ISSUED: May 20, 1992
I. Purpose
This Temporary Instruction (TI) provides guidance for implementing the
October 22, 1991 order of the United States District Court for the Western
District of Washington in the Morrison, Doe & Decker v.
Sullivan class action, which involves multiple disability
issues. Issues relevant to this order concern the evaluation of treating
physician opinion and obtaining consultative examinations and medical
evidence of record.
Adjudicators throughout the country must be familiar with this TI because
Morrison class members who now reside outside of
Washington must have their cases processed in accordance with the court's
order.
II. Background
On April 4, 1989, the district court approved a stipulated settlement
agreement that required, among other things, continued compliance with the
amended preliminary injunction of June 16, 1983, continued compliance with
the second preliminary injunction of August 20, 1984, and the
implementation of a December 16, 1988 order for readjudication of certain
first injunction cases with respect to the evaluation of treating
physician opinion. The 1989 settlement agreement also included a provision
wherein the Secretary reserved the right to seek modification of the
agreement in the event of a change in controlling precedent, governing
statute or applicable valid regulation.
On August 1, 1991, a change in the applicable valid regulation occurred
when the Secretary published final regulations, “Standards for
Consultative Examinations and Existing Medical Evidence.” These
regulations also included guidance on the evaluation of treating physician
opinion. Accordingly, the Secretary notified the court of his desire to
substitute the new regulations for the relevant provisions of the amended
first and second preliminary injunctions and the December 1988 order.
After briefing by the parties, the court, on October 22, 1991, granted the
Secretary's motion for modification. The court also stated that its order
did not preclude any person from filing suit to challenge the validity of
the new regulations or any actions taken thereunder.
III. Guiding Principles
Paragraph C of the amended first preliminary injunction, paragraph 2 of
the second preliminary injunction and paragraph 2 of the readjudication
order are no longer in effect.
Paragraph C of the amended first preliminary injunction enjoined the
Secretary from failing to apply the standards enunciated in Day
v. Weinberger, 552 F.2d 1154 (9th Cir. 1975) and
Rhodes v. Schweiker, 660 F.2d 722 (9th Cir.
1981).
Paragraph 2 of the second preliminary injunction required SSA to: 1)
purchase consultative examinations from nontreating sources only after
asking specific questions of the treating source in an effort to obtain
supplemental information for adjudication prior to the purchase of a
consultative examination; 2) purchase such examination only after making
efforts to purchase a consultative examination from the treating source;
and 3) document reasons for purchasing a consultative examination from a
nontreating source.
Paragraph 2 of the readjudication order required the Secretary to
distribute Appendix A of the court's order to all Disability Determination
Service and SSA staff members responsible for adjudicating class member
claims. Appendix A contained the district court's ruling on the standards
to be applied in deciding claims involving the opinion(s) of one or more
treating physicians who have examined the claimant.
The regulations published on August 1, 1991 must be applied in their
entirety to all initial and continuing disability claims under titles II
and/or XVI of Washington State residents. This includes
Morrison class member which have been consolidated
at the OHA level with pending subsequent claims.
The Secretary must continue to comply with the remaining provisions of the April 1989 settlement order.
IV. Inquiries
Hearing office 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 (FTS) 305-0022.