State of New York v. Sullivan,
United States Court of Appeals for the Second Circuit.
TN 43 (11-94)
DI 12594.001 Class Membership Requirements
The State of New York class consists of all individuals:
whose title II or title XVI disability was denied or ceased at any level on or after June 1, 1980 (see 2.f. below);and
who have had ischemic heart disease, hypertensive vascular disease, myocardiopathies, or rheumatic or syphilitic heart disease; and
whose denial or cessation was based on an evaluation that considered the results of a treadmill or other exercise test;and
who resided in the State of New York at the time of the final decision by the Secretary to deny their application or cease their disability.
The class includes individuals who filed title II or title XVI claims as disabled widow(er)s or disabled children, as well as primary disability claimants.
Individuals who were denied at step 2 or ceased at the comparable steps of the sequential evaluation process are not entitled to readjudication.
EXCEPTION: Otherwise qualified individuals who were denied or ceased at step 2 between December 4, 1989, and the date these instructions were implemented (February 2, 1994) are entitled to readjudication.
Non-medical denials and cessations (e.g., based on SGA) are excluded from the class.
For determinations made on or after 2/1/87:
If the case was listed under code 170, the individual is presumed to be a class member unless there is evidence to the contrary.
If the case was not listed under code 170, the individual is a class member if all of the requirements in 1.a.-d. above are met.
Membership in another class does not preclude membership in the State of New York class.
Denials and cessations made on or after the date that these instructions were initially issued (February 2, 1994) do not qualify for readjudication. This does not preclude class membership for anyone who had a determination made between June 1, 1980, and February 1, 1994, inclusive.
“Determination” includes both determinations made by the DDS and decisions made by an ALJ or the Appeals Council.