and
last known addresses of potentially eligible plaintiffs. Federal defendant
shall send potentially eligible plaintiffs notice by first-class mail to
the last known address of such identified potentially eligible plaintiffs
informing them of their possible entitlement to a redetermination of their
claim. The form and content of such notice shall be submitted to and
approved by plaintiffs' representative before it is sent.
2.
Potentially eligible plaintiffs who receive the subparagraph (a) notice
must, in order to obtain a redetermination of their claim, return the
reply form in the pre-addressed postage prepaid envelope enclosed with the
notice or otherwise request redetermination through any Social Security
field office within ninety days after presumptive receipt of the notice
pursuant to 20 C.F.R.
§§ 404.901 and
416.1401. If they
do not respond within ninety days of receipt, their disability claim will
not be reviewed under this Agreement unless the potentially eligible
plaintiff provides federal defendant with evidence of “good
cause” for untimely response as defined in
20 C.F.R. §§
404.911 and
416.1411.
3.
Should any mailed notice be returned as undeliverable, federal defendant
will attempt to obtain updated addresses by providing state defendants
with a computer tape of those potentially eligible plaintiffs whose notice
was returned as undeliverable for the sole purpose of obtaining updated
addresses. State defendant shall use its good faith efforts and available
resources to provide federal defendant with a computer tape of updated
addresses. Within sixty days of receipt of an updated address tape from
state defendants, federal defendant shall make a good faith effort to
resend the notice by first-class mail (the “second mailed
notice”). Following the second mailed notice, federal defendant
shall provide state defendants and plaintiffs with a computer tape of
those potentially eligible plaintiffs whose second mailed notice was
returned as undeliverable.
4.
Within 120 days following receipt of the computer tape of those
potentially eligible plaintiffs whose second mailed notice was returned as
undeliverable, plaintiffs' representative may attempt to give notice to
those potentially eligible plaintiffs whose second mailed notice was
returned as undeliverable as set forth in a separate letter agreement
between state defendants and plaintiffs, attached as Exhibit 1.
5.
The ninety day response requirement following the receipt, actual or
presumptive, set forth in paragraph 4(b) also applies to second mailed
notices and any notice made pursuant to paragraph 4(d). In no event,
absent a finding of good cause, shall the response period applicable to
any notice extend beyond ninety days following the actual or presumptive
receipt of any notice described in this Agreement. Federal defendant's
attempts to obtain updated addresses are subject to the requirements of
the Privacy Act, as amended by the Computer Matching and Privacy
Protection Act, 5 U.S.C. § 552a. Federal defendant shall not be
required to institute legal proceedings to gain access to any potentially
updated address of any potentially eligible plaintiffs, nor shall federal
defendant compensate state defendants for providing any updated address of
any potentially eligible plaintiffs.
6.
If federal defendant determines that a potentially eligible plaintiff who
responded to the notice or otherwise requested review is not in fact a
class member entitled to relief under this Agreement, federal defendant
shall notify the potentially eligible plaintiff and class counsel in
writing of the reason for that determination.
5.
NOTICE BY POSTER: Upon issuance of
the Instructional POMS, federal defendant shall prepare a poster notice.
The posters shall inform potentially eligible plaintiffs of their
potential right to redetermination of their claims under the terms of this
Agreement. The form and content of such poster notice shall be submitted
to and approved by plaintiffs' representative before it is sent. Federal
defendant shall distribute posters to all SSA field offices in Utah for
posting in such offices. Posters shall remain in SSA field offices for a
period of 180 days from posting. Potentially eligible plaintiffs shall be
required to advise federal defendant in writing of their desire to have a
claim redetermined. Absent a finding of good cause, potentially eligible
plaintiffs shall so notify federal defendant not later than ninety days
after the poster period display period has ended. Potentially eligible
plaintiffs who received mailed notice shall not be eligible to have the
time period extended within which they must respond to mailed notice by
responding to the poster notice. Federal defendant shall provide to class
counsel a reasonable supply of posters that class counsel may post in
locations that class counsel determines would best reach potential class
members during the same poster display period as in SSA field
offices.
6.
SCREENING PROCESS: The claim files
of all potentially eligible plaintiffs who timely respond to notice as set
forth in paragraphs 4 and/or 5 shall be screened to determine if they meet
the criteria for redetermination as described in the Agreement. Screening
for exclusion under paragraph 3(d) of this Agreement shall be done by Utah
DDS employees familiar with the handwriting of Utah DDS psychiatrists and
psychologists. Screeners from the Utah DDS shall set aside those claim
files (“set asides”) in which they believe, based on their
familiarity with Utah DDS psychiatrists' or psychologists' handwriting,
that the PRTF and MRFC forms were completed in their entireties by a Utah
DDS psychiatrist or psychologist employed by Utah DDS between January 1,
1991 and February 20, 1994, inclusive. The PRTF and MRFC in each
“set aside” case shall then be reviewed by the Utah DDS
psychologists or psychiatrists employed by Utah DDS between January 1,
1991 and February 20, 1994, inclusive, to confirm that they completed the
forms in their entirety. The results of this “double
screening” shall then be presented to an individual designated by
class counsel (“plaintiffs' representative”). Plaintiffs'
representative's participation in the screening process shall be limited
to spending a reasonable amount of time reviewing the results of the Utah
DDS's exclusion 3(d) screen process. Plaintiffs' representative shall not
challenge the disability determination itself. If the Utah DDS
psychiatrist or psychologist is unsure about his or her personal
completion of the PRTF or MRFC forms, or if the Utah DDS psychiatrist or
psychologist is no longer available to confirm his or her personal
completion of the PRTF or MRFC forms, or if plaintiffs' representative has
a good faith belief that the forms were not personally completed by Utah
psychiatrists or psychologists, then the case shall be redetermined as set
forth in paragraph 2 of this Agreement. Further details of the screening
process are set forth in Exhibit 2 of this Agreement.
7.
PROSPECTIVE RELIEF: Defendants agree
to the following prospective relief:
1.
Defendants shall issue a directive, to be posted in the medical
consultants' offices at Utah DDS, stating that “The medical
consultant or psychological consultant, by signing the SSA 2506-BK, SSA
4734-U8, SSA-4734-F4 Supp., attests that he/she is responsible for its
content, including the findings of fact and discussion of supporting
evidence.” POMS
DI 24510.005B.2.
In addition, each medical consultant employed by Utah DDS shall be
required to acknowledge, in writing, on an annual basis, compliance with
the policy as set forth in POMS
DI 24510.005B.2,
a copy of the current version of which is attached as Exhibit 3. This
provision shall remain in effect for such time as the current language in
POMS DI
24510.005B.2 and
20 C.F.R. §§
404.1546 and
416.946, or their
substantial equivalent, remain in effect.
2.
Defendants shall issue a directive, to be posted in disability examiners'
offices at Utah DDS, prohibiting all disability examiners currently
employed by Utah DDS or to be employed by Utah DDS in the future from
making entries on the PRTF that is in the final version completed and
signed by the medical consultant. In addition, each medical consultant
employed by Utah DDS shall be required to acknowledge, in writing, on an
annual basis, compliance with the policy prohibiting examiners from making
any entries on the final version of the PRTF as set forth in POMS
DI 24505.030. This
provisions shall remain in effect for such time as the current language in
POMS DI 24505.030
and 20 C.F.R.
§§ 404.1520a(d)(1) and
416.920a(d)(1),
or their substantial equivalent, remain in effect. A copy of the current
version of POMS DI
24505.030 is attached as Exhibit 4.
3.
Defendants shall issue a directive to be posted in the disability
examiners' offices at Utah DDS providing that when a disability examiner
is seeking a second opinion from a medical consultant concerning an
examiner-drafted physical or mental residual functional capacity form that
was previously reviewed by a medical consultant, the disability examiner
must so notify the second medical consultant.
4.
Defendants shall issue a directive prohibiting any disability examiner
employed by Utah DDS from drafting an MRFC form for medical consultant
review and signature unless and until that disability examiner has
undergone sufficient training specific to the drafting of the MRFC form as
determined by defendants, and reaffirming that although a disability
examiner may assist in drafting an MRFC form, the determination must be
made by a psychiatrist or psychologist consultant. This provision shall
remain in effect for such time as the requirements substantially the same
as those presented contained in POMS
DI 24510.005B.2
and 20 C.F.R.
§§ 404.1546 and
416.946 remain in
effect.
5.
Defendants shall notify plaintiffs' representative of any change to the
language of 20 C.F.R.
§§ 404.1546 and
416.946 and POMS
DI 24510.005B2
and/or 20 C.F.R.
§§ 404.1520a(d)(1) and
416.920a(d)(1),
and POMS DI
24505.030 as of the effective date of any such change and before
Utah DDS implements any such policy change. Nothing in this Agreement
shall constitute an admission by defendants that any such change must be
made in compliance with the requirements of the Administrative Procedure
Act (“APA”), 5 U.S.C. § 701 et seq., nor shall anything
in this Agreement preclude any plaintiff from bringing any action (1) to
enjoin any such change, (2) to require that any such change comply with
the APA, (3) or to claim that such change is otherwise unlawful.
8.
ATTORNEYS' FEES AND COSTS: Federal
defendant shall pay plaintiffs' reasonable attorneys' fees and costs in
connection with the pursuit and settlement of this action. Federal
defendant and plaintiffs shall negotiate in good faith in an effort to
agree upon reasonable attorneys' fees and costs, which in any event shall
not be an amount less than $100,000. In the event no negotiated settlement
concerning attorneys' fees and costs is reached, plaintiffs may move the
Court at any time after the Effective Date of this Agreement to enter an
award of attorneys' fees and costs in excess of $100,000. If plaintiffs
move the Court to enter an aware of attorneys' fees and costs in excess of
$100,000, federal defendant has the right to oppose plaintiffs' motion for
an award of attorneys' fees and costs in excess of $100,000. Except as set
forth in Exhibit 2, class counsel agrees to accept the payment made by
federal defendant under this paragraph, either as the parties agree or as
ordered by the Court as full and final settlement of all attorneys' fees
and costs from all defendants in this case for all time incurred in the
past and to be incurred in the future. Class counsel shall require no
further compensation for any additional work after the Effective Date of
this Agreement regardless of the circumstances, except (1) in the event
the parties are unable to reach a negotiated settlement concerning
attorneys' fees and costs and plaintiffs move the Court for an award of
attorneys' fees and costs in excess of $100,000 as provided in this
paragraph, plaintiffs shall be entitled to move the Court to include an
award of attorneys' fees and costs in connection with their motion for
attorneys' fees and costs in excess of $100,000; and (2) if class counsel
or other representative of plaintiffs successfully brings any action to
enforce the provisions of this Agreement or otherwise successfully asserts
before any appropriate administrative or judicial agency that federal or
state defendants have violated the terms of this Agreement, class counsel
or other representative of plaintiffs may move the Court for an award of
attorneys' fees and costs in connection with their successful motion to
enforce this Agreement. Class counsel represents and warrants that he
shall distribute the fees received among respective counsel involved in
this case now and in the past and shall hold the federal defendant, his
administrators, and any department, agency, or establishment of the United
States harmless from any dispute over the proper allocation of attorneys'
fees.
9.
RESOURCES FOR REDETERMINATIONS:
Defendants shall make a good faith effort to provide sufficient resources
to meet their commitments as set forth in this Agreement without a
substantial adverse impact on the ability of state defendants to timely
process the applications for disability submitted by applicants who are
not class members.
10.
REPORTS: Beginning six months after
the Effective Date, federal defendant shall provide plaintiffs with
semi-annual status reports based on data maintained by federal defendant's
Class Action Tracking System. Such reports shall include (1) the number of
notices mailed to the potentially eligible plaintiffs; (2) the number of
all potentially eligible plaintiffs who have requested redetermination
pursuant to paragraph 2; (3) the number of potentially eligible plaintiffs
determined not to be eligible for redetermination because of the screening
process set forth in paragraph 2; (4) the number of redeterminations made
by defendants and the number of allowances and denials among those
redeterminations; and (5) the average time the Utah DDS takes to process
initial applications for disability benefits on the Effective Date of this
Agreement and at each semi-annual reporting period. The reporting
provisions of this paragraph shall terminate upon the substantial
completion of all redeterminations except for those of potentially
eligible plaintiffs whose request for redetermination is allowed under the
“good cause” exception set forth in paragraph 4 (e).
11.
FULL SETTLEMENT AND SATISFACTION OF CLAIMS:
The defendants, their administrators or successors, and any department,
agency, or establishment of the United States and/or the State of Utah and
any officers, employees, agents, or successors of any such department,
agency, establishment, are discharged and released from any claims and
causes of action that have been or may have been asserted in this action,
or administratively, by reason of, or with respect to, or in connection
with, or that arise out of, any matters alleged in this action.
Individuals in the class shall be barred and enjoined forever from (a)
prosecuting any claims or causes of action that have been or could be
asserted by reason of, or with respect to, or in connection with, or that
arise out of any of the matters alleged in this action; and (b) seeking
judicial relief that would have the effect, directly or indirectly, of
requiring that the redeterminations specified in paragraph 2 be reopened,
redetermined, readjudicated, or otherwise reviewed in any manner by
defendants. Nothing in this paragraph shall relieve the defendants of the
duty to comply with this Agreement nor shall potentially eligible
plaintiffs be prevented from seeking further administrative and judicial
review of redeterminations as provided in paragraph 2.
12.
ENFORCEMENT: Upon the Effective Date
and subject to the Court's approval of this Agreement, the Complaint and
any amendments and claims included shall be dismissed with prejudice, and
the Court shall retain continuing jurisdiction in this action only over
material breaches of the terms of this Agreement and if the parties cannot
reach a negotiated settlement concerning the payment of attorneys' fees
and costs, to award attorneys' fees and costs as provided in paragraph 8.
In the event plaintiffs allege a material breach of this Agreement,
plaintiffs shall provide defendants with notice of the alleged material
breach. The parties shall first attempt to resolve any disputes arising
under this Agreement by negotiation between counsel or their designees,
and defendants shall have sixty days to cure any alleged material breach
before the plaintiffs may invoke the Court's continuing jurisdiction to
enforce this Agreement. The parties reserve the right to seek a
modification of the Agreement from the Court in the event of a change in
the law.
14.
NOTICES TO CLASS COUNSEL OR PLAINTIFFS' REPRESENTATIVES:
Any notices to class counsel or plaintiffs' representative as specified in
this Agreement may be given by mailing a copy of such notice, postage
prepaid, to
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Brent Manning, Esq. |
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Manning Curtis Bradshaw & Bednar, LLC |
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370 East South Temple, Suite 200 |
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Salt Lake City, Utah 84111 |
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and |
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Michael E. Bulson, Esq. |
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Utah Legal Services |
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550 24th Street, Suite 300 |
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|
Ogden, Utah 84401 |
Upon reasonable notice to defendants, plaintiffs shall be permitted to
designate substitute class counsel or plaintiffs' representatives to
receive notice under this paragraph, so long as the number of substitute
class counsel and plaintiffs' representatives receiving notice does not
exceed two.
15.
COLLATERAL USE OF THE AGREEMENT PROHIBITED:
Because this Agreement is entered by agreement of the parties, as a means
of avoiding further litigation and to terminate and resolve all issues in
the class complaint filed in this action, the terms of this Agreement, the
negotiations leading up to this Agreement, or the data, documents or
information exchanged between the parties in the course of those
negotiations, shall not be offered, taken, construed, or introduced as
evidence of liability or as an admission or statement of wrongdoing by
defendants, or cited as precedent in this or any subsequent proceeding of
any nature. This Agreement is not and shall not be construed as an
admission by defendants of the truth of any allegation or the validity of
any claim asserted in this action or of the defendants' liability, nor is
it a concession or an admission of any fault or omission in any act or
failure to act, or in any statement, communication, report, instruction,
rule, regulation, or other document made or maintained by defendants, nor
shall it be construed by anyone for any purpose whatsoever as an admission
or presumption of any wrongdoing on the part of defendants. This Agreement
may not be used as an admission or finding that the position of defendants
was not substantially justified or that defendants are liable as a matter
of law for the payment of any attorneys' fees, expenses, or costs, or that
they agree to pay reasonable attorneys' fees and costs in this proceeding
except as provided in paragraph 8.
16.
REPRESENTATIONS OF COUNSEL BY SIGNATURES:
Class counsel, by signing below, warrants and guarantees that he is sole
counsel to the plaintiff class. Based on the approvals and consents set
forth in the attached Exhibit 5, counsel for plaintiffs represent that
they are authorized to stipulate to the settlement of the issues in this
action. Counsel for defendants represent that they are authorized to
stipulate to the settlement of the issues in this action.
17.
COUNTERPARTS: This Agreement may be
executed in one or more counterparts and each executed copy shall be
deemed an original which shall be binding on all parties.
18.
SCHEDULE AND PROCEDURE FOR APPROVAL:
Federal defendant shall provide poster and publication notice, attached as
Exhibit 6, of the time, date and location of the fairness hearing required
under Rule 23(e) of the Federal Rules of Civil Procedure. The parties
agree to recommend to the Court that this Agreement is fair, reasonable,
and adequate under Rules 23(e). Counsel for the parties shall request
prompt judicial approval of this Agreement after formal notice to class
members and fairness hearing.
19.
EFFECTIVE DATE: The entry of this
Agreement and accompanying Order, and the Clerk's entry of final judgment
in accordance with Rules 54, 58, and 79(a) of the Federal Rules of Civil
Procedure, shall be a condition precedent to any obligation of any party
pursuant to this Agreement. This Agreement shall become effective on the
sixty-first day after such entry of final judgment; provided, however,
that this Agreement shall not be effective if an appeal of the Court's
entry of the Order or final judgment is filed, in which event the
Agreement shall be effective only upon the expiration of all the
applicable appeal periods.
20.
ENTIRE AGREEMENT: This Agreement,
including all exhibits attached to it, constitutes the entire agreement
between and among the parties with respect to the subject matter of this
suit.
21.
HEADINGS: The headings of this
Agreement are for the convenience of the parties only and shall not limit,
expand, modify, amplify or aid in the interpretation or construction of
this Agreement.
22.
OBLIGATIONS OF THE DEFENDANTS: All
obligations of the “defendants” under this Agreement are
joint and several obligations unless specifically designated as
“federal defendant” obligations or as “state
defendant” obligations.
23.
PRIVACY ACT: The parties jointly
agree to move the Court to amend the protective order entered on November
8, 1994 as needed to carry out the obligations of the parties under this
Agreement.
Respectfully submitted,
/s/
|
/s/
|
|
_________________________ |
_________________________ |
|
BRENT V. MANNING |
JOHN S. McALLISTER |
|
Manning Curtis Bradshaw & Bednar, LLC |
Assistant Attorney General |
|
370 East South Temple, Suite 200 |
Education Division, Fifth Floor |
|
Salt Lake City, Utah 84111 |
Heber Wells Building |
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|
160 East, 300 South |
|
Attorney for plaintiffs |
Salt Lake City, Utah 84114 |
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Attorney for Defendants |
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Bean, Peterson and Nakao |
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/s/
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_________________________ |
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RICHARD G. LEPLEY |
|
|
AARON K. KANN |
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|
JOHN R. NIEMEYER |
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Attorneys |
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U. S. Department of Justice |
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Civil Division |
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Federal Programs Branch |
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901 E Street, N. W. |
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Washington, D. C. 20530 |
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Attorneys for Defendant |
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Kenneth S. Apfel |
______________________________
1 The terms “finally” and
“final,” as used herein, refer to the date of the
administrative decision that became the binding decision of the
Commissioner pursuant to
20 C.F.R.§§
404.905,
404.921, 404.955,
404.972, 404.981, 416.1405, 416.1421, 416.1455, 416.1472 and 416.1481, and
do not mean that a class member must have exhausted administrative
remedies under sections 205(g) and (h) of the Social Security Act, 42
U.S.C. § 405(g) and (h).
Attachment 2. - Sample Goodnight
COURT CASE FLAG/ALERT
CTWALTO1 999785 00000
REVIEW
PSC DOC TOE ALERT DATE RESPONSE DATE OLD BOAN/PAN
OFFICE
SSN
(BOAN OR PAN) NAME BIRTH DATE REFERENCE #
FOLDER LOCATION INFORMATION
CAN/HUN
BIC/MFT CATG TITLE CFL CFL DATE ACN
*NOTE:
A SEPARATE SCREENING SHEET MUST BE PREPARED FOR EACH CLAIM NUMBER
NOTED ABOVE
PAYEE ADDRESS
SHIP
TO ADDRESS:
Utah Disability Determination
Services
Attn: Goodnight
Coordinator
P.O.
Box 144032
Salt Lake City, UT 84114-4032
SPECIAL INSTRUCTIONS:
IF A CLAIM IS PENDING OR STORED IN OHA HEADQUARTERS OR FEDERAL DISTRICT
COURT, THEN SHIP THE ALERT PACKAGE (AND ANY ASSOCIATED CLAIMS FILE(S))
TO:
|
|
Office of Hearings and Appeals
Office
of Appellate Operations (OAO)
One Skyline Tower, Suite
701
5107 Leesburg Pike
Falls Church, VA
22041-3200
Attn:
OAO Class Action Coordinator
(Case locator code
5007)
|
IF A CLAIM IS PENDING IN AN OHA HEARING OFFICE, SHIP THE ALERT PACKAGE
(AND ANY ASSOCIATED CLAIM FILE(S)) DIRECTLY TO THAT OFFICE
|
Goodnight Class Action Case |
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RECONSTRUCTION NECESSARY |
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Claimant's Name: |
__________________________________ |
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SSN : |
__________________________________ |
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This claimant is a potential Goodnight class member. However, a definitive class membership determination can not be made without locating or reconstructing the potential Goodnight claim file. An alert on the potential Goodnight claim was originally sent to OHA because the SSA Case Control System indicated that a current claim was pending or stored at OHA or because the claimant had a pending civil action. On ____________, we sent your office a memorandum requesting reconstruction (a copy of the memorandum is attached). |
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OHA has now completed its action on the pending or stored claim and we are forwarding the attached class action material to your office for association with the pending reconstruction request. Upon completion of your reconstruction actions, you will need to forward the class action material, along with the reconstructed file, to the Utah DDS for screening and possible readjudication. |
Attachment 4. - Screening Flag -- Inside OHA
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Goodnight Class Action Case |
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SCREENING NECESSARY |
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Claimant's Name: |
__________________________________ |
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SSN : |
__________________________________ |
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This claimant may be a Goodnight class member. The attached folder location information indicates that a current claim file is located in your office. Accordingly, we are forwarding the attached alert [and prior claim file(s)] for association, screening for class membership, consolidation consideration and possible readjudication. |
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Please refer to HALLEX Temporary Instruction 5-4-61 for additional information and instructions. |
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TO: ______________________________ |
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__________________________________ |
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__________________________________ |
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__________________________________ |
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Attachment 5. -
GOODNIGHT SCREENING SHEET
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CLASS ACTION CODE: G N |
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1. CLAIMANT'S SSN: ___ ___ ___ - ___ ___ - ___ ___ ___ ___ |
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2. CLAIMANT'S NAME: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ |
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(Please Print) (Last) (First) |
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3. DATE OF BIRTH: ___ ___ / ___ ___ / ___ ___ ___ ___ |
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(MM/DD/YYYY) |
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4. CLAIM #: ___ ___ ___ - ___ ___ - ___ ___ ___ ___ - ___ ___ |
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(BIC/ID) |
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5. DATE OF SCREENING: ___ ___ / ___ ___ / ___ ___ ___ ___ |
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(MM/DD/YYYY) |
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6. A. SCREENING RESULT:
Member Entitled Nonmember/Member Not
___ to Relief (J) ___ Entitled to Relief (F)
B. SCREENOUT CODE:
__
__ (See Item 15.)
______________________________________________________________
|
7. Did the Utah Disability Determination Services (DDS) deny the claim during the period January 1, 1991 through February 20, 1994? |
___ Yes
(if Yes, go to 8)
___ No
(if No, go to 15)
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___________________________________________________________________________ |
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8. Was the claimant denied disability benefits for a non-medical reason? |
___ Yes
(if Yes, go to 15)
___ No
(if No, go to 9)
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|
____________________________________________________________________________ |
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9. Did the claimant appeal his or her class claim to an Administrative Law Judge (ALJ), the Appeals Council or to Federal court? |
___ Yes
(if Yes, go to 15)
___ No
(if No, go to 10)
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|
____________________________________________________________________________ |
|
10. Did the claimant receive a disability determination after February 20, 1994 that adjudicated the same time period covered by the class claim? |
___ Yes
(if Yes, go to 15)
___ No
(if No, go to 11)
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|
____________________________________________________________________________ |
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11. Did the claimant receive an award of benefits with respect to the same period of time at issue in the class? |
___ Yes
(if Yes, go to 15)
___ No
(if No, go to 12)
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|
____________________________________________________________________________ |
|
12. Was a mental impairment listed as a primary or secondary diagnosis in Blocks 16A or 16B on SSA Form 831-U3/C3? |
___ Yes
(if Yes, go to 13)
___ No
(if No, go to 14)
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|
____________________________________________________________________________ |
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13. Does the file contain a Mental Residual Capacity Form (SSA-4734-F4-SUP) or a Psychiatric Review Technique Form (SSA-2506-BK) each completed in its entirety by a Utah DDS psychiatrist or psychologist? |
___ Yes
(if Yes, set the case aside and send to the Utah DDS for review)
___ No
(if No, the person is entitled to relief, go to 6.a. and check entitled to relief)
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|
____________________________________________________________________________ |
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14. Was the Form SSA 831-U3/C3 signed by either by Manya Atiya, M.D. or Rebecca Dalisay, M.D.? |
___ Yes
(if Yes, the person is entitled to relief, go to 6.a. and check entitled to relief)
___ No
(if No, go to 15)
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____________________________________________________________________________ |
|
15.SCREENING INFORMATION
If you checked questions “NO” in blocks 7, or 14 or “YES” in blocks 8, 9, 10 or 11, the individual is not a Goodnight class member entitled to relief. Check the “Nonmember/Member Not Entitled to Relief” block (F) in Item 6.a. Enter the screenout code in item 6.b. as follows:
Enter 07 if question O7 was answered “NO.”
Enter 08 if question 08 was answered “YES.”
Enter 09 if question 09 was answered “YES.”
Enter 10 if question 10 was answered “YES.”
Enter 11 if question 11 was answered “YES.”
Leave item 6 blank if question 13 was answered “YES.”
Enter 14 if question 14 was answered “NO.”
Reason to use in the Notice of Non-Class Membership:
If screenout code is 07, check reason No. 1.
If screenout code is 08, check reason No. 2.
If screenout code is 09, check reason No. 3.
If screenout code is 10, check reason No. 4.
If screenout code is 11, check reason No. 5.
If screenout code is 14, check reason No. 6.
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|
____________________________________________________________________________ |
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16.If you checked “YES” in blocks [ ], the claimant is entitled to relief as a class member. Check the “Member Entitled to Relief” block (J) in Item 6.a.
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____________________________________________________________________________ |
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17.Enter the dates of all applications screened and the date of the final administrative decision for each application.
___________________ ___________________ ________________
___________________ ___________________ ______________
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SIGNATURE OF REVIEWER/DATE
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OFFICE
|
|
INSTRUCTIONS FOR COMPLETING GOODNIGHT SCREENING SHEET |
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General Instructions: A separate
screening sheet must be prepared for each claim number. Make sure the
claim number, BIC/ID and SSN, are the same as on the
Goodnight Case Flag Alert to ensure proper case
clearance.
Question 1:
Please fill in the claimant's SSN from BOAN/PAN field on alert.
Question 2:
Print the claimant's name (last name, and first name).
Question 3:
Fill in the claimant's date of birth (month, day, 4-digit year).
Question 4:
Fill in the claim number (social security number) under which this claim
is being processed. Include the BIC (Title II)/ID (Title XVI).
Question 5:
Complete the screening date using 2-digit month, 2-digit day, and 4-digit
year.
Question 6:
Complete this information last. Do not
fill in until the screening process has been completed.
Questions 7-12 and 14:
Answer each question in the order in which it appears on the screening sheet. You may leave a question blank only when it has been determined that the claimant is not eligible for review. For example, if question 7 is checked “NO,” go to number 15 and screen out as directed. Once the claimant is screened out, it is not necessary to continue to answer the remaining questions through number 14.
Question 7:
Review the SSA-831-U5 to determine if the individual's claim was denied by
the Utah Disability Determination Services (DDS).
Question 8:
Check the SSA-831 (item 22) to determine if the individual received a
non-medical denial.
Question 9:
Review the file to determine if the individual appealed his/her
Goodnight decision to an ALJ, the AC or to Federal
court.
NOTE: For class membership screening purposes, a Federal court remand is
not a decision and not a valid reason for denial of class membership.
Question 10:
Review the claim file to determine if the individual received a subsequent
decision that covered the same time period covered by the class claim. If
in the subsequent claim, the alleged onset date is the same or earlier
than the alleged onset date in the class claim and the entire period from
the alleged onset was adjudicated in the subsequent claim, the answer to
this question is “YES.” If the entire period from the alleged
onset was not adjudicated in the subsequent claim or if the claimant
alleged a later onset in a subsequent claim than was alleged in the class
claim, the answer to this question is “NO.”
Question 11:
Review the claim file to determine if the individual received a subsequent
award of benefits that covered the same time period at issue as in the
Goodnight class claim.
Question 12:
Review the SSA-831 (Item 16) to determine if the individual's primary or
secondary diagnosis (if there is a secondary diagnosis) is a mental
impairment(s).
Question 13:
If the claim file contains a MRFC (SSA-4734-F4-SUP) or a PRTF
(SSA-4734-F4-SUP) which appears to be completed in its entirety by a Utah
DDS psychiatrist or psychologist, do not proceed with screening the case
any further. Send the case to the DDS using Attachment 6. Do not send the
claimant a notice of denial of class membership. Any notice to be sent to
the claimant concerning class membership status will be taken by the DDS
following its review of the case.
Question 14:
Review the file to determine if the SSA-831 was signed by Manya Atiya,
M.D. or Rebecca Dalisay, M.D.
Questions 15 and 16:
Screening instructions. Self-explanatory.
Question 17:
Enter the dates of ALL the applications that were screened under
Goodnight. Also indicate whether these applications
were screened in or screened out.
Instructions if the Claimant is Determined to be a Class Member Entitled
to Relief:
a.
Check the “Member Entitled to Relief (J”) block in Item 6.a.
of the screening sheet.
b.
Sign and date the screening sheet. Enter the name of the screening
component, e.g., OHA, OAO, Branch XX.
c.
Retain the original screening sheet in the claim file. OHA Headquarters
components and hearing offices (HOs) will send a copy of the screening
sheet to:
Office of Hearings and Appeals
Office of Appellate
Operations
One Skyline Tower, Suite 701
5107 Leesburg
Pike
Falls Church, VA 22041-3200
Attn:
OAO Class Action CoordinatorThe OAO Class Action Coordinator will enter the screening sheet
information into a data base and forward the screening sheet to the
Division of Litigation Analysis and Implementation (DLAI). [DLAI will
retain a copy of each screening sheet received from the OAO Class Action
Coordinator and forward a copy to Litigation Staff at SSA Headquarters for
entry into the Civil Action Tracking System.]
Instructions if Claimant is Determined to be a Non-Class Member
a.
Check the “Non-Class Member (F)” block in Item 6.a. of the
screening sheet and enter the appropriate screenout code in Item 6.b.
b.
Follow items b. and c. above.
c.
Prepare and send the class membership denial letter (Attachment 8) to the
claimant with a copy to his/her representative, if any and to class
counsel. Retain a copy of the denial letter in the claim file.
d.
Retain the claim file(s) for the normal retention period, then forward to
the appropriate storage location if not otherwise needed.
Attachment 6. - Screening Flag -- to DDS
|
Goodnight Class Action Case |
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SCREENING NECESSARY |
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Claimant's Name: |
__________________________________ |
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|
SSN : |
__________________________________ |
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This claimant may be a Goodnight class member. This case contains a PRTF and MRFC form which appears to be completed in its entirety by a Utah DDS psychiatrist or psychologist employed by the Utah DDS between January 1, 1991 and February 20, 1994, inclusive. Please review the file to confirm and verify whether a Utah DDS psychiatrist or psychologist actually completed the forms in their entirety. Follow the instructions in the Program Operation Manual System instructions at DI 52510.001 for screening this case. |
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Attachment 7. - Screening Flag -- Outside OHA
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ROUTING AND TRANSMITTAL SLIP |
DATE: |
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TO: |
INITIALS |
DATE |
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1. |
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2. |
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3. |
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4. |
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5. |
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6. |
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7. |
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XX |
ACTION |
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FILE |
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NOTE AND RETURN |
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APPROVAL |
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FOR CLEARANCE |
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PER CONVERSATION |
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AS REQUESTED |
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FOR CORRECTION |
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PREPARE REPLY |
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CIRCULATE |
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FOR YOUR
INFORMATION |
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SEE ME |
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COMMENT |
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INVESTIGATE |
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SIGNATURE |
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COORDINATION |
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JUSTIFY |
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REMARKS |
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Goodnight CASE |
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Claimant: ___________________________ |
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SSN: ________________________________ |
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OHA received the attached alert [and prior claim file(s)] for screening and no longer has the current claim file. Our records show that you now have possession of the current claim. Accordingly, we are forwarding the alert and any accompanying prior claim file(s) for association with the current claim. After associating the alert with the current claim, please forward to the Utah Disability Determination Services for screening and possible readjudication. SEE POMS DI 52510.001. |
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DO NOT use this form as a RECORD of approvals, concurrences, disposals, |
|
clearances, and similar actions. |
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FROM: Office of Hearings and Appeals __________________________________________ |
SUITE/BUILDING |
|
PHONE NUMBER |
|
OPTIONAL FORM 41 (Rev. 7-76) |
|
*U.S.GPO:1985-0-461-274/20020 Prescribed by GSA |
|
FPMR (41 CFR) 101-11.206 |
Attachment 8. - Notice of Non-Class Membership
SOCIAL SECURITY ADMINISTRATION
Important
Information
Non-Class
Membership Notice
Date:
Name
BT Date:
Address
Claim Number:
City, State,
Zip DOC:
You asked Social Security to look again at your prior claim for disability
benefits. We have looked at your case. You are not eligible for review
under the Goodnight court case for the reason given
below. This means that we will not review your claim.
You are not entitled to review under Goodnight
because:
|
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____ 1. |
The Utah Disability Determination Services did not deny your claim during the period January 1, 1991 through February 20, 1994. |
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____ 2. |
Your claim was denied for a non-medical reason. |
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____ 3. |
You appealed your potential Goodnight claim to an Administrative Law Judge or to the Appeals Council or filed a civil action in Federal court. |
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____ 4. |
You received a disability determination after February 20, 1994 that covered the same time period as your Goodnight claim. |
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____ 5. |
You received a subsequent award of benefits with respect to the same period of time at issue in your Goodnight claim. |
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____ 6. |
The Form SSA-831-U3/C3 was not signed by either Manya Atiya, M.D. or Rebecca Dalisay, M.D. |
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____ 7. |
Other (Explain) |
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________________________________________________________. |
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________________________________________________________. |
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We Are Not Deciding If You Are Disabled
It is important for you to know that we are not making a decision about
whether you are disabled. We are deciding only that you are not eligible
for review under Goodnight v. Apfel.
If You Do Not Agree With This Determination
If you do not agree with this decision, you have 60 days after receiving
this notice to notify class counsel, at the address listed below, that you
think that our decision is wrong. He will answer without charge your
questions about eligibility for having your claim reviewed. The attorney's
name, address and telephone number are as follows:
Brent
V. Manning
Manning
Curtis Bradshaw & Bednar, LLC
370
E. South Temple, Suite 200
Salt
Lake City, UT 84111
Telephone:
(801) 363-5678
If You Think You Are Disabled Now
If you are not currently receiving disability payments and you think you
are disabled now, you may file a new application. A new application is not
the same as asking us to review your claim under
Goodnight. In the new application, you may not be
able to receive disability benefits for the period of time you asked for
in your prior claim. If you decide to file a new application, contact any
Social Security office.
If You Have Any Questions
If you have any questions, you may contact the class attorney listed above
or your local Social Security office at: _____________________ [insert
address and phone number of district office]. You may also call us toll
free at 1-800-772-1213 if you have any questions. If you call or visit a
Social Security office, please have this letter with you. It will help us
to answer your questions.
Si usted habla espanol y no entiende esta carta, favor de llevarla a la
oficina de Seguro Social arriba mencionada para que se la expliquen.
CC:
Brent Manning
Manning Curtis Bradshaw & Bednar,
LLC
Attachment 9. - Readjudication Flag for OHA Retention Cases
|
Goodnight Class Action Case |
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READJUDICATION NECESSARY |
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Claimant's Name: |
__________________________________ |
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SSN : |
__________________________________ |
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This claimant is a Goodnight class member. We are forwarding the attached claim file(s) to the Utah DDS for readjudication at the following address: |
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Utah
Disability Determination Services
P.O.
Box 144032
Salt
Lake City, UT 84114-4032
|
Attachment 10. - Readjudication Flag for Non-Consolidation Cases
|
Goodnight Class Action Case |
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READJUDICATION NECESSARY |
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Claimant's Name: |
|
__________________________________ |
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: |
|
__________________________________ |
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This claimant is a Goodnight class member. The attached Goodnight claim file was forwarded to this hearing office for possible consolidation with a current claim. |
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_______ |
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The Administrative Law Judge has determined that the prior and current claims do not share a common issue and, therefore, should not be consolidated. |
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OR |
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_______ |
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The claims have not been consolidated because |
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[state reason(s)]__________________________________ |
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______________________________________________ |
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Accordingly, we are forwarding the attached alert and prior claim file(s) to your location for any necessary Goodnight readjudication action. |
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We are sending the alert and prior file(s) to: |
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Utah
Disability Determination Services
P.O.
Box 144032
Salt
Lake City, UT 84114-4032
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