ISSUED: June 29, 1993
I. Purpose
This Temporary Instruction (TI) sets forth procedures for implementing the
July 24, 1992 Settlement Order approved by the United States District
Court for the Middle District of Florida in the LaBelle, et al.
v. Sullivan action involving the effect of loans of in-kind
support and maintenance on Supplemental Security Income (SSI) eligibility
and payment amounts.
Adjudicators throughout the country must be familiar with this TI because
individuals eligible for relief under the LaBelle
Settlement Order who now reside outside of the Eleventh Circuit must have
their cases processed in accordance with the requirements of the court's
Settlement Order.
II. Background
On December 5, 1991, plaintiffs filed an Eleventh circuit-wide class
action challenging the Secretary's policy that restricted the definition
of “loan” to transactions that involved an exchange of money,
and resulted in treating advances of food and/or shelter as income for SSI
purposes.
On December 16, 1991, the Social Security Administration (SSA) announced a
policy reinterpretation, effective December 17, 1991, that permitted bona
fide loans based on advances of food and/or shelter to be disregarded in
the same manner as cash loans in computing SSI eligibility and benefits
amounts. SSA issued teletype instruction IT-67-91 (Attachment 1) to
provide operating components with instructions on implementing the policy
change. IT-67-91 permitted one-year reopening of prior determinations or
decisions based on this change of position.
On July 24, 1992, the district court approved the parties' jointly
submitted Settlement Order setting forth the terms for applying the
Secretary's change of policy retroactively to certain Eleventh Circuit
(Alabama, Florida and Georgia) residents (Attachment 2).
On September 8, 1992, SSA published
Social Security Ruling (SSR)
92-8p which provides a uniform national policy interpretation on
the treatment of advances of in-kind support and maintenance and
implements the December 1991 policy change that permits bona fide loans
based on advances of food and/or shelter to be disregarded in computing
SSI eligibility and benefit amounts.
III. Guiding Principles
Under LaBelle, the Secretary will make a new
determination for persons who: 1) respond to notice informing them of the
opportunity for review; and 2) are determined to be eligible for relief
under the Settlement Order after screening (see
Part V. below). The Southeastern Program
Service Center (SEPSC) or the SSA field office (FO) (i.e., district office
or branch office) servicing the claimant's residence, as appropriate, will
screen cases to determine who is eligible for relief under the
LaBelle Settlement Order.
The FO will make a new determination at the reconsideration level
regardless of the final level at which the case was previously decided.
Individuals eligible for relief under the LaBelle
Settlement Order who receive adverse determinations will have appeal
rights (i.e., Administrative Law Judge (ALJ) hearing, Appeals Council and
judicial review).
Generally, the LaBelle Settlement Order does not
require any change in OHA's adjudicatory policies because, since December
16, 1991, OHA adjudicators have been excluding bona fide loans based on
advances of food and/or shelter in computing SSI eligibility and benefits
amounts. However, under the LaBelle Settlement
Order, the Secretary will recognize and accept as determinative and final
any prior decision of the Secretary at any administrative level that there
did exist a bona fide loan based on the advance of food and/or shelter and
honor that determination without further inquiry.
IV. Definition of Individuals Eligible for
LaBelle Relief
Except as noted below, for purposes of implementing the July 24, 1992
Settlement Order, individuals eligible for relief under the
LaBelle Settlement Order include all past or
present residents of Alabama, Florida and Georgia who, between January 1,
1990, and December 31, 1991, inclusive, received a determination or
decision at any administrative level (initial, reconsideration, ALJ
hearing or Appeals Council review) that reduced, suspended or denied SSI
benefits because SSA counted as income food and/or shelter that an
individual received as a bona fide loan.
A person is not eligible for relief under the
LaBelle Settlement Order if
(1) the individual is a former resident of Alabama, Florida and Georgia
and received a determination or decision between January 1, 1990, and
December 31, 1991, inclusive, but the individual was not a resident of
Alabama, Florida or Georgia at the time of the determination or decision;
or
(2) the individual's income (after excluding bona fide loans of food
and/or shelter) or resources preclude SSI eligibility or additional
payment.
Current residents of Alabama, Florida or Georgia are potential class
members if they received a determination or decision between January 1,
1990, and December 31, 1991, inclusive, even if they were not residents of
Alabama, Florida or Georgia at the time they received the determination or
decision.
V. Preadjudication Actions
On January 19, 1993, SSA began sending notices to all individuals
potentially eligible for relief under the LaBelle
Settlement Order as identified by computer run. The notice included a
reply form and a postage-paid return envelope addressed to the SEPSC.
Individuals have 180 days from the date of receipt of the notice to
request that SSA readjudicate their claims under the terms of the
LaBelle Settlement Order. Receipt will be presumed
to have occurred within 5 days of the notice.
The SEPSC will send all untimely responses to the servicing FO to develop
good cause for the untimely response. Good cause determinations will be
based on the standards in
20 CFR §
416.1411.
B. Identifying Individuals Eligible for LaBelle
Relief
1.
SEPSC Responsibilities
Upon receipt of a reply form, SEPSC will obtain an SSID query for the
respondent. SEPSC will not routinely obtain the claim folder. SEPSC will
attempt to telephone each respondent, briefly explain the
LaBelle Settlement Order, and ask each respondent
if he or she considers the food and/or shelter received to be the basis
for a loan. If a respondent does not allege a loan, SEPSC will document
the allegation on a report of contact and issue a notice (see
Part V. B. 3. below) advising the
respondent that he or she is not eligible for relief under the
LaBelle Settlement Order. SEPSC will forward the
case information and a copy of the notice to the servicing FO.
If a respondent alleges a loan based on an advance of food and/or shelter,
or a questionable situation arises, SEPSC will advise the respondent that
the local FO will contact him or her for further information. SEPSC will
document the discussion on a report of contact and forward the case
information to the servicing FO for further development.
If SEPSC is unable to contact a respondent by telephone, it will forward
the case information to the servicing FO for further action.
2.
FO Responsibilities
The FO will initiate contact with a respondent to explain the
LaBelle Settlement Order, and ask each respondent
if he or she considers the food and/or shelter received to be the basis
for a loan, when:
•
SEPSC is unable to contact a respondent by telephone;
•
a reply form is returned to the FO rather than to SEPSC;
•
an individual not previously sent a LaBelle notice
contacts the FO inquiring about potential relief.
The FO will contact a respondent to develop for good cause when a reply is
made more than 185 days after the date of the
LaBelle notice.
3.
Notice to Individuals Not Eligible for LaBelle
Relief
SEPSC or the FO will send the notice in Attachment 3, modified to fit the
circumstances of the case, to any individual who is not eligible for
relief under the LaBelle Settlement Order because
the individual:
•
does not allege an advance of food and/or shelter as the basis for a
loan;
•
has income (after excluding bona fide loans based on advances of food
and/or shelter) or resources that preclude SSI eligibility or additional
payment;
•
was not a past or present resident of the Eleventh Circuit who received a
determination or decision at any administrative level between January 1,
1990, and December 31, 1991, inclusive;
•
is deceased and there is no survivor who is eligible to receive an SSI
underpayment.
An individual who wishes to challenge a finding that he or she is not
eligible for LaBelle relief for any of the above
reasons may do so only through class counsel, as explained in the notice
(Attachment 3).
VI. Processing and Adjudication
A. FO Adjudication of LaBelle Claims
The FO will conduct the first LaBelle review. The
FO determination will be at the reconsideration level, regardless of the
administrative level at which the LaBelle claim(s) was previously decided,
with full appeal rights (i.e., ALJ hearing, Appeals Council and judicial
review). Prior determinations or decisions which had counted as income
advances of food and/or shelter received under a bona fide loan will be
reopened and revised, as appropriate.
If the FO determines that a claimant received food and/or shelter under a
bona fide loan agreement, the FO will recompute the claimant's SSI
benefits for any month(s) in the retroactive period in which the claimant
was charged in-kind support and maintenance, calculate any underpayment,
make appropriate systems input, and issue a notice advising the claimant
regarding the change in payment.
If the FO determines that the food and/or shelter a claimant received was
not received under a bona fide loan agreement, the FO will issue a notice
advising the claimant of this determination and of his or her further
appeal rights (Attachment 4).
B. OHA Adjudication of LaBelle Claims
The following instruction applies to LaBelle
readjudication cases in which the claimant requests a hearing or Appeals
Council review. OHA should not receive any unadjudicated
LaBelle claims for possible consolidation with a
current claim pending in OHA because the claims generally will not have
common issues. Except as otherwise noted in this instruction, hearing
offices and Headquarters will process LaBelle cases
according to all other current practices and procedures including coding,
scheduling, developing evidence, routing, etc.
1.
Type of Review and Period to be Considered
Pursuant to the LaBelle Settlement Order, the type
of review to be conducted is a reopening. For initial SSI claims and
appeals of determinations on initial claims, adjudicators will apply the
December 1991 policy change represented by IT-67-91 beginning with the
month of the effective date of filing, even if it precedes January 1,
1990.
For posteligibility situations, adjudicators will apply the December 1991
policy change represented by IT-67-91 beginning with the date of the
notice of the initial determination (as a result of an SSI
redetermination) that reduced or suspended benefits because SSA counted as
income food and/or shelter that the claimant received under a bona fide
loan agreement.
Because LaBelle reopenings are being made pursuant
to a court-approved settlement order, the ordinary rules of administrative
finality (20 CFR §
416.1487ff) do not apply. However, any reopenings and revisions
made subsequently on these same cases will be subject to administrative
finality, unless the subsequent reopenings are also made pursuant to the
LaBelle Settlement Order.
2.
Loans of In-kind Support and Maintenance
LaBelle does not require any change in OHA's
adjudicatory policies because, since December 16, 1991, OHA adjudicators
have been excluding bona fide loans of food and/or shelter in computing
SSI eligibility and benefits amounts. However, under the
LaBelle Settlement Order, the Secretary will
recognize and accept as determinative and final any prior decision of the
Secretary at any administrative level that there did exist a bona fide
loan and honor that determination without further inquiry.
3.
Class Member is Deceased
If a class member is deceased, the usual survivor and substitute party
provisions and existing procedures for determining distribution of any
potential underpayment apply.
VII. Case Coding
HO personnel will code prior claims into the Hearing Office Tracking
System (HOTS) and the OHA Case Control System (OHACCS) as
“reopenings.”
To identify class member cases in HOTS, HO personnel will code
“LB” in the “Class Action” field. No special
identification codes will be used in the OHACCS.
VIII. Inquiries
HO personnel should direct any questions to their Regional Office.
Regional Office personnel should contact the Division of Field Practices
and Procedures in the Office of the Chief Administrative Law Judge at
(703) 305-0022.
Attachment 1. - Teletype Instruction IT-67-91 Issued December 16, 1991
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TELEGRAPHIC MESSAGE |
[Transmitted 12/16/91] |
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NAME OF AGENCY |
PRECEDENCE
ACTION: PRIORITY
INFO:
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SECURITY CLASSIFICATION
UNCLASSIFIED
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ACCOUNTING CLASSIFICATION
HHSS
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DATE PREPARED
12/3/91
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FILE |
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FOR INFORMATION CALL |
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NAME
Stephen H. Fear
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PHONE NUMBER
59824
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TYPE OF MESSAGE
__ __ __
SINGLE BOOK MULTIPLE-
ADDRESS
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THIS SPACE FOR USE OF COMMUNICATION UNIT
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MESSAGE TO BE TRANSMITTED (Use double spacing and all capital letters) |
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TO:
FM: SSA, OSSI
TO: ALL SSA RCS
TO: ALL SSA ARCS
TO: ALL SSA PSC/ODIO/INTPSC
TO: OPIRQS/OPIRSOS
TO: SSA ADS
TO: ALL DOS/BOS/TSCS
TO: OPIR
TO: OMPI
TO: HCFA
TO: OHA
EMERGENCY SSI INSTRUCTIONS OSSI-92-008 [IT-67-91]
SUBJECT: POLICY REINTERPRETATION - APPLICABILITY OF LOAN POLICY TO ADVANCES OF FOOD AND/OR SHELTER
MANUAL REVISION TO FOLLOW SHORTLY IN POMS SI 00835.480.
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SECURITY CLASSIFICATION |
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PAGE NO.
1
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NO. OF PGS.
5
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STANDARD FORM 14 Previous editions usable NSN 7540-00-684-0964
14-103
REVISED 11-90
GSA FPMR (41 CFR
101-25.206
|
TELEGRAPHIC MESSAGE |
[Transmitted 12/16/91] |
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NAME OF AGENCY |
PRECEDENCE
ACTION: PRIORITY
INFO:
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SECURITY CLASSIFICATION
UNCLASSIFIED
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ACCOUNTING CLASSIFICATION
HHSS
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DATE PREPARED
12/3/91
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FILE |
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FOR INFORMATION CALL |
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NAME
Stephen H. Fear
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PHONE NUMBER
59824
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TYPE OF MESSAGE
__ __ __
SINGLE BOOK MULTIPLE-
ADDRESS
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THIS SPACE FOR USE OF COMMUNICATION UNIT
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MESSAGE TO BE TRANSMITTED (Use double spacing and all capital letters) |
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TO:
POLICY REINTERPRETATION
EFFECTIVE IMMEDIATELY, FOOD AND/OR SHELTER THAT AN INDIVIDUAL RECEIVES FROM THE HOUSEHOLD IN WHICH HE OR SHE LIVES AND HAS AN OBLIGATION TO PAY FOR AT A FUTURE DATE MAY BE THE BASIS OF A LOAN. DISREGARD THE BAN IN SI 00835.480 C.2. AGAINST TREATING SUCH ADVANCES AS LOANS.
ASKING ABOUT A LOAN AGREEMENT -- INITIAL CLAIMS AND REINSTATEMENTS
IF AN INDIVIDUAL WHO IS APPLYING FOR BENEFITS OR BEING REINSTATED AFTER A PERIOD OF INELIGIBILITY IS NOT PAYING A PRO RATA SHARE OF THE HOUSEHOLD FOOD AND/OR SHELTER EXPENSES, ASK IF HE OR SHE WILL HAVE TO PAY THE HOUSEHOLDER BACK FOR IT. DOCUMENT THE ANSWER OVER THE INDIVIDUAL'S SIGNATURE. A YES ANSWER IS A LOAN ALLEGATION.
DETERMINING WHETHER A BONA FIDE LOAN EXISTS
FOLLOW SI 01120.220 AND APPLICABLE REGIONAL INSTRUCTIONS TO
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SECURITY CLASSIFICATION |
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PAGE NO.
2
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NO. OF PGS.
5
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STANDARD FORM 14 Previous editions usable NSN 7540-00-684-0964
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REVISED 11-90
GSA FPMR (41 CFR
101-25.206
|
TELEGRAPHIC MESSAGE |
[Transmitted 12/16/91] |
|
NAME OF AGENCY |
PRECEDENCE
ACTION: PRIORITY
INFO:
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SECURITY CLASSIFICATION
UNCLASSIFIED
|
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ACCOUNTING CLASSIFICATION
HHSS
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DATE PREPARED
12/3/91
|
FILE |
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FOR INFORMATION CALL |
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NAME
Stephen H. Fear
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PHONE NUMBER
59824
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TYPE OF MESSAGE
__ __ __
SINGLE BOOK MULTIPLE-
ADDRESS
|
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THIS SPACE FOR USE OF COMMUNICATION UNIT
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MESSAGE TO BE TRANSMITTED (Use double spacing and all capital letters) |
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TO:
DOCUMENT AN ALLEGED LOAN AND TO DETERMINE WHETHER IT IS BONA FIDE. DO NOT USE FORMS SSA-2854 AND SSA-2855 FOR IN-KIND LOAN DEVELOPMENT. IF THE ADVANCE OF FOOD AND/OR SHELTER IS THE BASIS FOR A BONA FIDE LOAN, IT IS NOT INCOME.
LOAN AMOUNT SPECIFIED
IF THE INDIVIDUAL GIVES A DOLLAR AMOUNT FOR THE LOAN, COMPLETE SHARING DEVELOPMENT (SI 00835.160) OR EARMARKED - SHARING DEVELOPMENT (SI 00835.170), AS APPLICABLE, USING THE LOAN AMOUNT AS THE AMOUNT OF THE INDIVIDUAL'S CONTRIBUTION. COUNTABLE ISM MAY BE CHARGED IF THE AMOUNT OF THE CONTRIBUTION IS LESS THAN THE PRO RATA SHARE.
LOAN AMOUNT NOT SPECIFIED -- OPERATING ASSUMPTION FOR INITIAL CLAIMS AND REINSTATEMENTS
IF NO DOLLAR AMOUNT HAS BEEN SPECIFIED (FOR EXAMPLE, IF THE AGREEMENT IS THAT "WE ARE GOING TO FIGURE OUT WHAT I OWE
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SECURITY CLASSIFICATION |
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PAGE NO.
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NO. OF PGS.
5
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STANDARD FORM 14 Previous editions usable NSN 7540-00-684-0964
14-103
REVISED 11-90
GSA FPMR (41 CFR
101-25.206
|
TELEGRAPHIC MESSAGE |
[Transmitted 12/16/91] |
|
NAME OF AGENCY |
PRECEDENCE
ACTION: PRIORITY
INFO:
|
SECURITY CLASSIFICATION
UNCLASSIFIED
|
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ACCOUNTING CLASSIFICATION
HHSS
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DATE PREPARED
12/3/91
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FILE |
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FOR INFORMATION CALL |
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NAME
Stephen H. Fear
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PHONE NUMBER
59824
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TYPE OF MESSAGE
__ __ __
SINGLE BOOK MULTIPLE-
ADDRESS
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THIS SPACE FOR USE OF COMMUNICATION UNIT
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MESSAGE TO BE TRANSMITTED (Use double spacing and all capital letters) |
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TO:
LATER AND I AM GOING TO PAY IT OUT OF MY SSI"), ASSUME THAT THE LOAN AGREEMENT COVERS THE INDIVIDUAL'S PRO RATA SHARE OF THE FOOD AND/OR SHELTER EXPENSES, AS APPLICABLE. DO NOT DEVELOP HOUSEHOLD EXPENSES FOR THE PURPOSE OF DETERMINING THE AMOUNT OF THE LOAN. THIS OPERATING ASSUMPTION DOES NOT APPLY IN CONTINUTING ELIGIBILITY SITUATIONS.
TYPE H INCOME INPUT
IF NO ISM IS BEING CHARGED BECAUSE OF A BONA FIDE LOAN, INPUT A TYPE H INCOME AMOUNT OF ZERO AND TYPE H ID OF “A LOAN” (SEE SM 01005.193 FOR TYPE H INCOME INPUT INSTRUCTIONS).
RT DIARY INPUT AND DEVELOPMENT
IF NO ISM IS BEING CHARGED BECAUSE OF A BONA FIDE LOAN, SET AN RT DIARY FOR 3 MONTHS AFTER THE ESTIMATED FIRST MONTH OF PAYMENT (SEE SM 01005.230 FOR DA FIELD INPUT INSTRUCTIONS).
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SECURITY CLASSIFICATION |
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NO. OF PGS.
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STANDARD FORM 14 Previous editions usable NSN 7540-00-684-0964
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REVISED 11-90
GSA FPMR (41 CFR
101-25.206
|
TELEGRAPHIC MESSAGE |
[Transmitted 12/16/91] |
|
NAME OF AGENCY |
PRECEDENCE
ACTION: PRIORITY
INFO:
|
SECURITY CLASSIFICATION
UNCLASSIFIED
|
|
ACCOUNTING CLASSIFICATION
HHSS
|
DATE PREPARED
12/3/91
|
FILE |
|
FOR INFORMATION CALL |
|
NAME
Stephen H. Fear
|
PHONE NUMBER
59824
|
TYPE OF MESSAGE
__ __ __
SINGLE BOOK MULTIPLE-
ADDRESS
|
|
THIS SPACE FOR USE OF COMMUNICATION UNIT
|
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MESSAGE TO BE TRANSMITTED (Use double spacing and all capital letters) |
|
TO:
WHEN THE DIARY MATURES, DO PRO RATA SHARE DEVELOPMENT BEGINNING WITH THE MONTH AFTER THE INDIVIDUAL FIRST RECEIVED PAYMENT, USING THE AVERAGING INSTRUCTIONS IN SI 00835.475 D.
ADMINISTRATIVE FINALITY
ONE YEAR REOPENING OF PRIOR DETERMINATIONS FOR CHANGE-OF- POSITION POLICY APPLIES (SEE SI 04070.040 C.3.).
/S/
RHODA
M. G. DAVIS
ASSOCIATE COMMISSIONER
FOR SUPPLEMENTAL
SECURITY INCOME
PUBLISHED INSTRUCTIONS ARE TARGETED
TO REACH USERS BY 7/31/92.
FILE CODE: SI
1-3.2.5
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SECURITY CLASSIFICATION |
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5
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STANDARD FORM 14 Previous editions usable NSN 7540-00-684-0964
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REVISED 11-90
GSA FPMR (41 CFR
101-25.206
Attachment 2. - LaBelle v. Sullivan Settlement Order Dated July 24, 1992
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IN THE UNITED STATES DISTRICT COURT |
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FOR THE MIDDLE DISTRICT OF FLORIDA |
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MARIE L. LABELLE, |
* |
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MICHAEL A. ANGELO, and |
* |
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WILLIE M. LEWIS, |
* |
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individually and on behalf of |
* |
[Filed July 24, 1992] |
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all others similarly situated, |
* |
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Plaintiffs, |
* |
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* |
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vs. |
* |
CASE NO. 91-1041-CIV-J-16 |
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* |
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LOUIS W. SULLIVAN, Secretary of |
* |
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the Department of Health and |
* |
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Human Services, |
* |
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* |
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Defendant. |
* |
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SETTLEMENT ORDER
The Court having approved the parties' settlement proposal, IT IS HEREBY
ORDERED, ADJUDGED, AND DECREED that:
1.
Effective December 17, 1991, Defendant began treating in-kind advances of
food and/or shelter in the same manner that cash loans and credit
purchases are treated under 20 C.F.R § 416.1103(f), with the result
that bona fide in-kind loans are no longer charged as income to SSI
applicants and recipients. On December 16, 1991, SSA issued teletype
instruction IT-67-91 (Exhibit 1) to provide the appropriate SSA operating
components with instructions on implementing the change of position on the
treatment of in-kind loans. IT-67-91 is applicable to determinations made
on or after December 17, 1990. By this order the Defendant agrees to apply
the change of position described in IT-67-91 to past or present residents
of Alabama, Georgia and Florida, who, during the period January 1, 1990,
through December 31, 1991, received a determination or decision at any
administrative level (initial, reconsideration, hearing, or Appeals
Council), that resulted in or upheld a reduction of an individual's
initial SSI payment (including any initial payment made after a period of
suspension) that had occurred due to SSA's counting as income food or
shelter that the individual had received as a bona fide loan. This
provision also applies to individuals who filed an SSI claim that was
denied between January 1, 1990, and December 31, 1991 because SSA had
counted as income food and/or shelter that was received as a bona fide
loan.
2.
With regard to the individuals described in paragraph 1, Defendant Louis
W. Sullivan, Secretary of Health and Human Services, his agents,
employees, and all persons acting in concert with them, agree not to apply
any and all written or oral directives of the Social Security
Administration that require or permit bona fide loans of food or shelter
from within a household to be treated as income to the SSI applicant or
recipient. This includes, but is not limited to, any regulations, proposed
regulations, Social Security rulings, program circulars, Program
Operations Manual System (POMS) provisions, and any other written or oral
directives, guidelines, memoranda, etc. of the Social Security
Administration.
3.
The Defendant will apply the provisions of this agreement to Plaintiffs
Marie LaBelle, Michael Angelo, and Willie M. Lewis.
4.
Not later than the date when the notices described in paragraph 5 are
issued, Defendant will send by teletype or overnight means of
communication to all appropriate offices, divisions, levels, departments,
etc., of the Social Security Administration a directive explaining how the
claims of individuals responding to this notice will be processed, and
directing:
That in determining eligibility for and the amount of SSI benefits for all
individuals described in paragraph 1, adjudicators shall treat in-kind
loans of food and/or shelter in the same manner as cash loans or credit
purchases are treated, namely, that the value of bona fide in-kind loans
shall not be counted as income.
5.
Within one hundred and eighty (180) days of entry of this order, Defendant
shall identify and provide written notification of this agreement to all
individuals described in paragraph 1. The contents of the notice shall be
written by the Secretary and submitted to plaintiffs for review and shall
include, but shall not necessarily be limited to, an explanation in clear,
layperson's language of the general provisions of this agreement and how
the individual may request relief thereunder. To quality for consideration
for relief, an individual must contact SSA within one hundred and eighty
(180) days from the date he/she receives the aforementioned notice unless
he/she can establish good cause for not contacting SSA within the 180-day
period. Receipt will be presumed to have occurred within 5 days of the
date of the notice, unless an individual shows otherwise. To decide
whether an individual has established good cause for missing the deadline
to request review under this agreement, the Defendant will apply the
criteria in 20 C.F.R.
§ 416.1411.
6.
Defendant further agrees to,
a.
Recognize and accept as determinative and final any prior decision of the
Secretary at any administrative level for those members of the group as
defined in paragraph 1, that there did exist a bona fide loan of food
and/or shelter and to honor that determination without further inquiry;
and
b.
Provide, for the claims of those individuals defined in paragraph 1 where
no determination was made as to the existence of a bona fide loan, a full
opportunity for individuals notified pursuant to paragraph 5 to
demonstrate that the food and/or shelter they received for any month was a
bona fide loan.
7.
Upon the request of any individual as described in paragraph 1, Defendant
shall, for all months to which the determination or decision described in
paragraph 1 applies to such individual, redetermine the SSI benefit amount
and/or eligibility of such individual and make any appropriate retroactive
payment to him or her. If the determination or decision described in
paragraph 1 pertains to an application for benefits, the months to which
it applies begin with the month in which the application was filed. If the
determination or decision pertains to a reinstatement of benefits, the
months to which it applies begin with the first month for which benefits
were suspended or reduced.
8.
Within one hundred and twenty (120) days of the date of this order, and
every sixty (60) days thereafter until relief is provided to all
individuals notified under paragraph 5 who are entitled to relief,
Defendant shall submit a written report to this Court, with a copy served
on Plaintiffs' counsel, describing Defendant's compliance with this Order.
Each report shall include, but not necessarily be limited to, descriptions
of the following:
a.
All actions taken by the Defendant to comply with paragraph 4 of this
Order, including the date(s) of such actions
b.
All actions taken by the Defendant to comply with paragraph 5 of this
Order, including number of individuals identified, and the number provided
relief under the Order.
9.
The Court shall retain jurisdiction to enforce or clarify this Order to
ensure that its terms are carried out.
IT IS SO ORDERED.
ENTERED this 24 day of July, 1992, at Jacksonville, Florida.
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/s/ |
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____________________________________ |
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UNITED STATES DISTRICT JUDGE |
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cc:
Karen J. Aviles, Esq.
Ralph
Lee, Esq.
Gill Deford, Esq.
Sarah Harriet Bohr,
Esq.
Thomas F. Woods, Esq.
James J. Taylor. Jr.,
Esq.
WE HEREBY CONSENT TO ENTRY OF THE FOREGOING ORDER IN:
Marie L. Laelle. et al. v. Sullivan,
Case No.
91-1041-CIV-J-16
For the Defendant:
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ROBERT W. GENZMAN
United
States Attorney
By: ____________/s/____________
RALPH
J. LEE
Assistant United States Attorney
Id. No.
USA004
Post Office Box 60D
Jacksonville, Florida
32201
Telephone No. (904) 232-2682
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OF COUNSEL:
DONALD A GONYA
Chief
Counsel for Social Security
RANDOLPH W. GAINES
Deputy
Chief Counsel for Social Security
JOHN M. SACCHETTI
Chief,
Retirement, Survivors
and
Supplemental Assistance Litigation
Branch
KAREN J. AVILES
Attorney
Office
of the General Counsel
Social
Security Division
Department
of Health and Human Services
For the Plaintiffs:
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____________/s/____________
Sara
H. Bohr, Esquire
Id. No. 264008
Jacksonville Area
Legal Aid, Inc
604 Hogan Street
Jacksonville,
Florida 32202
(904) 356-8371, Extension 345
Gil
Deford, Esquire
National Senior Citizens Law Center
Los
Angeles, California
Pro Hoc Vice
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Attachment 3. - Notice to Individuals Not Eligibile For LaBelle Relief
SUPPLEMENTAL
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SECURITY |
Important Information |
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INCOME
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From: |
Department of Health and Human
Services
Social Security Administration
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Office Address: |
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Telephone Number: |
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____________________________ |
Date: |
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____________________________ |
Social Security Number: |
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999-99-9999 |
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____________________________ |
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You asked us to look at your Supplemental Security Income (SSI) case to
see if we owe you any money because of the LaBelle
court case. This case changes how we count help you receive from someone
you live with if you do not pay for it. The LaBelle
case says that we should not count the help you received (food or shelter
or both) if the help you received was intended to be a loan.
The information we have shows that you are not
fill-in (1) because of the
LaBelle case for the following reason(s):
fill-in (2).
Do You Think We're Wrong?
If you think we're wrong, you may have your lawyer contact the attorneys
for the LaBelle case. If you don't have a lawyer,
there are groups that can find you one. We can give you the names of these
groups.
The attorneys for the LaBelle case will answer your
questions about class membership. If they think we are wrong, we may
change our minds and look at your case again. The attorney for the
LaBelle case is Jacksonville Legal Aid, Inc. The
address is 604 Hogan Street, Jacksonville, Florida, 32202.
If You Have Any Questions
If you have any questions, you may call your local Social Security office.
If you call or visit our office, please have this letter with you.
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.
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(FO Manager's Name)
Manager
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Fill-ins
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1 - |
Choice 1: eligible to receive SSI payments |
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Choice 2: due more SSI payments |
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2 - |
Choice 1: When we contacted you, you told us that the (food/ food and shelter/shelter) you received did not have to be paid back. It was not intended to be a loan. |
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Choice 2: The amount of your income was still to high after we subtracted the amount we counted for the help (you) received. (List all other income counted.) |
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Choice 3: We find that (your) resources were more than $_____ (appropriate dollar amount for resource limit) for _____ (month/year) through _____ (month/year that resources exceed the limit). |
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For you to receive (more) SSI payments, the resources that (you) own cannot be worth more than $_____ (appropriate dollar amount). We call this amount the resource limit. |
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Resources are the things that (you) own such as cash, stocks, bank accounts, certain types of life insurance, buildings and land on which (you) do not live. We do not include as resources the home in which (you) live, one car used for necessary activities, and some other things. |
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Choice 4: To be eligible for Supplemental Security Income payments under the LaBelle case, (you) must have lived in the State of (Alabama, Florida, or Georgia) for one or more months during the period January 1, 1990, through December 31, 1991. Our records show that (you) did not/do not meet this requirement because you were/are living in (name of state/foreign country). |
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Choice 5: (Other -- fill in appropriate explanation.) |
Attachment 4. - Notice of FO Determination That No Bona Fide Loan Exists
SUPPLEMENTAL
|
SECURITY |
Important Information |
|
INCOME
|
From: |
Department of Health and Human
Services Social Security Administration
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Office Address: |
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Telephone Number: |
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____________________________ |
Date: |
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____________________________ |
Social Security Number: |
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999-99-9999 |
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____________________________ |
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You asked us to look at your Supplemental Security Income (SSI) case to
see if we owe you any money because of the LaBelle
court case. This case changes how we count help you receive from someone
you live with if you do not pay for it. The LaBelle
case says that we should not count the help you received (food or shelter
or both) if the help you received was intended to be a loan.
The information we have shows that you are not
fill-in (1) because of the
LaBelle case for the following reason(s):
You did not receive a loan of food or shelter because
fill-in (2).
Do You Disagree With the Decision?
If you disagree with the decision, you have the right to appeal. A person
who hasn't seen this case will look at it. That person will be an
Administrative Law Judge. In the rest of our letter we'll call this person
an ALJ. The ALJ will correct mistakes and look at any new facts you have
before deciding this case. We call this a hearing.
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You have 60 days to ask for a hearing.
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The 60 days start the day after you get this letter.
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You'll have to have a good reason for waiting more than 60 days to ask for
a hearing.
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You have to ask for a hearing in writing. We'll ask you to sign an SSA
form HA-501, called “Request for Hearing.” Contact one of our
offices if you want help.
How a Hearing Works
A hearing works like this.
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The ALJ will tell you the time and place for the hearing.
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The ALJ will explain the law in this case. The ALJ will state the known
facts and tell you what has to be decided.
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You can tell the ALJ why you think we're wrong. You can give the ALJ more
facts. And you can bring people to say why you're right.
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The ALJ can make people come to the hearing and bring important papers.
You can question these people at the hearing.
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We'll ask if you want to go the hearing in person. If you say you want to
go, you should attend if at all possible. If you change your mind or if
you can't get to the hearing, you should tell us. You should know that
your being there may help the ALJ decide the case.
If You Want Help With The Hearing
You may want help from a friend, lawyer or someone else. There are groups
that can find you a lawyer. We can give you the names of these groups.
Your lawyer may contact the attorney in the LaBelle
case, Jacksonville Legal Aid, Inc. The address is 604 Hogan Street,
Jacksonville, Florida, 32202.
If You Have Any Questions
If you have any questions, you can call, write or visit any Social
Security office. If you call or visit our office, please have this letter
with you and ask for (claims representative's name). The telephone number
is (xxx) xxx-xxxx.
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.
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(FO Manager's Name)
Manager
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Fill-ins
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1 - |
Choice 1: eligible to receive SSI payments |
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Choice 2: due more SSI payments |
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2 - |
Fill in reason no loan was found to exist. |