Effective immediately, all persons who decide Social Security Act disability benefit claims of New York State residents or who review such decisions shall follow and apply the holdings of the United States Court of Appeals for the Second Circuit, except when written instructions to the contrary are issued pursuant to paragraphs D and E. This instruction applies to all Second Circuit disability decisions except those that are expressly designated not for publication.

Holdings of the Second Circuit Court of Appeals must be applied at all levels of administrative review to all claims for title II and title XVI disability benefits filed by New York State residents, unless written instructions to the contrary are issued pursuant to paragraphs D and E. You must apply those holdings in good faith and to the best of your ability and understanding whether or not you view them as correct or sound.

In general, a holding in a decision is a legal principle that is the basis of the court's decision on any issue in the case. There may be more than one holding in a decision. A holding must be applied whenever the legal principle is relevant.

Not all of the discussion in a decision is a holding. For example, the factual discussion in a decision is not a holding although it can help you understand the holding by placing it in context. Also, in their decisions courts may make observations or other remarks that are helpful in understanding the court's reasoning. You are required to apply the holdings, not those observations or other comments of the court.

Of course, you should continue to make sure that the decision whether a claimant is disabled is an individualized decision based on the evidence regarding that claimant.

help ensure that decisionmakers and reviewers of decisions apply Second Circuit holdings, SSA will do the following:

1. 1. 

   SSA will provide each office of decisionmakers and reviewers of decisions with a copy of the settlement approved by the Court in Stieberger v. Sullivan.

2. 2. 

   SSA will provide all decisionmakers and reviewers of decisions with a Manual of Second Circuit disability decisions (“Manual”) containing excerpts of the principal holdings of the Second Circuit issued before June 18, 1992, the date that the settlement in Stieberger was approved by the Court.

3. 3. 

   SSA will provide each office of decisionmakers and reviewers of decisions with a copy of each Second Circuit disability decision issued after June 17, 1992 promptly after the decision is issued by the Court. Each such office shall maintain a volume containing copies of these decisions. This volume shall be readily accessible to decisionmakers and reviewers of decisions.

4. 4. 

   SSA will issue instructions to ODD decisionmakers and reviewers of decisions about applying Second Circuit decisions rendered after June 17, 1992. These instructions must be added to the Manual as supplements. SSA may issue instructions to OHO adjudicators.

You should familiarize yourself with the Manual, with SSA's instructions on Second Circuit holdings, and with Second Circuit decisions as they are issued.

While SSA will take the steps described above to help you apply Second Circuit holdings, you must apply the holdings even in the absence of an instruction, and even if they are not included in the Manual.

EXAMPLE:You have become aware of a Second Circuit disability decision (for example, a claimant draws it to your attention or you receive notification of it from SSA), but you have not yet received the instruction from SSA on how to apply the decision and it is not in the Manual. You must apply the holding[s] of that decision to all claims where it is relevant.

1. 1. 

   You must apply the holdings in a decision once the decision becomes effective. A decision of the Second Circuit generally becomes effective 20 ^[1] days after the decision is issued by the Court, unless a specific written instruction is issued that requires the decision to be applied earlier or later. If you have not received instructions about a particular Second Circuit decision issued after the date of this instruction, consult with your supervisor for further guidance about whether the decision has become effective. (If you are an administrative law judge, you may inquire with the Regional Office concerning the status of the decision.)

2. 2. 

   As long as a Second Circuit decision is pending further court review, SSA may instruct decisionmakers and reviewers of decisions not to apply some or all holdings stated in that Second Circuit decision. In such instances SSA will issue specific instructions explaining which holdings are not to be applied and identifying the issues addressed by those holdings. When such instructions are issued, decisionmaking and reviewing offices will maintain a list of disability claims decisions that may be affected because the Second Circuit holding is not being applied. Any notice sent to claimants on the list, denying benefits in whole or in part, will include the following language:

   If you do not agree with this decision, you can appeal. You must ask for an appeal within 60 days.

   You should know that we decided your claim without applying all of what the court said about the law in       .        is a recent court ruling that we do not consider final because it may be reviewed further by the courts. If it becomes final, we may contact you again.

   If you disagree with our decision in your case, do not wait for us to contact you. You should appeal within 60 days of the date you receive this notice. If you do not appeal within 60 days, you may lose benefits.

3. 3. 

   When no further judicial review of a Second Circuit decision will occur, SSA will promptly rescind any instructions issued under this paragraph D, and will advise decisionmakers and reviewers of decisions about the final decision in the case. SSA will also explain what action is to be taken, including any reopenings, with respect to claimants whose cases may have been affected by the instruction not to apply the Second Circuit decision pending further court review.

This instruction on application of Second Circuit decisions to disability benefit claims does not prevent SSA from issuing or rescinding acquiescence rulings, or relitigating issues under 20 C.F.R. 404.985 and 416.1485.

This instruction is issued pursuant to the settlement agreement in Stieberger v. Sullivan, 84 Civ. 1302 (S.D.N.Y.). A copy of the complete agreement is available in your office. Any questions about applying Second Circuit decisions that you cannot resolve yourself may be directed to your supervisors and, if more guidance is needed, through supervisory channels to the Litigation Staff in SSA Central Office in Baltimore, Maryland. In addition, a team of SSA personnel will visit the New York ODD one month after you receive this instruction and quarterly thereafter for 3 years to discuss any questions decisionmakers and reviewers of decisions have about applying Second Circuit disability decisions.

This instruction is binding on all personnel, including state employees, ALJ's Appeals Council Administrative Appeals Judges, quality assurance staff, and all other personnel who process, render decisions on, or review claims of New York residents for disability benefits under the Social Security Act.

Because this instruction arises out of a lawsuit, it does not apply to claims of any persons who do not reside in the State of New York. However, this limitation does not lessen the extent to which court decisions are to be applied to claims of persons who reside in any other state. This limitation also should not be deemed to suggest that such decisions are not given or should not be given proper consideration in any other state.

                   

Jean H. Hinckley,        

Director,          

ODCP Litigation Staff    

 

File Code: HA-4-7

 

Published instructions are targeted to reach users by October 2, 1992.

Exhibit 2 - Stieberger Supplement

 

STIEBERGER SUPPLEMENT
To be completed in all Stieberger Case Reviews

 

Name                         

Social Security Number          /      /           

PART I. (For Social Security Administration Completion)

1. A. 

   Earliest Date Covered by a Stieberger Denial/Termination (AOD for Title II, Date of Filing for Title XVI:     /     /      

2. B. 

   Earliest Date Covered by the SSA-3368:       /     /      

PART II. Information about your disability.

1. C. 

   1. Have any conditions you mentioned on the Disability Report (SSA-3368) changed since the date in A. above?

                Y   N

   1. 2. 

      If there was any change in your condition, did it get

                    Worse   Better

   2. 3. 

      Describe when and how your condition was worse or better

                                                                 

                                                                 

                                                                 

                                                                 

                                                                 

                                                                 

2. D. 

   1. Have you had any conditions, during the period between the dates in Part I A. & B above, that you did not describe on the Disability Report (SSA-3368)?

                Y     N

   1. 2. 

      If yes, describe the other conditions and when they bothered you                                                            

                                                                 

                                                                 

                                                                 

                                                                 

   2. 3. 

      If the other condition(s) that you described in D.2 made you feel worse during the period between the dates in Part I A & B above, describe how and when.

                                                                 

                                                                 

                                                                 

                                                                 

                                                                 

3. E. 

   1. Did you receive treatment for any condition, from a medical source (doctor, hospital, clinic, etc.) that is not already listed on the Disability Report (SSA-3368)?

                Y   N

   If yes, show the names and addresses of the source, the dates of treatment and the condition you were treated for.

                                                              

                                                              

                                                              

                                                              

                                                              

                                                              

PART III PAYMENT PERIOD Questions

1. F. 

   1. Since the date in A. above, have you been incarcerated due to conviction on a felony or felony-level offense?

                Y   N

   1. 2. 

      If yes, show the dates and place(s) of confinement below.

                                                                 

                                                                 

                                                                 

2. G. 

   1. Were there any months since the date in A. above that you resided in a public institution?

                Y   N

   1. 2. 

      If yes, show the name of the institution and the dates of residence                                                      

                                                                 

                                                                 

                                                                 

3. H. 

   1. Were there any times since the date in A. above that you were outside the United States throughout a calendar month or for 30 days or more? (Outside the United States means outside the 50 states, American Samoa and/or the Northern Mariana Islands)?

                Y   N

   1. 2. 

      If yes, for each period of absence, show the date you left and the date on which you returned.                                 

                                                                 

                                                                 

                                                                 

                                                                 

PART IV. Protective Filing

1. I.  

   If you wish to protect the rights of your spouse and/or children to any benefits to which they may be entitled on your record as a result of the Stieberger review, show their name(s) and date(s) of birth below.

                                                              

                                                              

                                                              

                                                              

                                                              

                                                              

Signature                          Date                     

Exhibit 3 - Acknowledgment Letter

SOCIAL SECURITY ADMINISTRATION

 

Important Information

 

1. A. 

   We are writing to tell you that we received your request asking for a review of our earlier decision that you were not or no longer disabled.

2. B. 

   We expect to receive many requests for review and it may take several months before we look at your file.

When we start our review, we will decide if you are a member of the “class” of people entitled to reopening included in the suit.

1. a. 

   If you are a member of the class entitled to a review of our earlier decision that you were not or no longer disabled, your local Social Security office will contact you when it is time for you to come in to submit additional evidence (if you have any). You should begin now to collect any evidence you may have that you feel will be pertinent to your review. BUT, PLEASE DO NOT SUBMIT THE EVIDENCE UNTIL WE CONTACT YOU.

2. b. 

   If you are not a member of the class entitled to reopening we will send you a notice telling you why and advising you of any further right you may have.

Exhibit 4 - Stieberger Potential Class Member Notice

 

SOCIAL SECURITY ADMINISTRATION

 

Important Information

 

We have good news for you about your past claim for disability benefits. We are writing to you about a court case that may affect you. Because of this court case you may be entitled to money from Social Security. Please read this letter carefully.

 

INFORMATION ABOUT THE COURT CASE

 

You may be entitled to Social Security or Supplemental Security Income disability payments based on a past claim you filed. In a recent court case called Stieberger v. Sullivan, we agreed to look again at certain claims that were denied or where payments were stopped. We believe that your claim may be one of those that we agreed to look at again.

 

HOW TO ASK FOR A REVIEW

 

We will not look at your claim again unless you ask us to do so. If you want us to do this, fill out the enclosed reply form that came with this letter and mail it right away in the enclosed envelope. You have 180 days from the day you received this letter to ask us to look at your claim again, but don't wait. If you don't send the form back, we will not look at your claim again. We will write to you when we receive your reply form.

 

IF YOU NOW GET MONEY FROM SOCIAL SECURITY

 

Even if you get money from Social Security, we may still owe you more money. Return the reply form in this letter within 180 days to ask us to look at your past claim again.

 

PROTECTING YOUR RIGHTS

 

Sending in the enclosed reply form does not protect your rights on any other claim for benefits. If you have a claim for benefits that we are still considering or that we recently denied and you disagree with our decision, you must follow the guidelines that we tell you about in the notice on that claim.

 

IF YOU HAVE ANY QUESTIONS

 

If you have any questions, you may contact any Social Security office. The address and phone number of your local Social Security office are printed at the top of this letter. If you call or visit an office, please take this letter with you. It will help us answer your questions.

 

FOR HELP

 

Additionally, if you have someone helping you with your claim, you should contact him/her. You also may contact one of the following offices to obtain a legal representative, or you may contact the lawyers in this case. These offices are listed below.

OFFICES THAT WILL REFER YOU TO ORGANIZATIONS THAT PROVIDE FREE LEGAL REPRESENTATION

•  

  New York City Area:

  Legal Services for New York City, (212) 431-7200 or

  The Legal Aid Society, (718) 722-3100.

  The Rest of New York State:

  Greater Upstate Law Project, (800) 724-0490, or

  (800) 635-0355.

OFFICE THAT WILL REFER YOU TO AN ATTORNEY WHO WILL CHARGE A FEE FOR REPRESENTATION

•  

  Throughout New York State:

  National Organization of Social Security Claimants'

  Representatives, (800) 431-2804, or (914) 735-8812.

OFFICES OF THE LAWYERS THAT REPRESENTED CLAIMANTS IN THIS LAWSUIT

•  

  The Legal Aid Society of New York

  Civil Division, Civil Appeals & Law Reform Unit

  11 Park Place, Room 1805

  New York, New York 10007

  (212) 406-0745

   

  Legal Services for the Elderly

  130 W. 42nd Street, 17th Floor

  New York, New York 10036-7803

  (212) 391-0120

   

  MFY Legal Services

  35 Avenue A

  New York, New York 10009

  (212) 475-8000

   

Enclosure:

Reply form and envelope

Exhibit 5 - Stieberger Reply Form

Exhibit 6 - Request For Court Case Review/Change of Address Worksheet

 

13.                                      
SIGNATURE (If claimant/payee appears in person, please obtain signature).

1. 14. 

   For SSA Use Only

PREPARED BY:             OFFICE CODE             

 

PREPARERS TELEPHONE NO:             (INCLUDE AREA CODE)

Instructions For Completion of the Request For Court Case Review/Change of Address Worksheet

Item 1.

Print the name of the court case claimant/payee/representative is inquiring about (i.e., “Stieberger”).

Item 2.

This worksheet can be used to implement all class action court cases. The court case identifier for “Stieberger” is ST.

Item 3.

If a claimant/payee/representative is requesting review (e.g., walk-in) under the “Stieberger” Court Order, check the first block. If the claimant/payee/representative has previously requested review under “Stieberger” and is informing SSA of a new address, check the second block. If the claimant/payee/representative is requesting review and notifying SSA of a new address simultaneously, check both blocks.

Item 4.

Provide date of contact (mm/dd/yyyy).

Item 5.

Provide claimant's own social security number.

Item 6.

Provide claimant's date of birth (mm/dd/yyyy).

Item 7.

Print claimant's complete first name, middle initial, if appropriate, and complete last name, allowing one letter for each underscore provided on the worksheet.

Item 8.

Print the street address, city, state abbreviation, and zip code of the claimant or claimant's payee/representative, as appropriate, allowing one letter for each underscore provided on the worksheet.

Item 9.

Provide the telephone number, including area code, of the claimant/payee/representative, as appropriate.

Item 10.

Print the complete first name, middle initial, and last name of the payee, not to exceed 19 characters, if appropriate. If the complete name exceeds 19 characters, shorten the first name to ensure that the complete last name is provided. Leave a space after the first name and after the middle initial.

Item 11.

Print the complete first name, middle initial, if appropriate, and complete last name of the attorney/representative, if claimant has representation.

Items 12.

Complete only if claimant/payee/representative is requesting court case review. It is not necessary to complete the claims information when only reporting a change of address. This information is required to establish a “walk-in” record on the Civil Action Tracking System (CATS). If not complete, the form will be returned for completion.

Provide all claim numbers, including BIC and/or ID, under which the claimant filed for benefits. Use the back of the sheet, if necessary. This is needed to ensure that all appropriate claims are reviewed under the class action. Attempt to verify the claim numbers via MBR and/or SSR. If there is no record on the MBR/SSR, verify the SSN on the Numident. Be sure to write “YES” in the space provided in the “VERIFY” column on the worksheet indicating that the account numbers were verified.

Item 13.

Obtain the signature of the claimant/payee/representative only if he/she appears in person.

Item 14.

Print the name, office code, and telephone number, including area code, of the SSA employee completing this form.

MAIL THE COMPLETED WORKSHEET TO THE FOLLOWING ADDRESS:

•  

  SSA, Office of Disability and International Operations
  Class Action Section
  Attn: STIEBERGER Coordinator
  P. O. Box 17369
  Baltimore, MD 21298-0050

Exhibit 7 - Stieberger Screening Sheet

 

STIEBERGER
SCREENING SHEET

IMPORTANT: A separate screening sheet must be prepared for each claim number and the applications screened must be identified. See IV below.

CLASS ACTION CODE: S T

1. CLAIMANT'S SSN:        -       -             

2. CLAIMANT'S NAME:                                     

(Please Print)  (Last)          (First)

3. DATE OF BIRTH:     /     /            

                           (MM/DD/YYYY)

4. CLAIM #:        -       -             -       

          (BIC/ID)

5. DATE OF SCREENING:     /      /           

                                   (MM/DD/YYYY)

6. SCREENING RESULT:

I. CLASS MEMBERSHIP REOPENING ENTITLEMENT DETERMINATION

 

 

BEFORE SIGNING, PLEASE BE SURE TO COMPLETE ITEM 4 on PAGE 1.

                                                             
Print name and phone number          Signature

Stieberger Screening Sheet Instructions

General Instructions: It is expected that most screening will be completed based on related queries (FACT, SSIRD, STALE, earnings query extract, OHO query extract, etc.) which are part of the alert package. If the folder is available, use the folder to complete the screening sheet. Since the answer to some of these questions is not readily apparent from queries only, if the claim file is not available, assume the claim is not screened out and go on to the next question. If a conclusive class membership determination cannot be made from the information available, the claimant should be screened in.

A SEPARATE screening sheet must be prepared for each claim number. Make sure the claim number, BIC/ID and SSN, are the same as on the STIEBERGER Case Flag Alert to ensure proper case clearance. Consider all Title II and Title XVI claims (denials/cessations) decided at any level of administrative review (initial, reconsideration or OHO) during the period of October 1, 1981 and October 17, 1985, inclusive; or, at the ALJ or Appeals Council level between October 18, 1985 and July 2, 1992, inclusive.

Question 1:

Please fill in the claimant's SSN from BOAN/PAN field on alert.

Question 2:

Print the claimant's name (last name, and first name).

Question 3:

Fill in the claimant's date of birth (2-digit month, 2- digit day, 4-digit year).

Question 4:

Fill in the claim number(s) (social security number) under which this claim is being processed. Include the BIC (Title II)/ID (Title XVI).

Question 5:

Complete the screening date using 2-digit month, 2-digit day, and 4-digit year.

Question 6:

Complete this information last. Do not fill in until the screening process has been completed.

Question 7:

If the Stieberger alert package indicates that no claim for disability benefits was filed under the claim number given, obtain an MBR or SSR under the beneficiary's own social security number if it is different from the claim number given. If there is still no evidence that a disability claim was filed, check block 7 and follow II.

Question 8:

Screen for residency as of the date of the final determination(s)/ decision(s), not date of application. If there is a SSIRD in file check for claimant's past address(es). If there is an OHO query extract in file check for hearing office code as follows: 5024, 5200, 5308, 5023, 5310, 5102, 5020, 5021, 5110, 5135. If there is only an MBR in package, check claimant's address. If the claimant was not a resident of New York at the time any claims were finally decided within the Stieberger period, those claims are not entitled to Stieberger reopening. Continue to screen any remaining claims in which the claimant was a resident of New York and go to question 9. NOTE: If a non-New York denial decision within the Stieberger timeframe was due to the res judicata effect being given to a New York decision, move on to question 9. If not check block 8 and follow II.

Question 9:

Review the query package and/or folder to determine if the claimant was denied for medical or vocational reasons as opposed to technical reasons (insured status, engaging in SGA, excess income and resources) on any claim. Look for basis denial codes for title II of: E1, E2, E3, E4, F1, F2, G1, G2, H1, H2, J1, J2, K1, K2, L1, L2, M5, M6. For Title XVI look for: N30, N31, N32, N34, N35, N36, N37, N39, N40, N41, N42, N43, N45, N46, N47, N48, N51. If claimant was denied for other than medical reasons, state the reason on the line provided. If any claims were finally denied for non-medical/vocational reasons within the Stieberger period, those claims are not entitled to Stieberger reopening. Check block 9 and follow II. Continue to screen any remaining claims in which there are medical/vocational determinations and go to question 10.

Question 10:

Review queries to determine dates of all disability applications denied/ ceased. If claimant's application(s) for disability benefits were not denied/ ceased between October 1, 1981 and October 17, 1985, inclusive, at any level of administrative review, or, between October 18, 1985 and July 2, 1992, inclusive, at the ALJ or Appeals Council levels of review, those claims are not entitled to Stieberger reopening. Check block 10 and follow II. Continue to screen any remaining claims which meet the date criteria and go to question 11.

Question 11:

If the post-October 17, 1985 determination by the NYDDS was a decision review under P.L. 98-460 of a prior cessation, the claimant is not entitled to Stieberger reopening on either the prior cessation determination or the decision review completed under P.L. 98-460. Check block 11 and follow II. Continue to screen any remaining claims in which the claimant did not receive a decision review or in which the claimant did receive a decision review and appealed it to an ALJ and go to question 12.

Question 12:

If the claimant received a final decision which was rendered by a non-New York jurisdiction on a claim(s) which covered the entire Stieberger period, claimant is not entitled to Stieberger reopening on this claim. Check block 12 and follow II. Continue to screen any remaining claims within the Stieberger period. NOTE: If the non-New York denial decision was due to the res judicata effect being given to a New York decision, move on to question 13.

Question 13:

If the claimant received a decision on a claim(s) under any other New York class action order which covered the entire Stieberger period, e.g., State of New York, Dixon or Hill, that reopened the claim, the claimant is not entitled to Stieberger reopening of this claim. Check block 13 and follow II. Obtain a DDSQ to determine if the claimant received a favorable decision under the above-referenced court cases. If claim was last decided at the OHO level, you will have to contact the DPB of your Regional Office. They will obtain a CATS query to determine if the claimant has received a court decision. Continue to screen any remaining claims within the Stieberger period which were not covered by any other New York class action. NOTE: The criteria for readjudications may be different for each class action. For example, if the claimant received a decision under State of New York, but that decision provided only a limited redetermination of the claim, the claimant is eligible for review under Stieberger on that claim. However, if the relief under the other class action is as broad as what the claimant would receive under Stieberger, that claim is not eligible for Stieberger review.

Question 14:

Check the OHO query to determine court activity. If the claimant received a court decision on the merits that covered the entire period of the Stieberger claim, the claimant is not entitled Stieberger reopening of this claim. If the claim was last decided at OHO level, you will have to contact the DPB of your Regional Office. They will obtain a CATS query to determine if claimant has received a court decision. In addition, any claim in which the claimant opted for court review instead of Stieberger reopening is not entitled further review on that claim. If either condition is satisfied, check block 14 and follow II. Continue to screen any remaining claims within the Stieberger period which were not covered by a court decision or option for court review.

THIS NOTICE IS ABOUT YOUR SOCIAL SECURITY/SUPPLEMENTAL SECURITY INCOME BENEFITS.

PLEASE READ IT CAREFULLY!

1. A. 

   WE HAVE FOUND THAT YOU ARE NOT ENTITLED TO REOPENING UNDER STIEBERGER v. SULLIVAN.

   You asked us to review your case under the terms of the Stieberger court decision. We have looked at your case and decided that you are not a Stieberger class member entitled to reopening. This means that we will not review under the Stieberger class action our earlier decision to deny or cease your benefits. The reason you are not a class member entitled to reopening under the Stieberger court decision is checked below.

2. B. 

   WHY YOU ARE NOT A CLASS MEMBER ENTITLED TO REOPENING

   YOU ARE NOT A STIEBERGER CLASS MEMBER ENTITLED TO REOPENING BECAUSE:

1. C. 

   WE ARE NOT DECIDING WHETHER YOU ARE DISABLED

   It is important for you to know that this notice is not a decision about whether you are or were disabled. We are deciding only that you are not a Stieberger class member entitled to reopening.

2. D. 

   WHAT YOU MAY DO IF YOU DISAGREE WITH THIS DETERMINATION

   You have 60 days from the date you receive this notice to send your written disagreement directly to:

   The Office of the General Counsel
   Social Security Administration
   Rm. 617 Altmeyer Bldg.
   6401 Security Blvd.
   Baltimore, MD 21235
   Attn: The Stieberger Case Coordinator

   We will assume that you received this notice 5 days after the date of the notice unless you show us otherwise.

   You may ask to see the record on which we decided you were not a class member entitled to reopening. If you do ask to see it, you will have 45 days after we tell you that it is available for inspection at a mutually agreed upon Social Security office. You may also ask for your attorney or other representative to look at the record.

   When your written disagreement is received, the Office of the General Counsel will look at your case again, notify you of the final determination and advise you of any further appeal rights you may have.

3. E. 

   IF YOU HAVE A LEGAL REPRESENTATIVE OR WOULD LIKE TO OBTAIN ONE

   If you have a legal representative, you should show this notice to that person.

   If you would like to obtain a legal representative, you may contact one of the attorneys representing the Stieberger class at the following address:

   The Legal Aid Society of New York
   Stieberger Implementation Project
   841 Broadway, 3rd Floor
   New York, NY 10003
   (212) 477-5010

   If you would like a referral to an attorney who will charge a fee for representation, you may contact the National Organization of Social Security Claimants' Representatives by calling (800) 431-2804.

4. F. 

   YOU CONTINUE TO HAVE THE RIGHT TO FILE A NEW APPLICATION FOR BENEFITS. FILING A NEW APPLICATION IS NOT THE SAME AS CHALLENGING OUR CLASS MEMBERSHIP DECISION, AND OBTAINING A NEW DECISION ON A PAST APPLICATION.

   Si usted habla espanol y no entiende esta carta, favor de llevarla a la oficina de Seguro Social arriba mencionada para que se la expliquen.

Exhibit 9 - Stieberger Alert

999889   00000

CTWALT01          STIEBERGER COURT CASE FLAG/ALERT

 

REVIEW  PSC  DOC  TOE  ALERT DATE  RESPONSE DATE  OLD BOAN/PAN
OFFICE

 

SSN (BOAN OR PAN)     NAME          BIRTH DATE     REFERENCE #

 

FOLDER LOCATION INFORMATION

CAN/HUN  BIC/MFT  CATG  TITLE  CFL   CFL DATE   ACN

 

PAYEE ADDRESS

 

SHIP TO ADDRESS

 

SERVICING FO

 

SPECIAL INSTRUCTIONS:

IF A CURRENT CLAIM IS PENDING AT TIME OF FO INTERVIEW, THIS CLAIM MAY BE CONSOLIDATED WITH THE CURRENT CLAIM. SEE DI 12586.025B. FOR ADDITIONAL INSTRUCTIONS

Exhibit 10 - Development/Payment Period Worksheet

 

STIEBERGER DEVELOPMENT/PAYMENT PERIOD WORKSHEET SUMMARY SHEET --- KEEP ON TOP!

 

CLAIMANT'S SSN:          -       -           

PERSON WHO COMPLETED THIS WORKSHEET:

                      ,  ;           ;  (        )          -             
Surname and initial        Office code          Telephone

============================================================== = =====

FIRST MONTH OF DEVELOPMENT PERIOD:       /     

============================================================== = =====

TITLE II PAYMENT: BIC:       

POTENTIAL ADMINISTRATIVE ONSET:       /0 1/      [  ] Cessation Case

                                                                  See DI 32586.020

POTENTIAL MOET:                    /      

TITLE XVI PAYMENT:

POTENTIAL ONSET AND ENTITLEMENT:       / 0 1 /      (“administrative

                                                        onset”)

DDS could establish onset as early as       /     /       if 10(e)(5) exception is met.

STIEBERGER DEVELOPMENT/PAYMENT PERIOD WORKSHEET

PART I. GATHER INFORMATION - DEVELOPMENT PERIOD

PART II. DETERMINE THE DEVELOPMENT PERIOD

 

USE THE CHART ON THE NEXT PAGE TO COMPUTE THE DEVELOPMENT PERIOD

For the following calculations, use the results of Part I.

1. 1. 

   “X” out any month later than the month shown in A.3.

2. 2. 

   Find the earlier of the months shown in B.2., C OR D. “X” out any months before this month.

3. 3. 

   “X” out any months in the periods shown in E, F, G, or H

4. 4. 

   “X” out ALL months in any year shown in J.

5. 5. 

   Find the most recent 48 months that were not been “X'ed” out. If there are fewer than 48 such months, use all the boxes that were not “X'ed”. Counting back with the month shown in A.3, place a “D” in the 48th month not “X'ed” out. Enter that month here:

        /     

6. 6. 

   If the month in 5. above is later than the month shown in B.4 or B.6, enter the month shown in B.4 or B.6.

        /     

7. 7. 

   The first month of the DEVELOPMENT PERIOD is the earlier of the month in 5. or 6. above. Show that month at the top of the Summary Sheet.

        /     

    

   Stieberger DEVELOPMENT PERIOD Chart:

    

PART III: GATHER INFORMATION - PAYMENT PERIOD(S)

Before you compute PAYMENT PERIODS, you will have to show additional information (from your interview with the class member, if necessary):

1. K. 

   Periods of entitlement to “A” (reduced or unreduced), “HA” , DWB or CDB benefits:

   began:     /        ended:     /     

   began:     /        ended:     /     

2. L. 

   Periods the class member was confined due to felony-related conviction:

   began:     /        ended:     /     

   began:     /        ended:     /     

3. M. 

   Periods the class member absent from the U.S., or institutionalized (N02) (SI 00501.400):

   began:     /        ended:     /     

   began:     /        ended:     /     

    

PART IV: COMPUTE THE TITLE II PAYMENT PERIOD

USE THE CHART ON THE NEXT PAGE TO COMPUTE THE TITLE II PAYMENT PERIOD

     /      

1. 1. 

   Determine the MOET based on the earliest Stieberger claim. If the claimant had no previous Title II entitlement, you can use the following procedure; otherwise, use regular Title II rules for the result of this step.

   If the Stieberger determination is a cessation, show the month of termination, as shown in D above:

        /      

   If it was an initial claim for HA, HC, or DWB benefits, subtract 12 months from the month shown in B.1. If it was a claim for C benefits (RSI), subtract 6 months from the month shown in B.1:

        /      

   If it was a claim for HA or DWB benefits, add 5 full calendar months to the date shown in B.2. If it was a claim for C or HC benefits, show the month shown in B.2 (or the following month, if the AOD in B.2 is not the first day of the month):

        /      

   If it was a claim for DWB or surviving child benefits, show the date of death of the number holder as shown in B.3:

        /      

   If it was a claim for DWB benefits, show the date the DWB attained age 50 as shown in B.3:

Circle the latest date.

1. 2. 

   Using the chart on THIS page, “X” out any month before the month you circled in step 1 above.

2. 3. 

   Put a “T” in the box for any month in the period shown in H.

3. 4. 

   “X” out any months in periods shown in G, K or L.

4. 5. 

   Count the LATEST 48 months that have not been marked. Mark these boxes with an “E”.

   The FIRST “E” month is the potential month of entitlement (MOET):

        /      

5. 6. 

   The Potential MOET is also the potential administrative onset for cessations, all SSI claims , and CDB claims. For initial claims for HA or DWB benefits, subtract 5 months from the MOET. This will be the potential established onset date:

        /0 1/      .

   (note: The DDS may make the onset as early as the AOD [or termination date in cessations], if the 10(e)(5) conditions are met).

6. 7. 

   If any “T” months are shown, benefits AND THE PERIOD OF DISABILITY will TERMINATE with the first “T” month. Benefits and the period of disability will resume with the first non-“T” month if the claimant is found to be currently disabled.

   Potential benefits would terminate:  

        /      

   Potential resumption of benefits:  

        /      

    

   Stieberger PAYMENT PERIOD CHART Title II

    

PART V: COMPUTE THE TITLE XVI PAYMENT PERIOD

USE THE CHART ON THIS PAGE TO COMPUTE THE TITLE XVI PAYMENT PERIOD

 

Stieberger PAYMENT PERIOD CHART Title XVI

 

1. 1. 

   “X” out any month before the month shown in C.

2. 2. 

   “X” out any month in the periods shown in F, G, H, K, or M.

3. 3. 

   Count the LATEST 48 months that have not been marked. Mark these boxes with an “E”.

   The FIRST “E” month is the potential established onset date:

        /0 1/     

   (note: The DDS may make the onset as early as the AOD, if the 10(e)(5) conditions are met).

4. 4. 

   Payment may be made for all “E” months, subject to the regular rules of eligibility and applying the Stieberger tolerances in DI 12586.080. As of Jan. 1st of the year prior to the year in which the favorable SSA-831 was signed, regular development rules apply.

Exhibit 11 - Stieberger Folder Request Memo

 

STIEBERGER Folder Request Memo

 

Please obtain the Title II and XVI claim file/medical evidence for the following Stieberger application(s) and forward to this office.

                                                       
Requestor's Name               Requestor's Telephone No.

Attachment: Copy of Stieberger Alert-Query Package

Exhibit 12 - Stieberger 48-Month Chart

Exhibit 13 - Stieberger Title II SGA Denial Letter

(Title II SGA Denial Notice)

 

SOCIAL SECURITY ADMINISTRATION

 

Important Information

IMPORTANT INFORMATION

A settlement agreement in the Stieberger v. Sullivan class action lawsuit requires the Social Security Administration to look at your case again to determine if our earlier decision that you were not or were no longer disabled was correct.

Because you worked continuously during the period we reviewed, we have looked only at your work and earnings, not your health problems. We have completed this review and we still find that the determination in your case is proper and in accordance with the law. Therefore, the denial of your application remains unchanged.

Include the paragraph below only if the claimant is in current pay:

This notice does not affect the checks that you are getting now based on your later application.

THE DISABILITY RULES

To be considered disabled, your health problems must meet all of the following rules.

INFORMATION ABOUT SUBSTANTIAL GAINFUL WORK

• •

  Keep you from doing any kind of substantial gainful work. This kind of work is described below.

• •

  Exist at the same time you have the required number of work credits.

• •

  Last, or be expected to last, for at least 12 months in a row, or result in death.

Generally, substantial gainful work is physical or mental work you are paid to do. Work can be substantial even if it is part- time. To decide if your work is substantial, we consider the nature of your job duties, the skills and experience you need to do the job, and how much you actually earn.

Usually, we consider work to be substantial and gainful if monthly earnings, after allowable deductions, average over $500 per month ($300 before January 1, 1990). The law provides for a higher earnings test for substantial gainful activity if you are blind. That amount in 1995 was $940.00. If you are self- employed, we may give more consideration to the kind and value of your work, including your part in the management of the business, than to your income alone.

Your work may now be different than before your disability began. It may not be as hard to do and your pay may be less. However, we may still consider your work to be substantial and gainful under our rules.

THE BASIS FOR OUR DECISION

(Include personalized explanation according to NL 00603.100)

IF YOU DISAGREE WITH THE DECISION

If you disagree with this decision, you have the right to appeal. We will review your case and look at any new facts you have. Then, a person who did not make the first decision will decide your case.

• •

  You have 60 days to ask for an appeal.

• •

  The 60 days start the day after you receive this letter. We assume you got this letter 5 days after the date on it unless you show us that you did not get it within the 5-day period.

• •

  You must have a good reason if you wait more than 60 days to ask for an appeal.

• •

  You have to ask for an appeal in writing. We will ask you to sign a form SSA-501-U2, called “Request for Hearing”. Contact one of our offices if you want help.

Please read the enclosed pamphlet, “Your Right to Question the Decision Made on Your Social Security Claim”. It contains more information about the appeal.

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 this decision and you file a new application instead of appealing:

• •

  you might lose benefits, or not qualify for any benefits, and

• •

  we could deny the new application using this decision, if the facts and issues are the same.

So, if you disagree with this decision, you should file an appeal within 60 days.

IF YOU WANT HELP WITH YOUR APPEAL

You can have a friend, a lawyer, or someone else help you. There are groups that can help you find a lawyer or give you free legal services if you qualify. There are also lawyers who do not charge unless you win your appeal. We have a list of groups that can help you with your appeal.

If you get someone to help you, you should let us know. If you hire someone, we must approve the fee before he or she can collect it. And, if you hire a lawyer, we will withhold up to 25 percent of any past due benefits to pay toward the fee.

IF YOU HAVE ANY QUESTIONS

If you have any questions, you may call, write, or visit any Social Security office. If you call or visit our office, please bring this letter with you. It will help us answer your questions.

Also, if you plan to visit an office, you may call ahead to make an appointment. This will help us serve you more quickly when you arrive at the office.

 

Enclosure:

Pamphlet entitled, “Your Right to Question the Decision Made on Your Social Security Claim”

Exhibit 14 - Stieberger Title XVI SGA Denial Letter

(Title XVI SGA Denial Notice)

SOCIAL SECURITY ADMINISTRATION

 

Important Information

IMPORTANT INFORMATION

A settlement agreement in the Stieberger v. Sullivan class action lawsuit requires the Social Security Administration to look at your case again to determine if our earlier decision that you were not or were no longer disabled was correct.

Because you worked continuously during the period we reviewed, we have looked only at your work and earnings, not your health problems. We have completed this review and we still find that the determination in your case is proper and in accordance with the law. Therefore, the denial of your application remains unchanged.

Include the paragraph below only if the claimant is in current pay:

This notice does not affect the checks that you are getting now based on your later application.

ADDITIONAL INFORMATION ABOUT SSI DISABILITY

For you to be considered disabled for SSI payments, your health problems must meet the following rule:

Your health problems must last, or be expected to last at least 12 months in a row, or result in death. And, your health problems must keep you from doing any kind of substantial gainful work. This kind of work is described below.

INFORMATION ABOUT SUBSTANTIAL GAINFUL WORK

Generally, substantial gainful work is physical or mental work you are paid to do. Work can be substantial even if it is part- time. To decide if your work is substantial, we consider the nature of your job duties, the skills and experience you need to do the job, and how much you actually earn.

Usually, we consider work to be substantial and gainful if monthly earnings, after allowable deductions, average over $500 per month ($300 before January 1, 1990). The law provides for a higher earnings test for substantial gainful activity if you are blind. That amount in 1995 was $940.00. If you are self- employed, we may give more consideration to the kind and value of your work, including your part in the management of the business, than to your income alone.

Your work may now be different than before your disability began. It may not be as hard to do and your pay may be less. However, we may still consider your work to be substantial and gainful under our rules.

THE BASIS FOR OUR DECISION

(Include personalized explanation according to NL 00603.100)

IF YOU DISAGREE WITH THE DECISION

If you disagree with this decision, you have the right to appeal. We will review your case and look at any new facts you have. Then, a person who did not make the first decision will decide your case.

• •

  You have 60 days to ask for an appeal.

• •

  The 60 days start the day after you receive this letter. We assume you got this letter 5 days after the date on it unless you show us that you did not get it within the 5-day period.

• •

  You must have a good reason if you wait more than 60 days to ask for an appeal.

• •

  You have to ask for an appeal in writing. We will ask you to sign a form SSA-501-U2, called “Request for Hearing”. Contact one of our offices if you want help.

Please read the enclosed pamphlet, “Your Right to Question the Decision Made on Your Social Security Claim”. It contains more information about the appeal.

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 this decision and you file a new application instead of appealing you might lose benefits, or not qualify for any benefits. So, if you disagree with this decision, you should file an appeal within 60 days.

IF YOU WANT HELP WITH YOUR APPEAL

You can have a friend, a lawyer, or someone else help you. There are groups that can help you find a lawyer or give you free legal services if you qualify. There are also lawyers who do not charge unless you win your appeal. We have a list of groups that can help you with your appeal.

If you get someone to help you, you should let us know. If you hire someone, we must approve the fee before he or she can collect it.

IF YOU HAVE ANY QUESTIONS

If you have any questions, you may call, write, or visit any Social Security office. If you call or visit our office, please bring this letter with you. It will help us answer your questions.

Also, if you plan to visit an office, you may call ahead to make an appointment. This will help us serve you more quickly when you arrive at the office.

 

Enclosure:

Pamphlet entitled, “Your Right to Question the Decision Made on Your Social Security Claim”