TN 43 (11-94)

DI 12594.010 Relief to be Given to Class Members

Policy

1. Screening

  1. Folders of potential class members will be screened for class membership by ODIO, NEPSC, or the DDS or OHA, if they have jurisdiction of the readjudication.

  2. All individuals will be notified as to the results of the folder screening. See Exhibits 1 and 7, DI 12594.095.

2. Jurisdiction - No Current Claim Pending

Class members will have their determinations readjudicated as follows:

  1. Determinations originally made by the DDS will be readjudicated by the DDS.

  2. Determinations originally made by the ALJ or Appeals Council will be readjudicated by an ALJ.

    NOTE: If a class member has more than one determination that meets all of the requirements of DI 12594.001, jurisdiction is determined by the level at which the most recent determination was adjudicated.

3. Jurisdiction - Current Claim Pending

  1. If a claim is currently pending at the initial or reconsideration level and if a common issue exists (see DI 12045.010), the current claim and the State of New York case will be consolidated at the level at which the current claim is pending, regardless of the level of adjudication of the State of New York case.

  2. If a claim is currently pending at the ALJ level, the ALJ will afford the class member the option of having the cases consolidated or proceeding with them separately. The current claim and the State of New York case will be consolidated at the ALJ level, regardless of the level of adjudication of the State of New York case, if

    • the class member agrees to the consolidation and

    • the ALJ finds that a common issue exists.

    If either of these criteria is not met, the cases will be processed separately.

  3. If a claim is currently pending at the Appeals Council level, there will normally be no consolidation.

  4. If a claim is currently pending in court, the class member will be notified of the option to have the cases consolidated or pursue them separately.

    • If the class member chooses to have the cases consolidated, they will both be adjudicated by an ALJ.

    • If the class member chooses to pursue the pending claim at the court level, the State of New York, case will be readjudicated separately.

4. Method of Readjudication

  1. Original determination was a denial - After fully developing medical and vocational evidence for the period of time covered by the application subject to readjudication, the adjudicator, using the court-ordered review standard, will readjudicate the same period covered by the original determination. If this results in reversal to an allowance, the DDS will also readjudicate the period from the earlier determination date up to the present.

  2. Original determination was a cessation - After fully developing medical and vocational evidence for the period from the date of the original determination through the present, the adjudicator, using the court-ordered review standard, will readjudicate the period covered by the original determination and will also readjudicate the remaining period up to the present.

NOTE: In some cases, the claimant may have received an allowance on a subsequent claim after a prior claim for initial entitlement was denied or after a prior award of benefits was ceased. In these cases in the absence of evidence to the contrary, SSA adjudicators will assume that the favorable decision on the subsequent claim was correct and will limit development and readjudication to the period up to the date of onset established in connection with the subsequent claim. However, if new evidence submitted or developed in connection with the State of New York readjudication raises a question of continuing disability, SSA adjudicators will not be barred from considering and deciding the issue under the normal continuing disability review procedures and standard. In this situation, the DDS will return the folder to the FO with a request to conduct a face-to-face CDR interview.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0412594010