Dixon, et al. v. Shalala,
United States District Court for the Southern District of New York
TN 42 (08-95)
DI 42521.001 Dixon , et al. v. Shalala Court Order
1. Issuance of court order
On December 22, 1993, the United States District Court for the Southern District of New York issued an order in Dixon, et al. v. Shalala, which provides relief to certain individuals denied or terminated between June 1, 1976, and July 19, 1983, inclusive, based on a finding that they did not have a severe impairment or that their impairment(s) was only slight.
On April 19, 1995, following the Social Security Administration's (SSA's) appeal, the United States Court of Appeals for the Second Circuit affirmed the district court's decision and clarified how the 1993 Dixon court order should be implemented.
2. Class counsel
Class Counsel is:
Individuals who properly respond to the Dixon notice and who meet the criteria in B.1. below, will have the opportunity to request a review of their prior claim(s).
1. General class description
Subject to the exclusions described in B.2. below, the Dixon class consists of all individuals:
whose claim(s) for title II and/or title XVI disability was finally denied or ceased by the New York Office of Disability Determinations (ODD) or SSA between June 1, 1976, and July 19, 1983, inclusive; and
whose denial or cessation was based on a finding that they did not have a severe impairment, or that their impairment(s) was only slight; and
who resided in the State of New York at the time their claim(s) for disability benefits was finally denied or ceased by the New York ODD or SSA.
The following claims are not subject to review.
Determinations/decisions that were appealed and finally adjudicated in a subsequent administrative determination/decision after July 19, 1983.
Determinations/decisions that were appealed and finally adjudicated in a subsequent administrative determination/decision on or before July 19, 1983, and that were not based upon a finding of a not severe impairment.
Determinations/decisions in which the administrative determination/ decision was affirmed by a Federal court.
Determinations/decisions in which the individual had a subsequent application(s) denied after July 19, 1983, and the subsequent application(s) covered the entire period at issue in the potential Dixon claim(s).
Claims in which the denial or cessation was based on a non-medical factor (e.g., a denial based on substantial gainful activity (SGA)).
Cessations for which replacement decisions (i.e., decision reviews) were made after July 19, 1983, which covered the entire timeframe at issue in the potential Dixon claim(s).
Persons who request and are entitled to readjudication will receive a reopening at the reconsideration level (see B.7. below).
If the prior claim(s) is unavailable, SSA will:
Allow the claim(s) if certain presumptions apply (see
DI 42521.025A.2.); or
Deny the claim(s) if certain other presumptions apply (see DI 42521.025A.3.); or
Reconstruct the claim(s) and reopen if neither allowance nor denial presumptions apply (see DI 42521.020B.4.f.).
5. Review jurisdiction
Normally the New York ODD will perform the Dixon review at the reconsideration level of the administrative process, even if the individual has left New York unless there is a claim pending or stored in OHA (see DI 42502.001 and DI 42521.025 for exceptions).
If a claim is pending or stored in OHA, the ALJ or AC may consolidate a class member's Dixon claim and a subsequent claim at the OHA level.
6. Appeal rights
Class members whose claim(s) are readjudicated under the Dixon review standard at the reconsideration level have full appeal rights and may appeal their claim(s) to an ALJ.
7. Disability review
If the Dixon class claim(s) has been retrieved or reconstructed and the individual is a class member entitled to relief, the Dixon class claim(s) will be reopened and developed from the earliest date based on the application(s) which results in class membership up to the:
alleged onset date (AOD) (including AOD in later onset date allowance cases or date of filing (DOF) in title XVI cases), covered by any subsequent claim(s) that is denied for any reason after July 19, 1983, or for a reason other than not severe on or before July 19, 1983, or EOD in a subsequent allowance (regardless of whether the subsequent allowance is continuing, ceased or was a closed period), or
present where no subsequent applications have been filed.
When readjudicating the Dixon claim(s), SSA will ONLY consider subsequent impairment(s) that can reasonably be said to be related to the impairment(s) which provided the basis for the determination in the Dixon claim(s).
8. Folder consolidation
If a class member has more than one claim subject to review, SSA may, at its option, consolidate all such claims and readjudicate them at the same time.
9. Administrative finality
Dixon class claims will be reviewed outside the normal time limits of administrative finality, if doing so is necessary to comply with the court order.