ISSUED: November 4, 2013
UPDATED: May 20, 2014
REVISED: October 2, 2017
I. Purpose
This Temporary Instruction sets forth the procedures for implementing
a joint settlement agreement, approved by the United States District
Court for the Eastern District of New York on October 18, 2013,
in the Padro et al. v. Colvin (Padro)
class action. A copy of the settlement agreement is located in Attachment
1. The Padro case involves allegations of “general
bias” by five administrative law judges (ALJ) against claimants
for disability benefits. The five ALJs named in the class action
are Michael D. Cofresi, Seymour Fier, Marilyn P. Hoppenfeld, David
Z. Nisnewitz, and Hazel C. Strauss.
II. Important Information
about the Settlement Agreement
On April 12, 2011, plaintiffs filed a class action lawsuit
against the Commissioner of Social Security, in the United States
District Court for the Eastern District of New York. Plaintiffs alleged
that five ALJs in the Social Security Administration's (SSA) Queens
hearing office exhibited “general bias” against claimants for
disability benefits.
On May 4, 2011, plaintiffs filed an Amended Complaint, adding
three named plaintiffs and supplementing the prior allegations.
On October 18, 2013, the District Court approved a class action
settlement agreement in Padro. Under the
settlement, SSA agreed to take certain actions on all unfavorable
and partially favorable decisions issued by the five ALJs through
a specified time period.
As discussed below, the Commissioner has agreed to offer two
types of relief under Padro – retrospective
and prospective. The type of relief a class member will receive
will depend on when he or she was issued an unfavorable or partially
favorable decision by one of the named ALJs.
The class potentially eligible for relief under Padro consists
of all claimants for Social Security Disability Insurance Benefits
(title II) and/or Supplemental Security Income (title XVI) payments
based on disability who:
•
Received an unfavorable
or partially favorable decision on a claim from any of the five named
ALJs between January 1, 2008 and October 18, 2013. These claimants
may be eligible for retrospective relief; or
•
Received an unfavorable or partially favorable decision
on a claim from one of the five named ALJs between October 19, 2013
and April 18, 2016. These claimants may be eligible for prospective
relief.
To be considered part of the class, the claimant must also
meet the more detailed eligibility criteria for either retrospective
or prospective relief, as described below.
C. Eligibility for Relief
A class member eligible for retrospective relief is a claimant
who received an unfavorable or partially favorable decision on a
disability claim – including age 18 disability redeterminations
and Continuing Disability Reviews (CDR) – from any of the
five named ALJs between January 1, 2008 and October 18, 2013, with
certain exceptions described below.
A claimant is not eligible for retrospective relief if:
•
a United States District
Court affirmed the ALJ decision, and the claimant did not have a
motion to alter or amend the Court's judgment pending as of December
18, 2013; or
•
a United States District Court remanded the claim
in an order that expressly declined to reassign the remanded claim
to a different ALJ, and the claimant did not have a motion to alter
or amend the Court's judgment pending as of December 18, 2013; or
•
the claimant was already found eligible for all
benefits for which he or she could be eligible based on the claim
decided by one of the named ALJs; or
•
the claimant already received a new decision on
his or her claim by an ALJ who is not a named ALJ; or
•
the claim decided by a named ALJ is pending with
a different ALJ (other than one of the ALJs named above) at the
time the claimant requests relief.
For retrospective relief under Padro,
the Commissioner will readjudicate the title II and title XVI disability
claims of those eligible members of the class who request readjudication. All
readjudications will occur at the hearing or Appeals Council (AC)
levels, and will be conducted by an ALJ not involved in the class-action
lawsuit, an attorney advisor (if a fully favorable decision based
on the record is warranted), or the AC.
The time period readjudicated starts with the period at issue
in the unfavorable or partially favorable decision that led to class
membership, and continues through the earlier of:
•
the date of the new
decision;
•
the day before the established onset date of a later
allowance (subject to reopening provisions);
•
the day before the date of a decision issued by
an ALJ not named in the settlement agreement or the AC on a later
claim (subject to reopening provisions), or
•
the date last insured in a claim for Disability
Insurance Benefits (DIB), age 22 in a claim for Childhood Disability
Benefits (CDB), or the end of the prescribed period in a claim for
Disabled Widow(er)'s Benefits (DWB).
The readjudication will be based on all evidence in the file,
including newly obtained evidence relevant to the period at issue.
Claimants who receive unfavorable or partially favorable readjudication
decisions will have full appeal rights (i.e., AC and judicial review).
A potential class member eligible for prospective relief is
a claimant who, during the 30 month period beginning October 19,
2013, is issued an unfavorable or partially favorable decision on
a claim for disability benefits under title II or title XVI of the
Social Security Act – including Age 18 disability redeterminations
and CDRs – by any of the five named ALJs.
Although a potential class member,
a claimant who receives a partially favorable decision from any
of the five named ALJs, must specifically request AC review of the
decision or, if the decision is a partially favorable decision after
court remand, must file written exceptions or proceed with a civil
action in order to receive prospective relief. See section V.A.3-4.
As discussed below, the Padro Screening
Unit (PSU) will screen requests for retrospective relief, notify
individuals of the eligibility determination, issue return orders,
and forward case files to appropriate locations. The PSU will consist
of Office of Appellate Operations (OAO) staff from Court Case Preparation
and Review Branches (CCPRB) and the Executive Director's Office
(EDO).
As discussed below, specialized OAO staff will implement the
prospective relief required under the Padro settlement.
III. Determining Class
Membership, Notifying Class Members, and Establishing Cases for Eligible
Claimants
The following instructions apply in determining and notifying
a claimant who may be entitled to retrospective relief under Padro.
A. Notifying Claimants
Affected by the Settlement
1. Sending Written
Notice
Relying on data collected from multiple sources, OAO will
compile a list of all claimants who were issued an unfavorable or
partially favorable decision on the merits of a claim for disability
benefits by one of the named ALJs between January 1, 2008 and October
18, 2013. The Office of the Chief Administrative Law Judge (OCALJ)
sent a copy of Notice “A” (attached to the settlement
agreement) on February 13, 2014 to the last known address of any claimant
identified on the list as a potential class member eligible for
retrospective relief, and to the appointed representative, if any.
The claimant will have 60 days from the date he or she receives
the notice, unless extended for good cause, to request readjudication
under the terms of Padro by submitting a
written request to the PSU. SSA will presume receipt of the notice within
five days after the date of the notice, unless the notice is returned
as undeliverable or the claimant establishes that receipt actually
occurred later.
Prior to final approval of the settlement,
SSA mailed a Notice of Proposed Class Action Settlement and Fairness
Hearing to all claimants identified as potential class members for
retrospective relief. The PSU attempted to update addresses for
those claimants whose copy of the Notice of Proposed Class Action
Settlement and Fairness Hearing was returned as undeliverable. If
no updated address was found for the claimant, SSA will not send
the claimant Notice A. Instead, the PSU will include the claimant's
name and last known address on the list mentioned in A.4 below.
2. Receiving a Response
to Notice A
If the PSU receives a response to Notice A, the PSU will establish
a case in the Appeals Review Processing System (ARPS) according
to the instructions provided below.
a. No Request
for Review (RR) on the Padro claim
If the claimant did not request AC review of the Padro claim,
but the claimant responds to Notice A, the PSU will manually establish
a case in ARPS under the Supplemental Review Court Remand (SRR)
workload. (See ARPS Module
3 - Establish a Case for instructions on how to manually
establish a case in ARPS.) Use the civil action number for the Padro case, 1:11-cv-01788-CBA-RLM,
for the entry. Enter the jurisdiction as EDNY.
b. Pending RR
on the Padro claim
If the claimant has a request for review on the Padro claim
currently pending with the AC, the claimant responds to Notice A,
and the claimant is screened out as not eligible for Padro relief,
the PSU will still use ARPS to manually establish a case under the
SRR workload (see ARPS Module
3 - Establish a Case for instructions on how to manually
establish a case in ARPS). Use the civil action number for the Padro case,
1:11-cv-01788-CBA-RLM, for the entry. Enter the jurisdiction as
EDNY.
The PSU will inform the disability processing branch (DPB)
currently working the request for review of the screening result,
and, when the case is screened out, close out the SRR level case
according to the instructions in III.D.2.
If the claimant responds to Notice A, and is eligible for
Padro relief, the PSU will add the “PDRO” case characteristic
in ARPS, and notify the DPB where the Padro claim
is pending. The DPB will close out the request for review according
to the instructions in III.D.1.
c. RR closed on
the Padro claim - No Civil Action Pending
If the claimant requested AC review of the Padro claim
after the ALJ decision, the AC has already acted on the case and
has closed it in ARPS, no court level case has been created, and the
claimant responds to “Notice A,” the PSU will create
a CR level record in ARPS by reactivating the closed RR. (See ARPS Module
3 - Establish a Case for instructions on how to create an
ARPS case by reactivation.) Use “Court Remand” as the
reason for reactivation. Use the civil action number for the Padro case
(1:11-cv-01788-CBA-RLM) for the entry. Enter the jurisdiction as
EDNY. The PSU will close out the new CR level case according to
the instructions in III.D.1. or III.D.2. depending on whether the
case is screened in or screened out.
d. Civil Action
for Padro claim - No Court Remand
If a court case is established in ARPS but has not been remanded,
and the claimant responds to Notice A, the PSU must first determine
whether the court case is pending or closed.
•
If there is a pending
civil action, the PSU must notify the EDO and OGC in Region II before
screening to determine whether the claimant is eligible for retrospective
relief. If the claimant is screened in and the pending civil action
is the Padro claim, no action can be taken
until remand is obtained from the court. See III.C.2. This applies
even when there is no open case in ARPS.
Once a court remand is obtained on a court level Padro claim
pending under an “EOT,” “FDR,” “NCC,” “RRV,” “RVR,” “SRC,” “SRE,” “SRO,” or “SRR” workload
type in ARPS, the PSU will enter Special Dismissal (SPDI) as the recommended
action in the case analysis, and will close out the open record(s)
in ARPS. Once closed, the PSU will create a new court remand case
in ARPS. Use the civil action number for the Padro case
(1:11-cv-01788-CBA-RLM) for the claimant's court claim. The PSU
will close out the new court remand case according to the instructions
in III.D.1. or III.D.2. depending on whether the case is screened
in or screened out.
•
If there is no pending civil action, there is a
court level Padro claim closed in ARPS, and
there is no court remand, the PSU will create a new ARPS case by
reactivating the prior court level entry. (See ARPS Module
3 - Establish a Case for instructions on how to create an
ARPS case by reactivation.) Use “Court Remand” as the
reason for reactivation. Use the civil action number for the Padro case
(1:11-cv-01788-CBA-RLM) for the entry. Enter the jurisdiction as
EDNY. The PSU will close out the court remand case according to
the instructions in III.D.1. or III.D.2. depending on whether the
case is screened in or screened out.
e. Court Remand
on the Padro claim - No Final Decision (FinDec)
Issued
If the Padro claim is pending with
the AC as a CR at the time the claimant responds to Notice A, and
the claimant is screened out as not eligible for Padro relief, the
PSU will still use ARPS to manually establish a case under the SRR
workload (see ARPS Module 3 – Establish a Case for instructions
on how to manually establish a case in ARPS). Use the civil action
number for the Padro case, 1:11-cv-01788-CBA-RLM,
for the entry. Enter the jurisdiction as EDNY.
The PSU will inform the CCPRB currently working the court
remand of the screening result, and, when the case is screened out,
close out the SRR level case according to the instructions in III.D.2.
If the claimant responds to Notice A, and is eligible for
Padro relief, the PSU will add the “PDRO” characteristic
in the existing CR level in ARPS, and notify the CCPRB where the Padro claim
is pending. The CCPRB will close out the court remand according
to the instructions in III.D.1.
If the claimant filed a civil action on the Padro claim,
the AC subsequently remanded the claim to an HO, and the claimant
responds to Notice A, the PSU will manually establish a case in
ARPS under the SRR workload. (See ARPS Module
3 - Establish a Case for instructions on how to manually
establish a case in ARPS.) Use the civil action number for the Padro case
(1:11-cv-01788-CBA-RLM) for the entry. Enter the jurisdiction as
EDNY. The PSU will close out the SRR case according to the instructions
in III.D.1 or III.D.2 depending on whether the case is screened
in or screened out.
f. New Pending
FinDec on Padro Claim
If the claimant responds to Notice A, the Padro claim
was a FinDec, there is a pending FinDec in ARPS, and the claimant
is screened out as not eligible for Padro relief, the PSU will use
ARPS to manually establish a case under the SRR workload. (See ARPS Module
3 - Establish a Case for instructions on how to manually
establish a case in ARPS.) Use the civil action number for the Padro case
(1:11-cv-01788-CBA-RLM) for the entry. Enter the jurisdiction as
EDNY.
The PSU will inform the CCPRB currently working the FinDec
that the claim is not eligible for Padro relief, and will close
out the SRR level case according to the instructions in III.D.2.
If the claimant is screened in as a Padro claim, the PSU will
add the “PDRO” case characteristic in ARPS, and notify
the CCPRB where the Padro claim is pending.
The CCPRB will close out the FinDec according to the instructions
in III.D.1.
g. Closed FinDec
on the Padro claim
If the claimant responds to Notice A, and the Padro claim
is a closed FinDec with no subsequent federal court case, the PSU
will create a new court remand by reactivating the closed FinDec
entry. (See ARPS Module
3 - Establish a Case for instructions on how to create an
ARPS case by reactivation.) Use Court Remand as the reason for reactivation.
Use the civil action number for the Padro case
(1:11-cv-01788-CBA-RLM) for the entry. Enter the jurisdiction as
EDNY. The PSU will close out the court remand level case according
to the instructions in III.D.1 or III.D.2. depending on whether
the case is screened in or screened out.
h. Pending RR on
subsequent claim (non-Padro)
If the claimant has a subsequent claim pending at the time
the claimant responds to Notice A, the PSU will determine whether
the individual is eligible for Padro relief. The PSU will ask the
disability processing branch (DPB) to halt processing on the subsequent
claim until screening is complete.
•
If the prior case
is screened out, the PSU will use ARPS to manually establish a case under
the SRR workload. (See ARPS Module
3 - Establish a Case for instructions on how to manually
establish a case in ARPS.) Use the civil action number for the Padro case
(1:11-cv-01788-CBA-RLM) for the entry. Enter the jurisdiction as
EDNY. The PSU will close out the SRR level case according to the
instructions in III.D.2. The PSU will then ask the DPB to continue
processing the subsequent claim.
•
If the prior case is screened in as a Padro case,
the PSU will create a CR level for the prior Padro claim
by reactivation. (See ARPS Module
3 - Establish a Case for instructions on how to create an
ARPS case by reactivation.) Use “Court Remand” as the reason
for reactivation. Use the civil action number for the Padro case
(1:11-cv-01788-CBA-RLM) for the entry. Enter the jurisdiction as
EDNY. The PSU will add the “PDRO” case characteristic
in ARPS on the CR level, and then transfer the case to the DPB.
The DPB will work the RR on the pending subsequent claim using normal
procedures, and act on the CR level case in accordance with the
instructions in IV.C.
3. Tracking Responses
to Notice A
If the claim is paper, the PSU will place the Notice A response
form in the case file once it is received (see III.B. below). If
the claim is electronic, the PSU will scan the response into the B
section of the electronic folder, using a barcode with the “Misc
Jurisdictional Documents/notice” document type. It will also
be necessary to annotate the note field of this entry in eView with “Notice
A response.” The PSU will code receipt of all reply forms
into an internal database.
A claimant eligible for retrospective
relief must request relief. If we do not receive such a request
and there is no indication that the claimant did not receive Notice
A (see subsection 4 below), the agency will not disturb the prior
decision.
If SSA later learns of a claimant
who may be eligible or who claims to be eligible for retrospective
relief as a class member, but who did not receive Notice A, the
PSU will review available records to determine whether the claimant
meets the requirements for retrospective relief. The PSU will code the
screening outcome into an internal database.
If the individual asserting class membership makes the assertion
to a field office (FO) employee, the FO will contact the PSU by
sending an email to ^ODAR HQ OAO Padro. The PSU will code the screening
outcome into an internal database.
If the reply is untimely, the PSU will evaluate good cause
using the standards in 20 CFR 404.911 and 416.1411.
If good cause is established, the PSU will annotate the internal database.
If good cause is not established, the PSU will appropriately annotate
the internal database, and send the claimant a notice explaining
that the request for retrospective relief will not be considered
because the request was not timely submitted. (See Attachment 5.)
4. Notice A Returned
as Undeliverable
If a Notice A is returned as undeliverable, the PSU will associate
the information with the claim file(s) and annotate the internal
database. In addition to appropriately identifying the claimant,
the PSU must also note the address to which the notice was mailed
in the internal database. If a claimant on this list later submits
a request for retrospective relief under the settlement, the PSU
will evaluate good cause.
This list will also include the names
and addresses of claimants for whom no updated address could be
found after the return of an undeliverable Notice of Proposed Class
Action Settlement and Fairness Hearing. See Part III.A.1. NOTE.
OGC will provide Class Counsel with a copy of the list.
The PSU must annotate the internal database, and update ARPS,
if the claimant indicates a change of address on the response form
or at any other time.
B. Referring the File
to the PSU
If the Padro claim is paper, the PSU
will request the file once a claimant's response to Notice A is
received. Paper Padro claim files will be
forwarded to OAO at the following address (location code Y46):
Appeals Council
Office of Disability Adjudication
and Review
Padro Screening Unit
5107 Leesburg Pike
Falls
Church, VA 22041-3255
As necessary, the PSU will request and track claim files needed
for screening. The PSU will annotate the internal database whenever
a paper claim file is requested. The information will be necessary
to do the final class membership reconciliation. See Part VI.
If we cannot locate the claim file(s),
the PSU will attempt to determine a claimant's eligibility for retrospective
relief by using system queries. If information contained in the
queries or otherwise obtained clearly indicates that the claimant
is not a class member, or is not eligible for retrospective relief,
we will not reconstruct the file.
We anticipate that information from system queries will contain
information about whether the claimant received a decision from
one of the named ALJs between January 1, 2008 and October 18, 2013.
If eligibility cannot be determined via queries, but the PSU determines
it is more likely than not that the claimant was issued a qualifying
decision, class membership will be presumed. The PSU will forward
any information to the appropriate HO for reconstruction and readjudication.
C. Alerting Processing
Components of Possible Padro Class Membership
1. Claim(s) Pending
at AC
If a claim is pending before the AC at the time the response
to Notice A is received, the PSU will notify the appropriate DPB
that there is a potential Padro claim involved.
The PSU will notify the DPB of the outcome of the screening. No
action should be taken on the claim until the DPB is notified of
the screening outcome. See Part III.A.2.
A DPB should not treat a case as
a Padro claim unless the PSU has designated
the case as such. If a claimant with claim pending before the AC
alleges Padro class membership but has not
been designated as such, the DPB will contact the PSU for assistance
by sending an email to ^ODAR HQ OAO Padro.
If the claim is currently pending in court, no action can
be taken until remand is obtained from the District Court. The PSU
must notify OGC in Region II when the response to Notice A is received.
If the claimant is screened in, and the claim pending in court
is the potential class member claim, the PSU will forward the claim
file(s) to the appropriate CCPRB for action. The CCPRB will immediately
notify OGC that the claimant has a class member claim pending in court.
If appropriate, OGC will then notify the Assistant United States
Attorney (AUSA) in order to obtain remand from the court. No other
action can be taken until the claim is remanded by the court.
OGC will notify the CCPRB once remand of the court claim is
obtained. The CCPRB will then process the court remand using the
instructions in III.D. below.
If the claim pending in court is not the class member claim,
the CCPRB will return the claim file(s) to the PSU. The PSU will
notify OGC, and follow the instructions in III.D.1.b. below.
3. No Active Claim
Pending
If there is no active claim pending administrative review,
but the file is located in the Office of Hearings Operations (OHO)
Headquarters or the Office of Analytics, Review, and Oversight (OARO)
pending possible receipt
of a request for review, written exceptions, or notification that
a civil action has been filed, the PSU will handle the matter. If
the file is paper, the PSU determines that the claimant is not a
class member eligible for relief, and the claimant does not dispute
the denial of eligibility of relief, the PSU will return the file
to the office that previously held the file.
D. Determining Eligibility
for Retrospective Relief and Initial OAO Processing
When a potential class member responds to Notice A, the PSU
will determine whether the claimant is eligible for retrospective
relief by:
•
Establishing a case
in ARPS under the “SRR,” “RR,” or “CR” workloads
in accordance with the instructions provided in section III.A.2.;
•
Considering all unfavorable or partially favorable
decisions on the merits of a claim for disability benefits under
title II or title XVI of the Act that were issued by one of the
five named ALJs from January 1, 2008 through October 18, 2013;
•
Following all instructions on the screening sheet;
•
Signing and dating the original screening sheet;
•
Associating the screening sheet with the claim file(s)
by placing it in section B of a paper modular disability folder,
or scanning the sheet into the B section of the electronic folder
using a barcode with the “Misc Jurisdictional Documents/notices” document type.
(Be sure to also add “screening sheet” to the note
field in eView.);
•
Annotating the internal database about the screening
outcome; and
•
Entering the case characteristic “PDRO” in
ARPS.
1. Eligible for Retrospective
Relief
a. Padro claim
currently pending review with the AC
If the claim entitling the claimant to retrospective relief
is currently pending review with the AC, the PSU will add the “PDRO” case
characteristic and transfer the case to the processing DPB or CCPRB
to prepare the remand order (unless a fully favorable decision is warranted).
If there are reasons for remand other than the Padro settlement,
use a REM 45, CREM 10 or CREM 45 (remand order), as appropriate,
stating the reasons for remand. If the pending case is an RR, and
there is no other basis for review present, use a REM 45 that grants
review based on a broad policy or procedural issue that may affect
the general public interest. If the pending case is a CR, use a
CREM 10 or CREM 45 in accordance with ordinary procedures. In all
cases, the remand order will direct reassignment of the claim to
an ALJ other than one of the five named in the Padro settlement,
and will direct consolidation when appropriate (see IV.B.4.). Include
the following sentence in the remand:
“The Appeals Council considered this case in accordance
with the Padro v. Colvin class action settlement.”
After remanding the case, close the ARPS record according
to standard procedures.
b. Padro claim not currently
pending review with the AC
If the PSU determines a claimant is eligible for retrospective
relief, and the Padro claim is not currently
pending review with the AC, the PSU will:
•
Note “Appropriate
Action Taken (NACT)” as the recommendation in the ARPS case analysis
if the SRR workload was created; OR
•
Note “REM1” as the recommendation in
the ARPS case analysis if the RR or CR workload was created. If
REM1 is used, enter “Miscellaneous” in Group 1 of the Remand
reasons, and “Other” as Reason 1.
•
Add the following in the “Remarks” box
on the case analysis tab in ARPS: “Claimant determined to
be class member eligible for retrospective relief pursuant to the Padro settlement.”;
•
Click the “Save and Mark Final Complete” button;
•
Draft an AC return order (see Attachment 1D). Create
the AC return order by opening a REM 45, CREM 10, CREM 45, or blank
remand order (as appropriate) in DGS. Enter the claimant's SSN,
and hit the “Retrieve Information” button, selecting
the appropriate ARPS record. Skip to the “Signature” tab,
select eSign if the case is electronic or Imprinted if paper, and
the ARPS Case option in the Select Code 1 box. Hit Done. Save the
document as appropriate.
Once DGS generates the notice, change the word “Remanding” in
the bolded title to “Returning.” Then delete the text
under the “What This Order Means” subheading, and replace
it with the language provided in Attachment 1D. Enter the hearing
office address.
In the “If You Have Any Questions” section, copy
and paste the paragraph in Attachment 1D containing the contact
information for class counsel.
In the body of the order, replace “REMANDING” with “RETURNING.” Select
the text in the order and replace it with the language provided
in Attachment 1D.
If there is a current claim pending at disability determination
services (DDS) or HO, and the other conditions for consolidation
apply, the AC's return order will direct consolidation of both claims.
The AC's return order will also indicate whether folder reconstruction
is necessary.
Once the AC return order is complete, if the claim is electronic,
lock it for approval according to ordinary OAO policies and procedures
concerning eSign. If paper, print the order and bring it to an adjudicator
in the Division of Civil Actions (DCA) using the usual OAO procedures.
•
Change the case status
in ARPS to A/AO Review of Recommendation (ARRC) with an adjudicator
in DCA.
Once the adjudicator has approved the recommendation and order,
he or she will return the case to a CCPRB in “Ready to Mail
Final” status. The CCPRB will then take the following actions:
•
Associate the AC order with the file;
In electronic cases, unless the eSign
process outlined above was used, the CCPRB will scan the AC order
into the A section in eView, using a barcode with document type “AC
Order.” If the case is paper, a copy of the AC order will
be associated in the claim folder.
•
Send copies to the claimant and his or her representative
of record, if any;
•
Close the case in ARPS; and
•
Return the case to the HO.
If the claim file is paper, the CCPRB
will use Attachment 4 when returning the file. The CCPRB will identify
the HO that will readjudicate the claim based on the claimant's
residence, and will note the address of the HO on the Padro Flag/Alert
used to forward the claim. If the claim is electronic, the CCPRB
will annotate the HO's code and address on the Alerts/Messages tab in
eView.
2. Not Eligible for
Retrospective Relief
If the PSU determines the claimant is not a class member eligible
for relief, the PSU will:
•
Notify the EDO and
OGC of the determination via email to ^ODAR HQ OAO Padro and ^NY
OGC Padro;
•
Add the following in the “Remarks” box
on the case analysis tab in ARPS: “Claimant determined not
to be class member eligible for retrospective relief under the Padro settlement;”
•
Use Special Dismissal (SPDI) to close the case in
ARPS;
•
Notify the claimant and representative, if any,
that he or she was determined not to be a Padro class
member or was found to be ineligible for retrospective relief by
completing the screen-out notice and indicating the reason(s) for
the determination (see Attachment 5);
•
Associate a copy of the notice in the paper claim
file(s) or scan the notice into the B section of the claimant's
electronic folder using a barcode with the “AC Correspondence” document
type; and
•
Retain, or otherwise hold, the claim file(s) for
65 days pending a possible class membership dispute.
a. Class Membership
Disputes
The claimant or his or her representative of record may ask
class counsel to review the PSU determination. The PSU will send
the file to OGC in Region II, when requested, by using the pre-addressed
route slip in Attachment 6.
OGC will notify the PSU of the determination, and will return
the claim file if paper. If OGC resolves the dispute in the claimant's
favor, the PSU will:
•
Reopen the ARPS record
and document that the claimant was determined to be eligible for
retrospective relief (following the instructions in III.D.1.);
•
Prepare a revised screening sheet;
•
Identify the appropriate HO for readjudication;
•
Draft an AC return order following the procedure
in III.D.1.; and
•
Annotate the internal database and, if a paper file
is involved, send the paper file by priority mail to the identified
HO.
If the dispute is not resolved in the claimant's favor, the
PSU will:
•
Retain any paper file
for 195 days pending possible court action. Once the court appeal period
or court action is over, the PSU will send the file to the appropriate
storage facility; and
•
Include a notation in the file that no request for
court review was received. (This information will be annotated in
the Alerts/Messages tab of eView in electronic cases).
E. Determining Eligibility
for Prospective Relief
No screening is required to determine eligibility for prospective
relief. During the 30-month period beginning October 19, 2013, HO
personnel will add the “CAPA” case characteristic in
CPMS on all cases in which one of the five named ALJs issues an
unfavorable or partially favorable decision on a claim for disability
benefits under title II or title XVI, including age 18 rederminations
and medical CDRs.
IV. Retrospective Processing
and Adjudication
For information relating to eligibility for retrospective
relief, including the period at issue, evidence issues, and appeal
rights, refer to II.C.1. above.
Except as noted in the following information, an HO or the
AC will process Padro class member cases
using current practices and procedures, including coding, developing evidence,
and routing. Social
Security Ruling 13-3p will be applied when appropriate. Do not
assign any Padro class member cases returned
by the AC to any of the five ALJs named in the settlement.
B. HO Processing Considerations
In a case designated as a Padro class
member case, the Notice of Hearing will include the following statement:
“The hearing will be held pursuant to the Padro Settlement
Agreement and Order approved by the United States District Court
for the Eastern District of New York on October 18, 2013.”
In order to preserve the ability
to send the notice of hearing through central print, HO employees
should add this language in the “More Issues” text
box in the DGS template (on the “Type of Notice of Hearing & More
Issues” tab, or the “Additional Issues” tab
in the Widow/Widower template).
2. Subsequent Applications
If the claimant filed a subsequent application after the decision
that entitled him or her to Padro relief,
the adjudicator must consider the outcome of the subsequent application consistent
with reopening provisions. See HALLEX .
Once a Padro claim has been returned
or remanded to an HO, the HO will add the “CAPA” case
characteristic in CPMS. The case characteristic will be added even
if the Padro claim is consolidated with a
non-Padro claim.
If the Padro class member claim was
already remanded by the AC and is pending before one of the five
named ALJs, the case will be reassigned to an ALJ who was not named
in the settlement, even if a hearing has already been held. In that
case, the ALJ to whom the claim has been reassigned must offer the
claimant an opportunity for a de novo hearing,
unless a fully favorable decision can be issued on the record, or
one of the other conditions is present to decide a case without
a hearing. See 20
CFR 404.948 and 416.1448.
Claims should only be consolidated if practicable. If it is
practicable to consolidate the claims, dismiss the non-Padro application
using CPMS code SPDI, and add the “CAPA” case characteristic
to the prior Padro claim.
If consolidating a prior Padro claim
will unreasonably delay a decision on the non-Padro claim,
consolidation is not appropriate. When the claims are not consolidated,
add the “CAPA” case characteristic to both CPMS cases. To
the extent practicable, both claims should be adjudicated by the
same ALJ. Neither claim should be adjudicated by one of the five
ALJs named in the Padro settlement.
If the claimant has a non-Padro claim
pending at the DDS level and the ALJ or AC determines consolidation
is warranted, the DDS level case must be escalated to the hearing
level for consolidation with the prior Padro claim.
If the non-Padro claim is paper, the HO must
contact the DDS and have them forward the non-Padro claim
to the HO. If both claims are electronic, the HO will use the eView
Join Claims function to ask the DDS to stop processing.
At the hearing level, irrespective of whether a hearing has
been scheduled or held, if the claimant has a request for hearing
on a non-Padro claim pending with one of
the five named ALJs, the claim will be consolidated with the prior Padro claim
and reassigned to an ALJ not named in the Padro settlement.
The ALJ to whom the claim has been reassigned must offer the
claimant an opportunity for a de novo hearing,
unless a fully favorable decision can be issued on the record, or
one of the other conditions is present to decide a case without
a hearing. See 20
CFR 404.948 and 416.1448.
If the claimant has a request for hearing on a non-Padro claim
pending with an ALJ other than one of the five named ALJs, the Padro claim
and the non-Padro claim will be consolidated
and adjudicated by the ALJ assigned to the non-Padro claim.
If the consolidated claims are
reassigned because the ALJ who conducted the hearing in the non-Padro claim
is now unavailable to issue the decision, pursuant to HALLEX HA 01280.040,
the case will not be reassigned to one of the five named ALJs.
C. Subsequent Application
Pending at AC
If a subsequent application is pending at the AC and the prior
claim(s) is designated as a Padro case, the
PSU will notify the branch chief in the branch processing the subsequent application.
If the Padro claim is paper, the PSU will
forward it and the completed screening sheet to the branch chief.
If electronic files are involved, the PSU will annotate the current
segment by entering “Prior Padro claim” in the Alerts/Messages
tab in eView.
The AC action taken on the non-Padro claim
could determine the disposition of the Padro claim.
Therefore, if either the Padro claim or the
non-Padro claim is paper, the AC must keep
the claim files together until the action on the non-Padro claim
is complete.
1. AC Dismisses, Denies
Review, or Issues Unfavorable Decision on non-Padro Claim
If the subsequent claim does not cover the entire prior period
to be readjudicated in the Padro claim(s),
the AC will proceed with its intended action on the non-Padro claim. Once
the AC completes its action on the non-Padro claim,
one of the following instructions will apply:
•
If both the non-Padro and Padro claims
are paper, the branch will return the files to the PSU. The PSU
will attach a Padro case flag (Attachment
4) to the prior Padro claim and associate
a copy of the Padro case flag in the non-Padro claim
file. The PSU will send the prior Padro claim
file to the appropriate HO for action. The AC will handle the non-Padro file
using standard operating procedures.
•
If the non-Padro claim is
paper, but the prior Padro claim is electronic,
the PSU will add a Padro case flag to the
non-Padro claim file (specifically noting
that the Padro case is a prior electronic
folder), and use the procedures in III.D.1. to return the prior Padro claim
to the appropriate HO for action. The AC will handle the non-Padro file using
standard operating procedures.
•
If the non-Padro claim is
electronic, but the prior Padro claim is
paper, the PSU will attach a Padro case flag
to the prior Padro claim, annotate the record
associated with the non-Padro claim by adding “Prior
Padro claim” in the Alerts/Messages tab of eView, and otherwise
follow the instructions in III.D.1. to return the prior Padro claim to
the appropriate HO for action.
•
If both the prior Padro claim
and the non-Padro claim are electronic, the
PSU will annotate the record associated with the non-Padro claim
by adding “Prior Padro claim” in the Alerts/Messages
tab of eView, and otherwise follow the instructions in III.D.1.
to return the prior Padro claim to the appropriate
HO for action.
2. AC Remands the
non-Padro Claim to an ALJ
The AC remand order will direct the ALJ to consolidate the
prior Padro claim with the action on the
non-Padro claim, unless the non-Padro claim
and the prior Padro claim do not have any
common issues. The remand order will state that the consolidated
claims are to be assigned to an ALJ who is not named in the Padro case.
Include the following sentence in the remand order: “The
Appeals Council has also considered your prior case in accordance
with the Padro v. Colvin class action settlement.”
Do not close the “PDRO” case
characteristic when taking final action on these cases.
3. AC Issues a Favorable
Decision on the non-Padro Claim
•
If the AC issues a
favorable decision on the non-Padro claim(s),
and the decision is fully favorable with respect to all issues raised
in the prior Padro claim(s), the AC will consolidate
the claims, readjudicate the prior Padro claim,
and issue a favorable decision that adjudicates both applications.
The AC's decision will state that the AC readjudicated the prior Padro claim
pursuant to the Padro Settlement and Order.
The following sentence should be included in the AC action
document: “The Appeals Council considered this case in accordance
with the Padro v. Colvin class action settlement.”
•
If the AC's favorable decision would not be fully
favorable with respect to all issues raised by the prior Padro claim,
the AC will proceed with its intended action on the non-Padro claim.
Once the AC completes its action on the non-Padro claim,
the DPB will act on the Padro claim following
the instructions in III.D.1.b. The non-Padro claim
will be sent for effectuation.
If the AC makes a partially favorable
decision that adjudicates any part of the period at issue in the Padro claim
and the Padro case file is paper, the PSU
will monitor the effectuation of the AC's decision and once effectuated will
retrieve the folder before taking any further action.
V. Prospective Processing
and Adjudication
1. Unfavorable Decision
Issued by an ALJ Named in the Settlement - No Court Remand
Any claimant who receives an unfavorable decision from an
ALJ named in the settlement agreement, within the 30 month period
beginning October 19, 2013, is eligible for prospective relief.
These claimants will receive an unfavorable Padro notice
of decision instead of the standard notice of decision. See Attachment
1B. The unfavorable Padro notice of decision informs
the claimant that:
•
Any request for review
of a prospective unfavorable decision will be assigned to designated
staff within OAO;
•
The claimant will be deemed to have requested review
by the AC even if the claimant does not do so within 65 days after
the date of the unfavorable decision;
•
If the decision is remanded for a new hearing, the
hearing after remand will be conducted by an ALJ other than one
of the five ALJs named in the Padro case;
and
•
The claimant may opt out of Padro relief,
but he or she must do so within the time period stated in the notice.
HO personnel will draft the decision using the “Findings
Integrated Templates (FIT) Unfavorable Decision” template
in DGS. Once the decision is generated, HO personnel should copy
and paste the “Padro Notice of Decision – Unfavorable” (Attachment
1B) over the standard notice of decision. HO personnel will add
the claimant's SSN and address, and the representative's address,
in the spaces indicated. HO personnel will then continue processing the
decision according to normal HO business procedures.
2. Unfavorable Decision
Issued by an ALJ Named in the Settlement After Court Remand
Any claimant who receives an unfavorable decision after court
remand from an ALJ named in the settlement agreement within the
30 month period beginning October 19, 2013 is eligible for prospective
relief.
These claimants will receive an unfavorable Padro notice
of decision after court remand instead of the standard notice of
decision after court remand. See Attachment 1B-FinDec. The unfavorable Padro notice
of decision after court remand informs the claimant that:
•
Any written exceptions
to an unfavorable decision after court remand will be assigned to
designated staff within OAO;
•
The claimant will be deemed to have filed written
exceptions to the unfavorable decision after court remand on the
day the decision is issued. The claimant will have the opportunity
to withdraw the deemed written exceptions and/or submit additional
written exceptions;
•
The claimant must submit any additional written
exceptions within 65 days after the date of the unfavorable decision
after court remand;
•
If an unfavorable decision after court remand is
remanded for a new hearing, the hearing will be conducted by an
ALJ other than one of the five named ALJs;
•
If the claimant withdraws the deemed written exceptions,
the AC does not assume jurisdiction over the claim under 20 CFR 404.984 and 416.1484,
the claimant files or pursues a civil action in Federal court, and
the Federal court remands the claim for a new hearing, the hearing
will be conducted by an ALJ other than one of the five named in Padro;
and
•
The claimant may opt out of Padro relief,
but he or she must do so within the time period stated in the notice.
HO personnel will draft the decision using the “FIT
Unfavorable Decision” template in DGS. Once the decision
is generated, HO personnel will copy and paste the “Padro Notice of
Decision After Court Remand – Unfavorable” (Attachment
1B-FinDec) over the standard notice of decision. HO personnel will
add the claimant's SSN and address, and the representative's address,
in the spaces indicated. HO personnel will then continue processing
the decision according to normal HO business procedures.
3. Partially Favorable
Decision Issued by an ALJ Named in the Settlement - No Court Remand
Any claimant who receives a partially favorable decision from
an ALJ named in the settlement agreement, within the 30 month period
beginning October 19, 2013 may be eligible for prospective relief
if he or she requests AC review of the decision.
These claimants will receive a partially favorable Padro notice
of decision instead of the standard notice of decision. See Attachment
1C. The partially favorable Padro notice
of decision informs the potential class member that:
•
The claimant must
request AC review of a partially favorable decision in order to
be entitled to Padro relief;
•
Any request for review of a partially favorable
decision will be assigned to designated staff within OAO;
•
If a partially favorable decision is remanded for
a new hearing, the hearing will be conducted by an ALJ other than
one of the five named in Padro; and
•
The claimant may opt out of Padro relief,
but he or she must do so within the time period stated in the notice.
HO personnel will draft the decision using the appropriate
FIT decision template in DGS. Once the decision is generated, HO
personnel will copy and paste the “Padro Notice
of Decision – Partially Favorable” (Attachment 1C)
over the standard notice of decision. HO personnel will add the
claimant's SSN and address, and the representative's address, in
the spaces indicated. HO personnel will then continue processing
the decision according to normal HO business procedures.
4. Partially favorable
Decision Issued by an ALJ Named in the Settlement After Court Remand
Any claimant who receives a partially favorable decision from
an ALJ named in the settlement agreement within the 30 month period
beginning October 19, 2013 may be eligible for prospective relief.
These claimants will receive a partially favorable Padro notice
of decision after court remand instead of the standard notice of
decision after court remand. See Attachment 1C-FinDec. This Padro FinDec
notice informs the potential class member that:
•
The claimant must
submit written exceptions to a partially favorable decision after court
remand, or file a civil action, in order to be entitled to Padro relief;
•
Any written exceptions to a partially favorable
decision after court remand will be assigned to designated staff
within OAO;
•
The claimant must submit any written exceptions
within 65 days after the date of the partially favorable decision
after court remand;
•
If the claimant files written exceptions to a partially
favorable decision after court remand, and the designated staff
remands the claim for a new hearing, the hearing will be conducted
by an ALJ other than one of the five named in Padro;
•
If the claimant does not file written exceptions
to a partially favorable decision after court remand, the AC does
not assume jurisdiction over the claim under 20 CFR 404.984 and 416.1484,
the claimant files or pursues a civil action in Federal court, and the
Federal court remands the claim for a new hearing, the hearing will
be conducted by an ALJ other than one of the five named in Padro;
and
•
The claimant may opt out of Padro relief,
but he or she must do so within the time period stated in the notice.
HO personnel will draft the decision using the appropriate
FIT decision template in DGS. Once the decision is generated, HO
personnel will copy and paste the “Padro Notice
of Decision After Court Remand – Partially Favorable” (Attachment
1C) over the standard notice of decision. HO personnel will add
the claimant's SSN and address, and the representative's address,
in the spaces indicated. HO personnel will then continue processing
the decision according to normal HO business procedures.
B. HO Actions After Case
Closure
Any paper files in which an unfavorable decision was issued
by one of the five named ALJs must be routed to the AC. The HO will
forward the files to:
Appeals Council
Office of Disability Adjudication
and Review
Padro Unit
5107 Leesburg Pike
Falls
Church, VA 22041-3255
HOs will forward paper files with partially favorable decisions
to the effectuating component for effectuation. The AC will monitor
these cases and will request the paper folders once effectuation
is complete.
OAO staff will annotate an internal database to document all
claim dispositions. Once the AC completes one of the actions discussed
below, OAO staff will document the action in the internal database.
Specified OAO staff will evaluate the unfavorable and/or partially
favorable decision that entitles the claimant to Padro prospective
relief.
The staff will make a recommendation as to whether the ALJ's
decision is legally sufficient or contains an error of law or abuse
of discretion. The staff will consider, among other things, whether
the ALJ correctly:
•
Evaluated treating
source opinions;
•
Developed the record; and
•
Conducted the hearing(s).
As applicable, the AC will:
•
Consider whether there is a basis to grant the request
for review under the regulatory criteria in 20 CFR 404.970 and 416.1470;
and
•
Take appropriate action according to those regulations.
In any case in which the AC remands
an unfavorable or partially favorable decision issued by one of
the five named ALJs, the AC remand order must direct that the case
be assigned to an ALJ not named in the Padro case.
However, if the unfavorable or partially favorable decision
was issued after a court remand, the staff, as applicable, will
consider exceptions as provided under 20 CFR 404.984 and 416.1484,
and will take appropriate action according to those regulations.
If the recommendation is to deny review or not assume jurisdiction,
the AC action document will include the following sentence:
“We considered your case in accordance with the Padro
v. Colvin class action settlement.”
If the recommendation is to remand, or issue an AC decision,
the AC action document will include the following sentence:
“The Appeals Council considered this case in accordance
with the Padro v. Colvin class action settlement.”
2. Withdrawal at Class
Member's Request
A claimant has the right to withdraw any claim to the extent
provided by applicable rules and regulations.
3. Unfavorable Decision
Issued by an ALJ Named in the Settlement - No Court Remand
Any request for review or “deemed” request for
review of an unfavorable decision issued by a named ALJ during the
30 month period beginning October 19, 2013 will be assigned to specified
OAO staff. Upon receipt of the claimant's request for review, or
notification of a deemed request for review, and creation of the
appropriate record in ARPS, OAO staff will add the “PDRP” case
characteristic. OAO staff will evaluate the claimant's request for review
in accordance with section V.C.1. above.
As explained previously, if a claimant
does not request AC review within 65 days after the date of the
unfavorable decision, he or she will be deemed to have made such
a request.
4. Unfavorable Decision
Issued After Court Remand by an ALJ Named in the Settlement
The claimant will be deemed to have filed written exceptions
to the unfavorable decision after court remand on the day the decision
is issued by one of the five named ALJs. Written exceptions – deemed
or submitted – to unfavorable decisions after court remand
issued by a named ALJ during the 30 month period beginning on October
19, 2013 will be assigned to specified OAO staff in OAO's CCPRBs.
Under the terms of the Padro settlement,
claimants have 60 days to file additional written exceptions, or
request withdrawal of the deemed written exceptions to the unfavorable
decision after court remand. As such, the specified CCPRB staff
will not act until the 66th day after
the unfavorable decision after court remand was issued. Requests
for extensions of time to file additional written exceptions will
be evaluated in accordance with current rules and regulations.
Upon receipt of the case file, if paper, or upon notification
from the EDO if electronic, specified staff in the CCPRBs will create
an appropriate ARPS record and add the “PDRP” case characteristic.
The specified CCPRB staff will evaluate the claimant's written exceptions
in accordance with V.C.1. above.
5. Partially Favorable
Decision Issued by an ALJ Named in the Settlement - No Court Remand
The claimant must request AC review of a partially favorable
decision in order to be eligible for Padro relief.
Requests for review of partially favorable decisions issued by a
named ALJ during the 30 month period beginning October 19, 2013
will be assigned to specified OAO staff. The standard rules and
regulations concerning the timeliness of requests for review apply.
Upon receipt of the claimant's request for review and creation
of the appropriate ARPS record, OAO staff will add the “PDRP” case
characteristic. The specified OAO staff will evaluate the claimant's
request for review according to V.C.1. above.
6. Partially Favorable
Decision Issued After Court Remand by an ALJ Named in the Settlement
Written exceptions to partially favorable decisions issued
after court remand by a named ALJ during the 30 month period beginning
October 19, 2013 will be assigned to specified staff in OAO's CCPRBs.
Upon receipt of the case file, if paper, or upon notification from
the EDO if electronic, specified staff in the CCPRBs will create
the appropriate ARPS record and add the “PDRP” case
characteristic.
Under the terms of the Padro settlement,
claimants have 60 days to file additional written exceptions. Specified
staff in OAO's CCPRBs should not act until the 66th day
after the partially favorable decision after court remand was issued.
Requests for extensions of time to file additional written exceptions
will be evaluated in accordance with current rules and regulations.
Specified CCPRB staff will evaluate the claimant's written
exceptions in accordance with V.C.1. above.
VI. Reconciling Implementation
Data
At appropriate intervals, information concerning the implementation
of the Padro settlement will be reconciled
via database queries and review of the internal database mentioned above.
This internal OAO database will be a computer-based record of AC
and HO implementation activity (i.e., a record of cases screened
by the PSU, and a record of cases readjudicated at both the hearings and
AC levels), as reported by HOs, the PSU, and OAO.
VII. Inquiries
HO personnel should direct any questions to the Regional Office.
Regional Office personnel may direct questions to the appropriate
contact in the Division of Field Procedures in the Office of the
Chief Administrative Law Judge.
OAO personnel should direct any questions to the Executive
Director's Office.
Attachment 1. Padro Settlement
and Order; Approved by the U.S. District Court for the Eastern District
of New York on October 18, 2013.
UNITED STATES
DISTRICT COURT
EASTERN DISTRICT OF NEW YORK
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LORRAINE PADRO,
LESLIE BAILEY,
MARIE THELOT, SARAH RODRIGUEZ,
DHANASAR
RAMAN, TOBY MARLOW,
as court-appointed guardian for
JUDITH BLUMENSOHN,
CARMEN DURAN, JOHN EDWARDS,
ERNESTA
GUTIERREZ, JULIA JUAN,
and JANE DOE, individually and
on behalf
of all others similarly situated,
Plaintiffs,
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Civil Action
CV-11-1788
(Amon, Ch. J.)
(Mann,
M.J.)
|
-against-
MICHAEL
J. ASTRUE,
Commissioner of Social Security,
Defendant.
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SETTLEMENT AGREEMENT
WHEREAS, Plaintiffs are applicants for Social Security Disability
Insurance Benefits and/or Supplemental Security Income payments
based on disability. On April 12, 2011, Plaintiffs, on behalf of
a putative class, filed against the Social Security Administration
(“SSA”) a Complaint alleging that five Administrative
Law Judges (“ALJs”) in SSA's Queens Office of Disability Adjudication
and Review (“ODAR”) have exhibited “general bias” against
claimants for disability benefits. On May 4, 2011, Plaintiffs filed
an Amended Complaint in this action (hereinafter referred to as “the
Case”), which added three named plaintiffs and supplemented
the allegations;
WHEREAS, the Commissioner of Social Security expressly denies
any wrongdoing, as alleged in the Case or otherwise, and does not
admit or concede any actual or potential fault, wrongdoing or liability
in connection with any facts or claims that have been or could have
been alleged in the Case. Nonetheless, the Commissioner considers
it desirable to settle the Case on the terms set forth in this Settlement
Agreement;
WHEREAS, Plaintiffs and the Commissioner of Social Security
(collectively “the Parties”) wish to avoid further
litigation in this matter and to bring the Case to a close, and
have determined to settle the Case, including all claims that Plaintiffs,
the proposed Class (as defined below), and the members of that Class
have brought or could have brought in the Case;
WHEREAS, the purpose of this Settlement Agreement is to make
a full, complete, and final resolution of all claims and causes
of action that have been or could have been asserted in the Case
against the Commissioner by the Plaintiffs, the proposed Class (as
defined below), and the members of that Class arising out of the
conduct alleged therein;
NOW, THEREFORE, in reliance on the mutual promises, covenants,
releases, and obligations as set out in this Settlement Agreement,
and for good and valuable consideration, the Parties hereby stipulate
and agree to resolve all claims that were or could have been at
issue in this Case as follows:
I. DEFINITIONS
As used in this Settlement Agreement:
A.
The terms “ALJ” and “an
administrative law judge” refer to an individual appointed
in accordance with 5 U.S.C. § 3105, who conducts
hearings and makes decisions on claims for disability benefits as
provided in 20 C.F.R. §§ 404.929 and
416.1429.
B.
The term “Appeals Council” refers to
the component of SSA's Office of Disability Adjudication and Review
that, under direct delegation from the Commissioner of Social Security, provides
the final level of administrative review for claims filed under
Titles II and XVI of the Social Security Act (hereinafter referred
to as “the Act”).
C.
The term “Class member” refers to an
individual who meets the criteria set forth in section II.
D.
The term “days” means calendar days.
E.
The “date the Class member receives” a
notice refers to the date five (5) days after the date on the notice,
unless the Class member can show that he or she received the notice later.
F.
The “date of final approval” refers
to the date on which an order granting approval of this Settlement
Agreement is entered, via the Electronic Case Filing System of the
U.S. District Court for the Eastern District of New York, on the
docket of this Case.
G.
The “date on which the Settlement becomes
effective” refers to the date as of which no timely appeals
may be taken from the Court's order granting approval of this Settlement Agreement,
and as of which any and all appeals of such an order have been resolved.
H.
The term “good cause” means good cause
as used in 20 C.F.R. §§ 404.911 and 416.1411.
I.
The term “Named ALJs” refers to the
administrative law judges identified in the Amended Complaint as
Michael D. Cofresi, Seymour Fier, Marilyn P. Hoppenfeld, David Z. Nisnewitz,
and Hazel C. Strauss.
J.
The term “Noticing Party” refers to
a Party seeking enforcement of section III pursuant to the provisions
in section V.
K.
The term “Plaintiffs” refers to Lorraine
Padro, Sarah Rodriguez, Dhanasar Raman, Toby Marlow as court-appointed
guardian for Judith Blumensohn, Carmen Duran, John Edwards, Julia
Juan, and Jane Doe.
L.
The term “Post-Settlement Claim” refers
to a claim for disability benefits under Titles II and/or XVI of
the Act that is the predicate for a decision that forms the basis
for prospective relief as described in paragraph III.B.1 of this
Agreement.
M.
The term “Responding Party” refers
to the party from whom enforcement is sought pursuant to the provisions
in section V.
N.
The term “Retrospective Claim” refers
to a claim for disability benefits under Titles II and/or XVI of
the Act that is the predicate for an ALJ decision that forms the
basis for retrospective relief, as described in paragraph III.A.1
of this Agreement.
O.
The terms “section” and “paragraph” refer
to the numbered and lettered parts of this Settlement Agreement.
P.
The terms “unfavorable decision” and “partially
favorable decision” refer to decisions by an ALJ, in which
the ALJ finds either that a claimant is not entitled to disability
benefits (unfavorable decision) or is not entitled to all of the
disability benefits sought in the underlying claim (partially favorable
decision). The terms “unfavorable decision after court remand” and “partially
favorable decision after court remand” refer to an “unfavorable decision” or “partially
favorable decision” that is issued after a claim is remanded
by a federal court for further consideration, as provided in 20
C.F.R. §§ 404.984, 416.1484. The Parties
agree that an order of dismissal under 20 C.F.R. §§ 404.957,
416.1457 will not be considered an “unfavorable decision” or
a “partially favorable decision” when determining whether
an individual is eligible for relief under the Settlement Agreement.
Q.
The terms “unfavorable Post-Settlement Decision” and “partially
favorable Post- Settlement Decision” refer to an unfavorable
or partially favorable ALJ decision that forms the basis for a Class
member's eligibility for prospective relief as described in paragraph
III.B.1 of this Agreement. An “unfavorable Post- Settlement
Decision” is a decision described in paragraph III.B.1(a)
and a “partially favorable Post-Settlement Decision” is
a decision described in paragraph III.B.1(b).
II. CLASS
A.
Class Defined: The
Parties agree to the certification by the Court upon Plaintiffs' motion,
for purposes of this Settlement Agreement only, of a plaintiff class
(hereinafter referred to as “the Class”) defined as
follows: all claimants for Social Security Disability Insurance
Benefits and/or Supplemental Security Income payments based on disability
who, during the period beginning January 1, 2008 and ending thirty
(30) months after the date of final approval of the Settlement Agreement,
have been or will be issued an unfavorable or partially favorable
decision on a claim for disability benefits under Title II or Title
XVI of the Act from any of the five Named ALJs and who also meet
the criteria for relief set forth in section III below.
B.
Rule
23(b)(2) class: The Parties agree, for purposes
of this Settlement Agreement only, to certification of the Class
pursuant to Federal Rule of Civil Procedure 23(b)(2). Upon certification
of the Class by the Court and as of the date on which the Settlement
becomes effective, all Class members eligible for relief who are
not given the right by this Settlement Agreement (including its
attachments) to opt out of the terms of this Settlement Agreement, and
all those who are given the right to opt out who do not opt out,
are bound by the terms of the Settlement Agreement.
III. INDIVIDUAL
RELIEF
A.
Retrospective Relief
1.
Eligibility for Retrospective
Relief: A Class member eligible for retrospective relief
is someone who, during the period from January 1, 2008 through the
date of final approval of the Settlement Agreement, was issued an
unfavorable or partially favorable decision on the merits of a claim
for disability benefits under Title II or Title XVI of the Act by
any of the Named ALJs, provided that the exceptions in paragraphs
III.A.1(a) through III.A.1(d) do not apply. The ALJ decision will
not entitle the individual to retrospective relief if:
a) a United States District Court affirmed the ALJ decision
described in paragraph III.A.1, above, in an order as to which no
motion under Rule 59 of the Federal Rules of Civil Procedure is
pending with the Court as of the date on which the Settlement becomes
effective; or
b) a United States District Court remanded the claim described
in paragraph III.A.1, above, in an order that expressly declined
to reassign such remanded claim to a different ALJ, and as to which
no motion under Rule 59 of the Federal Rules of Civil Procedure
is pending with the Court as of the date on which the Settlement
becomes effective; or
c) the potential Class member has already been found eligible
for all benefits for which he or she could be eligible pursuant
to the claim described in paragraph III.A.1, above; or
d) the claim described in paragraph III.A.1, above, has either:
(i) already been readjudicated by an ALJ other than a Named ALJ,
or (ii) is pending readjudication by an ALJ other than a Named ALJ
at the time of the potential Class member's request for relief.
2.
Retrospective
Relief -- Readjudication: Each Class member
who is eligible for retrospective relief will be entitled to readjudication
of his or her Retrospective Claim, provided the Class member requests
this relief within the time limit set forth in paragraph III.A.3,
below. Readjudication shall be conducted by an ALJ other than a
Named ALJ, or may be provided by an attorney advisor or the Appeals
Council in accordance with existing SSA rules and regulations. If
a claim to be readjudicated has been remanded by the Appeals Council
and is pending before a Named ALJ at the time of the Class member's
request for readjudication, the claim shall be reassigned. If the
Class member has another claim pending either at the Appeals Council
or before an ALJ other than a Named ALJ, or has more than one Retrospective
Claim, SSA may consolidate all such claims for any given claimant
and review them simultaneously, provided that this would not cause
unreasonable delay. A Class member eligible for retrospective relief: shall
have the right to appeal any new hearing decision received pursuant
to this Settlement Agreement, as set forth in 42 U.S.C. § 405(g)
and its implementing regulations; and shall have the right to withdraw
the claim to the extent provided by applicable SSA rules and regulations.
3.
Retrospective
Relief -- Time to Request Readjudication:
A Class member eligible for retrospective relief must affirmatively
request readjudication within sixty (60) days after the date the
Class member receives the notice informing him or her of his or
her right to relief (described herein as “Notice A”),
using the procedures described in that notice, unless the Class
member can demonstrate that this deadline was missed for good cause.
4.
Notice
of Retrospective Relief (“Notice A”): Notice
A shall advise Class members eligible for retrospective relief that,
as a result of the Settlement Agreement, they may request readjudication
of Retrospective Claims. Further, Notice A shall inform Class members
eligible for retrospective relief that in order to obtain this readjudication, they
must affirmatively opt for readjudication within sixty (60) days
after the date the Class member receives Notice A. Notice A shall
also set forth the procedures Class members must follow to obtain
readjudication. Notice A shall provide contact information for Class
counsel. SSA shall send Notice A within sixty (60) days after the
date on which the Settlement becomes effective by first class mail
to: the last known address in SSA's records for each Class member
eligible for retrospective relief; and the Class member's appointed
representative, if any such representative is identified in SSA's records.
SSA shall bear the cost of Notice A. SSA shall provide Class counsel
with a list of the names and addresses to which Notice A was mailed;
in the event that any Notice A mailings are returned to SSA as undeliverable,
the list will identify the mailings that were returned to SSA as
undeliverable. This list shall be considered Confidential Information
pursuant to section VI, below. Attached to this Settlement Agreement
is Notice A (Exh. A), the language of which has been agreed to by
the Parties and the terms of which are incorporated into this Agreement.
Personal information such as a Class member's address, appropriate
field office, and similar information, will be included by SSA in Notice
A. The bracketed dates and website address will be added prior to
mailing.
B.
Prospective Relief
1.
Eligibility for Prospective
Relief: A Class member eligible for prospective
relief is someone who:
a) During the thirty (30) month period beginning on the day
after the date of final approval of the Settlement Agreement, is
issued an unfavorable decision on a claim for disability benefits
under Title II or Title XVI of the Act by any of the Named ALJs;
or
b) During the thirty (30) month period beginning on the day
after the date of final approval of the Settlement Agreement, is
issued a partially favorable decision on a claim for disability
benefits under Title II or Title XVI of the Act by any of the Named
ALJs, and either requests Appeals Council review of that decision
or (if the decision is a partially favorable decision after court
remand) files written exceptions or proceeds with a civil action
seeking review of that decision.
2.
Prospective
Relief -- Appeals Council Review: SSA's Office
of Disability Adjudication and Review, Office of Appellate Operations,
will assign specified Staff (hereinafter referred to as “Staff”)
to review Class members' unfavorable and partially favorable Post-
Settlement Decisions as follows:
a) The Staff shall report through normal supervisory chains
and ultimately to the Executive Director of the Office of Appellate
Operations, Office of Disability Adjudication and Review.
b) The Staff shall consider requests for review or written
exceptions (as appropriate) filed by Class members eligible for
prospective relief who appeal from unfavorable or partially favorable
Post-Settlement Decisions, or who are deemed to have filed an appeal or
written exceptions regarding an unfavorable Post-Settlement Decision
as provided in paragraph III.B.2(c).
c) If, as of sixty five (65) days after the date an unfavorable
Post-Settlement Decision is issued, a Class member eligible for
prospective relief has not requested Appeals Council review of that
Decision, the Class member shall be deemed to have requested Appeals Council
review under 20 C.F.R. §§ 404.967, 416.1467;
or, alternately, if the Post-Settlement Decision is an unfavorable
decision after court remand, the Class member will be deemed to
have filed written exceptions as provided in 20 C.F.R. §§ 404.984,
416.1484 on the day the decision is issued, but shall be given an
opportunity to withdraw these exceptions or to submit additional
written exceptions.
3.
Prospective
Relief -- Standards for Review of Claims and Related Rights: The Staff
will consider a Class member's Post-Settlement Claim to determine
whether the ALJ decision is legally sufficient, or contains an error
of law or abuse of discretion, including but not limited to an error
related to (1) evaluating treating source opinions, (2) assessing
credibility, (3) developing the record, and (4) conducting
hearings. The Staff will use the standards ordinarily applicable
to requests for review under 20 C.F.R. §§ 404.967,
416.1467; will consider whether there is a basis to grant the request
for review under the regulatory criteria set forth at 20 C.F.R. §§
404.970, 416.1470; and will take appropriate action in accordance with those
regulations; except that if the Post-Settlement Decision is a decision
after court remand, the Staff will consider exceptions as provided
under 20 C.F.R. §§ 404.984,
416.1484; and will take appropriate action in accordance with those
regulations. A Class member shall have the right to withdraw such
a claim to the extent provided by applicable SSA rules and regulations.
4.
Prospective
Relief -- Rehearing before New ALJ: If a Post-Settlement
Claim is remanded for a new hearing, the hearing after remand shall
be conducted by an ALJ other than a Named ALJ. If the Post-Settlement
Claim is appealed more than once, any subsequent hearings after
remand shall be assigned in accordance with ordinary agency procedures,
except that no subsequent hearings regarding such Claim may be conducted before
a Named ALJ. Pursuant to existing SSA rules and regulations, readjudication
may also be provided by an attorney advisor or the Appeals Council.
5.
Notices
of Prospective Relief (“Notice B” and “Notice
C”): Notice B shall be sent to each
claimant for disability benefits who is issued an unfavorable Post-Settlement Decision,
except that a modified version of Notice B (attached hereto as Notice
B – Decision After Court Remand) shall be sent to each
claimant for disability benefits who is issued an unfavorable decision
after court remand. Both versions of Notice B shall advise such
claimant: that, as a result of the Settlement Agreement, any request
for administrative review of an unfavorable Post-Settlement Decision
will be directed to Staff at the Appeals Council; that, if a Post-Settlement
Claim is remanded for a new hearing, the hearing after remand will
be conducted by an ALJ other than a Named ALJ; and that the claimant
may opt out of the terms of this Agreement but, if he or she wishes to
opt out, he or she must do so in a manner specified in Notice B
either at the time of his or her request for further administrative
review or within sixty (60) days after the date the Class member
receives Notice B. Notice B will further advise the claimant that,
if he or she does not request review by the Appeals Council within
sixty five (65) days after the date an unfavorable Post-Settlement
Decision is issued, he or she will be deemed to have made such a
request; while the modified version of Notice B will advise that
a claimant who receives an unfavorable decision after court remand
will be deemed to have filed written exceptions regarding that decision
on the day the decision is issued, but will be given an opportunity
to withdraw those exceptions or to submit additional written exceptions.
Notice C shall be sent to each claimant for disability benefits
who is issued a partially favorable Post-Settlement Decision, except
that a modified version of Notice C (attached hereto as Notice C – Decision
After Court Remand) shall be sent to each claimant for disability
benefits who is issued a partially favorable decision after court
remand. Both versions of Notice C shall advise such claimant that:
as a result of the Settlement Agreement, any request for administrative
review of a partially favorable Post-Settlement Decision shall be
directed to Staff at the Appeals Council; and any subsequent hearings will
be heard by an ALJ other than a Named ALJ. Notice C shall further
advise that: in order to obtain relief under this Settlement Agreement,
the claimant must seek further administrative or court review of
his or her claim; and he or she may opt out of the terms of this
Agreement but, if he or she wishes to do so, he or she must do so
in a manner specified in Notice C either at the time of his or her
request for further administrative review or within sixty (60) days
after the date the Class member receives Notice C.
SSA shall send Notice B and/or Notice C, as appropriate, at
the same time an unfavorable or partially favorable Post-Settlement
Decision is mailed to the claimant. The notice will be sent to the
same address or addresses as the decision, and may be sent in the
same manner and in the same envelope as the decision. SSA shall
bear the cost of Notice B and Notice C. Attached to this Settlement
Agreement are Notice B and Notice C (Exhs. B & C), the
language of which has been agreed to by the Parties and the terms
of which are incorporated into this Agreement. Personal information
such as a Class member's address, appropriate field office, and
similar information, will be included by SSA in Notice B and Notice
C. The bracketed dates and website address will be added prior to mailing.
Additional language will be included if required by law or internal
procedures applicable to the issuance of hearing decisions.
C.
Establishing
the Right to Retrospective or Prospective Relief:
If SSA learns of an individual who may be entitled to relief as
a Class member under this Settlement Agreement but who did not receive
Notice A, B, or C, or if an individual contacts SSA and claims to
be entitled to relief as a Class member under this Settlement Agreement
but did not receive Notice A, B, or C, SSA shall review available
records to determine whether the individual meets the requirements
for retrospective or prospective relief, and shall determine within
a reasonable time whether the individual is eligible. If SSA determines
that such an individual is entitled to relief, SSA shall issue Notice
D, a copy of which is attached (Exh. D), and the language of which
has been agreed to by the Parties and the terms of which are incorporated
into this Agreement. If the individual is entitled to prospective
relief, SSA may alternately resend Notice B or Notice C as appropriate.
Personal information such as a Class member's address, appropriate
field office, and similar information, will be included by SSA in
Notice D, and the bracketed website address will be added prior
to mailing. If SSA determines that the individual is not entitled
to relief, SSA shall notify the individual in writing of the reason
for the determination.
IV. OTHER
RELIEF
A.
SSR: SSA
shall issue a Social Security Ruling (“SSR”) regarding
agency procedures for addressing allegations of an unfair ALJ hearing,
ALJ bias, and ALJ misconduct. Plaintiffs agree that they will not
have an opportunity to review the SSR prior to its publication in
the Federal Register and that SSA makes no commitment to issue the
SSR by a date certain.
B.
Training: In
calendar year 2012 or 2013, SSA shall conduct (and may already have conducted
by the time of approval of this Settlement Agreement) training programs
designed to instruct experienced ALJs on the following issues: (1)
evaluating treating source opinions; (2) assessing credibility;
(3) developing the record; and (4) conducting hearings. SSA retains discretion
to determine the timing and content of the training provided in
such training programs, as well as which among its ALJs will be
required to participate. SSA shall also provide mentors for experienced
ALJs. Such mentors will be available to ALJs as a resource with
respect to the substantive issues covered in the training described
above, and also to provide feedback to the ALJs on the manner in
which their decisions reflect the issues covered in the training.
SSA retains discretion to determine the roles and responsibilities
of such mentors, as well as which among its ALJs will be required
to consult with a mentor. Nothing in this agreement shall preclude
SSA from exercising its discretion in pursuing any training and/or
mentoring it deems appropriate.
V. ENFORCEMENT
The Court shall not retain jurisdiction over this action after
the date on which the Settlement becomes effective, except with
respect to the enforcement of section III, and such jurisdiction
will be only as set forth in this section V. Specifically, a Party
may seek enforcement only of the paragraphs listed herein, and only
as follows:
A.
A Noticing
Party may not seek enforcement (or review of any kind) regarding
the composition of the Staff which has been assigned pursuant to
paragraph III.B.2.
B.
A Noticing Party seeking enforcement of any term
in section III shall serve on the Responding Party a written notice
that describes the alleged breach or violation with particularity.
Such notice must include the following: (a) an identification of
the term(s) that has allegedly been violated; (b) a description
of the specific errors or omissions upon which the alleged violation
is based; and (c) a description of the corrective action sought.
Such notice must be served within a reasonable time, but not to
exceed sixty (60) days, after the Noticing Party becomes aware,
or reasonably should have become aware, of a potential violation.
If the alleged breach relates to a decision or Class membership
determination regarding an individual Class member, notice must
be served within sixty (60) days from the date of any contested
decision or Class membership determination, unless the Noticing
Party can demonstrate that the deadline was missed for good cause.
C.
Within forty-five (45) days of the Responding Party's
receipt of a written notice of breach or violation, counsel for
the Noticing and Responding Parties will meet and confer, and otherwise
begin to address the allegation. The Noticing and Responding Parties
shall make their best efforts to resolve any and all allegations
of breach or violation without the Court's involvement. If requested
to do so, the Noticing Party shall provide to the Responding Party any
discoverable information and materials reasonably available to the
Noticing Party that constitutes evidence of the alleged breach or
violation.
D.
If the Responding Party fails to respond to a notice
of breach or violation within forty-five (45) days, or the Noticing
and Responding Parties otherwise cannot resolve the issue or issues
raised in that notice, the Noticing Party may move for enforcement
as early as seventy-five (75) days after the date on which the notice
was served, but no later than one hundred thirty-five (135) days
after the date on which the notice was served, unless the Parties
otherwise agree in writing. The Parties agree that any such motion
for enforcement shall not include a request that any Party or non-party
be held in contempt.
E.
Except to his or her counsel, the Noticing Party
shall not disclose the allegation of a breach or violation to the
Court or to any individual or party other than the Responding Party
unless: (a) at least seventy-five (75) days have passed since the
written notice was submitted to the Responding Party; and (b) the
Noticing Party and the Responding Party have not agreed on corrective
action pursuant to the process specified above.
VI. PRESERVATION
OF CONFIDENTIALITY
The provisions set forth in the November 15, 2011 Stipulation
and Order for the Protection of Confidential Documents and Testimony
shall remain in effect with regard to all further proceedings relating
to this Settlement Agreement, and with regard to any Confidential
Information (as that term is defined in the November 15, 2011 Stipulation
and Order) disclosed pursuant to this Settlement Agreement.
VII. PROCEDURES
FOR APPROVAL OF SETTLEMENT
A.
Preliminary approval: Following
its execution, the Parties shall promptly present the Settlement
Agreement to the Court with a request that the Court preliminarily
approve the Settlement Agreement. The Parties shall further request
that upon such preliminary approval the Court will schedule a hearing
pursuant to Rule 23(e) of the Federal Rules of Civil Procedure (hereinafter
referred to as the “Fairness Hearing”), after which
the Court will determine whether to grant its final approval of
the Settlement Agreement. At the same time, Plaintiffs will move
for certification of the Class defined above, with such Certification
being for the purposes of this Settlement Agreement only and being
conditional upon final approval of this Settlement Agreement.
B.
Notice
of Proposed Class Action Settlement and Fairness Hearing: Within
thirty (30) days after the date on which the Court preliminarily
approves the Settlement Agreement, SSA will mail a Notice of Proposed
Class Action Settlement and Fairness Hearing (“Notice E”)
(Exh. E), the language of which has been agreed to by the Parties,
or such other notice as is ordered by the Court. Notice E contains
a brief description of the claims advanced by Plaintiffs and the
Commissioner's denial of liability for such claims, a summary of
the terms of the proposed settlement, and information regarding
the upcoming Fairness Hearing. SSA will send such notice to each
individual for whom, during the period from January 1, 2008 until
the date on which the notices are prepared, a Named ALJ issued an
unfavorable or partially favorable decision on a claim for disability
benefits under Title II or Title XVI of the Act. The notice will
be sent by first class mail to the last known address shown in SSA's records
for each such individual, as well as to the individual's appointed
representative, if any such representative is identified in SSA's
records. SSA shall bear the cost of such notice.
VIII. PUBLICATION
Within ten (10) days after the date on which the Court preliminarily
approves the Settlement Agreement, SSA shall: (i) deliver for publication
a copy of Notice E, or such other notice as ordered by the Court,
to two (2) newspapers of general circulation in the New York Metropolitan area
with instructions that the Notice be published at least once per
week for three (3) successive weeks as a one-eighth (1/8th)
page advertisement; (ii) post a copy of Notice E, or such
other notice as ordered by the Court, on its official public website, www.socialsecurity.gov; and (iii) post a copy of Notice
E, or such other notice as ordered by the Court, in the Queens ODAR.
IX. DISMISSAL
AND SETTLEMENT AGREEMENT
Plaintiffs agree to the dismissal of the Case with prejudice
under Federal Rules of Civil Procedure 41(a)(1) and 23(e), subject
to the terms of the Settlement Agreement and to the Court's continuing
jurisdiction as set forth in section V. In accordance with the terms
of this Settlement Agreement, Plaintiffs will move for dismissal
of the Case with prejudice to be effective on the date of final
approval of this Settlement Agreement.
X. RELEASES
Plaintiffs, the members of the Class defined above, and their
heirs, administrators, representatives, attorneys, successors, and
assigns, and each of them hereby RELEASE, WAIVE, ACQUIT, and FOREVER
DISCHARGE the United States and the Commissioner from, and are hereby FOREVER
BARRED and PRECLUDED from prosecuting, any and all claims, causes
of action, or requests for any injunctive and/or monetary and/or
any other form of relief, including, but not limited to, damages,
tax payments, debt relief, costs, attorneys' fees, expenses, and/or
interest, whether presently known or unknown, that have been or
could have been asserted in the Case by reason of, with respect
to, in connection with, or which arise out of, any matters alleged
in the Case. The Parties agree that the terms of this section are
not designed otherwise to interfere with the rights of Plaintiffs,
the members of the Class defined above, and their heirs, administrators, representatives,
attorneys, successors, and assigns under 42 U.S.C. § 405(g)
and its implementing regulations.
XI. NO
ADMISSION OF LIABILITY
A.
Neither this
Settlement Agreement nor any order approving it constitutes an admission
by the Commissioner and/or the United States of the truth of any
allegation or the validity of any claim asserted in the Case, or
of the liability of the Commissioner and/or the United States, nor
a concession or an admission of any fault or omission of any act
or failure to act, or of any statement, written document, or report
heretofore issued, filed or made by the Commissioner and/or the
United States.
B.
Neither this Settlement Agreement nor any confidential
papers related to the Agreement and created for settlement purposes
only, nor any of the terms of either, may be offered or received
as evidence of discrimination or unfair treatment in any civil,
criminal, or administrative action or proceeding, nor shall they
be the subject of any discovery or construed by anyone for any purpose
whatsoever as an admission or presumption of any wrongdoing on the
part of the Commissioner and/or the United States, or as an admission
by any Party to this Settlement Agreement that the consideration
to be given under the terms of this Agreement represents the relief
that could have been recovered after trial.
XII. DUTIES
CONSISTENT WITH LAW AND REGULATIONS
Nothing contained in this Settlement Agreement shall impose
on the Commissioner and/or the United States any duty, obligation,
or requirement, the performance of which would be inconsistent with
law, as set forth in federal statutes, federal regulations, or elsewhere
in effect at the time of such performance.
XIII. INTEGRATION
This Settlement Agreement and its Exhibits constitute the
entire agreement of the Parties, and no prior statement, representation,
or agreement that is not contained herein, will have any force or effect.
XIV. MODIFICATION
This Settlement Agreement may be modified with the written
agreement of the Parties and with the approval of the District Court,
upon such notice to the Class, if any, as the District Court may require.
XV. DUTY
TO DEFEND
The Parties to this Settlement Agreement shall defend against
any challenges to it in any forum.
XVI. SEVERABILITY
Should any non-material provision of this Settlement Agreement
be found by a court to be invalid or unenforceable, then (A) the
validity of other provisions of this Settlement Agreement shall
not be affected or impaired, and (B) such provisions shall be enforced
to the maximum extent possible.
XVII. CONDITIONS
THAT RENDER SETTLEMENT AGREEMENT VOID OR VOIDABLE
This Settlement Agreement shall be void if it is disapproved
at any stage by the Court and/or if the Court denies the motion
for dismissal mentioned in section IX above.
XVIII. EFFECT
OF SETTLEMENT AGREEMENT IF VOIDED
A.
Should this
Settlement Agreement become void after its execution, the Commissioner
will not object to reinstatement of this action in the same posture
and form as it was pending as of the date of execution of this Agreement.
B.
All negotiations in connection herewith, and all
statements made by the Parties at or submitted to the District Court
during the Fairness Hearing shall be without prejudice to the Parties
to this Settlement Agreement and shall not be deemed or construed
to be an admission by a Party of any fact, matter, or proposition.
C.
The Commissioner retains all defenses, arguments,
and motions as to all claims that have been or might later be asserted
in the Case, and nothing in this Settlement Agreement shall be raised
or construed by any Plaintiffs, Class members, or Plaintiffs' counsel,
to defeat or limit any defenses, arguments, or motions asserted
by the Commissioner. Neither this Settlement Agreement, nor the
fact of its having been made, nor any exhibit or other document
prepared in connection with this Settlement Agreement, shall be
admissible, entered into evidence, or used in any form or manner
in discovery in the Case or in any other action or proceeding for any
purpose inconsistent with Rule 408 of the Federal Rules of Evidence.
D.
The provisions set forth in section XI will apply
even if the Settlement Agreement is otherwise rendered void.
XIX. ATTORNEY
FEES
A.
The Parties
agree that the amount of $125,000 will be paid to Plaintiffs' counsel
the Urban Justice Center, as attorney fees. Those funds are the
only funds to be paid by the Commissioner and/or the United States
under this Settlement Agreement and/or otherwise in connection with
this action (aside from any payments made to cover the costs associated
with Notices A, B, C, D, and E as set forth above). Plaintiffs'
counsel Gibson, Dunn & Crutcher has agreed to waive additional
fees incurred in connection with this action.
B.
Within seven (7) calendar days of the date on which
the Settlement becomes effective, Plaintiffs' counsel will notify
the Commissioner and the Commissioner's counsel in writing of the
identity of the account and bank designated for the deposit of funds,
and will provide any necessary tax reporting information as well
as all information necessary and appropriate to direct any and all
deposits provided for in this Settlement Agreement.
C.
Upon receipt of the information described in paragraph
B above, the Commissioner shall promptly complete any intra-governmental
forms and documentation that are required from SSA in order to issue
payment.
XX. COUNTERPARTS
This Settlement Agreement may be executed in counterparts.
All executed counterparts and each of them shall be deemed to be
one and the same instrument.
XXI. WARRANTY
Plaintiffs' counsel and the Commissioner's counsel warrant
that they are authorized to stipulate to settlement of the Case
in accordance with the provisions set forth in the Settlement Agreement.
Attachment 1A. Notice
A – Notice of Retrospective Relief and Response Form
Social Security Administration
Important Information
Notice of Padro et al. v. Colvin Class Action Settlement
And
60 Day Deadline to Ask for a New Hearing and Decision
You May Be Eligible For A New Hearing
And Decision On Your Disability Claim – Please Mail Us
The Enclosed Form Within 60 Days After You Get This Notice
Our records show that you received an unfavorable or partially
favorable decision between January 1, 2008 and October 18, 2013,
on a claim for Social Security Disability Insurance Benefits and/or
Supplemental Security Income. Your decision was issued by one of
the following five Administrative Law Judges (ALJs): Michael D.
Cofresi, Seymour Fier, Marilyn P. Hoppenfeld, David Z. Nisnewitz,
and Hazel C. Strauss, at the Queens, New York Office of Disability
Adjudication and Review.
On October 18, 2013, the United States District Court for
the Eastern District of New York approved a settlement in the class-action
lawsuit Padro et al. v. Colvin. This lawsuit
challenged unfavorable and partially favorable decisions on claims
for disability benefits made by the ALJs named above.
Because of the settlement, you may be eligible for a new hearing
and decision on your claim. The new decision would be made by an
ALJ who is not one of the ALJs named above or, in certain circumstances,
by an attorney advisor or the Appeals Council.
You may be eligible for a new hearing and decision unless:
•
You appealed the decision
you received from one of the ALJs named above to a United States
District Court, and:
•
The United States
District Court affirmed the ALJ's decision, and you did not have
a motion to alter or amend the Court's judgment pending as of December
18, 2013; or
•
The United States District Court remanded your claim,
the Court's order said the claim did not need to be assigned to
a different ALJ, and you did not have a motion to alter or amend
the Court's judgment pending as of December 18, 2013; or
•
You were already found eligible for all benefits
for which you could be eligible based on the claim decided by one
of the ALJs named above; or
•
You already received a new decision on your claim
by an ALJ who is not an ALJ named above; or
•
The claim decided by one of the ALJs named above
is pending with a different ALJ (other than the five ALJs named
above) at the time you return the enclosed form.
This notice explains what you must do if you want a new hearing
and decision on the disability claim that one of the ALJs named
above decided between January 1, 2008 and October
18, 2013.
How To Ask for A New Hearing and Decision
To ask for a new hearing and decision, you must fill out the
enclosed request form. You must do this
even if you have appealed your decision to the Appeals Council.
You must mail the enclosed form back to us within
60 days after you get this notice. We will assume that
you got the notice 5 days after the date of the notice, unless you
show that you got the notice later. We have included an envelope
for you to use.
If you do not respond within 60 days,
you may lose your chance for a new hearing and decision. We
will not consider a late request unless you show you had a good
reason for not responding in time.
What We Will Do If You Ask For A New
Hearing And Decision
If you send back the form, we will check to see if you are
eligible for relief under the settlement.
If you are eligible, and an appeal of your claim is pending
in a United States District Court, we will contact you, or your
attorney if you have one.
If you are eligible, and you do not have an appeal pending
in a United States District Court, we will write to tell you that
we are sending your claim to an ALJ for a new hearing and decision.
The new decision will be made by an ALJ who is not one of the five
named above or, in certain circumstances, by an attorney advisor
or the Appeals Council.
If you are not eligible for a new hearing and decision, we
will send you a notice that tells you why.
If You Have Any Questions
If you have any questions about this notice, please visit
or call your local Social Security office, or call Social Security's
toll-free phone number at 1-800-772-1213. If you are deaf or hard
of hearing, please use our TTY number at 1-800-325-0778.
More information about the Padro et al. v. Colvin settlement
is also available on our website at http://www.socialsecurity.gov/padrosettlement/.
If you call or visit an office, please have this letter with you.
It will help us answer your questions.
If a representative was helping you with your claim for disability
benefits, you should contact that person to let him or her know
about this notice. If we have information about your representative,
we will send that person a copy of this notice. That person's name
will also be listed below.
You can also contact the Urban Justice Center, the lawyers
who brought the Padro et al. v. Colvin lawsuit,
by writing to them at Urban Justice Center, Padro Class Counsel,
Church Street Station, P.O. Box 3363, New York, NY 10008-3363, or
calling them at (646) 459-3068.
Enclosure(s):
Padro et al. v. Colvin Request Form
Return Envelope
cc:
[Representative of Record]
[Representative Payee]
Padro et al. v. Colvin
- Request Form
(Request for Retrospective Relief)
IMPORTANT
Return This Form Within 60 Days
If You Want A New Hearing And Decision
[Name] [Date]
[Address] [Social Security Number]
[City State Zip]
If you want a new hearing and decision, please sign and date
this form and return it in the enclosed pre-paid envelope within
60 days after you get this notice.
I want a new hearing and decision.
SIGNATURE
DATE
If your address is different from the one shown above, please
write your correct address.
ADDRESS (Number and Street, Apartment Number, Post Office
Box, or Rural Route)
CITY AND STATE ZIP CODE
Attachment 1A-SP. Notice A – Notice of Retrospective Relief and Response
Form (Spanish)
Administración del Seguro Social
Información Importante
Aviso del acuerdo colectivo Padro et al. v. Colvin y
el límite de tiempo de 60 días para solicitar una
nueva audiencia y un nuevo fallo
Es posible que usted tenga derecho
a una nueva audiencia y un nuevo fallo en su reclamación
de los beneficios por incapacidad – Por favor devuélvanos
el formulario incluido dentro de 60 días que comienzan
a partir de la fecha en que reciba este aviso
De acuerdo con nuestros registros, usted recibió un
fallo desfavorable o desfavorable en parte entre las fechas de 1
de enero de 2008 y 18 de octubre de 2013 en su reclamación
de los beneficios de Seguro Social por incapacidad o la Seguridad
de Ingreso Suplementario. Su fallo fue emitido por uno de los siguientes
cinco Jueces de Derecho Administrativo (ALJ): Michael D. Cofresi,
Seymour Fier, Marilyn P. Hoppenfeld, David Z. Nisnewitz y Hazel
C. Strauss, de la Oficina de Adjudicación y Revisiones
de Reclamaciones de Beneficios por Incapacidad en Queens, Nueva
York.
El 18 de octubre de 2013, el Tribunal de Distrito de los Estados
Unidos para el Distrito del Este de Nueva York aprobó un
acuerdo de la demanda colectiva Padro et al. v. Colvin.
Esta demanda retó las reclamaciones que recibieron fallos
desfavorables y desfavorables en parte, que fueron emitidos por
los ALJ anteriormente nombrados, en reclamaciones de los beneficios
por incapacidad.
Como parte del acuerdo, es posible que usted tenga derecho
a una nueva audiencia y un nuevo fallo en su reclamación.
El nuevo fallo será emitido por un ALJ, pero no será uno
de los ALJ anteriormente nombrados o, en ciertos casos, por un abogado
asesor o por el Consejo de Apelaciones.
Usted puede tener derecho a una nueva audiencia y un nuevo
fallo a menos que:
•
Ya haya apelado a
un Tribunal de Distrito de los Estados Unidos el fallo que emitido
por uno de los ALJ anteriormente nombrados, y:
•
El Tribunal de Distrito
de los Estados Unidos afirmó el fallo del ALJ y usted no presentó una
moción para modificar o enmendar el fallo del Tribunal
que está pendiente a partir de diciembre 18, 2013; o
•
El Tribunal de Distrito de los Estados Unidos regresó su
reclamación, la orden del Tribunal estipulaba que la reclamación
no necesariamente tenía que ser asignada a un ALJ diferente
y usted no presentó una moción para modificar
o enmendar el fallo del Tribunal que está pendiente a partir
de la fecha de diciembre 18, 2013; o
•
Ya se le aprobaron todos los beneficios a los que
usted tenía derecho a recibir basados en la reclamación
en las que falló uno de los ALJ anteriormente nombrados;
o
•
Ya recibió un nuevo fallo de su reclamación
por un ALJ quien no es uno de los ALJ anteriormente nombrados; o
•
La reclamación en la que fallo uno de los
ALJ anteriormente nombrados está pendiente con un ALJ diferente
(otro ALJ que no es uno de los cinco ALJ anteriormente nombrados)
en el momento en que usted devolvió el formulario incluido
con este aviso.
Esto aviso le explica lo que tiene que hacer si quiere una
nueva audiencia y un fallo nuevo en su reclamación de beneficios
por incapacidad en la que uno de los ALJ anteriormente nombrados fallo
entre las fechas de 1 de enero de 2008 y 18 de octubre de 2013.
Cómo solicitar una nueva
audiencia y un nuevo fallo
Para solicitar una nueva audiencia y un nuevo fallo, necesita
llenar el formulario que incluimos con este aviso. Tiene que llenar el formulario aunque ya haya
apelado el fallo con el Consejo de Apelaciones.
Tiene que devolvernos el formulario dentro
de 60 días a partir de la fecha en el encabezamiento
de este aviso. Supondremos que recibió este aviso 5 días
a partir de la fecha que aparece en el encabezamiento de este aviso,
a menos que pueda probarnos que recibió el aviso más
de cinco días después. Hemos incluido un sobre
de correos para que su conveniencia.
Si no responde a este aviso dentro
de los 60 días, se corre el riesgo de perder su oportunidad
de solicitar una nueva audiencia y un nuevo fallo. No
tomaremos en consideración ninguna solicitud tardía
a menos que pueda probar una razón justificada por no haber
respondido a tiempo.
Lo que nosotros haremos si usted solicita
una nueva audiencia y un nuevo fallo
Si ya devolvió el formulario, nosotros investigaremos
si usted tiene derecho a mitigación según las
estipulaciones del acuerdo.
Si tiene derecho y su apelación referente a su reclamación
de beneficios está pendiente en el Tribunal de Distrito
de los Estados Unidos, nos comunicaremos con usted o su abogado,
si es que ha contratado a un abogado.
Si tiene derecho y pero no tiene pendiente una apelación
referente a su reclamación de beneficios en el Tribunal
de Distrito de los Estados Unidos, le escribiremos haciéndole
saber que enviaremos su reclamación de beneficios a un
ALJ para una nueva audiencia y un nuevo fallo. El nuevo fallo lo
emitirá un ALJ pero no será uno de los cinco anteriormente
nombrados o, en algunos casos, el fallo será emitido por
un abogado asesor o el Consejo de Apelaciones.
Si no tiene derecho a una nueva audiencia o a un nuevo fallo,
le enviaremos un aviso haciéndole saber el por qué.
Si tiene más preguntas
Si tiene más preguntas acerca de este aviso, por
favor visite o llame a su oficina local del Seguro Social o llame
al número gratis del Seguro Social 1-800-772-1213. Si es
sordo o tiene problemas de audición, por favor llame a
nuestro número de teléfono TTY 1-800-325-0778.
Puede encontrar más información acerca del
acuerdo de Padro et al. v. Colvin en nuestra
página de Internet, http://www.socialsecurity.gov/padrosettlement/ (solo
disponible en inglés). Si llama o visita una de nuestras
oficinas, por favor tenga este aviso consigo. Esto nos ayudará a
contestar sus preguntas.
Si un abogado u otro representante aprobado le estaba ayudando
con su reclamación de beneficios por incapacidad, usted
debe comunicarse con esa persona y hacerle saber que recibió este aviso.
Si nosotros tenemos la información de su abogado o representante,
le enviaremos una copia de este aviso directamente al abogado o
su representante. Si tiene un abogado o representante, el nombre
de esa persona aparece al pie de este aviso.
También puede comunicarse con el «Urban
Justice Center», los abogados que presentaron la demanda
de Padro et al. v. Colvin, escribiéndoles
a la siguiente dirección: Urban Justice Center, Padro Class
Counsel, Church
Street Station, P.O. Box 3363, New York, NY 10008-3363, o
llamándolos al (646) 459-3068.
Anejo(s):
Padro et al. v. Colvin Formulario de
solicitud
Sobre de retorno
cc:
[Representative of Record]
[Representative Payee]
Padro et al. v. Colvin – Formulario
de solicitud
(Solicitud para mitigación retroactiva)
IMPORTANTE
Devuelva este formulario dentro de 60 días
Si quiere una nueva audiencia y un nuevo
fallo
[Name] [Date]
[Address] [Social Security Number]
[City State Zip]
Si quiere una nueva audiencia y un nuevo fallo, por favor
firme y feche este formulario y devuélvalo dentro de 60
días, a partir de la fecha en que usted recibió este
aviso, en el sobre de retorno franqueado que incluimos.
Yo quiero una nueva audiencia y un nuevo fallo.
FIRMA __________
FECHA
Si su dirección postal no es la misma que aparece
en el encabezamiento de este formulario, por favor escriba su dirección
postal correcta.
DIRECCIÓN (Número de casa y nombre de la
calle, número de apartamento, casilla de correos o ruta
rural)
CIUDAD Y ESTADO CÓDIGO POSTAL
Attachment 1B. Notice
B — Padro Notice of Decision – Unfavorable
(Prospective Relief)
[standard header will be used]
Notice of Decision – Unfavorable
I carefully reviewed the facts of your case and made the enclosed
decision. Please read this notice and my decision.
If You Disagree With My Decision
If you disagree with my decision, you may file an appeal with
the Appeals Council. This notice will explain your options, including
how to file an appeal.
Special Review Procedures Under the Padro
et al. v. Colvin Class-Action Settlement
On October 18, 2013, the U.S. District Court for the Eastern
District of New York approved a settlement in the class-action lawsuit Padro
et al. v. Colvin. This lawsuit challenged decisions
on disability claims made by certain administrative law judges.
Under the settlement agreement, my decision will be reviewed
using special review procedures. These special review procedures
include: (1) assigning your claim to be reviewed by a specified group
of staff at the Appeals Council, (2) if your claim is returned for
a new hearing and decision, it will not be assigned to me but instead
will be assigned to an administrative law judge who was not involved
in the Padro et al. v. Colvin class-action
lawsuit, and (3) if you have not filed a written appeal on the 65th day
following this notice, the Appeals Council will deem you to have filed
a timely request for review. We call these special review procedures “Padro review.” We will
apply these procedures unless you write and tell us you do not want Padro review.
How to File an Appeal
To file an appeal you or your representative must ask in writing
that the Appeals Council review my decision. You may use our Request
for Review form (HA-520) or write a letter. The form is available
at www.socialsecurity.gov. Please put the Social Security number
shown above on any appeal you file. Please also refer to the Padro
et al v. Colvin settlement. We will assume that you want Padro review
unless you tell us you do not. If you need help, you may file in
person at any Social Security or hearing office.
Please send your request to:
Appeals Council
Office of Disability Adjudication and Review
Padro Staff
5107
Leesburg Pike
Falls Church,
VA 22041-3255
Time Limit to File an Appeal
You must file your written appeal within
60 days of the date you get this notice. The Appeals Council
assumes you got this notice 5 days after the date shown above unless
you show you did not get it within the 5-day period.
If You Do Not File an Appeal
Under the terms of the Padro et al. v. Colvin settlement,
if you do not file your written appeal within 60 days after you
receive this notice, the Appeals Council will deem you to have filed
a timely request for review. This will happen on the 65th day
after the date on this notice, unless you tell us that you do not
want Padro review.
If You Do Not Want Padro Review
If you do not want my decision reviewed under the special
review procedures, you must write and tell the Appeals Council that
you do not want Padro review. You can do
this either with or without filing an appeal.
To file an appeal without Padro review,
you must tell the Appeals Council that you do not want Padro review
at the time you file the appeal. This will mean that (1) your claim
may not be assigned to a specified group of staff at the Appeals
Council, and (2) if your claim is returned for a new hearing and
decision, it may be returned to me or to one of the other administrative
law judges who were involved in the Padro et al. v. Colvin class-action
lawsuit.
If you do not want the Appeals Council to deem you to have
filed a request for review, you must send us a request in writing.
You must say that you do not want Padro review,
and also do not want to file an appeal. You must do this within 60 days of the date you get
this notice. The time limit is the same as the time limit to file
an appeal, and you should write to the Appeals Council at the same
address. This will mean that the Appeals Council may not review
my decision at all, and that my decision may become final.
If you tell the Appeals Council that you do not want Padro review,
the settlement relief and limitations will not apply to you. You
will have the right to appeal as if there were no class-action settlement.
What Else You May Send Us
You or your representative may send us a written statement
about your case. You may also send us new evidence. You should send
your written statement and any new evidence with
your appeal. Sending your written statement and any new
evidence with your appeal may help us review your case sooner.
How a Written or Deemed Appeal Works
The Appeals Council will consider your entire case. It will
consider all of my decision, even the parts with which you agree.
Review can make any part of my decision more or less favorable or unfavorable
to you.
Under the terms of the Padro et al. v. Colvin settlement,
we will assign your case to a specified group of staff within the
Appeals Council. This staff will use the same rules for considering
your case that would apply if you tell us you do not want Padro review.
The rules the Appeals Council uses are in the Code of Federal Regulations,
Title 20, Chapter III, Part 404 (Subpart J) and Part 416 (Subpart
N).
The Appeals Council may:
•
Deny your written
or deemed appeal,
•
Return your case to me if you decline Padro review,
or, if you accept Padro review, return your
case to another administrative law judge for a new decision,
•
Issue its own decision, or
The Appeals Council will send you a notice telling you what
it decides to do.
Under the terms of the Padro et al. v. Colvin settlement,
if the Appeals Council returns your case for a new decision, your
case will be assigned to an administrative law judge who was not involved
in the Padro et al. v. Colvin class-action
lawsuit. Any subsequent hearing will be conducted by that other
administrative law judge.
If you tell us you do not want Padro review,
and the Appeals Council returns your case for a new decision, your
case may be assigned to me or to another administrative law judge
who was involved in the class-action lawsuit. If the Appeals Council
denies your appeal, my decision will become the final decision.
The Appeals Council May Review My
Decision On Its Own
The Appeals Council may review my decision even if you do
not appeal, and even if you tell us you do not want Padro review.
They may decide to review my decision within 60 days after the date
of the decision. The Appeals Council will mail you a notice of review
if they decide to review my decision.
When There Is No Appeals Council Review
If you tell us you do not want Padro review,
do not appeal, and the Appeals Council does not review my decision
on its own, my decision will become final. A final decision can
be changed only under special circumstances. You will not have the
right to Federal court review.
[The following language will be included
only if the claimant is unrepresented:
Your Right to Representation
You may choose to have an attorney or other person help you.
Many representatives do not charge a fee unless you win your appeal.
Groups are available to help you find a representative or, if you
qualify, to give you free legal services. Your local Social Security
office has a list of groups that can help you in this process.
If you get someone to help you with your appeal, you or that
person must let the Appeals Council know. If you hire someone, we
must approve the fee before he or she is allowed to collect it.]
New Application
You have the right to file a new application at any time,
but filing a new application is not the same as appealing this decision.
If you disagree with my decision and you file a new application instead
of appealing, you might lose some benefits or not qualify for benefits
at all. My decision could also be used to deny a new application
for benefits if the facts and issues are the same. If you disagree
with my decision, you should file an appeal within 60 days.
If You Have Any Questions
We invite you to visit our website located at www.socialsecurity.gov
to find answers to general questions about social security. You
may also call (800) 772-1213 with questions. If you are deaf or
hard of hearing, please use our TTY number (800) 325-0778.
More information about the Padro et al. v. Colvin settlement
is available on our website located at http://www.socialsecurity.gov/padrosettlement.
You can also contact the Urban Justice Center, the lawyers who brought
the Padro et al. v. Colvin lawsuit, by writing
to them at Urban Justice Center, Padro Class Counsel, Church Street
Station, P.O. Box 3363, New York, NY 10008-3363, or calling them
at (646) 459-3068.
If you have any other questions, please call, write, or visit
any Social Security office. Please have this notice and decision
with you. The telephone number of the local office that serves your
area is [field office phone number].
Its address is:
[FIELD OFFICE ADDRESS]
[ALJ Name]
Administrative Law Judge
Enclosures:
Decision Rationale
Form HA-L39 (Exhibit List)
cc: [Representative of Record]
Attachment 1B-SP. Notice B — Padro Notice of
Decision – Unfavorable (Prospective Relief)(Spanish)
[standard header will be used]
Aviso del Fallo – Desfavorable
Yo revise detenidamente los hechos de su caso y emití el
fallo adjunto. Por favor lea este aviso y mi fallo.
Si no está de acuerdo con
mi fallo
Si no está de acuerdo con mi fallo, usted puede presentar
una apelación al Consejo de Apelaciones. En este aviso
le explica sus opciones disponibles, incluso cómo presentar
una apelación.
Procedimientos especiales de revisión
en conformidad con el Acuerdo de la Demanda Colectiva Padro
et al. v. Colvin
El 18 de octubre de 2013, el Tribunal de Distrito de los Estados
Unidos para el Distrito del Este de Nueva York aprobó un
acuerdo de la demanda colectiva Padro et al. v. Colvin.
Esta demanda retó las reclamaciones que recibieron fallos
que fueron emitidos por ciertos jueces de derecho administrativo
en reclamaciones de los beneficios por incapacidad.
En conformidad con el acuerdo de la demanda colectiva, mi
fallo será revisado usando unos procedimientos especiales.
Estos procedimientos especiales de revisión incluyen: (1)
asignar su reclamación para ser revisado por un grupo específico
de los miembros del Consejo de Apelaciones, (2) si su reclamación
es devuelta para una nueva audiencia y un nuevo fallo, no será asignada
a mi persona, sino que será asignada a un juez de derecho
administrativo quien no tuvo nada que ver con la demanda colectiva
de Padro et al. v. Colvin, y (3) si usted
no ha presentado una apelación por escrito, a no más
tardar del día número 65 después de la
fecha de este aviso el Consejo de Apelaciones juzgará que
su solicitud para una revisión ha sido presentada dentro
del tiempo límite establecido. Ha estos procedimientos
especiales para una revisión le llamamos «revisiones Padro».
Aplicaremos estos procedimientos a menos que usted nos escriba y
nos diga que no quiere una revisión Padro.
Cómo presentar una apelación
Para presentar una apelación, usted o su abogado
o representante tienen que hacerlo por escrito, solicitando que
el Consejo de Apelaciones revise mi fallo. Puede usar nuestro formulario
(HA-520) titulado, «Request for Review» o escriba
una carta. El formulario está disponible por Internet en
www.segurosocial.gov. Por favor escriba en sus apelaciones el número
de Seguro Social que aparece en el encabezamiento de este aviso.
También, escriba que la apelación es referente
al acuerdo de la demanda colectiva Padro et al v. Colvin.
Supondremos que solicita una revisión Padro a
menos que nos indique lo contrario. Si necesita ayuda, puede ir
personalmente a cualquier oficina del Seguro Social o a una de las
oficinas de audiencias del Seguro Social y presentar su apelación.
Por favor envíe su petición a:
Appeals Council
Office of Disability Adjudication and Review
Padro Staff
5107
Leesburg Pike
Falls Church,
VA 22041-3255
Tiempo límite para presentar
su apelación
Tiene que presentar su apelación dentro
de 60 días a partir de la fecha de este aviso.
El Consejo de Apelaciones supone que usted recibió este
aviso 5 días después de la fecha que aparece en
el encabezamiento de este aviso, a menos que usted pueda probar
que no lo recibió dentro de este periodo de 5 días.
Si no presenta una apelación
Conforme a las condiciones del acuerdo de la demanda colectiva Padro
et al. v. Colvin, si usted no presenta por escrito una
apelación dentro de los 60 días después
que recibe este aviso, el Consejo de Apelaciones juzgará que
usted ha presentado a tiempo una solicitud para revisión. Esto
sucederá el día número 65, a partir de
la fecha en el encabezamiento de este aviso, a menos que nos haga
saber que no quiere una revisión Padro.
Si usted no quiere una revisión Padro
Si usted no quiere que mi fallo sea emitido conforme a los
procedimientos especiales de revisión, entonces tiene que
hacerle saber por escrito al Consejo de Apelaciones que no quiere
una revisión Padro.
Usted puede hacer saber sus deseos ya sea que presente o no presente
una apelación.
Para presentar una apelación sin que se utilice una revisión Padro,
entonces, en el momento en que presente su apelación, tiene
que hacerle saber al Consejo de Apelaciones que usted no quiere
que se utilice una revisión Padro.
Esta acción de su parte significará que (1) posiblemente
su reclamación no sea asignada a un grupo especial dentro
del Consejo de Apelaciones, y (2) si su reclamación es
devuelta para que se celebre una nueva audiencia y un nuevo fallo,
es posible que me la devuelvan a mi persona o a uno de los Jueces
de Derecho Administrativo que fue nombrado en la demanda colectiva
del caso Padro et al. v. Colvin.
Si no quiere que el Consejo de Apelaciones juzgue que usted
ha presentado una solicitud para una revisión de su caso,
entonces debe enviarnos una petición por escrito haciéndonos
saber sus deseos. En su petición por escrito debe especificar
que usted no quiere que se utilice una revisión Padro y
que usted tampoco quiere presentar una apelación. Esta
petición por escrito se debe presentar a no más
tardar de 60 días a
partir de la fecha en el encabezamiento de este aviso. Este límite
de tiempo es el mismo límite de tiempo que se les otorga
a las personas para presentar una apelación. La dirección
a la que debe enviar su petición por escrito es la misma dirección
que aparece en este aviso para el Consejo de Apelaciones. Al hacer
este tipo de petición, de no quiere que se utilice una revisión Padro y
que usted tampoco quiere presentar una apelación, significará que
es posible que el Consejo de Apelaciones no revise mi fallo y que
mi fallo posiblemente se convierta en el fallo final.
Si le hace saber al Consejo de Apelaciones que no quiere que
se utilice una revisión Padro,
el acuerdo de mitigación y sus limitaciones no se aplicarán
en su caso. Usted tendrá el derecho a apelar el fallo,
como si no existiera un acuerdo derivado de una demanda colectiva.
Qué otros documentos nos
puede enviar
Usted o su abogado o la persona que lo representa pueden enviarnos
una declaración por escrito referente a su caso. También
puede enviarnos documentos de evidencia nueva. Debe enviar su declaración
escrita y toda nueva evidencia junto con
su apelación. Al incluir su declaración escrita
y la nueva evidencia junto con su apelación nos ayudará a
revisar su caso con más prontitud.
Cómo funciona una apelación
por escrito o que se juzga que apeló
El Consejo de Apelaciones tomará en consideración
su caso en su totalidad. Tomará en consideración
mi fallo, incluso las partes del caso con la usted está de
acuerdo. La revisión puede cambiar mi fallo a un fallo
menos favorable o desfavorable para usted, de cualquier parte de
su caso.
En conformidad con las condiciones establecidas por el acuerdo Padro
et al. v. Colvin, asignaremos su caso a un grupo específico
dentro del Consejo de Apelaciones. Este grupo específico
utilizará los mismos reglamentos para revisar su caso que
aplicarían si usted nos hiciera saber que no quiere que
se utilice una revisión Padro.
Los reglamentos que el Consejo de Apelaciones utiliza se encuentran
en el tomo del Código de Reglamentos Federales (Code of
Federal Regulations), título 20 (Title 20), capítulo
III (Chapter III), parte 404 (inciso J) (Part 404 [Subpart J]) y
la parte 416 (inciso N) (Part 416 [Subpart N]).
El Consejo de Apelaciones puede:
•
Denegar su solicitud
de su apelación escrita o que este cuerpo juzga que usted
solicita,
•
Devolverme el caso si usted rechaza que se utilice
una revisión Padro,
o si usted acepta que se utilice una revisión Padro,
es posible que devuelvan su caso a otro Juez de Derecho Administrativo
para un nuevo fallo,
•
Emitir su propio fallo en su caso, o
El Consejo de Apelaciones le enviará un aviso haciéndole
saber su fallo.
En conformidad con las condiciones establecidas por el acuerdo
de la demanda colectiva Padro et al. v. Colvin,
si el Consejo de Apelaciones devuelve su caso para que se emita
un nuevo fallo, su caso será asignado a un Juez de Derecho
Administrativo que no fue uno de los que se nombra en la demanda
colectiva del caso Padro et al. v. Colvin.
Cualquier audiencia subsiguiente será celebrada por ese
otro Juez de Derecho Administrativo.
Si usted nos hace saber que no quiere que se utilice una revisión Padro,
entonces si el Consejo de Apelaciones devuelve su caso para que
se emita un nuevo fallo, es posible que su caso sea asignado a mi
persona o a uno de los Jueces de Derecho Administrativo que fue
nombrado en la demanda colectiva. Si el Consejo de Apelaciones rechaza
su apelación, entonces mi fallo se convierte en el fallo
final.
El Consejo de Apelaciones puede revisar
mi fallo por su propia cuenta
Es posible que el Consejo de Apelaciones revise mi fallo,
aunque usted no presente una apelación y ni tampoco quiera
que se utilice una revisión Padro.
El Consejo puede decidir el revisar mi fallo dentro de 60 días
después de la fecha de emisión del mismo. El Consejo
de Apelaciones le enviará un aviso de que revisará su
caso, si el Consejo decide revisar mi fallo.
En caso de que el Consejo de Apelaciones
no revise el fallo
Si usted nos hace saber que no quiere que se utilice una revisión Padro,
ni tampoco presenta una apelación y el Consejo de Apelaciones
decide no revisar mi fallo por su propia cuenta, entonces mi fallo
se convierte en el fallo final. Un fallo final solo se puede cambiar
de acuerdo a ciertas circunstancias especiales. Usted no tendrá el
derecho de peticionar a un tribunal federal para que el tribunal
revise su caso.
[The following language will be included
only if the claimant is unrepresented:
Su derecho a representación
Usted puede elegir a un abogado u otra persona para que le
ayude. Muchos abogados no cobran un honorario a menos que ganen
su apelación. También existen grupos que están
disponibles para ayudarle a conseguir un abogado o, si usted reúne
los requisitos, proveerle servicios legales de gratis. Su oficina
local del Seguro Social tiene una lista de grupos que pueden ayudarle
en este proceso.
Si retiene los servicios de alguien para que le ayude con
su apelación, usted y la persona que usted contrate tienen
que hacerle saber al Consejo de Apelaciones. Si contrata los servicios
de alguna persona, nosotros tenemos que aprobar el honorario a cobrar
antes de que la persona pueda cobrarlo.]
Una nueva solicitud
Usted tiene el derecho a presentar una nueva solicitud en
cualquier momento, pero debe entender que el presentar una nueva
solicitud no es lo mismo que apelar este fallo. Si no está de
acuerdo con mi fallo y decide presentar una nueva solicitud en vez
de una apelación, existe la posibilidad que pierda algunos
beneficios o que no tenga derecho a recibir ninguno de los beneficios
disponibles. Mi fallo también puede usarse como base para
denegar su nueva solicitud, si es que los hechos y asuntos presentados
son los mismos. Si no está de acuerdo con mi fallo, usted
debe presentar una apelación dentro de 60 días.
Si tiene preguntas
Le invitamos a que visite nuestro sitio de Internet en www.segurosocial.gov
para encontrar respuestas a sus preguntas en general referentes
a los servicios y programas administrados por el Seguro Social.
También puede llamarnos con sus preguntas al 1-(800)-772-1213.
Si es sordo o tiene problemas de audición, por favor marque
nuestro número TTY 1-(800)-325-0778.
Para informarse mejor acerca del acuerdo de la demanda colectiva Padro
et al. v. Colvin, puede visitar la página de
Internet http://www.socialsecurity.gov/padrosettlement (solo
disponible en inglés). También puede comunicarse
con el «Urban Justice Center», que son los abogados
que presentaron la demanda colectiva Padro et al. v.
Colvin, escribiéndoles a: Urban Justice Center, Padro
Class Counsel, Church Street Station, P.O. Box 3363, New York, NY
10008-3363, o llamándoles al (646) 459-3068.
Si tiene preguntas adicionales, por favor llame, escriba o
visite cualquier oficina del Seguro Social. Por favor, tenga consigo
este aviso y el fallo. El número de teléfono de
su oficina local que le presta servicio es [field
office phone number]. La dirección física
es:
[FIELD OFFICE ADDRESS]
[ALJ Name]
Juez de Derecho
Administrativo
Anejos:
Racional del fallo
Formulario
número HA-L39 (Lista de prueba documental)
cc:
[Representative of Record]
Attachment 1B-FinDec. Notice B — Padro Notice of
Decision After Court Remand – Unfavorable (Prospective
Relief)
[standard header will be used]
Notice of Decision – Unfavorable
I carefully reviewed the facts of your case and made the enclosed
decision. Please read this notice and my decision.
If You Disagree With My Decision
If you disagree with my decision, you or your representative
may submit written exceptions to the Appeals Council. “Written
exceptions” are your statements explaining why you disagree with
my decision. This notice will explain your options, including how
to submit written exceptions and the time limits to file a civil
action in Federal court.
Special Review Procedures Under the Padro
et al. v. Colvin Class-Action Settlement
On October 18, 2013, the U.S. District Court for the Eastern
District of New York approved a settlement in the class-action lawsuit Padro
et al. v. Colvin. This lawsuit challenged decisions
on disability claims made by certain administrative law judges (ALJs).
Under the settlement agreement, my decision may be reviewed
using special review procedures. These special review procedures
include: (1) deeming you to have filed general written exceptions
on the date of this notice, which you can choose to withdraw or
supplement, (2) assigning your claim to be reviewed by
a specified group of staff at the Appeals Council, and (3) if your claim
is returned for a new hearing and decision, it will not be assigned
to me but instead will be assigned to an ALJ who was not involved
in the Padro et al. v. Colvin class-action
lawsuit. “Deeming you to have filed general written exceptions” means
that your case will be treated as if you asked the Appeals Council
to review my decision.
We call these special review procedures “Padro review.” We
will apply these procedures unless you write and tell us you do
not want Padro review.
How To File Written Exceptions
Under the terms of the Padro et al. v. Colvin settlement,
your case will be treated as if you filed “general” written
exceptions on the date of this notice. You may also file “specific” written exceptions
(explaining in greater detail why you disagree with my decision)
within 60 days of the
date you get this notice.
If you file specific written exceptions, please put the Social
Security number shown above on any
written exceptions you send. Please also refer to the Padro
et al v. Colvin settlement. We will assume that you
want Padro review unless you tell us you
do not.
Please send your specific written exceptions to:
Appeals Council
Office of Disability Adjudication and Review
Padro Staff
5107
Leesburg Pike
Falls Church,
VA 22041-3255
If you need help, you may file in person at any Social Security
or hearing office.
Time Limit To File Specific Written
Exceptions (60 Days)
You must file your specific written exceptions with the Appeals
Council within 60 days of the date
you get this notice. The Appeals Council assumes that you got this
notice within 5 days after the date of the notice unless you show
that you did not get it within the 5-day period.
If you need more time to file your specific written exceptions,
you must file a written request with the Appeals Council. You must
file the request for an extension within 60 days of the date you
get this notice. If you request more than 30 days, you must explain
why you need the extra time. The Appeals Council will decide whether
to grant your request for more than a 30-day extension.
If You Want to Withdraw the Deemed
General Written Exceptions
Under the terms of the Padro et al. v. Colvin settlement,
your case will be treated as if you asked the Appeals Council to
review my decision. If you do not want my decision to be reviewed by
the Appeals Council, you may write and tell us that you want to
withdraw the general written exceptions. You may do this by writing
to the Appeals Council at the address given above within 60
days of the date you get this notice.
[The following language will be included
only if the claim was remanded pursuant to Sentence 4:
You would only choose this option if you do not plan to file
specific written exceptions. This means that if you write to tell
us that you want to withdraw the general written exceptions, and
the Appeals Council does not review my decision on its own, you
may file a new civil action in Federal court. We discuss the time
limits for filing a civil action below.]
[The following language will be included
only if the claim was remanded pursuant to Sentence 6:
You would only choose this option if you do not plan to file
specific written exceptions. This means that if you write to tell
us that you want to withdraw the general written exceptions, and
the Appeals Council does not review my decision on its own, you
will have the right to pursue your civil action with the court.
We discuss the time limits for pursuing your civil action with the
court below.]
We will assume that you want the rest of Padro review
unless you tell us you do not. This will mean that if you file a
civil action in Federal court and your claim is returned for a new
hearing and decision, it will be assigned to an ALJ who was not
involved in the Padro et al. v. Colvin class-action
lawsuit.
If You Do Not Want the Padro Special
Review Procedures
If you do not want my decision reviewed under the special
review procedures, whether you want to file written exceptions,
file a new civil action, or take no action on your case, you must
write to the Appeals Council at the address above and tell them
that you do not want Padro review within 60 days of the date you get
this notice. If you file written exceptions, you must say that you
do not want Padro review at the time you
file your exceptions.
If you tell the Appeals Council that you do not want Padro review,
the relief and limitations of the settlement will not apply to you.
This means that: (1) your deemed general exceptions will be withdrawn,
(2) your claim may not be assigned to a specified group of staff
at the Appeals Council, and (3) if your claim is returned for a
new hearing and decision, it may be returned to me or to one of
the other administrative law judges who were involved in the Padro
et al. v. Colvin class-action lawsuit.
You will still have the right either to file specific written
exceptions within 60 days of receiving my decision or to pursue
your case through Federal district court as described below as if
there were no class action settlement.
The Appeals Council May Review My
Decision On Its Own
The Appeals Council may review my decision even if you do
not file written exceptions. The Appeals Council will notify you
within 60 days of the date of this notice if it decides to review your
case.
How Written Exceptions Work
The Appeals Council will consider your entire case. It will
consider all of my decision, even the parts with which you agree.
The Appeals Council's action may be more or less favorable or unfavorable
to you.
Under the terms of the Padro et al. v. Colvin settlement,
we will assign your case to a specified group of staff within the
Appeals Council. This staff will use the same rules for considering
your case that would apply if you tell us you do not want Padro review.
The rules the Appeals Council uses are in the Code of Federal Regulations,
Title 20, Chapter III, Part 404 (Subpart J), Part
416 (Subpart N), Part 404 (Subpart J) and Part 416 (Subpart N).
The Appeals Council may:
•
Find that there is
no reason to change my decision,
•
Return your case to me if you decline Padro review
or, if you accept Padro review, return your
case to another ALJ for a new decision, or
The Appeals Council will send you a notice telling you what
it decides to do. If the Appeals Council does not change my decision,
my decision will become the final decision after remand. Any future
claim you file will not change a final decision on this claim if
the facts and issues are the same.
Under the terms of the Padro et al. v. Colvin settlement,
if the Appeals Council returns your case for a new decision, your
case will not be assigned to me but instead will be assigned to
an ALJ who was not involved in the Padro et al. v. Colvin class-action
lawsuit. Any subsequent hearing will be conducted by that other
ALJ.
If you tell us you do not want Padro review,
and the Appeals Council returns your case for a new decision, your
case may be assigned to me or to another ALJ who was involved in
the class-action lawsuit. If the Appeals Council does not change
my decision, my decision will become the final decision.
Filing An Action In Federal District
Court
[The following language will be included
only if the claim was remanded pursuant to Sentence 4:
If you withdraw the deemed general written exceptions, do
not file specific written exceptions, and the Appeals Council does
not review my decision on its own, my decision will become final on
the 61st day following the date of this
notice. After my decision becomes final, you will have 60 days to
file a new civil action in Federal district court. You will lose
the right to a court review if you do not file a civil action during
the 60-day period starting with the day my decision becomes final.
However, you can ask the Appeals Council to give you more time to
file a civil action. The Appeals Council will grant your request
for more time only if you can show a good reason for needing more
time. We will not send you any more notices about your right to
file in Federal district court.]
[The following language will be included
only if the claim was remanded pursuant to Sentence 6:
If you withdraw the deemed general written exceptions, do
not file specific written exceptions, and the Appeals Council does
not review your case on its own, my decision and a transcript of your
case record will be sent to the Office of the United States Attorney
for filing with the court when required. You have the right to pursue
your civil action with the court.]
New Application
You have the right to file a new application at any time,
but filing a new application is not the same as filing exceptions
to my decision or filing a civil action in Federal court. If you
disagree with my decision and you file a new application instead
of filing written exceptions or appealing to Federal court, you
might lose some benefits or not qualify for benefits at all. My
decision could also be used to deny a new application for benefits
if the facts and issues are the same. If you think my decision is
wrong, you should file your exceptions within 60 days or file a
new civil action between the 61st and
121st days after the date of this notice.
Your Right To Representation
If you file written exceptions, you may choose to have an
attorney or other person help you. Many representatives do not charge
a fee unless you win. Groups are available to help you find a representative
or, if you qualify, to give you free legal services. Your local
Social Security office has a list of groups that can help you in
this process.
If you get someone to help with filing specific written exceptions,
you or that person must let the Appeals Council know. If you hire
someone, we must approve the fee before he or she is allowed to
collect it.
If You Have Any Questions
We invite you to visit our website located at www.socialsecurity.gov
to find answers to general questions about social security. You
may also call (800) 772-1213 with questions. If you are deaf or
hard of hearing, please use our TTY number (800) 325-0778.
More information about the Padro et al. v. Colvin settlement
is available on our website located at http://www.socialsecurity.gov/padrosettlement.
You can also contact the Urban Justice Center, the lawyers who brought
the Padro et al. v. Colvin lawsuit, by writing
to them at Urban Justice Center, Padro Class Counsel, Church Street
Station, P.O. Box 3363, New York, NY 10008-3363, or calling them
at (646) 459-3068.
If you have any other questions, please call, write, or visit
any Social Security office. Please have this notice and decision
with you. The telephone number of the local office that serves your
area is [field office phone number].
Its address is:
[FIELD OFFICE ADDRESS]
[ALJ Name]
Administrative Law Judge
Enclosures:
Decision Rationale
Form HA-L39 (Exhibit List)
cc: [Representative of Record]
Attachment 1B-FinDec-SP. Notice B – Padro Notice
of Decision After Court Remand – Unfavorable (Prospective
Relief) (Spanish)
[standard header will be used]
Aviso del Fallo – Desfavorable
Yo revise detenidamente los hechos de su caso y emití el
fallo adjunto. Por favor lea este aviso y mi fallo.
Si no está de acuerdo con
mi fallo
Si no está de acuerdo con mi fallo, usted o su representante
pueden presentar excepciones por escrito al Consejo de Apelaciones.
Las «excepciones por escritos» son declaraciones
explicando el por qué usted no está de acuerdo
con mi fallo. En este aviso le explicaremos sus opciones, incluso
cómo presentar excepciones por escrito y los límites
de tiempo para presentar una acción civil en el tribunal
federal.
Procedimientos especiales de revisión
en conformidad con el Acuerdo de la Demanda Colectiva Padro
et al. v. Colvin
El 18 de octubre de 2013, el Tribunal de Distrito de los Estados
Unidos para el Distrito del Este de Nueva York aprobó un
acuerdo de la demanda colectiva Padro et al. v. Colvin.
Esta demanda retó las reclamaciones que recibieron fallos
que fueron emitidos por ciertos Jueces de Derecho Administrativo
(ALJ) en reclamaciones de los beneficios por incapacidad.
En conformidad con el acuerdo de la demanda colectiva, mi
fallo será revisado usando unos procedimientos especiales.
Estos procedimientos especiales de revisión incluyen: (1)
juzgar que usted ha presentado excepciones por escrito en la fecha
de este aviso, las cuales puede elegir a retirarlas o suplementarlas,
(2) asignar su reclamación para ser revisado por un grupo
específico de los miembros del Consejo de Apelaciones,
(3) si su reclamación es devuelta para una nueva audiencia
y un nuevo fallo, no será asignada a mi persona, sino que
será asignada a un juez de derecho administrativo quien
no tuvo nada que ver con la demanda colectiva de Padro
et al. v. Colvin. El « juzgar que usted ha
presentado excepciones generales por escrito» significa
que su caso será tratado como si usted hubiera solicitado
que el Consejo de Apelaciones revisara mi fallo.
Ha estos procedimientos especiales para una revisión
le llamamos «revisiones Padro».
Aplicaremos estos procedimientos a menos que usted nos escriba y
nos diga que no quiere una revisión Padro.
Cómo presentar excepciones
por escrito
En conformidad con las condiciones del acuerdo de la demanda
colectiva Padro et al. v. Colvin, su caso
será procesado como si hubiera presentado excepciones por
escrito «en general» en la fecha que se emitió este
aviso. También puede presentar excepciones por escrito «en
específico» (explicando con lujo de detalles el
por qué usted no está de acuerdo con mi fallo)
dentro de 60 días a
partir de la fecha que aparece en el encabezamiento de este aviso.
Si presenta excepciones específicas por escrito,
por favor escriba el número de Seguro Social que aparece
en el encabezamiento de este aviso en todas las excepciones por
escrito que presente. También, escriba que la apelación
es referente al acuerdo de la demanda colectiva Padro
et al v. Colvin. Supondremos que solicita una revisión Padro a
menos que nos indique lo contrario.
Por favor envíe sus excepciones específicas
por escrito a:
Appeals Council
Office of Disability Adjudication and Review
Padro Staff
5107
Leesburg Pike
Falls Church,
VA 22041-3255
Si necesita ayuda, puede presentar su petición personalmente
en cualquiera de las oficinas del Seguro Social o de las oficinas
de audiencias del Seguro Social.
Tiempo límite para presentar
sus excepciones específicas por escrito (60 días)
Tiene que presentar excepciones específicas por escrito,
por favor escriba el número de Seguro Social que aparece
en el encabezamiento de este aviso al Consejo de Apelaciones dentro de 60 días a partir
de la fecha en el encabezamiento de este aviso. El Consejo de Apelaciones
supone que usted recibió este aviso 5 días después
de la fecha que aparece en el encabezamiento de este aviso, a menos
que usted pueda probar que no lo recibió dentro de este
periodo de 5 días.
Si quiere retractar las excepciones
generales por escrito que han sido juzgadas como que usted las presentó
En conformidad con las condiciones del acuerdo de la demanda
colectiva Padro et al. v. Colvin, su caso
será procesado como si usted hubiera peticionado al Consejo
de Apelaciones que revisara mi fallo. Si no quiere que mi fallo
sea revisado por el Consejo de Apelaciones, puede escribirnos haciéndonos
saber que quiere retractar las excepciones generales por escrito.
Puede hacerlo escribiéndole directamente al Consejo de
Apelaciones a la dirección que aparece más arriba dentro de 60 días a partir
de la fecha que aparece en el encabezamiento de este aviso.
[The following language will be included
only if the claim was remanded pursuant to Sentence 4:
Usted solo podría usar esta opción si no
planifica presentar excepciones por escrito. Esto significa que
nos escribe para hacernos saber que quiere retractar excepciones
en general por escrito y el Consejo de Apelaciones no revisa mi
fallo por su propia cuenta, usted puede presentar una nueva acción
civil en la tribunal federal. Los límites de tiempo para
presentar una acción civil, los discutimos más
adelante.]
[The following language will be included
only if the claim was remanded pursuant to Sentence 6:
Usted solo podría usar esta opción si no
planifica presentar excepciones específicas por escrito. Esto
significa que nos escribe para hacernos saber que quiere retractar
excepciones en general por escrito y el Consejo de Apelaciones no
revisa mi fallo por su propia cuenta, usted tendrá el derecho
de presentar su acción civil en la tribunal federal. Los
límites de tiempo para presentar una acción civil,
los discutimos más adelante.]
Nosotros supondremos que usted quiere la otra parte de la revisión Padro,
a menos que nos diga lo contrario. Esto significará que
si usted presenta una acción civil en la tribunal federal
y su reclamación es devuelta para una nueva audiencia y
un nuevo fallo, la reclamación será asignada a
un ALJ que no tuvo nada que ver con la demanda colectiva Padro
et al. v. Colvin.
Si usted no quiere los procedimientos
especiales de una revisión Padro
Si usted no quiere que mi fallo sea revisado conforme a los
procedimientos especiales de revisión, ya sea que quiera
presentar excepciones por escrito, presentar una nueva acción
civil o que no se tome acción ninguna en su caso, entonces
tiene que hacerle saber por escrito al Consejo de Apelaciones que
no quiere una revisión Padro dirigiendo
su correspondencia a la dirección que aparece arriba y
hacerle saber que no quiere una revisión Padro dentro de 60 días a partir
de la fecha que aparece en el encabezamiento de este aviso. Si presenta
excepciones por escrito, tiene que declarar que quiere una revisión Padro cuando
presente sus excepciones.
Si le escribe al Consejo de Apelaciones haciéndole
saber que no quiere que se utilice una revisión Padro,
entonces, las mitigaciones y limitaciones del acuerdo no serán
aplicadas a su caso. Esta acción de su parte significará que
(1) sus excepciones generales que han juzgado que ha presentado
serán retractadas, (2) posiblemente su reclamación
no sea asignada a un grupo especial dentro del Consejo de Apelaciones
y (2) si su reclamación es devuelta para que se celebre
una nueva audiencia y un nuevo fallo, es posible que me la devuelvan
a mi persona o a uno de los Jueces de Derecho Administrativo que
fue nombrado en la demanda colectiva del caso Padro et al.
v. Colvin.
Usted todavía tendrá el derecho de presentar
excepciones específicas por escrito dentro de 60 días
después de recibir mi fallo o proseguir con su caso a un
Tribunal de Distrito de los Estados Unidos según se explica
más adelante, como si no existiera un acuerdo derivado
de una demanda colectiva.
El Consejo de Apelaciones puede revisar
mi fallo por su propia cuenta
Es posible que el Consejo de Apelaciones revise mi fallo,
aunque usted no presente ninguna excepción por escrito.
El Consejo de Apelaciones le enviará un aviso dentro de
60 días a partir de la fecha en el encabezamiento de este
aviso, si el Consejo decide revisar su caso.
Cómo funcionan las excepciones
por escrito
El Consejo de Apelaciones tomará en consideración
su caso en su totalidad. Tomará en consideración
mi fallo en su totalidad, incluso las partes del caso con la usted
está de acuerdo. La acción que tome el Consejo
de Apelaciones puede ser menos favorable o desfavorable para usted.
En conformidad con las condiciones establecidas por el acuerdo Padro
et al. v. Colvin, asignaremos su caso a un grupo específico
dentro del Consejo de Apelaciones. Este grupo específico
utilizará los mismos reglamentos para revisar su caso que
aplicarían si usted nos hiciera saber que no quiere que
se utilice una revisión Padro.
Los reglamentos que el Consejo de Apelaciones utiliza se encuentran
en el tomo del Código de Reglamentos Federales (Code of
Federal Regulations), título 20 (Title 20), capítulo
III (Chapter III), parte 404 (inciso J) (Part 404 [Subpart J]) y
la parte 416 (inciso N) (Part 416 [Subpart N]).
El Consejo de Apelaciones puede:
•
Encontrar que no hay
razón alguna por qué cambiar mi fallo,
•
Devolverme el caso si usted rechaza que se utilice
una revisión Padro,
o si usted acepta que se utilice una revisión Padro,
es posible que devuelvan su caso a otro Juez de Derecho Administrativo
para un nuevo fallo, o
•
Emitir su propio fallo en su caso.
El Consejo de Apelaciones le enviará un aviso haciéndole
saber su fallo. Si el Consejo de Apelaciones no cambia mi fallo,
entonces mi fallo se convierte en el fallo final después
de ser devuelto. Cualquier reclamación que usted presente
en el futuro no cambiará una decisión final en
esta reclamación, si los hechos y asuntos presentados son
los mismos.
En conformidad con las condiciones establecidas por el acuerdo
de la demanda colectiva Padro et al. v. Colvin,
si el Consejo de Apelaciones devuelve su caso para que se emita
un nuevo fallo, su caso no será asignado a mi otra vez,
sino que su caso será asignado a un Juez de Derecho Administrativo
que no fue uno de los que se nombra en la demanda colectiva del
caso Padro et al. v. Colvin. Cualquier audiencia
subsiguiente será celebrada por ese otro Juez de Derecho Administrativo.
Si usted nos hace saber que no quiere que se utilice una revisión Padro,
entonces si el Consejo de Apelaciones devuelve su caso para que
se emita un nuevo fallo, es posible que su caso sea asignado a mi
persona o a uno de los Jueces de Derecho Administrativo que fue
nombrado en la demanda colectiva. Si el Consejo de Apelaciones rechaza
su apelación, entonces mi fallo se convierte en el fallo
final.
Presentando una acción en
el Tribunal Federal de Distrito
[The following language will be included
only if the claim was remanded pursuant to Sentence 4:
Si retracta las excepciones generales por escrito que se juzgan
que usted ha presentado, usted no presenta excepciones específicas
por escrito y el Consejo de Apelaciones no revisa mi fallo por sí mismo,
mi fallo se convierte en el fallo final el día número
61 a partir de la fecha que aparece en el encabezamiento de este
aviso. Después que mi fallo se convierte en el fallo final,
usted tendrá 60 días para presentar una nueva
acción civil en el Tribunal Federal de Distrito. Usted
perderá su derecho a que la tribunal revise su caso si
no presenta una acción civil durante el periodo de 60 días
a partir de la fecha en que mi fallo se convierte en el fallo final.
No obstante, usted puede peticionar al Consejo de Apelaciones para
que le permita más tiempo para presentar una acción civil.
El Consejo de Apelaciones le otorgará su petición
para más tiempo solo si usted puede justificar la necesidad
de más tiempo. No le enviaremos más avisos acerca
de su derecho a presentar su caso en el Tribunal Federal de Distrito.]
[The following language will be included
only if the claim was remanded pursuant to Sentence 6:
Si retracta las excepciones generales por escrito que han
sido juzgadas como que usted las presentó y usted no presenta
excepciones específicas por escrito y el Consejo de Apelaciones
no revisa su caso por sí mismo, entonces mi fallo y la
transcripción de su caso y el registro del mismo serán
enviados a la Oficina del Abogado de los Estados Unidos para presentarlos
al tribunal cuando sea necesario. Usted tiene el derecho de continuar
con su acción civil con el tribunal.]
Una nueva solicitud
Usted tiene el derecho a presentar una nueva solicitud en
cualquier momento, pero debe entender que el presentar una nueva
solicitud no es lo mismo que presentar excepciones a mi fallo o
el presentar una acción civil en un tribunal federal. Si
no está de acuerdo con mi fallo y decide presentar una
nueva solicitud en vez de presentar excepciones o una apelación
en un tribunal federal, existe la posibilidad que pierda algunos
beneficios o que no tenga derecho a recibir ninguno de los beneficios
disponibles.
Mi fallo también puede usarse como base para denegar
su nueva solicitud para recibir los beneficios, si es que los hechos
y asuntos presentados son los mismos. Si cree que mi fallo es incorrecto, tiene
que presentar sus excepciones dentro de 60 días o presentar
una nueva acción civil entre los días números
61 y el 121 a partir de la fecha que aparece en el encabezamiento
de este aviso.
Su derecho a representación
Usted puede elegir a un abogado u otra persona para que le
ayude. Muchos abogados no cobran un honorario a menos que ganen
su apelación. También existen grupos que están
disponibles para ayudarle a conseguir un abogado o, si usted reúne
los requisitos, proveerle servicios legales de gratis. Su oficina
local del Seguro Social tiene una lista de grupos que pueden ayudarle
en este proceso.
Si retiene los servicios de alguien para que le ayude con
su apelación, usted y la persona que usted contrate tienen
que hacerle saber al Consejo de Apelaciones. Si contrata los servicios
de alguna persona, nosotros tenemos que aprobar el honorario a cobrar
antes de que la persona pueda cobrarlo.
Si tiene preguntas
Le invitamos a que visite nuestro sitio de Internet en www.segurosocial.gov
para encontrar respuestas a sus preguntas en general referentes
a los servicios y programas administrados por el Seguro Social.
También puede llamarnos con sus preguntas al 1-(800)-772-1213.
Si es sordo o tiene problemas de audición, por favor marque
nuestro número TTY 1-(800)-325-0778.
Para informarse mejor acerca del acuerdo de la demanda colectiva Padro
et al. v. Colvin, puede visitar la página de
Internet http://www.socialsecurity.gov/padrosettlement (solo
disponible en inglés). También puede comunicarse
con el «Urban Justice Center», que son los abogados
que presentaron la demanda colectiva Padro et al. v.
Colvin, escribiéndoles a: Urban Justice Center, Padro
Class Counsel, Church Street Station, P.O. Box 3363, New York, NY
10008-3363, o llamándoles al (646) 459-3068.
Si tiene preguntas adicionales, por favor llame, escriba o
visite cualquier oficina del Seguro Social. Por favor, tenga consigo
este aviso y el fallo. El número de teléfono de
su oficina local que le presta servicio es [field
office phone number]. La dirección física
es:
[FIELD OFFICE ADDRESS]
[ALJ Name]
Juez de Derecho Administrativo
Anejos:
Racional del fallo
Formulario número HA-L39 (Lista de prueba documental)
cc: [Representative of Record]
Attachment 1C. Notice
C — Padro Notice of Decision–
Partially Favorable (Prospective Relief)
[standard header will be used]
Notice of Decision – Partially Favorable
I carefully reviewed the facts of your case and made the enclosed
partially favorable decision. Please read this notice and my decision.
Another office will process my decision [the
following language will be included only for Title XVI or concurrent
claims: and decide if you meet the non-disability requirements
for Supplemental Security Income payments]. That office may ask
you for more information. If you do not hear anything within 60
days of the date of this notice, please contact your local office.
The contact information for your local office is at the end of this
notice.
If You Disagree With My Decision
If you disagree with my decision, you may file an appeal with
the Appeals Council. This notice will explain how to file an appeal.
Special Review Procedures Under the Padro
et al. v. Colvin Class-Action Settlement
On October 18, 2013, the U.S. District Court for the Eastern
District of New York approved a settlement in the class-action lawsuit Padro
et al. v. Colvin. This lawsuit challenged decisions
on disability claims made by certain administrative law judges.
Under the settlement agreement, if you appeal my decision,
my decision will be reviewed using special review procedures. These
special review procedures include: (1) assigning your claim to be
reviewed by a specified group of staff at the Appeals Council, and
(2) if your claim is returned for a new hearing and decision, it
will not be assigned to me but instead will be assigned to an administrative
law judge who was not involved in the Padro et al. v.
Colvin class-action lawsuit. We call these special review
procedures “Padro review.” If
you appeal my decision, we will apply these procedures unless you
write and tell us you do not want Padro review.
If you do not want Padro review, you must
tell us when you file your appeal.
How to File an Appeal
To file an appeal you or your representative must ask in writing
that the Appeals Council review my decision. You may use our Request
for Review form (HA-520) or write a letter. The form is available
at www.socialsecurity.gov. Please put the Social Security number
shown above on any appeal you file. Please also refer to the Padro
et al v. Colvin settlement. If you file an appeal, we will
assume that you want Padro review unless
you tell us you do not. If you need help, you may file in person
at any Social Security or hearing office.
Please send your request to:
Appeals Council
Office of Disability Adjudication and Review
Padro Staff
5107
Leesburg Pike
Falls Church,
VA 22041-3255
Time Limit to File an Appeal
You must file your written appeal within
60 days of the date you get this notice. The Appeals Council
assumes you got the notice 5 days after the date shown above unless
you show you did not get it within the 5-day period.
The Appeals Council will dismiss a late request unless you
show you had a good reason for not filing it on time.
If You Tell Us You Do Not Want Padro Review
If you appeal and tell us that you do not want Padro review,
the settlement relief and limitations will not apply to you. You
will have the right to appeal as if there were no class-action settlement.
This will mean that (1) your claim may not be assigned to
a specified group of staff at the Appeals Council, and (2) if your
claim is returned for a new hearing and decision, it may be assigned
to me or to one of the other administrative law judges who were
involved in the Padro et al. v. Colvin class-action
lawsuit.
What Else You May Send Us
You [the following language will
be included only if the claimant is represented: or your
representative] may send us a written statement about your case.
You may also send us new evidence. You should send your written
statement and any new evidence with your
appeal. Sending your written statement and any new evidence
with your appeal may help us review your case sooner.
How an Appeal Works
The Appeals Council will consider your entire case. It will
consider all of my decision, even the parts with which you agree.
Review can make any part of my decision more or less favorable or unfavorable
to you.
Under the terms of the Padro et al. v. Colvin settlement,
we will assign your case to a specified group of staff within the
Appeals Council if you appeal. We will do this unless you tell us
you do not want Padro review. This staff
will use the same rules for considering your case that would apply
if you tell us you do not want Padro review.
The rules the Appeals Council uses are in the Code of Federal Regulations,
Title 20, Chapter III, Part 404 (Subpart J) and Part 416 (Subpart
N).
You must appeal my decision if you
want us to assign your case to a specified group of staff within
the Appeals Council.
The Appeals Council may:
•
Return your case to me if you decline Padro review,
or, if you accept Padro review, return your
case to another administrative law judge for a new decision,
•
Issue its own decision, or
The Appeals Council will send you a notice telling you what
it decides to do.
Under the terms of the Padro et al. v. Colvin settlement,
if the Appeals Council returns your case for a new decision, your
case will be assigned to an administrative law judge who was not involved
in the Padro et al. v. Colvin class-action
lawsuit. Any subsequent hearing will be conducted by that other
administrative law judge.
If you tell us you do not want Padro review,
and the Appeals Council returns your case for a new decision, your
case may be assigned to me or to another administrative law judge
who was involved in the class-action lawsuit. If the Appeals Council
denies your appeal, my decision will become the final decision.
You must appeal my decision if you
want a new hearing and decision to be made by an administrative
law judge who was not involved in the Padro et al. v.
Colvin class action lawsuit should the Appeals Council
grant review and remand your case.
The Appeals Council May Review My
Decision On Its Own
The Appeals Council may review my decision even if you do
not appeal. They may decide to review my decision within 60 days
after the date of the decision. The Appeals Council will mail you
a notice of review if they decide to review my decision.
When There Is No Appeals Council Review
If you do not appeal and the Appeals Council does not review
my decision on its own, my decision will become final. A final decision
can be changed only under special circumstances. You will not have
the right to Federal court review.
[The following language will be included
only if the claimant is unrepresented:
Your Right to Representation
You may choose to have an attorney or other person help you.
Many representatives do not charge a fee unless you win your appeal.
Groups are available to help you find a representative or, if you
qualify, to give you free legal services. Your local Social Security
office has a list of groups that can help you in this process.
If you get someone to help you with your appeal, you or that
person must let the Appeals Council know. If you hire someone, we
must approve the fee before he or she is allowed to collect it.]
New Application
You have the right to file a new application at any time,
but filing a new application is not the same as appealing this decision.
If you disagree with my decision and you file a new application instead
of appealing, you might lose some benefits or not qualify for benefits
at all. My decision could also be used to deny a new application
for benefits if the facts and issues are the same. If you disagree
with my decision, you should file an appeal within 60 days.
If You Have Any Questions
We invite you to visit our website located at www.socialsecurity.gov
to find answers to general questions about social security. You
may also call (800) 772-1213 with questions. If you are deaf or
hard of hearing, please use our TTY number (800) 325-0778.
More information about the Padro et al. v. Colvin settlement
is available on our website located at http://www.socialsecurity.gov/padrosettlement.
You can also contact the Urban Justice Center, the lawyers who brought
the Padro et al. v. Colvin lawsuit, by writing
to them at Urban Justice Center, Padro Class Counsel, Church Street
Station, P.O. Box 3363, New York, NY 10008-3363, or calling them
at (646) 459-3068.
If you have any other questions, please call, write, or visit
any Social Security office. Please have this notice and decision
with you. The telephone number of the local office that serves your
area is [field office phone number]. Its address is:
[FIELD OFFICE ADDRESS]
[ALJ Name]
Administrative Law Judge
Enclosures:
Decision Rationale
Form HA-L39 (Exhibit List)
cc: [Representative of record]
Attachment 1C-SP. Notice C — Padro Notice of
Decision – Partially Favorable (Prospective Relief) (Spanish)
[standard header will be used]
Aviso del Fallo – Parcialmente Desfavorable
Yo revise detenidamente los hechos de su caso y emití el
fallo parcialmente desfavorable adjunto. Por favor lea este aviso
y mi fallo
Otra oficina procesará mi fallo [the following language will be included only
for Title XVI or concurrent claims: y tomará una
decisión referente a si usted reúne los requisitos
que no están relacionados con su incapacidad para ver si
puede recibir los beneficios de Seguridad de Ingreso Suplementario].
Esa oficina posiblemente solicite que usted presente más
información. Si la oficina no se comunica con usted dentro
de 60 días a partir de la fecha en el encabezamiento de este
aviso, por favor comuníquese con su oficina local del Seguro
Social. La información de la oficina local del Seguro Social
se encuentra al final de este aviso.
Si no está de acuerdo con
mi fallo
Si no está de acuerdo con mi fallo, usted puede presentar
una apelación al Consejo de Apelaciones. En este aviso
le explica sus opciones disponibles, incluso cómo presentar
una apelación.
Procedimientos especiales de revisión
en conformidad con el Acuerdo de la Demanda Colectiva Padro
et al. v. Colvin
El 18 de octubre de 2013, el Tribunal de Distrito de los Estados
Unidos para el Distrito del Este de Nueva York aprobó un
acuerdo de la demanda colectiva Padro et al. v. Colvin.
Esta demanda retó las reclamaciones que recibieron fallos
que fueron emitidos por ciertos jueces de derecho administrativo
en reclamaciones de los beneficios por incapacidad.
En conformidad con el acuerdo de la demanda colectiva, mi
fallo será revisado usando unos procedimientos especiales.
Estos procedimientos especiales de revisión incluyen: (1)
asignar su reclamación para ser revisado por un grupo específico
de los miembros del Consejo de Apelaciones, (2) si su reclamación
es devuelta para una nueva audiencia y un nuevo fallo, no será asignada
a mi persona, sino que será asignada a un juez de derecho
administrativo quien no tuvo nada que ver con la demanda colectiva
de Padro et al. v. Colvin, y (3) si usted
no ha presentado una apelación por escrito, a no más
tardar del día número 65 a partir de la fecha
en el encabezamiento de este aviso el Consejo de Apelaciones juzgará que
su solicitud para una revisión ha sido presentada dentro
del tiempo límite establecido. Ha estos procedimientos
especiales para una revisión le llamamos «revisiones Padro».
Si usted apela mi fallo, aplicaremos estos procedimientos a menos
que usted nos escriba y nos diga que no quiere una revisión Padro. Si que no quiere
una revisión Padro,
tiene que hacérnoslo saber cuando presente su apelación.
Cómo presentar una apelación
Para presentar una apelación, usted o su abogado
o representante tienen que hacerlo por escrito, solicitando que
el Consejo de Apelaciones revise mi fallo. Puede usar nuestro formulario
(HA-520) titulado, «Request for Review» o escriba
una carta. El formulario está disponible por Internet en
www.segurosocial.gov. Por favor escriba en sus apelaciones el número
de Seguro Social que aparece en el encabezamiento de este aviso.
También, escriba que la apelación es referente
al acuerdo de la demanda colectiva Padro et al v. Colvin.
Supondremos que solicita una revisión Padro a
menos que nos indique lo contrario. Si necesita ayuda, puede ir
personalmente a cualquier oficina del Seguro Social o a una de las
oficinas de audiencias del Seguro Social y presentar su apelación.
Por favor envíe su petición a:
Appeals Council
Office of Disability Adjudication and Review
Padro Staff
5107
Leesburg Pike
Falls Church,
VA 22041-3255
Tiempo límite para presentar
su apelación
Tiene que presentar su apelación dentro
de 60 días a partir de la fecha en el encabezamiento
de este aviso. El Consejo de Apelaciones supone que usted recibió este
aviso 5 días después de la fecha que aparece en
el encabezamiento de este aviso, a menos que usted pueda probar
que no lo recibió dentro de este periodo de 5 días.
El Consejo de Apelaciones desestimará una petición
tardía a menos que usted muestre que tuvo una razón
justificada para no presentar su apelación a tiempo.
Si nos hace saber que usted no quiere
una revisión Padro
Si usted apela y nos hace saber que no quiere una revisión Padro,
el acuerdo de mitigación y sus limitaciones no se aplicarán
en su caso. Usted tendrá el derecho a apealar, como si
no existiera un acuerdo derivado de una demanda colectiva.
Esta acción de su parte significará que
(1) posiblemente su reclamación no sea asignada a un grupo
especial dentro del Consejo de Apelaciones, y (2) si su reclamación
es devuelta para que se celebre una nueva audiencia y un nuevo fallo,
es posible que me la devuelvan a mi persona o a uno de los Jueces
de Derecho Administrativo que fue nombrado en la demanda colectiva
del caso Padro et al. v. Colvin.
Qué otros documentos nos
puede enviar
Usted [the following language will
be included only if the claimant is represented: o la
persona que lo representa] pueden enviarnos una declaración
por escrito referente a su caso. También puede enviarnos
documentos de evidencia nueva. Debe enviar su declaración
escrita y toda nueva evidencia junto con
su apelación. Al incluir su declaración
escrita y la nueva evidencia junto con su apelación nos
ayudará a revisar su caso con más prontitud.
Cómo funciona una apelación
El Consejo de Apelaciones tomará en consideración
su caso en su totalidad. Tomará en consideración
mi fallo en su totalidad, incluso las partes del caso con la usted
está de acuerdo. La revisión puede cambiar mi
fallo a un fallo menos favorable o desfavorable para usted, de cualquier
parte de su caso.
En conformidad con las condiciones establecidas por el acuerdo Padro
et al. v. Colvin, asignaremos su caso a un grupo específico
dentro del Consejo de Apelaciones. Este grupo específico
utilizará los mismos reglamentos para revisar su caso que
aplicarían si usted nos hiciera saber que no quiere que
se utilice una revisión Padro.
Los reglamentos que el Consejo de Apelaciones utiliza se encuentran
en el tomo del Código de Reglamentos Federales (Code of
Federal Regulations), título 20 (Title 20), capítulo
III (Chapter III), parte 404 (inciso J) (Part 404 [Subpart J]) y
la parte 416 (inciso N) (Part 416 [Subpart N]).
Usted tiene que apelar mi fallo si
quiere que le asignemos su caso a un grupo específico dentro
del Consejo de Apelaciones.
El Consejo de Apelaciones puede:
•
Denegar su solicitud
de su apelación escrita o que este cuerpo juzga que usted
solicita,
•
Devolverme el caso si usted rechaza que se utilice
una revisión Padro,
o si usted acepta que se utilice una revisión Padro,
es posible que devuelvan su caso a otro Juez de Derecho Administrativo
para un nuevo fallo,
•
Emitir su propio fallo en su caso, o
El Consejo de Apelaciones le enviará un aviso haciéndole
saber su fallo.
En conformidad con las condiciones establecidas por el acuerdo
de la demanda colectiva Padro et al. v. Colvin,
si el Consejo de Apelaciones devuelve su caso para que se emita
un nuevo fallo, su caso será asignado a un Juez de Derecho
Administrativo que no fue uno de los que se nombra en la demanda
colectiva del caso Padro et al. v. Colvin.
Cualquier audiencia subsiguiente será celebrada por ese
otro Juez de Derecho Administrativo.
Si usted nos hace saber que no quiere que se utilice una revisión Padro y
el Consejo de Apelaciones devuelve su caso para que se emita un
nuevo fallo, es posible que su caso sea asignado a mi persona o
a otro Juez de Derecho Administrativo que fue nombrado en la demanda
colectiva del caso Padro et al. v. Colvin.
Si el Consejo de Apelaciones deniega su apelación, entonces
mi fallo se convierte en el fallo final.
Usted tiene que apelar mi fallo si
quiere que se celebre una nueva audiencia y que se emita un nuevo
fallo por un Juez de Derecho Administrativo que no tuvo nada que
ver en la demanda colectiva Padro et al. v. Colvin si
es que el Consejo de Apelaciones le honra con una revisión
y devuelve su caso.
El Consejo de Apelaciones puede revisar
mi fallo por su propia cuenta
Es posible que el Consejo de Apelaciones revise mi fallo,
aunque usted no presente una apelación. El Consejo puede
decidir el revisar mi fallo dentro de 60 días después
de la fecha de emisión del mismo. El Consejo de Apelaciones
le enviará un aviso de que revisará su caso, si
el Consejo decide revisar mi fallo.
Cuando el Consejo de Apelaciones no
revisa el caso
Si usted no presenta una apelación y el Consejo de
Apelaciones decide no revisar mi fallo por su propia cuenta, entonces
mi fallo se convierte en el fallo final. Un fallo final solo se
puede cambiar de acuerdo a ciertas circunstancias especiales. Usted
no tendrá el derecho de peticionar a un tribunal federal
para que el tribunal revise su caso.
[The following language will be included
only if the claimant is unrepresented:
Su derecho a representación
Usted puede elegir a un abogado u otra persona para que le
ayude. Muchos abogados no cobran un honorario a menos que ganen
su apelación. También existen grupos que están
disponibles para ayudarle a conseguir un abogado o, si usted reúne
los requisitos, proveerle servicios legales de gratis. Su oficina
local del Seguro Social tiene una lista de grupos que pueden ayudarle
en este proceso.
Si retiene los servicios de alguien para que le ayude con
su apelación, usted y la persona que usted contrate tienen
que hacerle saber al Consejo de Apelaciones. Si contrata los servicios
de alguna persona, nosotros tenemos que aprobar el honorario a cobrar
antes de que la persona pueda cobrarlo.]
Una nueva solicitud
Usted tiene el derecho a presentar una nueva solicitud en
cualquier momento, pero debe entender que el presentar una nueva
solicitud no es lo mismo que apelar este fallo. Si no está de
acuerdo con mi fallo y decide presentar una nueva solicitud en vez
de una apelación, existe la posibilidad que pierda algunos
beneficios o que no tenga derecho a recibir ninguno de los beneficios
disponibles. Mi fallo también puede usarse como base para
denegar su nueva solicitud, si es que los hechos y asuntos presentados
son los mismos. Si no está de acuerdo con mi fallo, usted
debe presentar una apelación dentro de 60 días.
Si tiene preguntas
Le invitamos a que visite nuestro sitio de Internet en www.segurosocial.gov
para encontrar respuestas a sus preguntas en general referentes
a los servicios y programas administrados por el Seguro Social.
También puede llamarnos con sus preguntas al 1-(800)-772-1213.
Si es sordo o tiene problemas de audición, por favor marque
nuestro número TTY 1-(800)-325-0778.
Para informarse mejor acerca del acuerdo de la demanda colectiva Padro
et al. v. Colvin, puede visitar la página de
Internet http://www.socialsecurity.gov/padrosettlement (solo
disponible en inglés). También puede comunicarse
con el «Urban Justice Center», que son los abogados
que presentaron la demanda colectiva Padro et al. v.
Colvin, escribiéndoles a: Urban Justice Center, Padro
Class Counsel, Church Street Station, P.O. Box 3363, New York, NY
10008-3363, o llamándoles al (646) 459-3068.
Si tiene preguntas adicionales, por favor llame, escriba o
visite cualquier oficina del Seguro Social. Por favor, tenga consigo
este aviso y el fallo. El número de teléfono de
su oficina local que le presta servicio es [field
office phone number]. La dirección física
es:
[FIELD OFFICE ADDRESS]
[ALJ Name]
Juez de Derecho Administrativo
Anejos:
Racional del fallo
Formulario número HA-L39 (Lista de prueba documental)
cc: [Representative of record]
Attachment 1C-FinDec. Notice C — Padro Notice of
Decision After Court Remand – Partially Favorable (Prospective
Relief)
[standard header will be used]
Notice of Decision – Partially Favorable
I carefully reviewed the facts of your case and made the enclosed
decision. Please read this notice and my decision.
If You Disagree With My Decision
If you disagree with my decision, you or your representative
may submit written exceptions to the Appeals Council. “Written
exceptions” are your statements explaining why you disagree with
my decision. This notice will explain your options, including how
to submit written exceptions.
Special Review Procedures Under the Padro
et al. v. Colvin Class-Action Settlement
On October 18, 2013, the U.S. District Court for the Eastern
District of New York approved a settlement in the class-action lawsuit Padro
et al. v. Colvin. This lawsuit challenged decisions
on disability claims made by certain administrative law judges (ALJs).
Under the settlement agreement, if you file written exceptions
to my decision or file a civil action in Federal district court
and your claim is remanded to the Commissioner, my decision will
be reviewed using special review procedures. These special review
procedures are: (1) if you file written exceptions, your claim will
be reviewed by a specified group of staff at the Appeals Council,
and (2) if your claim is returned for a new hearing and decision,
it will not be assigned to me but instead will be assigned to an
ALJ who was not involved in the Padro et al. v. Colvin class-action
lawsuit. We call these special review procedures “Padro review.” We
will use these procedures unless you write and tell us you do not
want Padro review.
How To File Written Exceptions
Please put the Social Security number shown
above on any written exceptions you send. Please also refer to the Padro
et al v. Colvin settlement. We will assume that you
want Padro review unless you tell us you
do not.
Please send your written exceptions to:
Appeals Council
Office of Disability Adjudication and Review
Padro Staff
5107
Leesburg Pike
Falls Church,
VA 22041-3255
If you need help, you may file in person at any Social Security
or hearing office.
Time Limit To File Written Exceptions
(60 Days)
You must file your written exceptions with the Appeals Council within 60 days of the date you get
this notice. The Appeals Council assumes that you got this notice
within 5 days after the date of the notice unless you show that
you did not get it within the 5-day period.
If you need more time to file your written exceptions, you
must file a written request with the Appeals Council. You must file
the request for an extension within 60 days of the date you get
this notice. If you request more than 30 days, you must explain
why you need the extra time. The Appeals Council will decide whether
to grant your request for more than a 30-day extension.
If You Do Not Want Padro Review
If you do not want my decision reviewed under the special
review procedures, you must write and tell the Appeals Council that
you do not want Padro review. You can do
this either with or without filing written exceptions.
If you do file written exceptions, you must tell the Appeals
Council that you do not want Padro review
at the time you file your exceptions. This will mean that (1) your
claim may not be assigned to a specified group of staff at the Appeals
Council, and (2) if your claim is returned for a new hearing and
decision, it may be returned to me or to one of the other ALJs who
were involved in the Padro et al. v. Colvin class-action
lawsuit.
If you do not file written exceptions, you may still tell
the Appeals Council that you do not want Padro review.
You must do this within 60 days of
the date you get this notice. The time limit is the same as the
time limit to file written exceptions, and you should write to the
Appeals Council at the same address. You must say that you do not
want Padro review, and also do not want to
file written exceptions. This will mean that (1) the Appeals Council
may not review my decision at all, and that my decision may become
final, (2) if the Appeals Council does review my decision,
your claim may not be assigned to a specified group of staff at
the Appeals Council, and (3) if you file a civil action in Federal
district court and your claim is returned for a new hearing and
decision, it may be returned to me or to one of the other ALJs who
were involved in the Padro et al. v. Colvin class-action
lawsuit.
If you tell the Appeals Council that you do not want Padro review,
the relief and limitations of the settlement will not apply to you.
You will have the right to file written exceptions or a new civil
action as if there were no class-action settlement.
The Appeals Council May Review My
Decision On Its Own
The Appeals Council may review my decision even if you do
not file written exceptions. The Appeals Council will notify you
within 60 days of the date of this notice if it decides to review your
case.
How Written Exceptions Work
The Appeals Council will consider your entire case. It will
consider all of my decision, even the parts with which you agree.
The Appeals Council's action may be more or less favorable or unfavorable
to you.
Under the terms of the Padro et al. v. Colvin settlement,
we will assign your case to a specified group of staff within the
Appeals Council. This staff will use the same rules for considering
your case that would apply if you tell us you do not want Padro review.
The rules the Appeals Council uses are in the Code of Federal Regulations,
Title 20, Chapter III, Part 404 (Subpart J), Part 416 (Subpart
N), Part 404 (Subpart J) and Part 416 (Subpart N).
You must file written exceptions if
you want us to assign your case to a specified group of staff within
the Appeals Council, and have a new hearing and decision made by
an administrative law judge who was not involved in the Padro
et al. v. Colvin class
action lawsuit should the Appeals Council assume jurisdiction and
remand your case.
The Appeals Council may:
•
Find that there is
no reason to change my decision,
•
Return your case to me if you decline Padro review
or, if you accept Padro review, return your
case to another ALJ for a new decision, or
The Appeals Council will send you a notice telling you what
it decides to do. If the Appeals Council does not change my decision,
my decision will become the final decision after remand. Any future
claim you file will not change a final decision on this claim if
the facts and issues are the same.
Under the terms of the Padro et al. v. Colvin settlement,
if the Appeals Council returns your case for a new decision, your
case will not be assigned to me but instead will be assigned to
an ALJ who was not involved in the Padro et al. v. Colvin class-action
lawsuit.
If you tell us you do not want Padro review,
and the Appeals Council returns your case for a new decision, your
case may be assigned to me or to another ALJ who was involved in
the class-action lawsuit. If the Appeals Council does not change
my decision, my decision will become the final decision.
Filing An Action In Federal District
Court
[The following language will be included
only if the claim was remanded pursuant to Sentence 4:
If you do not file written exceptions, and the Appeals Council
does not review my decision on its own, my decision will become
final on the 61st day following the date
of this notice. After my decision becomes final, you will have 60
days to file a new civil action in Federal district court. You will
lose the right to a court review if you do not file a civil action
during the 60-day period starting with the day my decision becomes
final. However, you can ask the Appeals Council to give you more
time to file a civil action. The Appeals Council will grant your
request for more time only if you can show a good reason for needing
more time. We will not send you any more notices about your right
to file in Federal district court.]
[The following language will be included
only if the claim was remanded pursuant to Sentence 6:
If you do not file written exceptions, and the Appeals Council
does not review your case on its own, my decision and a transcript
of your case record will be sent to the Office of the United States
Attorney for filing with the court when required. You have the right
to pursue your civil action with the court.]
If you accept Padro relief, and your
claim is returned for a new hearing and decision by a Federal district
court, it will be assigned to an ALJ who was not involved in the Padro
et al. v. Colvin class-action lawsuit.
New Application
You have the right to file a new application at any time,
but filing a new application is not the same as filing exceptions
to my decision or filing a civil action in Federal court. If you
disagree with my decision and you file a new application instead
of filing written exceptions or appealing to Federal court, you
might lose some benefits or not qualify for benefits at all. My
decision could also be used to deny a new application for benefits
if the facts and issues are the same. If you think my decision is
wrong, you should file your exceptions within 60 days or file a
new civil action between the 61st and
121st days after the date of this notice.
Your Right To Representation
If you file written exceptions, you may choose to have an
attorney or other person help you. Many representatives do not charge
a fee unless you win. Groups are available to help you find a representative
or, if you qualify, to give you free legal services. Your local
Social Security office has a list of groups that can help you in
this process.
If you get someone to help with filing written exceptions,
you or that person must let the Appeals Council know. If you hire
someone, we must approve the fee before he or she is allowed to
collect it.
If You Have Any Questions
We invite you to visit our website located at www.socialsecurity.gov
to find answers to general questions about social security. You
may also call (800) 772-1213 with questions. If you are deaf or
hard of hearing, please use our TTY number (800) 325-0778.
More information about the Padro et al. v. Colvin settlement
is available on our website located at http://www.socialsecurity.gov/padrosettlement.
You can also contact the Urban Justice Center, the lawyers who brought
the Padro et al. v. Colvin lawsuit, by writing
to them at Urban Justice Center, Padro Class Counsel, Church Street
Station, P.O. Box 3363, New York, NY 10008-3363, or calling them
at (646) 459-3068.
If you have any other questions, please call, write, or visit
any Social Security office. Please have this notice and decision
with you. The telephone number of the local office that serves your
area is [field office phone number].
Its address is:
[FIELD OFFICE ADDRESS]
[ALJ Name]
Administrative Law Judge
Enclosures:
Decision Rationale
Form HA-L39 (Exhibit List)
cc: [Representative of Record]
Attachment 1C-FinDec-SP. Notice C — Padro Notice
of Decision After Court Remand – Partially Favorable (Prospective
Relief) (Spanish)
[standard header will be used]
Aviso del Fallo – Parcialmente Desfavorable
Yo revise detenidamente los hechos de su caso y emití el
fallo adjunto. Por favor lea este aviso y mi fallo.
Si no está de acuerdo con
mi fallo
Si no está de acuerdo con mi fallo, usted o su representante
pueden presentar excepciones por escrito al Consejo de Apelaciones.
Las «excepciones por escritos» son declaraciones
explicando el por qué usted no está de acuerdo
con mi fallo. En este aviso le explicaremos sus opciones, incluso
cómo presentar excepciones por escrito.
Procedimientos especiales de revisión
en conformidad con el Acuerdo de la Demanda Colectiva Padro
et al. v. Colvin
El 18 de octubre de 2013, el Tribunal de Distrito de los Estados
Unidos para el Distrito del Este de Nueva York aprobó un
acuerdo de la demanda colectiva Padro et al. v. Colvin.
Esta demanda retó las reclamaciones que recibieron fallos
que fueron emitidos por ciertos Jueces de Derecho Administrativo
(ALJ) en reclamaciones de los beneficios por incapacidad.
En conformidad con el acuerdo de la demanda colectiva, si
usted presenta excepciones por escrito contra mi fallo o presenta
una acción civil en el Tribunal federal de distrito y su reclamación
es devuelta al Comisionado, mi fallo será revisado usando
unos procedimientos especiales. . Estos procedimientos especiales
de revisión son: (1) si usted presentó excepciones
por escrito, su reclamación para ser revisado por un grupo
específico de los miembros del Consejo de Apelaciones y
(2) si su reclamación es devuelta para una nueva audiencia
y un nuevo fallo, no será asignada a mi persona, sino que
será asignada a un juez de derecho administrativo quien
no tuvo nada que ver con la demanda colectiva de Padro
et al. v. Colvin. Ha estos procedimientos especiales
para una revisión le llamamos «revisiones Padro».
Aplicaremos estos procedimientos a menos que usted nos escriba y
nos diga que no quiere una revisión Padro.
Cómo presentar excepciones
por escrito
Por favor escriba el número de Seguro Social que
aparece en el encabezamiento de este aviso en todas las excepciones
por escrito que presente. También, escriba que la apelación
es referente al acuerdo de la demanda colectiva Padro
et al v. Colvin. Supondremos que solicita una revisión Padro a
menos que nos indique lo contrario.
Por favor envíe sus excepciones específicas
por escrito a:
Appeals Council
Office of Disability Adjudication and Review
Padro Staff
5107
Leesburg Pike
Falls Church,
VA 22041-3255
Si necesita ayuda, puede presentar su petición personalmente
en cualquiera de las oficinas del Seguro Social o de las oficinas
de audiencias del Seguro Social.
Tiempo límite para presentar
sus excepciones por escrito (60 días)
Tiene que presentar excepciones por escrito, por favor escriba
el número de Seguro Social que aparece en el encabezamiento
de este aviso al Consejo de Apelaciones dentro
de 60 días a partir de la fecha en el encabezamiento
de este aviso. El Consejo de Apelaciones supone que usted recibió este
aviso 5 días después de la fecha que aparece en
el encabezamiento de este aviso, a menos que usted pueda probar
que no lo recibió dentro de este periodo de 5 días.
Si necesita más tiempo para presentar excepciones
por escrito, tiene que presentar por escrito una petición
al Consejo de Apelaciones. Tiene que presentar su petición
para una extensión de tiempo dentro de 60 días
a partir de la fecha en el encabezamiento de este aviso. Si solicita
una extensión de tiempo de más de 30 días,
tendrá que justificar el por qué necesita el tiempo
adicional. El Consejo de Apelaciones decidirá si se le
otorgará su petición de extensión de
tiempo mayor de 30 días.
Si usted no quiere los procedimientos
especiales de una revisión Padro
Si usted no quiere que mi fallo sea revisado conforme a los
procedimientos especiales de revisión, entonces tiene que
hacerle saber por escrito al Consejo de Apelaciones que no quiere
una revisión Padro.
Usted puede solicitar esto, ya sea que presente o no presente excepciones
por escrito.
Si presenta excepciones por escrito, tiene que hacerle al
Consejo de Apelaciones que no quiere una revisión Padro en
el momento en que presenta sus excepciones por escrito. Esta acción
de su parte significará que (1) posiblemente su reclamación
no sea asignada a un grupo especial dentro del Consejo de Apelaciones
y (2) si su reclamación es devuelta para que se celebre
una nueva audiencia y un nuevo fallo, es posible que me la devuelvan
a mi persona o a uno de los Jueces de Derecho Administrativo que
fue nombrado en la demanda colectiva del caso Padro et al.
v. Colvin.
Si no presenta excepciones por escrito, todavía puede
hacerle al Consejo de Apelaciones que no quiere una revisión Padro.
Tiene hacerle saber su decisión al Consejo de Apelaciones dentro de 60 días a partir
de la fecha en que reciba este aviso. El límite de tiempo
es el mismo límite de tiempo establecido para presentar
excepciones por escrito y debe dirigir su correspondencia para el
Consejo de Apelaciones a la misma dirección que aparece
más arriba. Tiene que declarar que no quiere una revisión Padro y
que no quiere presentar excepciones por escrito. Esta acción
de su parte significará que (1) es posible que el Consejo
de Apelaciones no revise mi fallo y que mi fallo se convertirá en
el fallo final, (2) si el Consejo de Apelaciones decide
revisar mi fallo, posiblemente su reclamación no sea asignada
a un grupo específico dentro del Consejo de Apelaciones
y (3) si presenta un acción civil en un Tribunal federal
de distrito y su reclamación es devuelta para que se celebre
una nueva audiencia y un nuevo fallo, es posible que me la devuelvan a
mi persona o a uno de los Jueces de Derecho Administrativo que fue
nombrado en la demanda colectiva del caso Padro et al.
v. Colvin.
Si le hace saber al Consejo de Apelaciones haciéndole
saber que no quiere que se utilice una revisión Padro,
entonces, las mitigaciones y limitaciones del acuerdo no serán
aplicadas a su caso. Usted tendrá el derecho de presentar
excepciones por escrito o una acción civil como si no existiera
un acuerdo de una demanda colectiva.
El Consejo de Apelaciones puede revisar
mi fallo por su propia cuenta
Es posible que el Consejo de Apelaciones revise mi fallo,
aunque usted no presente ninguna excepción por escrito.
El Consejo de Apelaciones le enviará un aviso dentro de
60 días a partir de la fecha en el encabezamiento de este
aviso, si el Consejo decide revisar su caso.
Cómo funcionan las excepciones
por escrito
El Consejo de Apelaciones tomará en consideración
su caso en su totalidad. El Consejo de Apelaciones tomará en
consideración mi fallo en su totalidad, incluso las partes
del caso con la usted está de acuerdo. La acción
que tome el Consejo de Apelaciones puede ser menos favorable o desfavorable
para usted.
En conformidad con las condiciones establecidas por el acuerdo Padro
et al. v. Colvin, asignaremos su caso a un grupo específico
dentro del Consejo de Apelaciones. Este grupo específico
utilizará los mismos reglamentos para revisar su caso que
aplicarían si usted nos hiciera saber que no quiere que
se utilice una revisión Padro.
Los reglamentos que el Consejo de Apelaciones utiliza se encuentran
en el tomo del Código de Reglamentos Federales (Code of
Federal Regulations), título 20 (Title 20), capítulo
III (Chapter III), parte 404 (inciso J) (Part 404 [Subpart J]) y
la parte 416 (inciso N) (Part 416 [Subpart N]).
Usted tiene que presentar excepciones
por escrito si quiere que se asigne su caso a un grupo específico
dentro del Consejo de Apelaciones y que se celebre una audiencia
y que se emita un fallo por un Juez de Derecho Administrativo que
no tuvo nada que ver con la demanda colectiva Padro et
al. v. Colvin, si
es que el Consejo de Apelaciones asume la jurisdicción
de su caso y lo devuelve.
El Consejo de Apelaciones puede:
•
Encontrar que no hay
razón alguna por qué cambiar mi fallo,
•
Devolverme el caso si usted rechaza que se utilice
una revisión Padro,
o si usted acepta que se utilice una revisión Padro,
es posible que devuelvan su caso a otro Juez de Derecho Administrativo
para un nuevo fallo, o
•
Emitir su propio fallo en su caso.
El Consejo de Apelaciones le enviará un aviso haciéndole
saber su fallo. Si el Consejo de Apelaciones no cambia mi fallo,
entonces mi fallo se convierte en el fallo final después
de ser devuelto. Cualquier reclamación que usted presente
en el futuro no cambiará una decisión final en
esta reclamación, si los hechos y asuntos presentados son
los mismos.
En conformidad con las condiciones establecidas por el acuerdo
de la demanda colectiva Padro et al. v. Colvin,
si el Consejo de Apelaciones devuelve su caso para que se emita
un nuevo fallo, su caso no será asignado a mi otra vez,
sino que su caso será asignado a un Juez de Derecho Administrativo
que no fue uno de los que se nombra en la demanda colectiva del
caso Padro et al. v. Colvin.
Si usted nos hace saber que no quiere que se utilice una revisión Padro,
entonces si el Consejo de Apelaciones devuelve su caso para que
se emita un nuevo fallo, es posible que su caso sea asignado a mi
persona o a uno de los Jueces de Derecho Administrativo que fue
nombrado en la demanda colectiva. Si el Consejo de Apelaciones rechaza
su apelación, entonces mi fallo se convierte en el fallo
final.
Presentando una acción en
el Tribunal Federal de Distrito
[The following language will be included
only if the claim was remanded pursuant to Sentence 4:
Si no presenta excepciones por escrito y el Consejo de Apelaciones
no revisa mi fallo por sí mismo, entonces mi fallo se convierte
en el fallo final el día número 61 a partir de
la fecha que aparece en el encabezamiento de este aviso. Después
que mi fallo se convierte en el fallo final, usted tendrá 60
días para presentar una nueva acción civil en
el Tribunal Federal de Distrito. Usted perderá su derecho
a que el tribunal revise su caso si no presenta una acción
civil durante el periodo de 60 días a partir de la fecha
en que mi fallo se convierte en el fallo final. No obstante, usted
puede peticionar al Consejo de Apelaciones para que le permita más
tiempo para presentar una acción civil. El Consejo de Apelaciones
le otorgará su petición para más tiempo
solo si usted puede justificar la necesidad de más tiempo.
No le enviaremos más avisos acerca de su derecho a presentar
su caso en el Tribunal Federal de Distrito.]
[The following language will be included
only if the claim was remanded pursuant to Sentence 6:
Si no presenta las excepciones generales por escrito y el
Consejo de Apelaciones no revisa su caso por sí mismo,
entonces mi fallo y la transcripción de su caso y el registro
del mismo serán enviados a la Oficina del Abogado de los
Estados Unidos para presentarlos al tribunal cuando sea necesario.
Usted tiene el derecho de continuar con su acción civil
con el tribunal.]
Si acepta las mitigaciones del acuerdo Padro y
su reclamación es devuelta para que se celebre una nueva
audiencia y se emita un nuevo fallo por un Tribunal Federal de Distrito,
su caso será asignado a un Juez de Derecho Administrativo
que no fue uno de los que se nombra en la demanda colectiva del
caso Padro et al. v. Colvin.
Una nueva solicitud
Usted tiene el derecho a presentar una nueva solicitud en
cualquier momento, pero debe entender que el presentar una nueva
solicitud no es lo mismo que presentar excepciones a mi fallo o
el presentar una acción civil en un tribunal federal. Si
no está de acuerdo con mi fallo y decide presentar una
nueva solicitud en vez de presentar excepciones o una apelación
en un tribunal federal, existe la posibilidad que pierda algunos
beneficios o que no tenga derecho a recibir ninguno de los beneficios
disponibles. Mi fallo también puede usarse como base para
denegar su nueva solicitud para recibir los beneficios, si es que
los hechos y asuntos presentados son los mismos. Si cree que mi
fallo es incorrecto, tiene que presentar sus excepciones dentro
de 60 días o presentar una nueva acción civil
entre los días números 61 y el 121 a partir de
la fecha que aparece en el encabezamiento de este aviso.
Su derecho a representación
Usted puede elegir a un abogado u otra persona para que le
ayude. Muchos abogados no cobran un honorario a menos que ganen
su apelación. También existen grupos que están
disponibles para ayudarle a conseguir un abogado o, si usted reúne
los requisitos, proveerle servicios legales de gratis. Su oficina
local del Seguro Social tiene una lista de grupos que pueden ayudarle
en este proceso.
Si retiene los servicios de alguien para que le ayude con
su apelación, usted y la persona que usted contrate tienen
que hacerle saber al Consejo de Apelaciones. Si contrata los servicios
de alguna persona, nosotros tenemos que aprobar el honorario a cobrar
antes de que la persona pueda cobrarlo.
Si tiene preguntas
Le invitamos a que visite nuestro sitio de Internet en www.segurosocial.gov
para encontrar respuestas a sus preguntas en general referentes
a los servicios y programas administrados por el Seguro Social.
También puede llamarnos con sus preguntas al 1-(800)-772-1213.
Si es sordo o tiene problemas de audición, por favor marque
nuestro número TTY 1-(800)-325-0778.
Para informarse mejor acerca del acuerdo de la demanda colectiva Padro
et al. v. Colvin, puede visitar la página de
Internet http://www.socialsecurity.gov/padrosettlement (solo
disponible en inglés). También puede comunicarse
con el «Urban Justice Center», que son los abogados
que presentaron la demanda colectiva Padro et al. v.
Colvin, escribiéndoles a: Urban Justice Center, Padro
Class Counsel, Church Street Station, P.O. Box 3363, New York, NY
10008-3363, o llamándoles al (646) 459-3068.
Si tiene preguntas adicionales, por favor llame, escriba o
visite cualquier oficina del Seguro Social. Por favor, tenga consigo
este aviso y el fallo. El número de teléfono de
su oficina local que le presta servicio es [field
office phone number]. La dirección física
es:
[FIELD OFFICE ADDRESS]
[ALJ Name]
Juez de Derecho Administrativo
Anejos:
Racional del fallo
Formulario número HA-L39 (Lista de prueba documental)
cc: [Representative of Record]
Attachment 1D. Notice
D — Appeals Council Return Order
[standard header will be used]
NOTICE OF ORDER OF
APPEALS COUNCIL
RETURNING CASE TO
ADMINISTRATIVE LAW JUDGE
[Claimant Name]
[Claimant Street Address]
[Claimant City, State, Zip]
What This Order Means
You have requested and are eligible for relief pursuant to
the settlement in the Padro et al v. Colvin class
action lawsuit. Based on your eligibility for relief, we have sent
this case back to an Administrative Law Judge who is not a named
Administrative Law Judge in the settlement agreement. In the enclosed
order, we explain why we did this and what the Administrative Law
Judge will do about this claim.
We are forwarding the claim file to:
Hearing Office Chief Administrative Law Judge
Office of Disability Adjudication and Review
[Hearing Office]
[Hearing Office Address]
[Hearing Office City, State, Zip]
What Happens Next
An Administrative Law Judge will contact you to tell you what
you need to do.
If You Have Any Questions
If you have any questions, you may call, write, or visit any
Social Security office. If you do call or visit an office, please
have this notice with you. The telephone number of the local office
that serves your area is xxx-xxx-xxxx. Its address is:
SOCIAL SECURITY
[Street Address]
[City, State, Zip]
More information about the Padro et al. v. Colvin settlement
is available on our website located at http://www.socialsecurity.gov/padrosettlement.
You can also contact the lawyers who brought the Padro
et al. v. Colvin lawsuit by writing to them at Urban
Justice Center, Padro Class Counsel, Church Street Station, P.O.
Box 3363, New York, NY 10008-3363, or calling them at (646) 459-3068.
<OSB>
<BSP>[Judge's Name]</BSP>
<BSP>Administrative Appeals Judge</BSP>
cc:
Representative of Record
Representative Payee
SOCIAL SECURITY ADMINISTRATION
OFFICE OF DISABILITY ADJUDICATION AND REVIEW
ORDER OF APPEALS
COUNCIL
RETURNING CASE TO ADMINISTRATIVE LAW JUDGE
In the case of
|
Claim for
|
Claimant Name
|
Period of Disability and
Disability Insurance Benefits/Supplemental Security Income
|
(Claimant)
|
|
|
xxx-xx-xxx
|
(Wage Earner) (Leave blank if same as above)
|
(Social Security Number)
|
The claimant is eligible for relief pursuant to the settlement
in the Padro et al v. Colvin class action
lawsuit. Therefore, the Appeals Council returns this case pursuant
to the terms of the settlement agreement. Specifically, this case
must be assigned to an Administrative Law Judge who is not named
in the class action.
[if it is unclear whether consolidation of the Padro claim
with a non-Padro claim is warranted, insert
this language]
The claimant filed a subsequent claim for [Title II][Title
XVI] benefits on . On return, the Administrative Law Judge will
consider whether the subsequent claim should be consolidated with
the current claim(s).
[end conditional for when it is unclear whether consolidation
of the Padro claim with a non-Padro claim
is warranted]
[if consolidation of the Padro claim
with a non-Padro claim is warranted, insert
this language]
The claimant filed [a] subsequent claim[s] for [Title II][Title
XVI][Title II and for Title XVI] benefits on . The Appeals Council's
action with respect to the prior claim renders the subsequent claims
duplicate. Therefore, the Administrative Law Judge will offer the
claimant the opportunity for a hearing, take any further action
needed to complete the administrative record, will associate the
claim files and issue a new decision on the associated claims.
[end conditional for when consolidation of the Padro claim
with a non-Padro claim is warranted]
In compliance with the above, the Administrative Law Judge
will offer the claimant the opportunity for a hearing, take any
further action needed to complete the administrative record and
issue a new decision.
APPEALS COUNCIL
<BSP></BSP>
<OSB>______________________________
[Judge's <BSP>Name]<
<BSP>Administrative Appeals Judge</BSP>
Date:
Attachment 1D-SP. Notice D — Appeals Council Return Order (Spanish)
[standard header will be used]
AVISO DE LA ORDEN
DEL CONSEJO DE APELACIONES
DEVOLVIENDO EL CASO
AL JUEZ DE DERECHO ADMINISTRATIVO
[Claimant Name]
[Claimant Street Address]
[Claimant City, State, Zip]
Lo que esta orden significa
Usted solicitó mitigación de su caso y tiene
derecho a ello en conformidad con el acuerdo de la demanda colectiva
del caso Padro et al v. Colvin. Basándonos
en su derecho a mitigación de su caso, hemos devuelto su
caso a un Juez de Derecho Administrativo quien no es uno de los
Jueces de Derecho Administrativo nombrados en el acuerdo de la demanda.
En la orden judicial que incluimos, explicamos el por qué hicimos
esto y lo que el Juez de derecho Administrativo hará referente
a esta reclamación.
Estamos enviando registro de reclamación de los beneficios
a:
Hearing Office Chief Administrative Law Judge
Office of Disability Adjudication and Review
[Hearing Office]
[Hearing Office Address]
[Hearing Office City, State, Zip]
Próximos pasos
Un Juez de Derecho Administrativo se comunicará con
usted y le hará saber lo que necesita hacer.
Si tiene alguna pregunta
Si tiene preguntas nos puede llamar, escribir o visitar una
de las oficinas del Seguro Social. Si decide llamar o visitar una
de nuestras oficinas, por favor tenga este aviso consigo. El número
de teléfono de la oficina local del Seguro Social que presta
servicios en su comunidad es xxx-xxx-xxxx. La dirección
física es:
SOCIAL SECURITY
[Street Address]
[City, State, Zip]
Para informarse mejor acerca del acuerdo de la demanda colectiva Padro
et al. v. Colvin está disponible en nuestro
sitio de Internet http://www.socialsecurity.gov/padrosettlement (solo disponible
en inglés). También puede comunicarse con el «Urban
Justice Center», que son los abogados que presentaron la
demanda colectiva Padro et al. v. Colvin,
escribiéndoles a: Urban Justice Center, Padro Class Counsel,
Church Street Station, P.O. Box 3363, New York, NY 10008-3363, o
llamándoles al (646) 459-3068.
[Judge's Name]
Juez de Derecho Administrativo
de Apelaciones
cc:
[Representative of Record]
[Representative Payee]
Attachment 1D. Notice
E – Notice of Proposed Class Action Settlement and Fairness Hearing
Notice of Proposed
Class Action Settlement and Fairness Hearing
Regarding Decisions
by Certain Administrative Law Judges in Queens, New York about
Social
Security Disability Benefits
This notice is about a proposed settlement in a class action
lawsuit concerning decisions about Social Security disability benefits
by certain Administrative Law Judges (ALJs) in Queens, New York.
Social Security disability benefits include both Disability Insurance
Benefits and Supplemental Security Income (SSI) payments based on
disability.
The proposed settlement may affect
your rights if you received or will receive an unfavorable
or partially favorable decision about your claim for disability
benefits from one of the five ALJs in Queens, New York listed below,
during the period that begins January 1, 2008, and ends 30 months
after the settlement becomes final. The proposed settlement will
become final when the Court approves it.
The lawsuit was brought in the United States District Court
for the Eastern District of New York, in Brooklyn, New York. The
Court will hold a public hearing before deciding whether to give final
approval to the proposed settlement.
This notice describes the lawsuit and the terms of the proposed
settlement. This notice also describes the process that the Court
will use to decide whether to approve the proposed settlement, and
what you can do if you have comments or object to the proposed settlement.
What Is The Lawsuit About?
The lawsuit is called Padro et al. v. Astrue.
Plaintiffs claimed that certain ALJs in Queens, New York (Michael
D. Cofresi, Seymour Fier, Marilyn P. Hoppenfeld, David Z. Nisnewitz,
and Hazel C. Strauss) were “generally biased” against
people applying for Social Security disability benefits. The Social
Security Administration denies any wrongdoing or liability. However,
the parties are proposing to settle the lawsuit.
Who Are Members Of The Class?
You may be a Class member if you received or will receive
an unfavorable or partially favorable decision from one of the five
ALJs listed above during the period beginning January 1, 2008, and ending
30 months after the date the proposed settlement becomes final.
What Are The Terms Of The Proposed
Settlement?
This notice contains only a summary of the proposed settlement.
To fully understand the proposed settlement, you should read the
entire proposed settlement agreement. Information about where you
can find a copy of the entire proposed settlement agreement appears
below.
The proposed settlement provides that:
1.
Class members
whose claims were denied by one of the five ALJs named above between January
1, 2008, and the date the proposed settlement becomes final will
have the right to a new hearing and decision on that claim. The
new decision will be made by an ALJ who is not one of the five listed
above or, in certain circumstances, may be made by a Social Security Administration
attorney advisor or the Social Security Administration's Appeals
Council.
2.
Class members whose claims are denied by the five
ALJs named above during the 30-month period after the date the proposed
settlement becomes final will have their claims reviewed by a specified
group of staff at the Appeals Council. If a class member's claim
is sent for another hearing after an appeal, the claim will be assigned
to an ALJ who is not one of the five listed above.
3.
The Social Security Administration will provide
other relief. This relief relates to ALJ training and to procedures
the agency uses to review complaints that an ALJ hearing was unfair.
4.
As part of the settlement, lead counsel for class
plaintiffs—Gibson, Dunn & Crutcher—agreed
to waive its fees. Gibson Dunn's co-counsel, a not-for-profit organization
called the Urban Justice Center, will be paid fees of $125,000 for
work done on this lawsuit. Those fees are the only funds to be paid
by the Social Security Administration in connection with this lawsuit,
except for the costs associated with sending the notices described
in the proposed settlement.
How Can You Get A Copy of The Proposed
Settlement?
You can get a copy of the proposed settlement in one of the
following ways:
2.
You can contact the Urban Justice Center, the lawyers
who brought the Padro et al. v. Astrue lawsuit,
at (646) 459-3068.
How Will The Court Decide Whether
To Approve The Proposed Settlement?
The Court will need to approve the proposed settlement before
it becomes final.
The Court will hold a public hearing, called a fairness hearing,
to decide if the proposed settlement is fair. The hearing will be
held on July 24, 2013 at 2:30 p.m., at the following address:
United States District Court
Eastern District of
New York
225 Cadman Plaza East
Brooklyn, New York
11201
Courtroom 10D South
Because the date and time of the hearing could change, please
check with the Court before attending.
What Can You Do If You Object To The
Settlement Or Have Other Comments?
IF YOU AGREE with the proposed settlement, you do not have
to do anything at this time. You have the right to attend the fairness
hearing, at the time and place above.
IF YOU DISAGREE OR HAVE COMMENTS about the proposed settlement,
you can write to the Court or ask to speak at the hearing. You must
do this by writing to the Clerk of the Court, at either:
The following mailing address:
Clerk of the Court
United States District Court
Eastern
District of New York
225 Cadman Plaza East
Brooklyn,
New York 11201
Or the following email address:
11cv1788@nyed.uscourts.gov
Your written comments or request to speak at the fairness
hearing must be postmarked or e-mailed by June 24, 2013.
The Clerk will provide copies of written comments to the lawyers
who brought the lawsuit and to the Social Security Administration
by filing the comments on the court's electronic case filing system.
If your comments involve your health or other personal information,
and you do not want such information to be widely available, you
may ask the Court to keep your comments private by requesting that
they be filed “under seal.” If you do this, your comments
will be seen by the Court and the lawyers and the Social Security
Administration, but the comments will not be made public. If you
do not say that you want your comments “under seal,” they
will become a part of the public record. This means that they will
be available online through the Court's public access service. They
may be read, downloaded, or distributed by anyone who has an account.
The Court will decide who gets to speak at the fairness hearing.
What Can You Do If You Have Questions?
If you have any questions about this lawsuit or about the
proposed settlement, please contact the lawyers who brought the
lawsuit at:
Urban Justice Center
Padro Class Counsel
123
William Street, 16th Floor
New
York, New York 10038-3800
Tel. (646) 459-3068
Fax.
(212) 533-4598
Attachment 1E-SP. >Notice
E – Notice of Proposed Class Action Settlement and Fairness Hearing
(Spanish)
Aviso del Acuerdo
Propuesto de la Demanda Colectiva y de la Audiencia de Equidad referente
a los fallos que emitieron ciertos Jueces de Derecho Administrativo
en Queens, Nueva York con respecto a solicitudes para recibir los
beneficios de Seguro Social por incapacidad
Este aviso es referente a la propuesta del acuerdo de la demanda
colectiva referente a los fallos sobre de las solicitudes para recibir
los beneficios de Seguro Social por incapacidad emitidos por ciertos
Jueces de Derecho Administrativos (ALJs) en Queens, Nueva York.
Los beneficios por incapacidad administrados por el Seguro Social
incluyen ambos los beneficios de Seguro Social por incapacidad y
los pagos de la Seguridad de Ingreso Suplementario (SSI) basados
en una incapacidad.
El acuerdo propuesto posiblemente
afecte sus derechos si recibió o recibirá un
fallo desfavorable o favorable en parte referente a su solicitud
para recibir los beneficios por incapacidad que uno de los cinco
ALJs, nombrados más adelante, en Queens, Nueva York, emitió,
durante el periodo de tiempo que comienza el 1° de enero
de 2008 y termina 30 meses después de la fecha en que el
acuerdo se finaliza. El acuerdo propuesto se finalizará cuando
el Tribunal lo apruebe.
La demanda fue ventilada en el Tribunal de Distrito de los
Estados Unidos para el Distrito Este de Nueva York, en Brooklyn,
Nueva York. El Tribunal celebrará una vista pública
antes de fallar en lo referente a si darle la aprobación
final al acuerdo propuesto.
Este aviso describe la demanda y los términos del
acuerdo propuesto. Este aviso también describe el procedimiento
que el Tribunal usará para fallar en si aprueba o no el
acuerdo propuesto y qué medidas usted puede tomar si tiene
comentarios u objeta al acuerdo propuesto.
¿A qué viene la
demanda?
La demanda se conoce como Padro et al. v. Astrue.
Los demandantes reclaman que ciertos ALJs en Queens, Nueva York
(Michael D. Cofresi, Seymour Fier, Marilyn P. Hoppenfeld, David Z.
Nisnewitz, y Hazel C. Strauss) estaba «en términos
generales prejuiciados» en contra de las personas que solicitan
los beneficios de Seguro Social por incapacidad. La Administración
del Seguro Social deniega cualquier acto ilegal o responsabilidad.
No obstante, las partes interesadas proponen llegar a un acuerdo
de la demanda.
¿Quiénes son los
miembros de la Demanda Colectiva?
Es posible que usted sea un miembro de la Demanda Colectiva
si recibió o recibirá un fallo desfavorable o
favorable en parte de uno de los cinco ALJs anteriormente nombrados
durante el periodo de tiempo que comienza el 1° de enero
de 2008 y termina 30 meses después de la fecha en que el
acuerdo se finaliza
¿Cuáles son los
términos del acuerdo propuesto?
Este aviso contiene solo un resumen del acuerdo propuesto.
Para poder comprender el acuerdo propuesto debe leer la propuesta
del acuerdo de la demanda colectiva en tu totalidad. Más adelante
encontrará información acerca de dónde
puede encontrar una copia de la propuesta del acuerdo en tu totalidad.
El acuerdo propuesto estipula que:
1.
Los miembros
de la Demanda Colectiva cuyas solicitudes fueron denegadas por uno
de los cinco ALJs anteriormente nombrados entre las fechas del 1° de
enero de 2008 y la fecha en que el acuerdo se finaliza, tendrán
el derecho a una nueva audiencia y un nuevo fallo de su solicitud.
El nuevo fallo será emitido por un ALJ que no es uno de
los cinco ALJs anteriormente mencionados o, bajo ciertas circunstancias,
es posible que el fallo sea emitido por un abogado asesor de la
Administración del Seguro Social o el Consejo de Apelaciones
de la Administración del Seguro Social.
2.
Los miembros de la Demanda Colectiva cuyas solicitudes
serían denegadas por uno de los cinco ALJs anteriormente
nombrados durante el periodo de tiempo de 30 meses después
que el acuerdo se finalice, tendrán sus solicitudes revisadas
por un grupo específico del Consejo de Apelaciones. Si
la solicitud de uno de los miembros de la Demanda Colectiva se le programa
otra audiencia después de una apelación, dicha
solicitud será asignada a un ALJ quien no es uno de los
cinco ALJs anteriormente nombrado.
3.
La Administración del Seguro Social proveerá otra
mitigación. Cuando nos hacemos referencia a mitigación,
nos referimos a la capacitación de los ALJs y a los procedimientos
que la agencia utiliza para revisar las querellas referentes a si
una audiencia con un ALJ fue parcial.
4.
Como parte del acuerdo, los abogados principales
de la Demanda Colectiva—Gibson, Dunn & Crutcher—acordaron
no exigir honorarios. A los abogados adjuntos al bufete de Gibson
Dunn, una organización sin fines de lucro llamada Urban
Justice Center, se les pagará honorarios por la cantidad
de $125,000 por sus servicios prestados en referencia a esta demanda.
Estos honorarios serán los únicos fondos que pagará la
Administración del Seguro Social en conexión a
esta demanda, excepto por los gastos asociados con el envío
de los avisos descritos en el acuerdo propuesto.
¿Cómo puedo conseguir
una copia del acuerdo propuesto?
Puede conseguir una copia del acuerdo propuesto por medio
de una de estas maneras:
1.
Puede leer el
acuerdo propuesto en esta página de Internet:
www.segurosocial.gov/padrosettlement (solo
disponible en inglés).
2.
Puede comunicarse con el «Urban Justice
Center», los abogados que presentaron la demanda de Padro
et al. v. Astrue, llamándolos al (646) 459-3068.
¿Cómo decidirá el
Tribunal si aprobar o no el acuerdo propuesto?
El Tribunal necesitará aprobar el acuerdo propuesto
antes de que éste se finalice.
El Tribunal celebrará una vista pública,
conocida como una audiencia de equidad, para decidir si el acuerdo
propuesto es justo. La vista pública se celebrará el
24 de julio de 2013, a las 2:30 p.m., en la siguiente dirección:
United States District Court
Eastern District of
New York
225 Cadman Plaza East
Brooklyn, New York
11201
Courtroom 10D South
Ya que es posible que cambie la fecha y hora de la vista pública,
así que por favor comuníquese con el Tribunal
antes de presentarse.
¿Qué debe hacer
si objeta al acuerdo o tiene otros comentarios?
SI ESTÁ DE ACUERDO con el acuerdo propuesto, no tiene
que hacer nada más. Usted tiene el derecho de asistir a
la audiencia de equidad, a la hora y en la dirección antes
indicada.
SI NO ESTÁ DE ACUERDO O TIENE OTROS COMENTARIOS acerca
del acuerdo propuesto, puede escribirle directamente al Tribunal
o puede ventilar su desacuerdo o sus comentarios durante la vista
pública. Para hacerle saber al Tribunal su intención,
tiene que hacerlo por escrito dirigiéndose al «Clerk
of the Court» (Secretario del Tribunal) a una de las dos
siguientes direcciones:
Dirección postal:
Clerk of the Court
United States District Court
Eastern
District of New York
225 Cadman Plaza East
Brooklyn,
New York 11201
O a la siguiente dirección de correo electrónico:
11cv1788@nyed.uscourts.gov
Sus comentarios o su petición para poder ventilar
su desacuerdo o sus comentarios durante la audiencia de equidad
por escrito tienen que estar franqueadas o enviadas por correo electrónico hasta
el 24 de junio de 2013.
El Secretario del Tribunal le proporcionará copias
de sus comentarios por escrito a los abogados que presentaron la
demanda colectiva, al igual que a la Administración del
Seguro Social, de manera de presentar los comentarios en el sistema
electrónico de presentar casos mantenido por el Tribunal.
Si sus comentarios incluyen asuntos pertinentes a su salúd
o alguna otra información personal y si no quiere que esta
información sea divulgada, usted le puede pedir al Secretario
del Tribunal que mantenga sus comentarios en privado de manera que
se mantendrán «sellados». Si decide hacer
esto, sus comentarios estarán a la disposición
del Tribunal, los abogados y la Administración del Seguro
Social, pero los comentarios no se publicarán. Si no expresa
que no quiere que sus comentarios sean «sellados»,
entonces sus comentarios vendrán a ser parte del registro público.
Esto significa que estarán disponibles por Internet por
medio del servicio de acceso público del Tribunal. Sus
comentarios podrán ser leídos, descargados o distribuidos
por cualquier persona que tenga una cuenta con el Tribunal.
El Tribunal decidirá a quién le permitirá ventilar
sus desacuerdos o comentarios durante la audiencia de equidad.
¿Qué debe hacer
si tiene alguna pregunta?
Si tiene alguna pregunta referente a esta demanda colectiva
o referente al acuerdo propuesto, por favor comuníquese
a la siguiente dirección y teléfono con los abogados
que presentaron esta demanda colectiva:
Urban Justice Center
Padro Class Counsel
123
William Street, 16thFloor
New
York, New York 10038-3800
Tel. (646) 459-3068
Fax.
(212) 533-4598
Attachment 1E (Revised). Notice E – Notice of Proposed Class Action Settlement
and Fairness Hearing
Notice of Proposed
Class Action Settlement and Fairness Hearing
Regarding Decisions
by Certain Administrative Law Judges in Queens, New York about
Social Security Disability
Benefits
This notice is about a proposed settlement in a class action
lawsuit concerning decisions about Social Security disability benefits
by certain Administrative Law Judges (ALJs) in Queens, New York.
Social Security disability benefits include both Disability Insurance
Benefits and Supplemental Security Income (SSI) payments based on
disability.
The proposed settlement may affect
your rights if you received or will receive an unfavorable
or partially favorable decision about your claim for disability
benefits from one of the five ALJs in Queens, New York listed below,
during the period that begins January 1, 2008, and ends 30 months
after the settlement becomes final. The proposed settlement will
become final when the Court approves it.
The lawsuit was brought in the United States District Court
for the Eastern District of New York, in Brooklyn, New York. The
Court is holding a public hearing before deciding whether to give final
approval to the proposed settlement.
This notice describes the lawsuit and the terms of the proposed
settlement. This notice also describes the process that the Court
will use to decide whether to approve the proposed settlement, and
what you can do if you have comments or object to the proposed settlement.
What Is The Lawsuit About?
The lawsuit is called Padro et al. v. Colvin.
Plaintiffs claimed that certain ALJs in Queens, New York (Michael
D. Cofresi, Seymour Fier, Marilyn P. Hoppenfeld, David Z. Nisnewitz,
and Hazel C. Strauss) were “generally biased” against
people applying for Social Security disability benefits. The Social
Security Administration denies any wrongdoing or liability. However,
the parties are proposing to settle the lawsuit.
Who Are Members Of The Class?
You may be a Class member if you received or will receive
an unfavorable or partially favorable decision from one of the five
ALJs listed above during the period beginning January 1, 2008, and ending
30 months after the date the proposed settlement becomes final.
What Are The Terms Of The Proposed
Settlement?
This notice contains only a summary of the proposed settlement.
To fully understand the proposed settlement, you should read the
entire proposed settlement agreement. Information about where you
can find a copy of the entire proposed settlement agreement appears
below.
The proposed settlement provides that:
1.
Class members whose claims were denied by one of the five
ALJs named above between January 1, 2008, and the date the proposed
settlement becomes final will have the right to a new hearing and
decision on that claim. The new decision will be made by an ALJ
who is not one of the five listed above or, in certain circumstances,
may be made by a Social Security Administration attorney advisor
or the Social Security Administration's Appeals Council.
2.
Class members whose claims are denied by the five ALJs
named above during the 30-month period after the date the proposed
settlement becomes final will have their claims reviewed by a specified
group of staff at the Appeals Council. If a class member's claim
is sent for another hearing after an appeal, the claim will be assigned
to an ALJ who is not one of the five listed above.
3.
The Social Security Administration will provide other
relief. This relief relates to ALJ training and to procedures the agency
uses to review complaints that an ALJ hearing was unfair.
4.
As part of the settlement, lead counsel for class
plaintiffs—Gibson, Dunn & Crutcher—agreed to waive its
fees. Gibson Dunn's co-counsel, a not-for-profit organization called the
Urban Justice Center, will be paid fees of $125,000 for work done on this
lawsuit. Those fees are the only funds to be paid by the Social
Security Administration in connection with this lawsuit, except
for the costs associated with sending the notices described in the
proposed settlement.
How Can You Get A Copy of The Proposed
Settlement?
You can get a copy of the proposed settlement in one of the
following ways:
2.
You can contact the Urban Justice Center, the lawyers who
brought the Padro et al. v. Colvin lawsuit,
at (646) 459-3068.
How Will The Court Decide Whether
To Approve The Proposed Settlement?
The Court will need to approve the proposed settlement before
it becomes final.
The Court is holding a public hearing, called a fairness hearing,
to decide if the proposed settlement is fair. The hearing, which
began on July 24, 2013, will continue on September 16, 2013 at 9:30
a.m., at the following address:
United States District Court
Eastern District of
New York
225 Cadman Plaza East
Brooklyn, New York
11201
Ceremonial Courtroom 2D North
Because the date and time of the hearing could change, please
check with the Court before attending.
What Can You Do If You Object To The
Settlement Or Have Other Comments?
IF YOU AGREE with the proposed settlement, you do not have
to do anything at this time. You have the right to attend the fairness
hearing, at the time and place above.
IF YOU DISAGREE OR HAVE COMMENTS about the proposed settlement,
you can write to the Court or ask to speak at the hearing. You must
do this by writing to the Clerk of the Court, at either:
The following mailing address:
Clerk of the Court
United States District Court
Eastern
District of New York
225 Cadman Plaza East
Brooklyn,
New York 11201
Or the following email address:
11cv1788@nyed.uscourts.gov
Your written comments or request to speak at the fairness
hearing must be postmarked or e-mailed by September 3, 2013.
The Clerk will provide copies of written comments to the lawyers
who brought the lawsuit and to the Social Security Administration
by filing the comments on the court's electronic case filing system.
If your comments involve your health or other personal information,
and you do not want such information to be widely available, you
may ask the Court to keep your comments private by requesting that
they be filed “under seal.” If you do this, your comments
will be seen by the Court and the lawyers and the Social Security
Administration, but the comments will not be made public. If you
do not say that you want your comments “under seal,” they
will become a part of the public record. This means that they will
be available online through the Court's public access service. They
may be read, downloaded, or distributed by anyone who has an account.
The Court will decide who gets to speak at the fairness hearing.
What Can You Do If You Have Questions?
If you have any questions about this lawsuit or about the
proposed settlement, please contact the lawyers who brought the
lawsuit at:
Urban Justice Center
Padro Class Counsel
123
William Street, 16th Floor
New
York, New York 10038-3800
Tel. (646) 459-3068
Fax.
(212) 533-4598
Attachment 1E-SP (Revised). Notice E – Notice
of Proposed Class Action Settlement and Fairness Hearing (Spanish)
Aviso del Acuerdo
Propuesto de la Demanda Colectiva y de la Audiencia de Equidad referente
a los fallos que emitieron ciertos Jueces de Derecho Administrativo
en Queens, Nueva York con respecto a solicitudes para recibir los
beneficios de Seguro Social por incapacidad
Este aviso es referente a la propuesta del acuerdo de la demanda
colectiva referente a los fallos sobre de las solicitudes para recibir
los beneficios de Seguro Social por incapacidad emitidos por ciertos
Jueces de Derecho Administrativos (ALJs) en Queens, Nueva York.
Los beneficios por incapacidad administrados por el Seguro Social
incluyen ambos los beneficios de Seguro Social por incapacidad y
los pagos de la Seguridad de Ingreso Suplementario (SSI) basados
en una incapacidad.
El acuerdo propuesto posiblemente
afecte sus derechos si recibió o recibirá un
fallo desfavorable o favorable en parte referente a su solicitud
para recibir los beneficios por incapacidad que uno de los cinco
ALJs, nombrados más adelante, en Queens, Nueva York, emitió,
durante el periodo de tiempo que comienza el 1 de enero de 2008
y termina 30 meses después de la fecha en que
el acuerdo se finaliza. El acuerdo propuesto se finalizará cuando
el Tribunal lo apruebe.
La demanda fue ventilada en el Tribunal de Distrito de los
Estados Unidos para el Distrito Este de Nueva York, en Brooklyn,
Nueva York. El Tribunal está celebrando una vista pública
antes de fallar en lo referente a si darle la aprobación
final al acuerdo propuesto.
Este aviso describe la demanda y los términos del
acuerdo propuesto. Este aviso también describe el procedimiento
que el Tribunal usará para fallar en si aprueba o no el
acuerdo propuesto y qué medidas usted puede tomar si tiene
comentarios u objeta al acuerdo propuesto.
¿A qué viene la
demanda?
La demanda se conoce como Padro et al. v. Colvin.
Los demandantes reclaman que ciertos ALJs en Queens, Nueva York
(Michael D. Cofresi, Seymour Fier, Marilyn P. Hoppenfeld, David Z.
Nisnewitz, y Hazel C. Strauss) estaba «en términos
generales prejuiciados» en contra de las personas que solicitan
los beneficios de Seguro Social por incapacidad. La Administración
del Seguro Social deniega cualquier acto ilegal o responsabilidad.
No obstante, las partes interesadas proponen llegar a un acuerdo
de la demanda.
¿Quiénes son los
miembros de la Demanda Colectiva?
Es posible que usted sea un miembro de la Demanda Colectiva
si recibió o recibirá un fallo desfavorable o
favorable en parte de uno de los cinco ALJs anteriormente nombrados
durante el periodo de tiempo que comienza el 1 de enero de 2008
y termina 30 meses después de la fecha en que
el acuerdo se finaliza.
¿Cuáles son los
términos del acuerdo propuesto?
Este aviso contiene solo un resumen del acuerdo propuesto.
Para poder comprender el acuerdo propuesto debe leer la propuesta
del acuerdo de la demanda colectiva en tu totalidad. Más adelante
encontrará información acerca de dónde
puede encontrar una copia de la propuesta del acuerdo en tu totalidad.
El acuerdo propuesto estipula que:
1.
Los miembros
de la Demanda Colectiva cuyas solicitudes fueron denegadas por uno
de los cinco ALJs anteriormente nombrados entre las fechas del 1
de enero de 2008 y la fecha en que el acuerdo se finaliza, tendrán
el derecho a una nueva audiencia y un nuevo fallo de su solicitud.
El nuevo fallo será emitido por un ALJ que no es uno de
los cinco ALJs anteriormente mencionados o, bajo ciertas circunstancias,
es posible que el fallo sea emitido por un abogado asesor de la
Administración del Seguro Social o el Consejo de Apelaciones
de la Administración del Seguro Social.
2.
Los miembros de la Demanda Colectiva cuyas solicitudes
serían denegadas por uno de los cinco ALJs anteriormente
nombrados durante el periodo de tiempo de 30 meses después
que el acuerdo se finalice, tendrán sus solicitudes revisadas
por un grupo específico del Consejo de Apelaciones. Si
la solicitud de uno de los miembros de la Demanda Colectiva se le programa
otra audiencia después de una apelación, dicha
solicitud será asignada a un ALJ quien no es uno de los
cinco ALJs anteriormente nombrado.
3.
La Administración del Seguro Social proveerá otra
mitigación. Cuando nos hacemos referencia a mitigación,
nos referimos a la capacitación de los ALJs y a los procedimientos
que la agencia utiliza para revisar las querellas referentes a si
una audiencia con un ALJ fue parcial.
4.
Como parte del acuerdo, los abogados principales
de la Demanda Colectiva—Gibson, Dunn & Crutcher—acordaron
no exigir honorarios. A los abogados adjuntos al bufete de Gibson
Dunn, una organización sin fines de lucro llamada Urban
Justice Center, se les pagará honorarios por la cantidad
de $125,000 por sus servicios prestados en referencia a esta demanda.
Estos honorarios serán los únicos fondos que pagará la
Administración del Seguro Social en conexión a
esta demanda, excepto por los gastos asociados con el envío
de los avisos descritos en el acuerdo propuesto.
¿Cómo puedo conseguir
una copia del acuerdo propuesto?
Puede conseguir una copia del acuerdo propuesto por medio
de una de estas maneras:
1.
Puede leer el
acuerdo propuesto en esta página de Internet:
www.segurosocial.gov/padrosettlement (solo
disponible en inglés).
2.
Puede comunicarse con el «Urban Justice
Center», los abogados que presentaron la demanda de Padro
et al. v. Colvin, llamándolos al (646) 459-3068.
¿Cómo decidirá el
Tribunal si aprobar o no el acuerdo propuesto?
El Tribunal necesitará aprobar el acuerdo propuesto
antes de que éste se finalice.
El Tribunal está celebrando una vista pública,
conocida como una audiencia de equidad, para decidir si el acuerdo
propuesto es justo. La vista pública, que comenzó el
24 de julio de 2013, continuará el 16 de septiembre de
2013, a las 9:30 a.m., en la siguiente dirección:
United States District Court
Eastern District of
New York
225 Cadman Plaza East
Brooklyn, New York
11201
Ceremonial Courtroom 2D North
Ya que es posible que cambie la fecha y hora de la vista pública,
así que por favor comuníquese con el Tribunal
antes de presentarse.
¿Qué debe hacer
si objeta al acuerdo o tiene otros comentarios?
SI ESTÁ DE ACUERDO con el acuerdo propuesto, no tiene
que hacer nada más. Usted tiene el derecho de asistir a
la audiencia de equidad, a la hora y en la dirección antes
indicada.
SI NO ESTÁ DE ACUERDO O TIENE OTROS COMENTARIOS acerca
del acuerdo propuesto, puede escribirle directamente al Tribunal
o puede ventilar su desacuerdo o sus comentarios durante la vista
pública. Para hacerle saber al Tribunal su intención,
tiene que hacerlo por escrito dirigiéndose al «Clerk
of the Court» (Secretario del Tribunal) a una de las dos
siguientes direcciones:
Dirección postal:
Clerk of the Court
United States District Court
Eastern
District of New York
225 Cadman Plaza East
Brooklyn,
New York 11201
O a la siguiente dirección de correo electrónico:
11cv1788@nyed.uscourts.gov
Sus comentarios o su petición para poder ventilar
su desacuerdo o sus comentarios durante la audiencia de equidad
por escrito tienen que estar franqueadas o enviadas por correo electrónico hasta
el 3 de septiembre de 2013.
El Secretario del Tribunal le proporcionará copias
de sus comentarios por escrito a los abogados que presentaron la
demanda colectiva, al igual que a la Administración del
Seguro Social, de manera de presentar los comentarios en el sistema
electrónico de presentar casos mantenido por el Tribunal.
Si sus comentarios incluyen asuntos pertinentes a su salúd
o alguna otra información personal y si no quiere que esta
información sea divulgada, usted le puede pedir al Secretario
del Tribunal que mantenga sus comentarios en privado de manera que
se mantendrán «sellados». Si decide hacer
esto, sus comentarios estarán a la disposición
del Tribunal, los abogados y la Administración del Seguro
Social, pero los comentarios no se publicarán. Si no expresa
que no quiere que sus comentarios sean «sellados»,
entonces sus comentarios vendrán a ser parte del registro público.
Esto significa que estarán disponibles por Internet por
medio del servicio de acceso público del Tribunal. Sus
comentarios podrán ser leídos, descargados o distribuidos
por cualquier persona que tenga una cuenta con el Tribunal.
El Tribunal decidirá a quién le permitirá ventilar
sus desacuerdos o comentarios durante la audiencia de equidad.
¿Qué debe hacer
si tiene alguna pregunta?
Si tiene alguna pregunta referente a esta demanda colectiva
o referente al acuerdo propuesto, por favor comuníquese
a la siguiente dirección y teléfono con los abogados
que presentaron esta demanda colectiva:
Urban Justice Center
Padro Class Counsel
123
William Street, 16th Floor
New
York, New York 10038-3800
Tel. (646) 459-3068
Fax.
(212) 533-4598
Attachment 2. Route
Slip/Case Flag with Alert: Possible Padro
Class Action Case for Screening
SCREENING NECESSARY
Claimant's
name:
|
___________________________
|
SSN:
|
___________________________
|
This claimant
may be a Padro class member. Accordingly,
we are forwarding the attached alert [and prior claim file(s)] for
association and screening for class membership and eligibility for
relief.
Please refer to HALLEX Temporary
Instruction I-5-4-71 for additional information and instructions.
|
TO:
|
Appeals Council Office of
Disability Adjudication and Review Padro Screening Unit 5107
Leesburg Pike Falls Church, VA 22041-3255
|
Attachment 3. Padro Case
Retrospective Relief Screening Sheet
CLASS
ACTION: Padro et al. v. Colvin
|
|
1. CLAIMANT'S SSN: ___ ___ ___ - ___ ___ - ___
___ ___ ___
|
2. CLAIMANT'S NAME (Last, First)
_____________________ _____________________
|
|
3. DATE OF BIRTH (Month, Day, Year)
|
|
4. CLAIM NUMBER (if different
from 1):
___ ___ ___ - ___ ___ - ___ ___ ___ ___
|
(BIC/ID)
___
___
|
5. SCREENING DATE (Month,
Day, Year)
___ ___ - ___ ___ - ___ ___ ___ ___
|
|
a. SCREENING RESULT:
___MEMBER
(J)/ELIGIBLE FOR RETROSPECTIVE RELIEF
___NONMEMBER/MEMBER
(F) NOT ELIGIBLE FOR RETROSPECTIVE RELIEF
|
c. SCREENOUT CODE
___
___(See item 14)
|
6. Was the claimant issued an unfavorable
or partially favorable decision on the merits of a claim for disability
benefits (including Age 18 Disability Redeterminations and Cessation
Disability Reviews) under Title II or Title XVI of the Social Security
Act by one of the following administrative law judges (ALJs): Michael
D. Cofresi, Seymour Fier, Marilyn P. Hoppenfeld, David Z. Nisnewitz,
or Hazel C. Strauss?
|
Yes___No___
If
No, go to 14.
|
7. Was the unfavorable or partially favorable
decision referred to in Question 6 issued between January 1, 2008
and October 18, 2013?
|
Yes___No___
If
No, go to 14.
|
8a. If the claimant appealed the decision
referred to in Question 6 to a United States District Court, did the
court: a) affirm the decision; or b) remand but expressly decline
to reassign the remanded claim to a different ALJ?
8b.
Was there a motion under Rule 59 of the Federal Rules of Civil Procedure
pending as of December 18, 2013?
|
Yes___No___N/A_____
If
Yes, go to 8b.
If No, or N/A, go to 9.
Yes___No___
If
No, go to 14.
|
9. Was the decision referred to in Question
6 changed to a fully favorable decision (not a
closed period or later onset decision) following an appeal, remand
from an appeal, or reopening?
|
Yes___No___
If
Yes, go to 14.
|
10. Did the claimant receive a decision
on a subsequent claim that was fully favorable and awarded benefits
for the entire time period(s) at issue in the hearing decision identified
in question 6 (i.e., the potential class member claim)?
|
Yes___No___
If
Yes, go to 14.
|
11. Did the claimant receive a new hearing
decision (whether favorable or unfavorable) covering the entire
time period covered in the hearing decision(s) identified in Question
6 (i.e., the potential class member claim), from an ALJ other than
one of the 5 ALJs named above?
|
Yes___No___
If
Yes, go to 14.
|
12. Was the potential class member claim
pending with an ALJ other than one of 5 named above at the time
of the claimant's request for relief (Notice A)?
|
Yes____No____
If
Yes, go to 14.
|
13. Was the claimant screened-out for
a reason not addressed in Questions 6 through 12?
|
Yes____ No______
If
Yes, please explain below and go to 14.
If No, go to
number 15, Instructions for Members in the Screening Sheet Instructions
below.
|
14. The claimant is not
a Padro class member eligible for relief. Check
the “Nonmember/Member Not Eligible for Relief” block
in item 5.a. and enter the screen-out code in item 5.c. as follows:
Enter 06 if question 6 was answered “NO;”
Enter 07 if question 7 was answered “NO;”
Enter 08 if question 8b was answered “NO;”
Enter 09 if question 9 was answered “YES;”
Enter 10 if question 10 was answered “YES;”
Enter 11 if question 11 was answered “YES;”
Enter 12 if question 12 was answered “YES;”
Enter 13 if question 13 was answered “YES.”
|
No other screen-out
code entry is appropriate.
|
15. On the lines below,
please enter the date(s) of all applications and final decisions
considered in the screening process and indicate the administrative
level at which the final decision was made (i.e., ALJ or AC). “Date
Claim Filed” and “Date of Decision” refer to
the claim mentioned in Question 6. “Date of Denial or Allowance” refers
to any subsequent disposition in Questions 9, 10, or 11.
Date
Claim Filed Date of Decision Date of Denial or Allowance
____________
_______________ _____________
____________ _______________
_____________
____________ _______________ _____________
|
16. IDENTIFICATION
OF SCREENER:
|
COMPONENT:
PHONE NUMBER:
|
DATE:
|
17.
SCREENER'S SIGNATURE:
|
INSTRUCTIONS FOR
COMPLETING PADRO SCREENING
SHEET
Complete a screening sheet in cases where the claimant has
requested relief under the Padro settlement.
Questions 1 - 4
You must consider all applications decided during the period
covered by the court order when making the class membership determination. A SEPARATE SCREENING SHEET MUST BE PREPARED FOR
EACH CLAIM NUMBER. If a claimant has more than one application during
the period covered by the court order, use different screening sheets
for each claim. If the claims are electronic, ensure the screening
sheet is uploaded in the corresponding entry in eView.
Fill in the identifying information as requested. Make sure
the Claim Number, BIC/ID and SSN, are correct and legible. (If SSN
is different from claim number, copy SSN from BOAN/PAN field on
alert).
Question 5
Fill in the member/nonmember information in question 5 when
the screening process is completed.
Questions 6 - 17 - General
a.
In a multiple
claims case, begin screening with the earliest claim in the Padro period
and stop with the last claim in the Padro period.
Remember, a separate screening sheet must be completed for each
claim number, and for each application in the period covered in
the court order.
b.
Read the Administrative Law Judge (ALJ)/Appeals
Council (AC)/U.S.D.C. (court) decision to answer the questions.
c.
If the decision does not yield enough information
to answer the questions, look further into the record.
d.
If questions 6-8b are answered “NO,” or
questions 9-13 are answered “YES,” check the nonmember
block found in item 5.b. on the screening sheet, then enter the
appropriate screen-out code in Item 5.c. as directed in question
14 on the screening sheet.
e.
Remember to follow instructions for members/nonmembers.
Question 6
Review the file and case control queries to determine if the
claimant received an unfavorable or partially favorable decision
on the merits of a claim for disability benefits (including Age
18 Disability Redeterminations and cessations resulting from continuing
disability reviews) under Title II or Title XVI of the Social Security
Act by one of the 5 ALJs named in the Padro settlement.
If information in the file or the case control queries indicates
that the claimant did not receive an unfavorable or partially favorable
decision from one of the 5 ALJs, the claimant is not a class member
eligible for relief.
Question 7
Screen for the date of the decision, not date of application.
Claimants are potentially eligible for retrospective relief if they
were issued an unfavorable or partially favorable decision on their claim
for disability benefits from one of the 5 ALJs between January 1,
2008 and October 18, 2013.
Question 8
Review the file and case control queries. If necessary, access
the civil action filing through the Public Access to Court Electronic
Records (PACER) system. If the court either affirmed the ALJ's decision,
or remanded but expressly declined to reassign the remanded claim
to a different ALJ, the claimant is not a class member eligible
for relief.
However, the claimant may still be
eligible for retrospective relief if there is a motion pending under
Rule 59 of the Federal Rules of Civil Procedure on December 18,
2013. If PACER indicates that a Rule 59 motion is pending,
send an email to ^ODAR HQ OAO Padro for further screening instructions.
Question 9
Review the file and case control queries. Review all subsequent
administrative and judicial determinations to determine if the decision
referred to in Question 6 was changed to a fully favorable decision.
Question 10
Review the file and case control queries. Determine if the
claimant received a fully favorable decision on another claim that
amounts to a fully favorable decision on the potential class member claim.
This requirement would be met if the decision on the other claim
resulted in an award of benefits for the entire time period(s) at
issue in the potential class member claim.
A claim cannot be screened out on
the basis of Question 10 unless it is clear that an ALJ or the Appeals
Council issued a fully favorable decision that adjudicated the entire
period covered by the Padro claim back to
the earliest alleged onset/entitlement date. At the ODAR level,
ALJ and Appeals Council decisions that do not consider the previously
adjudicated period usually will indicate that the previously adjudicated
period has not been reopened. These cases cannot be screened out.
Question 11
Review the file and case control queries to determine if the
claimant received a new hearing and decision (whether favorable
or unfavorable), from an ALJ other than one of the 5 named above, on
the potential class member claim, that considered the entire time
period(s) at issue.
Question 12
Review case control queries to determine if the potential
class member claim is currently pending with an ALJ other than one
of 5 named above.
Question 13
Review the file and case control queries. Determine whether
there is any other reason that the claimant is not eligible for
relief under the settlement. This may include that the claimant
did not return the response form timely, and did not have good cause.
Question 14
Self-explanatory
Question 15
Fill in the dates of the application(s), decision(s) and the
level of adjudication of the final decision(s) that were reviewed
in deciding class membership for the claim number in item 4. Remember
that you must prepare a separate screening sheet for each claim
number, and a separate screening sheet for each application in the
period covered in the court order.
INSTRUCTIONS FOR MEMBERS
a.
Check the “MEMBER ELIGIBLE FOR RELIEF” block
in item 5 a. of the screening sheet.
b.
Sign the form. Place it in the claim file if it
is paper, or scan it into the B section of the claimant's electronic
folder using a barcode with the “Misc Jurisdictional Documents/notice” document
type if electronic.
c.
If the claim file is paper, bring a copy of the
screening sheet to:
Appeals Council
Office of Disability Adjudication
and Review
5170 Leesburg Pike
Suite 1400
Attn: Padro CoordinatorIf the claim is electronic, notify the EDO via email to ^ODAR
HQ OAO Padro.
INSTRUCTIONS FOR NONMEMBERS
a.
Check the “NONMEMBER/MEMBER NOT ELIGIBLE FOR RELIEF” block
in item 5 a. and enter the appropriate screen-out code (the number
of the question that determined the claimant is not a class member,
numbers 6-13, see Item 14 on the screening sheet) in item 5.c.
b.
Follow items b and c above.
c.
Prepare and send the class membership denial notice
(Attachment 5) to the claimant with a copy to his/her representative,
if any. If the claim is paper, retain a copy of the denial letter
in the claim file. If electronic, scan it into the B section of
the claimant's electronic folder using a barcode with the “Misc
Jurisdictional Documents/notice” document type. Forward the claim
file(s) as indicated in HALLEX I-5-4-71,
Part III.D.
Attachment 4. Routing
and Transmittal Slip for Forwarding of Padro Class
Claim
ROUTING AND TRANSMITTAL SLIP
|
DATE:
|
TO:
Initials:
REMARKS
PADRO CASE
Claimant:___________________________
SSN:___________________________
We have determined that this claimant is a Padro class
member entitled to retrospective relief (see screening sheet). We
are forwarding this file to the hearing office, which should follow normal
procedures for updating the file.
FROM:
Appeals
Council
Padro Screening Unit
|
SUITE / BUILDING:
5107
Leesburg Pike Suite 1400 Falls Church, VA 22041
|
|
PHONE NUMBER
_______________
|
Attachment 5. Padro Notice
of Non-Class Membership/Ineligibility for Retrospective Relief
Important Information
SOCIAL SECURITY NOTICE
From: Social Security Administration
Claimant Name________________
Date: ______________
Claimant Address_______________
Claim Number: ____________________
____________________________ DOB: ___________________________
THIS NOTICE IS ABOUT
YOUR PAST CLAIM FOR SOCIAL SECURITY OR SUPPLEMENTAL SECURITY INCOME
BENEFITS
PLEASE READ IT CAREFULLY!
You asked us to consider your case under the terms of the Padro
et al v. Colvin settlement agreement. We have looked
at your case and decided that you are not
eligible for a new hearing decision (readjudication)
under the Padro settlement agreement.
The reason you are not eligible for
a new hearing decision is checked below.
You did not receive
an unfavorable or partially favorable decision issued between January 1,
2008 and October 18, 2013, by one of the following five Administrative
Law Judges (ALJs): Michael D. Cofresi, Seymour Fier, Marilyn P.
Hoppenfeld, David Z. Nisnewitz, and Hazel C. Strauss (the
named ALJs).
The decision you received from a named ALJ was not
about your claim for Social Security disability benefits or SSI
payments based on a disability.
You appealed a relevant decision of a named ALJ
to the United States District Court, and the Court found either:
(1) that the ALJ's decision was correct, or (2) that the ALJ's decision
was incorrect, but there was no reason for your case to go back
to a different ALJ for additional proceedings on remand.
The unfavorable or partially favorable decision
in your case was changed to a fully favorable decision following
appeal, remand, or reopening.
You filed a subsequent claim for benefits and have
already received all the benefits you could receive based on your Padro claim.
Your Padro claim was remanded
and you already received, or will receive, a new hearing decision
by an ALJ other than a named ALJ.
Your request was not timely.
Other:________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
This Notice Is Not a Determination
About Whether You Are Disabled
It is important for you to understand that we are not making
a decision about whether you are disabled. We are deciding only
that you are not eligible for a new decision under the Padro
et al v. Colvin settlement agreement.
If You Disagree With This Determination
You should contact the Urban Justice Center, the lawyers who
brought the Padro et al. v. Colvin lawsuit, immediately. The lawyers will have
60 days from the date you receive this notice to appeal our determination.
You can contact the Urban Justice Center at:
Urban Justice Center
Padro Class Counsel
Church
Street Station
P.O. Box 3363
New York, New York
10008-3363
Tel. (646) 459-3068
Fax. (212) 533-4598
If You Want More Information
More information about the Padro et al. v. Colvin settlement
is available on our website located at http://www.socialsecurity.gov/padrosettlement.
You can also contact the lawyers who brought the Padro
et al. v. Colvin lawsuit. We have listed the contact
information for the lawyers who brought the Padro et
al. v. Colvin lawsuit in the section directly above.
Attachment 5a. Padro Notice
of Non-Class Membership/Ineligibility for Retrospective Relief
(Spanish)
Información Importante
AVISO DEL SEGURO SOCIAL
De: La Administración del
Seguro Social
Claimant
Name ____________________
|
Fecha: ________________
|
Claimant
Address ___________________
|
Número de reclamación:
_______________
|
|
Fecha de nacimiento:
|
ESTE AVISO ES REFERENTE
A SU ANTIGUA RECLAMACIÓN PARA RECIBIR LOS BENEFICIOS DE
SEGURO SOCIAL O DE
SEGURIDAD DE INGRESO SUPLEMENTARIO
¡POR FAVOR
LEALO DETENIDAMENTE!
Usted solicitó que nosotros tomáramos en
consideración su caso en conformidad con las condiciones
del acuerdo de la demanda colectiva Padro et al v. Colvin.
Hemos revisado su caso y hemos determinado que usted no tiene derecho a una nueva audiencia
y un nuevo fallo (volver a fallar) en conformidad con el acuerdo
de la demanda colectiva Padro.
La razón por la que usted no
tiene derecho a un nuevo fallo por audiencia se indica
a seguir.
Usted no recibió un
fallo desfavorable o desfavorable en parte emitido entre las fechas
del 1 de enero de 2008 y 18 de octubre de 2013 por uno de los cinco
siguientes Jueces de Derecho Administrativo (ALJ): Michael D. Cofresi,
Seymour Fier, Marilyn P. Hoppenfeld, David Z. Nisnewitz
y Hazel C. Strauss (los ALJ nombrados).
El fallo que emitió uno de los ALJ nombrados
en su reclamación no era en referente a su reclamación
para recibir los beneficios por incapacidad de Seguro Social o de
Seguridad de Ingreso Suplementario (SSI).
Usted apeló a el Tribunal de Distrito de
los Estados Unidos un fallo pertinente emitido por unos de los ALJ
nombrados y el Tribunal falló: (1) que el ALJ había
fallado correctamente o (2) que el ALJ había fallado incorrectamente
pero que no existía razón para justificar que
su caso fuera devuelto a un ALJ diferente para procedimiento judicial
adicional.
El fallo favorable o en parte favorable en su reclamación
fue cambiada a un fallo completamente favorable después
de una apelación, devolución del caso o re-apertura
del mismo.
Usted presento una reclamación subsiguiente
para beneficios y ya recibió todos los beneficios disponibles
que usted podría recibir en conformidad con el acuerdo
de la demanda colectiva Padro.
Su caso fue devuelto y ya se le celebró o
se le celebrará una nueva audiencia para un fallo por un
ALJ que no es uno de los ALJ nombrados conforme al caso Padro.
No presentó su petición a tiempo.
Otra: _______________________________________________________
_________________________________________________________________
_________________________________________________________________
Este aviso no es una determinación
referente a si está o no está incapacitado
Es importante que usted entienda que no estamos tomando una
decisión referente a si está o no está incapacitado.
Nuestra decisión solo estipula que usted no tiene derecho
a un nuevo fallo en conformidad con el acuerdo de la demanda colectiva
del caso Padro et al v. Colvin.
Si usted no está de acuerdo
con esta determinación
Debe comunicarse inmediatamente con
el Urban Justice Center, los abogados que presentaron la demanda
colectiva Padro et al v. Colvin. Los abogados
tendrán 60 días a partir de la fecha en que usted
reciba este aviso para apelar nuestro fallo. A seguir, encontrará la
información para comunicarse con el Urban Justice Center:
Urban Justice Center
Padro Class Counsel
Church
Street Station
P.O. Box 3363
New York, New York
10008-3363
Tel. (646) 459-3068
Fax. (212) 533-4598
Si quiere informarse mejor
Puede informarse mejor acerca del acuerdo de la demanda colectiva
del caso Padro et al v. Colvin en nuestro
sitio de Internet, www.segurosocial.gov/padrosettlement (solo
disponible en inglés). También puede comunicarse
directamente con los abogados representantes en la demanda colectiva
del caso Padro et al v. Colvin. Hemos divulgado
la información de contacto de los abogados del caso Padro
et al v. Colvin en la sección anterior.
Attachment 6. Route
Slip for Forwarding Padro Class Action Claim
File(s) When Eligibility Determination is Disputed
TO:
|
Initials:
|
DATE:
|
Social Security Administration Office
of the General Counsel, Region II 26 Federal Plaza, Room
3904 New York, NY 10278 Attn: Padro Team
|
|
|
REMARKS
Padro Case
Claimant: ___________________________
SSN: ___________________________
We have determined that this claimant is not a Padro class
member eligible for retrospective relief. (See screening sheet and
copy of notice of non-class membership/ineligibility for relief
in the attached claim file(s).) We are forwarding this file to your
office because the claimant disputes the non-class membership determination
and has asked to review the file.
Attachment
DO NOT use this form as a RECORD of approvals, concurrences,
disposals, clearances, and similar actions.
FROM:
Appeals
Council
Padro Screening Unit
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SUITE / BUILDING
5107
Leesburg Pike Suite 1400 Falls Church, VA 22041
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PHONE NUMBER
_______________
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