ISSUED: August 12, 2003
I. Purpose
This Temporary Instruction (TI) sets forth the procedures
for implementing the parties' joint Settlement Agreement and Order,
approved by the United States District Court for the Middle District
of Pennsylvania on February 7, 2002, in the Grant v.
Commissioner of the Social Security Administration class
action involving allegations of misconduct by an Administrative
Law Judge (ALJ).
Adjudicators throughout the country must be familiar with
this TI because of case transfers and because Grant class
members who now reside outside of Pennsylvania and Washington D.C.
must have their cases processed in accordance with the requirements
of the joint Settlement Agreement and Order.
II. Background
On August 12, 1988, plaintiffs filed a class complaint alleging
bias on the part of ALJ Russell Rowell (also referred to as the “subject
ALJ”) who worked in the Harrisburg, Pennsylvania, and Washington
D.C., Hearing Offices (HOs) of the Office of Hearings and Appeals.
On February 21, 1990, the U.S. District Court for the Middle District
of Pennsylvania certified a class consisting of all claimants for
Social Security disability benefits or Supplemental Security Income
disability benefits, who received an adverse decision from the subject
ALJ on or after January 1, 1985, and all disability claimants whose
claims were assigned to the subject ALJ for a decision. The subject
ALJ died on September 25, 1994.
On September 20, 2001, the parties entered into a settlement
agreement. On February 7, 2002, the District Court issued an Order
granting final approval of the parties' settlement agreement (Attachment
1). On September 9, 2002, the District Court approved the Privacy Act
and Protective Order agreed to by the parties (Attachment 2).
Pursuant to the terms of the Settlement, SSA's Office of Acquiescence
and Litigation Coordination (OALC) will send individual notices
to potential class members informing them of their opportunity to
request review of their claims. With the exception of cases consolidated with
a current claim pending at the Appeals Council level for the purpose
of issuing a fully favorable decision (see Part VI.B.3.c. below),
class members who are found eligible for relief will receive an
opportunity for a new hearing decision on their claims.
III. Guiding Principles
Under Grant, the Commissioner will
redetermine the title II and title XVI disability claims of those
persons who: 1) respond to the notice informing them of the opportunity
for review; and 2) are determined, after screening, to be class
members eligible for relief (see Parts IV. and V. below). OHA will
screen the claims of all potential class members and will perform the
necessary redeterminations. In most cases, the HO nearest to the
claimant's residence will perform the required redeterminations.
Except for cases processed at the Appeals Council level pursuant
to Part VI.B.3.c., cases redetermined under the terms of the settlement
will be processed at the ALJ hearing level regardless of the final
level at which the claim was previously decided. The type of review will
be a redetermination (see Part VI. below). Class members who receive
adverse redetermination decisions will have full appeal rights (i.e.,
Appeals Council and judicial review).
IV. Definition of Class
Except as noted below, for purposes of implementing the terms
of the Settlement and Order, the Grant class
potentially eligible for relief consists of all individuals:
•
Who filed a claim
for disability benefits pursuant to title II and/or title XVI of
the Social Security Act; and
•
Who requested a hearing decision by an ALJ on that
claim or any issues arising from that claim; and
•
Whose request was dismissed by or who received a
less than fully favorable decision on the claim from the subject
ALJ; and
•
Whose dismissal or decision by the subject ALJ was
dated on or after January 1, 1985.
A person is not a class member
eligible for Grant relief if the individual:
a.
Successfully
appealed an adverse decision of the subject ALJ and ultimately received
all of the benefits sought in the claim before the subject ALJ,
or
b.
Appealed an adverse decision of the subject ALJ
and was granted a remand for a new hearing before another ALJ based
on the same claim that was considered by the subject ALJ; or
c.
Did not appeal an adverse decision of the subject
ALJ, but later reapplied and was found eligible or ineligible for
disability benefits (on the merits and not on res judicata grounds)
on a subsequent application and the subsequent application covered
the same time period that was covered by the application considered
by the subject ALJ.
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.
V. Determination of Class
Membership and Eligibility for Relief and Preadjudication Actions
A. Pre-Screening Actions — General
a.
SSA shall
send an individual notice to the last known address of every individual
who has been identified by computer run as a potential class member.
Individuals will have 90 days from the date of the notice (or of
the date of the mailing of the second copy of the notice, as described
below), unless extended for good cause, to request that SSA redetermine
their claims under the terms of the Grant Settlement
and Order. SSA will presume receipt of the notice within five days
after the date of notice, unless the notice is returned as undeliverable
or the individual establishes that receipt actually occurred later. Office
of Central Operations (OCO) will enter replies into the Civil Action
Tracking System (CATS). CATS generates court folder alerts. The
alerts will be used to locate and retrieve Grant claim
files. An individual who does not receive the potential class member
notice but believes that he/she is eligible for relief, may request
a review of his/her Grant claim(s) by contacting
any SSA office within 90 days of the most recent date that SSA mails
the notices to the system-identified potential class members (see
below explanation of second mailing after updated addresses are
received).
Undeliverable potential class member notices will be returned
to OCO to update CATS. If mailed notices are returned as undeliverable,
SSA shall provide to class counsel a list of those persons and their
last known addresses. Class counsel shall have 180 days after receipt
of such names to furnish current addresses for such listed individuals.
Upon timely receipt of such addresses from class counsel, SSA shall
mail a second copy of the class member notice to those class members
potentially eligible for relief at the updated addresses.
b.
OCO screens for the timeliness of the reply form.
OCO will notify the servicing FO of untimely responses and request
that the FO develop for possible evidence of good cause for the
untimely response. Good cause determinations will be based on the
standards in 20
CFR §§ 404.909, 404.911, 416.1409 and 416.1411.
If good cause is established, the FO will forward the good cause
determination and any folders currently in the FO, to OCO. The FO
will retrieve any prior title XVI folder from the Folder Servicing Operation
in Wilkes Barre (FSO in WB), Pennsylvania. All title XVI only folders, including
current claim folders currently reading into the FO will be associated
with the alert/query package. The FO will then ship the alert/query
package with all folders to the OHA Class Action Coordinator for
distribution for screening (see HA 01540.067 V.A.2.C. for the
address). If good cause is not established, the FO will send the
individual a good cause denial notice.
2. Alert and Folder
Retrieval Process
All response forms and requests for relief including those
filed by individuals who did not receive the potential class member
notice (i.e., individuals who contact SSA by telephone, in person,
or in writing) should be entered into CATS. If a request for relief
is received by an office that does not have access to CATS, it should
forward the request to a FO or OCO and should refer a claimant who
has contacted an office without CATS access to a FO. Requests for
change of address (filed using Attachment 3) should also be entered
into CATS. CATS will generate folder alerts for all reply forms.
See Attachment 4 for a sample Grant alert. The
computer-generated alerts will be associated with available title
II and concurrent title II and title XVI potential class member
claim file(s).
The following identifies which component is responsible for
folder retrieval after an individual requests review:
a.
OCO will
be responsible for retrieving OCO jurisdiction title II only and
concurrent title II/title XVI claims covered by the Grant timeframes
as well as subsequent claims except for those pending in OHA. OCO
will forward all other alert/query packages to the appropriate component
for folder retrieval.
b.
The Program Service Centers (PSCs) will be responsible
for retrieving PSC jurisdiction title II only and concurrent title
II/title XVI claims covered by the Grant timeframes
except for those pending in OHA.
c.
The FSO in WB and the FOs will be responsible for
retrieving title XVI claims except for those pending in OHA.
Once the claim files and alerts have
been associated, OCO, the PSCs, FOs or FSO in WB will forward the
alert and claim files to the OHA Class Action Coordinator at the
following address (Case locator code Y46):
Office of Hearings and Appeals
Office of Appellate
Operations
One Skyline Tower, Suite 1400
5107 Leesburg
Pike
Falls Church, VA 22041-3200
Attn:
OHA Class Action Coordinator The OHA Class Action Coordinator will code receipt of any
claim files into the case control system and enter information concerning
the claim into an internal OHA database and will forward the alert
package and folder search results to the Grant Screening
Unit. If the folder retrieval component determines that the potential
class member has a claim (the potential class claim or a subsequent
claim) that is pending or stored at OHA Headquarters or in an HO,
the folder retrieval component will send the alert, along with any
claim file(s) not in OHA's possession, to the OHA Class Action Coordinator
for association with the pending or stored claim file and screening.
If the claim is located in a HO or the Office of Appellate Operations
(OAO), the OHA Class Action Coordinator will coordinate retrieval/case
transfer of the file for screening at OHA Headquarters by the Grant Screening
Unit in such a manner that would not delay the current claim pending
at OHA.
The OHA Class Action Coordinator
is responsible for controlling and reconciling the disposition of
class alerts and claim files shipped to OHA Headquarters for screening.
The Coordinator will maintain a record of all alerts and claim files
received and the location, if any, to which they are transferred.
The Coordinator will periodically enter this information into CATS.
The information will be necessary to do the final class membership
reconciliation.
When claim folders cannot be located, the folder retrieval
component will forward any information it has on cases that need
to be reconstructed with a reconstruction request to the servicing
FO along with a copy of the alert and documentation of attempts
to locate the file, and will request that the reconstructed file
be forwarded to the OHA Class Action Coordinator for coordination
of final screening and assignment to a HO for redetermination if eligible
for relief. To avoid unnecessary requests for reconstruction, the
OHA Class Action Coordinator will provide the folder retrieval component
information concerning the OHA location of any existing potential
class member claim file(s) being retained for adjudication purposes,
and the date(s) of the claim(s) involved. For control and informational
purposes, the FOs or the FSO in WB will forward a copy of each reconstruction
request to the OHA Class Action Coordinator at the address listed
above.
In cases where an alert has been generated but the claim file(s)
cannot be located, systems queries will be obtained and utilized
to attempt to determine whether the individual in question is a
class member potentially eligible for relief. However, if information
contained in the queries or otherwise obtained clearly indicates
that the claimant is not a class member potentially eligible for
relief, reconstruction efforts will not be initiated. In such cases,
the alert and the information/evidence obtained up to that point
should be sent to the OHA Class Action Coordinator for coordination
with the Grant Screening Unit. If all the
missing claims cannot be screened out via queries, class membership
will be presumed and the claim file(s) will be reconstructed based
upon available information.
The OHA Class Action Coordinator will coordinate with HOs
and OAO in cases where there is a current claim pending at the OHA
level. The HO or OAO will not delay action on a pending claim when
a prior claim is being reconstructed for screening purposes, unless
the prior claim is needed for the adjudication of the pending claim.
If OHA completes action on the pending claim prior to receipt of
the reconstructed file, the HO or OAO, as appropriate, will forward
a copy of the action on the pending claim to the OHA Class Action
Coordinator who will associate the pending claim information with
the class action material, including the alert and claim files,
if any, and forward the entire package to the Grant Screening
Unit upon receipt of the reconstructed file from the FO which has
responsibility for initiating all file reconstruction. If, in reconstructing
the file, the FO finds evidence of substantial gainful activity
during the Grant period by the claimant,
the FO will include that information in the claim file.
4. Class Membership
Denials (Non-Eligibility for Relief)
Individuals who receive a notice of non-class membership have
60 days from receipt of the notice to dispute the determination.
The OHA Class Action Coordinator will hold for 90 days all claim
files of individuals to whom SSA sends notice of non-class membership
and ineligibility for relief, pending review by claimants, claimant's
representative or class counsel. If an individual wishes to dispute
SSA's class membership/eligibility for relief determination, he or
she must give timely written notice of the disagreement to the Office
of the General Counsel (OGC) (i.e., within 60 days of receipt of
notice that the individual is not a class member eligible for relief).
Upon request, claimant, claimant's representative or class counsel,
subject to the Privacy Act Protective Order entered into in this
case, will be given reasonable and timely access to potential class
members' claim files for the purpose of resolving class membership
disputes. Upon request, the OHA Class Action Coordinator will forward
the claim files or documentation used to deny class membership to
the Harrisburg HO.
1. Jurisdiction for
Screening
Because the relief offered in Grant is
a new hearing decision (or an Appeals Council decision if the claim
is consolidated with a current claim pending at the Appeals Council
level and a decision fully favorable to the Grant claim
is issued), all claims will be screened at the OHA level. The screening
will be performed at OHA Headquarters by the Grant Screening
Unit.
a. Current Claim
Is Pending or Stored at OHA
If a current claim is before the Appeals Council or pending
in a HO, the Coordinator will forward the alert and any prior claim
file(s) to the Grant Screening Unit for screening.
The Coordinator will also notify the appropriate OAO branch or the
HO that there is a potential Grant claim
pending. The Grant Screening Unit will notify
the OHA Class Action Coordinator and the OAO branch or the HO of
the outcome of the screening.
Do not screen pending cases unless
an alert has been received. The presence of an alert is evidence
that the claimant has responded to the notice of potential class
membership and that his or her case is ready for review. However,
if a claimant with a non-alerted pending case should allege class
membership, contact the Grant coordinator
in the Special Counsel Staff (SCS) for assistance in determining
the claimant's status. SCS's address is:
Special Counsel Staff
Office of Hearings and Appeals
One
Skyline Tower, Suite 1605
5107 Leesburg Pike
Falls
Church, VA 22041-3255
Attn: Grant Coordinator
Telephone
Number: (703) 605-8250 b. Current Claim
Pending in Court
If the OHA Class Action Coordinator receives an alert for
a claimant who has a civil action pending, either on the alerted
case or on a subsequent or prior claim, the Coordinator will forward
the alert and any accompanying claim file(s) to the Grant Screening
Unit for screening. The Coordinator will also notify the appropriate
OAO Court Case Preparation and Review Branch (CCPRB) that there
is a potential Grant claim. The Grant Screening
Unit will notify the OHA Class Action Coordinator and the CCPRB
of the outcome of the screening. See Part V.B.4. below for special
screening instructions when a civil action is involved.
c. Claim at OHA Headquarters
But No Current Action Pending
If a claim file (either a class member or a subsequent claim)
is located in OHA Headquarters but there is no claim actively pending
administrative review, i.e., Headquarters is holding the file awaiting
potential receipt of a request for review or notification that a
civil action has been filed, the OHA Class Action Coordinator will
retrieve that claim file and forward it to the Grant Screening
Unit (using Attachment 5) which will associate the alert with the
file and screen for class membership and eligibility for relief.
If the Screening Unit determines that the individual is not a class
member eligible for relief and the individual does not dispute the
denial of eligibility for relief, the Screening Unit will return
the file to the OHA Class Action Coordinator. (The OHA Class Action
Coordinator will coordinate the necessary actions, as explained
in Part V.) (See Part V.B.5., below, for non-class member processing instructions.)
3. General Screening
Instructions
The following instructions are applicable to claims in which
the individual requested relief after receiving a written notice.
The Grant Screening Unit will perform
the screening for all potential class member claims. The Screening
Unit will associate the alert and any prior claim file(s) with the
claim file(s) in its possession and then complete a screening sheet
(see Attachment 6) as follows:
•
Consider all applications
denied/ceased or other determinations/decisions adverse to the claimant
issued during the Grant timeframe ( on or
after January 1, 1985);
•
Follow all instructions on the screening sheet;
•
Sign and date the original screening sheet, place
it in the claim file (on the top right side of the file); and
•
Forward a copy of the screening sheet to the OHA
Class Action Coordinator at the address in Part V.A.2. above. (The
Coordinator will enter information from the screening sheet into
CATS and the Grant OHA database and will
forward the screening sheet to SCS).
4. Special Screening
Instructions if a Civil Action Is Involved
As noted in Part V.B.1. above, the Grant Screening
Unit will screen all requests for relief. However, if a civil action
is involved, after screening, the Grant Screening
Unit will forward the claim file(s) to the CCPRB for appropriate
action. The screening determination will dictate the appropriate
post-screening action.
If the claim pending in court is the potential class member
claim or a subsequent claim that involves unresolved Grant issues,
the CCPRB will immediately notify OGC (as appropriate, OGC will
then notify the Assistant United States Attorney (AUSA)) so that
OGC (or the AUSA) can notify the claimant of the option to agree
to a remand of the case for readjudication under Grant.
If the claim pending in court is not the class member claim and
does not involve any Grant issues, the CCRB
will not take any additional actions.
5. Post-Screening Actions
a. Individuals Determined
to Be Class Members Eligible for Relief
If the Grant Screening Unit determines
that the individual is a class member eligible for relief, it will
forward the claim, using Attachment 11, to the appropriate HO for
redetermination. The Screening Unit will identify the HO, based
on the claimant's residence, that will perform the redetermination
and will note the address of the HO on the Grant Flag/Alert used
to forward the claim (Attachment 11). Should the HO need to develop
evidence concerning the period that was before the subject ALJ it
should follow normal procedures. Once the development has been completed,
the HO will then proceed with processing in accordance with the
instructions in Part VI. below.
b. Individuals Determined
Not to Be Class Members Eligible for Relief
1.
If the Grant Screening
Unit determines that the individual is not a class member eligible
for relief, the Screening Unit will:
•
Notify the individual
and representative, if any, (with copies to class counsel and the
OHA Class Action Coordinator) of that determination using Attachment
7 which will state that the claimant has 60 days to request OGC
to review the determination (modified as necessary to fit the circumstances
and posture of the case when there is a current claim);
Include the date and claim number
at the top of Attachment 7 in the spaces indicated.
•
Retain a copy of the notice in the claim file;
•
Send a copy of the notice to Grant class
counsel:
Community Justice Project
118 Locust Street
Harrisburg,
PA 17101
Attn: Grant Class Counsel•
And retain the claim file(s) for 90 days pending
a possible class membership dispute.
An individual who wishes to dispute
a determination of non-class membership and ineligibility for relief
should do so directly, or through his/her representative of record.
2.
If class counsel makes a timely (i.e., within 60
days of claimant receiving the not eligible for relief notice) request
to OGC to review the claim file which contains the information used
by the Screening Unit, the Screening Unit will send the file to
the HO in Harrisburg, PA (Office Code Y10) using the pre-addressed
route slip in Attachment 8. The HO in Harrisburg will notify the
claimant, claimant's attorney, and class counsel when it has the
file available to review.
3.
The Harrisburg HO should hold the file for a maximum
of 60 days following the review by class counsel, claimant's attorney
and/or claimant. If at any time during this 60-day period the file
is requested by OGC, the HO will forward the claim file by priority
mail to the OGC Grant attorney. If at the
end of the 60-day period, no request for the file is made by the
OGC Grant attorney, the HO will return the
file to its normal storage facility. If the OGC Grant attorney
requests the file, (s)he will, if the dispute is being resolved
in the claimant's favor, send the file by priority mail back to
the Harrisburg HO and will notify the Grant Screening
Unit of the determination. If the dispute is not resolved in the
claimant's favor, the OGC Grant attorney
will, after notifying the claimant of the determination, retain
the file during the period regarding court review described below.
Once the court appeal period or court action is over, the OGC Grant attorney
can send the file back by priority mail to the OHA Class Action
Coordinator who will return the folder to its normal storage facility.
4.
If SSA, through OGC, resolves the dispute in the
claimant's favor:
a.
The Grant Screening
Unit will prepare a revised screening sheet and send notice of the
revised class membership/eligibility for relief determination (Attachment
9) to the claimant, and representative, if any; class counsel, and
to the Harrisburg HO;
b.
The Grant Screening Unit
will notify the OHA Class Action Coordinator of the revised determination
by forwarding a copy of the revised screening sheet to the Coordinator;
and
c.
The Harrisburg HO will forward the claim file to
the appropriate HO for redetermination and the case will proceed
in accordance with Part VI. below.
5.
If the dispute is not resolved in the claimant's
favor, OGC will send the claimant and class counsel a written notice
of OGC's determination that the person is not eligible for a new
hearing. The notice will also inform the claimant that he/she will
have 60 days to request that the court review the class membership/eligibility
for relief determination. The Harrisburg HO will, if it still retains
the claim file, send it to the OGC Grant attorney.
The OGC Grant attorney will retain the file
for 90 days pending possible court action. If at the end of the
90 day period there is no court action, or at the conclusion of
any court action, the OGC Grant attorney
will send the file back by priority mail to the OHA class action
coordinator who will return the file to its normal storage facility,
and will make a notation in the file that no request for court review
was received.
VI. Processing and Adjudication
A. OHA Adjudication
of Class Member Claims
All of the Grant redeterminations will
be conducted at the OHA level. In some instances, such as consolidation
cases, the Appeals Council will conduct the Grant redetermination.
In cases redetermined at the ALJ level, the individual will receive
a de novo hearing from an ALJ on the record
that was before the subject ALJ, with any necessary development
of evidence related to the period under review. Grant class
members who receive new hearing decisions will have full appeal
rights (i.e., Appeals Council and judicial review). Except as noted
herein, HOs and OHA Headquarters will process Grant class
member cases according to all other current practices and procedures
including coding, developing evidence, routing, etc. However, the
notice of hearing should include the following statement:
The hearing will be held pursuant to the Grant settlement
Agreement and Order approved by the United States District Court
for the Middle District of Pennsylvania on February 7, 2002.
1. Type of Review
and Period to Be Considered
Pursuant to the Grant Settlement and
Order, regardless of whether the claim under review is an initial
claim or a cessation case, the type of review to be conducted is
a redetermination. The redetermination
shall be a de novo evaluation of the class
member's eligibility for benefits based on all evidence in his or
her file including newly obtained evidence relevant to the period
at issue. The period at issue begins with the onset date that was
alleged before the subject ALJ (now deceased ALJ Rowell) and ends
with the date of the subject ALJ's decision. If the claimant is
found not disabled, this will end the inquiry. If the claimant is
found disabled, then the claim will be further developed and reopened
and considered through the present time.
Individuals who meet the criteria listed earlier in section
IV. will have the opportunity to request review of their prior claims.
B. No Current Claim
Pending at OHA
If the class member claim is the only claim at the OHA level
and the case has been screened in as a class member eligible for
relief, the Screening Unit will forward the case to the appropriate
HO for development, and redetermination as described in Part V.B.5.b.
above.
C. Processing and Adjudicating
Class Member Claims in Conjunction with Current Claims (Consolidation
Procedures)
Even claims subject to consolidation
should be consolidated only to the extent practicable. For example,
if consolidation would unreasonably delay a decision on the current
claim, consolidation would not be appropriate.
a. Current Claim
Pending at OHA
If a class member has a current claim pending at the OHA level
and consolidation is warranted according to the guidelines below,
the appropriate component will consolidate all Grant class
member claims with the current claim at the level (hearing or Appeals
Council) at which the current claim is pending.
b. Current Claim
Pending at the DDS
If the class member has a current claim pending at the DDS
level and the ALJ or the Appeals Council determines that consolidation
is warranted and would not unduly delay action on the current claim,
the DDS will forward the current claim to OHA for consolidation
with the Grant claim(s) pending at the OHA
level (hearing or Appeals Council levels).
2. Current Claim Pending
in the Hearing Office
a. Hearing Has Been
Scheduled or Held, and All Remand Cases
Except as noted below regarding current and Grant cases
with issues in common, if a Grant class member
has a request for hearing pending on a current claim, and the ALJ
has either scheduled or held a hearing, and in all remand cases,
the ALJ will not consolidate the Grant case
with the appeal on the current claim.
If the ALJ is prepared to issue
a fully favorable decision on the current claim, and this decision
would also be fully favorable with respect to all the issues raised
by the application that makes the claimant a Grant class
member, the ALJ will consolidate the claims and issue a favorable
decision.
If the claims are consolidated, follow Part VI.B.2.c. below.
If the claims are not consolidated, follow Part VI.B.2.d. below.
Except as noted below, if a Grant class
member has a request for hearing pending on a current claim and
the HO has not yet scheduled a hearing, the ALJ will consolidate
the Grant claim and the current claim (see
Part VI.B.2.d. below). However, the ALJ should not consolidate the
claims if consolidation would delay processing of the current claim.
The ALJ will not consolidate
the claims if:
•
the current claim
and the Grant claim do not have any issues
in common, or
•
a court remand contains a court-ordered time limit,
and it will not be possible to meet the time limit if the claims
are consolidated.
If the claims are consolidated, follow Part VI.B.2.c. below.
If the claims are not consolidated, follow Part VI.B.2.d. below.
c. Actions If Claims
Consolidated
When consolidating a Grant claim with
any subsequent claim, the issue is whether the claimant was disabled
during the period(s) at issue in the Grant claim
and the period(s) at issue in the subsequent claim. If the ALJ decides
to consolidate the current claim with the Grant claim(s),
the HO will:
•
give proper notice
of any new issue(s), not previously raised, as required by 20 CFR §§ 404.946(b) and 416.1446(b),
if the Grant claim raises any additional
issue(s) not raised by the current claim;
•
issue one decision that addresses both the issues
raised by the current request for hearing and those raised by the Grant claim
(the ALJ's decision will clearly indicate that the ALJ considered
the Grant claim pursuant to the Grant Settlement
and Order).
d. Action If Claims
Not Consolidated
If the ALJ decides not to consolidate the current claim with
the Grant claim because:
1)
1) the claims do not have any issues in common,
or
2)
2) there is a court-ordered time limit, the ALJ
will:
•
take the necessary
action to complete the record and issue a decision on the current claim.
•
schedule the hearing and issue a decision that redetermines
the Grant claim.
If the ALJ decides not to consolidate the Grant claim
with a current claim elevated by the FO or DDS or the claim(s) at
issue in another class action, the ALJ will return the current non-Grant claim(s)
to the FO or the DDS where the current non-Grant claim(s)
was pending.
3. Current Claim Pending
at the Appeals Council
If there is a current claim pending at the Appeals Council,
the Grant Screening Unit will forward the
claim file(s) and the completed screening sheet to the appropriate
OAO Disability Program Branch. The action the Appeals Council takes
on the current claim determines the disposition of the Grant claim.
Therefore, OAO must keep the claim files together until the Appeals
Council completes its action on the current claim. The following sections
identify possible Appeals Council actions on the current claim and
the corresponding action on the Grant claim.
a. Appeals Council
Intends to Dismiss, Deny Review or Issue a Denial Decision on the Current
Claim — No Grant Issue(s) will Remain
Unresolved.
This will usually arise when the current claim duplicates
the Grant review claim, i.e., the current
claim raises the issue of disability and covers the entire period
adjudicated in the Grant claim. In this instance,
the Appeals Council will consolidate the claims and proceed with
its intended action. The Appeals Council's order, decision or notice
of action will clearly indicate that the ALJ's or Appeals Council's
action resolved or resolves both the current claim and the Grant redetermination
claim.
b. Appeals Council
Intends to Dismiss, Deny Review or Issue a Denial Decision on the Current
Claim—Grant Issue(s) Will Remain
Unresolved.
This will usually arise when the current claim does not duplicate
the Grant claim, e.g., the current claim
raises the issue of disability but does not cover the entire prior
period adjudicated in the Grant claim. In
this instance, the Appeals Council will proceed with its intended
action on the current claim. OAO staff will attach a Grant case
flag (Attachment 10) to the Grant claim,
immediately forward the Grant claim to the
appropriate HO (see Part V.B.5.b. above), for action, and retain
a copy of Attachment 10 in the current claim file. The current claim
should not be forwarded with the Grant claim
unless the appeal period for the current claim has expired. OAO
will indicate on Attachment 10 that the Appeals Council's action
on the current claim does not resolve all Grant issues
and that the Grant class member claim is
being forwarded for separate redetermination processing. OAO staff will
include copies of the ALJ's decision and Appeals Council's decision
or order or notice of denial of request for review on the current
claim and the exhibit list used for the ALJ's and for the Appeals
Council's decision. If, upon receipt of the Grant claim,
the HO determines that additional development (medical or non-medical)
for the period at issue is required, the HO will follow standard
procedures (see Part V.B.5.b. above).
c. Appeals Council
Intends to Grant Claimant's Request for Review and to Issue a Favorable
Decision on the Claim — No Grant Issue(s)
Will Remain Unresolved.
If the Appeals Council intends to issue a favorable decision
on a current claim, and this decision would be fully favorable with
respect to all issues raised by the application that makes the claimant
a Grant class member, the Appeals Council
should proceed with its intended action. In this instance, the Appeals
Council will consolidate the claims, reopen the final decision on
the Grant claim and issue a favorable decision
that adjudicates both applications. The Appeals Council's decision
will clearly indicate that the Appeals Council considered the Grant claim
pursuant to the Grant Stipulation and Order.
d. Appeals Council
Intends to Issue a Favorable Decision on the Current Claim — Grant Issue(s)
Will Remain Unresolved.
If the Appeals Council intends to issue a favorable decision
on a current claim and this decision would not be fully favorable
with respect to all issues raised by the Grant claim,
the Appeals Council will proceed with its intended action. In this
situation, the Appeals Council will request the effectuating component
to forward the claim files to the appropriate HO (see Part V.B.5.b.
above), after the Appeals Council's decision is effectuated. OAO
staff will include the following language on the transmittal sheet
used to forward the case for effectuation: “Grant court
case review needed — following effectuation forward the
attached combined folders to the designated Hearing Office for further
action.” If the HO determines that additional development
(medical or non-medical) for the period at issue is required, the HO
will follow normal procedures using Attachment 11(see Part V.B.5.b.
above).
e. Appeals Council
Intends to Remand the Current Claim to an Administrative Law Judge.
If the Appeals Council intends to remand the current claim
to an ALJ, it will proceed with its intended action unless one of
the exceptions below applies. In its remand order, the Appeals Council
will direct the ALJ to consolidate the Grant claim
with the action on the current claim pursuant to the instructions
in Part VI.B.2.a. above.
The Appeals Council will not
direct the ALJ to consolidate the claim if:
•
the current claim
and the Grant claim do not have any issues
in common, or
•
a court remand contains a court-ordered time limit
and it will not be possible to meet the time limit if the claims
are consolidated.
If the claims do not share any common issues or a court-ordered
time limit makes consolidation impractical, OAO will forward the Grant class
member claim to the HO, for separate redetermination review. If
the HO determines that additional development (medical or non-medical)
for the period at issue is required, the HO will follow normal procedures
using Attachment 11 (see Part V.B.5.b. above).
VII. Case Coding
HO personnel will code prior claims into the Hearing Office
Tracking System (HOTS) and the OHA Case Control System (OHA CCS)
as “redeterminations.” If the prior claim is consolidated
with a current claim already pending at the hearing level (see Part
VI.B.2.c. above), HO personnel will not code the prior claim as
a separate hearing request.
To identify class member cases in HOTS, HO personnel will
code “GT” in the “Class Action” field.
No special identification codes will be used in the OHA CCS.
VIII. Reconciliation
of Implementation
At an appropriate time, the OHA Class Action Coordinator will
reconcile information concerning alerts, reconstruction of files
and medical development with information available on CATS. The
Class Action Coordinator is also responsible for maintaining a personal computer-based
record of OHA implementation activity (i.e., a record of cases screened
by the Grant Screening Unit and the alerts
processed by OAO, and a record of cases screened and redetermined
by OHA), as reported by HOs, the Screening Unit and OAO to the OHA Class
Action Coordinator directly or through SCS, after screening and/or
readjudication/redetermination.
IX. 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) 605-8500. OHA Headquarters personnel should contact
the Special Counsel Staff at 605-8250.
Attachment 1. Grant
Settlement and Order; Approved by the U.S. District Court for the Middle
District of Pennsylvania on February 7, 2002.
IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE
DISTRICT OF PENNSYLVANIA
|
LOIS M. GRANT, et
al., |
: |
|
|
|
: |
No. 3:CV-88-0921 |
|
Plaintiffs,
|
: |
|
|
|
: |
|
|
v.
|
: |
|
|
|
: |
|
|
COMMISSIONER OF THE
SOCIAL |
: |
(Judge Muir) |
|
SECURITY ADMINISTRATION, |
: |
|
|
|
: |
|
|
Defendant.
|
: |
CLASS ACTION |
SETTLEMENT
AGREEMENT
IMPLEMENTING DISTRICT COURT ORDER ENTERED
ON AUGUST 23, 2000
The parties to this dispute wish to resolve and settle all
outstanding issues arising from the filing of this action and the
entry of this Court's order on August 23, 2000, granting Plaintiffs'
motion for summary judgment and ordering new administrative hearings
for the class. Accordingly, the parties enter into the following
agreement that, inter alia, sets forth an implementation plan, resolves
Plaintiffs' claim for counsel fees, and withdraws Defendant's currently
pending appeal. This agreement implements this Court's Order of
August 23, 2000; it does not compromise the substance of Plaintiffs'
class claims. Accordingly, under Rule 23(e) of the Federal Rules
of Civil Procedure no notice to the class is required.
The class, as certified, consists of:
all applicants for Social Security disability benefits or
Supplemental Security Income disability benefits, or both, who have
received . . . an adverse decision from Administrative Law Judge
Russell Rowell on or after January 1, 1985....[1]
Judge Muir ordered an opportunity for new hearings for “each
member of the Plaintiff class whose claim for disability benefits
was denied by ALJ Rowell.” Order, August 23, 2000, No. 3.
1.
The parties hereby
agree that the class consists of those claimants who received unfavorable
decisions from ALJ Rowell on or after January 1, 1985, and those
claimants who received partially favorable decisions from ALJ Rowell
on or after January 1, 1985, in that ALJ Rowell awarded them either
disability benefits for a closed period of time or disability benefits
from a later onset date of disability than that alleged by such
claimants.
2.
The parties agree that class members who have already
received all of the relief sought in this case, that is, disability
benefits going back to the onset date alleged in the application(s) considered
by ALJ Rowell, and class members who have already received new hearing
decisions from another ALJ based on the same claim that was denied
by ALJ Rowell need not be provided additional hearings.
A.
Therefore,
class members will not get an opportunity for new hearings if:
(i) they successfully appealed adverse decisions of ALJ Rowell and
ultimately received all of the benefits sought before ALJ Rowell;
(ii) they appealed adverse decisions of ALJ Rowell and were granted
remands for new hearings before other ALJs based on the same applications
that were considered by ALJ Rowell; (iii) they did not appeal the
adverse decisions of ALJ Rowell, but later reapplied and were found
either eligible or ineligible for disability benefits(on the merits
and not on res judicata grounds) on the subsequent applications,
so long as these subsequent applications covered the same time period
as was covered in the applications considered by ALJ Rowell.
B.
On the other hand, class members will be entitled
to new hearings if: (i) they appealed ALJ Rowell's decisions but
lost on appeal and either never reapplied for benefits or reapplied
and were denied2 or were awarded benefits with later onset dates
than those alleged before ALJ Rowell; (ii) they did not appeal ALJ
Rowell's decisions and either did not reapply or reapplied and were
denied3 or were awarded benefits with a later onset date than that
alleged in the application(s) considered by ALJ Rowell.
3.
Although no notice to the class of this settlement
is required in this case under Rule 23(e), nonetheless, Defendant
shall send the attached notice to class members who may be eligible for
relief, as specified in paragraphs 1 and 2, supra, using last known
addresses available to the Defendant. The notice will advise each
class member that he/she may qualify for a new hearing on the claim
previously brought before ALJ Rowell. It will inform class members that
if they wish to seek a new hearing they must contact the Defendant,
by filling out and returning the attached response form, within
90 days of the date of notice (or of the date of mailing of the
second copy of notice pursuant to paragraph 4 below). The notice
shall inform the class members of Plaintiffs' counsel's toll-free
number (to be maintained and operated at Plaintiffs' counsel's expense),
so they can discuss with counsel the advisability of requesting a
hearing.
4.
Should any mailed notice be returned as undeliverable,
Defendant shall provide to class counsel a list of these persons
and their last known addresses. The parties will then determine what
methods to utilize to obtain updated mailing addresses for remaining
class members whose addresses have not been already obtained. Class
counsel shall have 180 days after receipt of such names to furnish
current addresses for such listed individuals. Upon timely receipt
of such addresses from class counsel, the Defendant shall mail a
second copy of the attached class member notice to those class members
potentially eligible for relief at the updated addresses (see paragraph
3, supra).
5.
If a hearing is timely requested by a class member,
then Defendant will examine its computer database and, if appropriate,
the claim folders, to decide whether the individual falls within
the category of class members set out in Paragraph 2B, who are entitled
to new hearings. If Defendant determines that a class member is
entitled to a new hearing the class member (as well as class counsel
and individual counsel, if any) will be so informed, and, Defendant
shall use its best efforts to locate and, if necessary, reconstruct
the file(s) pertaining to that individual's claim(s) for disability
benefits, and Defendant shall forward the claim folder to the Hearing
Office servicing the claimant's address for scheduling of a new hearing.
Defendant shall provide notice of the hearing according to the regulations,
and shall include in the notice the information that the hearing
is pursuant to this agreement implementing the Court's August 23,
2000 order. If, however, upon further review of the class member's
file, Defendant determines that the claimant falls within the category
of class members set out in Paragraph 2A, who are not entitled to
new hearings, Defendant shall follow the procedures set out in Paragraph
6, infra.
6.
If Defendant finds that an individual sending in
a notice seeking a new hearing falls within the category of class
members set out in Paragraph 2A, Defendant shall send to the individual,
class counsel, and the individual's counsel written notification
which will include an explanation of the factual and any other basis
for the conclusion that the individual will not get an opportunity
for a new hearing. The individual can seek further review of that
decision by contacting within 60 days of the date of the notification
the Office of General Counsel of the Social Security Administration,
which shall render the final agency determination on the question.
That determination would then, at the election of the class member,
be subject to review by this Court.
7.
The parties agree that the process for redetermining
the class members' claims shall begin at the ALJ hearing level and
proceed with further review from this point in the administrative process
in accordance with existing laws and regulations, i.e., class members
who receive new ALJ hearing decisions may seek Appeals Council review
and thereafter, if they so choose, court review.
8.
The parties agree that Plaintiffs' claim for past
and future attorneys' fees, including costs and expenses shall be
fixed at $ 125,000, payable by the Defendant to the Community Justice Project,
Inc. within 60 days of the date this settlement agreement is approved
by the District Court. Additional fees shall only be available if
Plaintiffs are able to demonstrate to the Court that such fees were
incurred to address actions of the Defendant, occurring after the
date of this settlement agreement, for which there is no substantial
justification.
9.
It is understood by Plaintiffs that the Defendant
may seek an order from this Court vacating its judgment issued on
August 23, 2000. The filing and pursuit of such motion shall not
be considered a violation of this settlement agreement, and the
decision of the Court on such motion shall not affect this agreement.
Upon execution of this agreement by the parties and upon approval
of this settlement agreement by this Court, Defendant shall withdraw
its currently pending appeal before the Third Circuit Court of Appeals.
10.
Additional details involving matters discussed herein
or other aspects of implementation of the Court's Order not addressed
in this agreement shall be discussed between the parties and, to
the extent possible, resolved by agreement.
11.
This Court shall retain jurisdiction of this case
for the limited purpose of enforcement of the terms of this agreement,
including any matters not able to be resolved by agreement of the parties
pursuant to paragraph 10, supra.
|
|
__________/s/______________
Laurence
E. Norton, II, Esquire
Peter Zurflieh, Esquire
Community
Justice Project
118 Locust Street
Harrisburg, PA
17101
(717) 236-9486
Attorneys for Plaintiffs
|
|
|
__________/s/______________
Felicia
L. Chambers, Esquire
U.S. Department of Justice
Civil
Division
Federal Programs Branch
Ben Franklin Station
P.O.
Box 883
Washington D.C. 20044
|
|
|
__________/s/______________
Robert
M. Loeb, Esquire
Special Appellate Counsel
U.S.
Department of Justice
Civil Division, Appellate Staff
601
"D" Street, N.W., Rm. 9136
Washington, D.C. 20530
Attorneys
for Defendant
|
Approved by the Court this ________ day of
__________, 2001.
______________________
Attachment 2. Privacy
Act and Protective Order approved by the U.S. District Court for the
Middle District of Pennsylvania on September 9, 2002.
IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE
DISTRICT OF PENNSYLVANIA
|
LOIS M. GRANT,
et al.,
|
|
 |
|
Plaintiffs,
|
|
|
|
CIVIL ACTION
NO. 3:CV-88-0921
|
|
v.
|
|
|
|
(Muir, J.]
|
|
JOANNE B. BARNHART,
|
|
|
Commissioner
of Social
|
|
|
Security
|
|
|
Defendant.
|
|
STIPULATED
PROTECTIVE ORDER
The parties, by and through counsel, stipulate to the following,
subject to the approval of the Court.
On February 7, 2002, the Court approved the agreement settling
this litigation involving allegations that now-deceased Administrative
Law Judge Russell Rowell was generally biased against disability
claimants. The court retained jurisdiction in this case “for
the limited purpose of enforcement of the terms of this agreement[.]”
Settlement Agreement ¶11. As part of the implementations
of that Settlement, defendant must disclose certain records regarding
individual claimants to class counsel. However, those records protected
from disclosure by the Privacy Act, 5 U.S.C. § 552a, the
Social Security Act, 42 U.S.C. 405, et seq. and Social Security
regulations, 20 C.F.R. Part 401. Accordingly, in order that the
parties may implement the settlement, they agree to the following:
Pursuant to 5 U.S.C. 552a(b)(11), 42 U.S.C. 1306(a), and 20
C.F.R. 401.115:
1.
Defendant may
disclose to class counsel information necessary to be disclosed
to them to implement the Settlement approved by the Court on February
7, 2002 without obtaining the prior written consent of the individual
to whom such records pertain, for the purpose of monitoring compliance
with the Settlement, facilitating implementation of the Settlement
and assisting class members in effectuating their rights under the
Settlement. Such information consists of names, addresses, and claim
files of potential class members, and other claimant-specific information
reasonably relevant to the implementation of the Settlement.
2.
Class counsel shall use the information disclosed
pursuant to ¶1 of this Protective Order only for the purposes
described in ¶1. Except as provided in ¶6 of this
Order, class counsel shall not make disclosures of such information
except: (a) to each other; (b) to members of class counsel's staff
and any outside consultants required to assist in the implementation
of this Settlement; (c) to defendant or her agents or counsel; (d)
to the particular class member to whom the records pertain; (e)
to that individual's representative, as defined at 20 C.F.R. 404.1705,
416.1505; and (f) to the Court in this action. Class counsel may,
however, disclose identifying information concerning absent class
members solely for the purpose of locating such absent class members
in order to provide them with notice of the settlement pursuant
to ¶4 of the “Settlement Agreement Implementing District
Court Order Entered on August 23, 2000.” Class counsel shall
advise any persons and entities to whom identifying information is
disclosed that in accordance with the terms of this Order, they
shall not otherwise use or redisclose the data obtained from class
counsel.
3.
Class counsel and members of their staff shall limit
the making of copies of the records disclosed pursuant to ¶I
of this Order to those necessary to the purposes described in ¶1.
4.
Before any confidential information is released
or disclosed to any outside consultant or representative acting
on behalf of a particular class member in accordance with ¶2
of this Order, class counsel shall provide such representative or
consultant with a copy of this Order. Class counsel shall obtain
the signed Acknowledgment of Protective Order Form (Exhibit A hereto)
from the aforementioned representative or consultant stating that
the individual has received a copy of this Order and agrees that
he or she is bound by the terms of this Order and that any violation
of this Order may constitute contempt of court punishable by fine
or imprisonment or both. Class counsel shall retain copies of such
acknowledgments and will present them to defendant upon request.
5.
Each person to whom any of the confidential information
described in ¶1 is disclosed or released shall:
a.
use the information
solely for the purpose described in this Order;
b.
make no copies of the documents, containing confidential
information and make no summary or exhibits of the confidential
information except at the discretion of class counsel;
c.
maintain the documents containing confidential information
in a safe and secure location; and
d.
shall destroy all documents and all copies immediately
upon the conclusion of the implementation of the Settlement. Class
counsel shall certify in writing to the defendant that the documents
have been destroyed. Any documents created by class counsel, any consultants,
or anyone acting as plaintiffs' representative containing information protected
by the referenced statutes and regulations must also be destroyed
immediately upon the conclusion of the implementation of this Settlement.
Class counsel shall also certify in writing to defendant that these
latter documents have been destroyed. Under no circumstances shall
the documents be retained by such person more than two years from the
date of receipt from class counsel unless the person advises defendant's
counsel that the documents are still required, in which case the
time for return of the documents shall be extended for one year.
Additional one-year extensions may be granted by defendant if necessary.
6.
Nothing in this Order shall prejudice the rights
of class counsel to use the information that they receive pursuant
to the Settlement that is not subject to restrictions on disclosure contained
in the Privacy and Social Security Acts and Social Security regulations,
or their rights to use information obtained outside of the context
of the Settlement.
7.
Failure to comply with all of the terms of this
Order shall subject the responsible individual to appropriate sanctions
by the Court, including a finding of contempt, punishable by fine, imprisonment
or both.
8.
Any party may seek modification of this Order from
the Court upon twenty days notice to the other parry.
So agreed:
|
|
ROBERT D. McCALLUM, JR.
Assistant
Attorney General
Civil Division
|
|
Dated: September
4, 2002 |
RICHARD G. LEPLEY
FELICIA L. CHAMBERS
U.S. Department of Justice
Civil Division
Federal Programs Branch
Ben Franklin Station
P.O. Box 883
Washington, D.C. 20044 Tel:
(202) 514-3259 Facsimile: (202)
616-8470
Counsel for Defendants
|
|
Dated: September 4, 2002 |
 LAURENCE
E. NORTON, II
PETER ZURFLIEH
Community Justice
Project
118 Locust Street
Harrisburg, PA 17101
(717)
236-9486 Facsimile:
(717) 233-4088
Counsel
for Plaintiffs
|
APPROVED:
DATE: 9/9/02
MALCOLM MUIR,
UNITED STATES DISTRICT
JUDGE
IN THE UNITED STATES DISTRICT COURT
FOR THE
MIDDLE DISTRICT OF PENNSYLVANIA
|
LOIS M. GRANT, et al.,
Plaintiffs,
v.
JOANNE B. BARNHART,
Commissioner of Social
Security
Defendant.
|
CIVIL
ACTION NO. 3.CV-88-0921
(MUIR, J.)
|
ACKNOWLEDGMENT
OF STIPULATED PROTECTIVE ORDER
I, ______________, hereby acknowledge that I have read the
Stipulated Protective Order (“Order”) approved on _______________,
a copy of which is attached hereto. I hereby agree to be bound by
the terms of the Order. I further agree that I will use private
information, as disclosed pursuant to the Order, solely for the
purposes of the implementation of the Settlement in this case, and
only to the Court or to the employees, counsel and outside consultants
of the parties who are required to assist the parties or the Court
with this matter, and who have signed this Acknowledgment, and not
to any other person. I hereby acknowledge that my duties under this
Acknowledgment are binding upon me for all time. In addition, I
acknowledge that violation of this Order will subject me to appropriate
sanctions by the Court, including a finding of contempt, punishable
by fine, imprisonment, or both.
|
DATE:
|
_________________
SIGNATURE
|
Exhibit A-1
Attachment 3. Request
for Court Case Review/Change of Address Worksheet
3.
CHECK ONE OR BOTH: [ ] REQUEST FOR REVIEW [ ] CHANGE
OF ADDRESS
4.
DATE OF CONTACT: _ _ -_ _ -_ _ _ _
5.
CLAIMANT'S OWN SSN: _ _ _ - _ _ - _ _ _ _
6.
CLAIMANT'S DATE OF BIRTH: _ _ -_ _ -_ _ _ _
7.
CLAIMANT'S FIRST NAME: _ _ _ _ _ _ _ _ _ _ _ _
CLAIMANT'S MIDDLE INITIAL: _
CLAIMANT'S LAST NAME: _ _ _ _ _ _ _ _ _ _ _ _
8.
STREET ADDRESS: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
CITY: _ _ _ _ _ _ _ _ _ _ _ _ _ STATE: _ _ ZIP: _ _ _ _ _
9.
PHONE #: (_ _ _) _ _ _ - _ _ _ _
10.
NAME OF PAYEE: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _
11.
NAME OF ATTY/REP: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _
12.
CLAIM/SSN NUMBERS (LIST ALL KNOWN CLAIM/SSN NUMBERS)
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/STALE. 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 the account numbers were verified.
|
TII (CLAIM NO. & BIC) |
VERIFY |
TXVI (SSN & ID) |
VERIFY |
|
_ _ _-_ _-_ _ _ _-_
_ |
_ _ _ |
_ _ _-_ _-_ _ _ _-_
_ |
_ _ _ |
|
_ _ _-_ _-_ _ _ _-_
_ |
_ _ _ |
_ _ _-_ _-_ _ _ _-_
_ |
_ _ _ |
|
_ _ _-_ _-_ _ _ _-_ _ _ |
_ _ _ |
_ _ _-_ _-_ _ _ _-_ _ |
_ _ _ |
13.
_____________________________________________________________
SIGNATURE (If claimant/payee appears in person, please obtain
signature).
******************************************************************
14.
For SSA Use Only
PREPARED BY: ______________________________ OFFICE CODE
PREPARER'S TELEPHONE NO: _______________ (INCLUDE AREA CODE)
Instructions For Completion of
the Request For Court Case Review/Change of Address Worksheet
MAIL THE COMPLETED WORKSHEET TO THE FOLLOWING ADDRESS:
Office of Disability and International Operations
Class
Action Section
Attn: Grant Coordinator
P. O. Box
17369
Baltimore, MD 21298-0050
Item 1.
Print the name of the court case claimant/payee/representative
is inquiring about (i.e., “Grant”).
Item 2.
This worksheet can be used to implement all class action court
cases. The court case identifier for “Grant” is GT.
Item 3.
If a claimant/payee/representative is requesting review (e.g.,
walk-in) under the “GRANT” Settlement Agreement, check
the first block. If the claimant/payee/representative has previously requested
review under “GRANT” 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.
Item 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.
Attachment 4. Grant Court
Case Flag/Alert
999xxx 00000
CTWALT01 GRANT 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 CAN
*NOTE: A separate screening sheet must be prepared for each
claim number noted above.
PAYEE ADDRESS
SHIP TO ADDRESS:
Office of Hearings and Appeals
Office of Appellate
Operations
One Skyline Tower, Suite 1400
5107 Leesburg
Pike
Falls Church, VA 22041-3200
SPECIAL INSTRUCTIONS:
IF CURRENT CLAIM IS PENDING/STORED IN OHA HEADQUARTERS OR
FEDERAL COURT, THEN SHIP FOLDER(S) TO: (OAO Case Locator Code Y46)
Office of Hearings and Appeals
Office of Appellate
Operations (OAO)
One Skyline Tower, Suite 1400
5107
Leesburg Pike
Falls Church, VA 22041-3200
ATTN:
OHA Class Action Coordinator
IF CURRENT CLAIM IS PENDING IN AN OHA HEARING OFFICE, THEN
SHIP FOLDER(S) DIRECTLY TO THAT OFFICE. IF UNABLE TO LOCATE THE
CLAIM FILE(S), FORWARD A RECONSTRUCTION REQUEST TO THE SERVICING
FIELD OFFICE.
Attachment 5. Route
Slip/Case Flag with Alert: Possible Grant Class
Action Case for Screening
SCREENING NECESSARY
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Claimant's name: |
___________________________ |
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SSN: |
___________________________ |
This
claimant may be a Grant 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 5-4-67 for additional information and instructions.
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TO: |
__________________________________
__________________________________
__________________________________
__________________________________
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Attachment 6. Grant Case
Screening Sheet
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CLASS ACTION
CODE: GT
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1. CLAIMANT'S
SSN: ___ ___ ___ - ___ ___ - ___ ___ ___ ___
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2. CLAIMANT'S NAME (Last, First)
_____________________
_____________________
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3. DATE OF BIRTH (Month, Day, Year)
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4. CLAIM NUMBER:___ ___ ___ - ___ ___
- ___ ___ ___ ___
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(BIC/ID)
___ ___
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5. SCREENING DATE (Month, Day, Year)
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___ - ___ ___ - ___ ___ ___ ___
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a. SCREENING
RESULT:
___MEMBER (J)/ELIGIBLE FOR RELIEF
___NONMEMBER/MEMBER
(F) NOT ELIGIBLE FOR RELIEF
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c. SCREENOUT CODE
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___(See item 12)
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6. Did the individual file a request
for hearing before an Administrative Law Judge (ALJ) on any issues
arising from a claim for disability benefits under titles II and/or
XVI of the Social Security Act?
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Yes___No___
If
No, go to 12.
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7. Did the individual receive a dismissal
or less than fully favorable decision on any hearing requests identified
in question 6 above from the ALJ whose conduct was the subject of
the Grant litigation (ALJ Russell Rowell, the subject ALJ)?
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Yes___No___
If
No, go to 12.
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8. Was the dismissal or less than fully
favorable decision referred to in Question 7 issued on or after
January 1, 1985?
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Yes___No___
If
No, go to 12.
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9. Was the dismissal or less than fully
favorable decision referred to in Question 8 changed to a fully
favorable decision following an appeal, remand from an appeal or
reopening?
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Yes___No___
If
No, go to 12.
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10. Did the individual 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 8 (i.e., the potential class member claim)?
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Yes___No___
If
No, go to 12.
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11. Did the individual receive a new
hearing decision (whether favorable or unfavorable) covering the
entire time period covered in the hearing decision(s) identified
in Question 8 (i.e., the potential class member claim), from an
ALJ other than the subject ALJ.
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Yes___No___
If
Yes, go to 12.
If NO, go to Question 13, Instructions
for Class Members on the Screening Sheet Instructions.
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12. The individual is not
a Grant class member eligible for relief. Check
the “Nonmember/Member Not Eligible for Relief” block
in item 5.b. and enter the screenout 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 8 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”.
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No
other screenout code entry is appropriate.
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13. 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 Date of Notice Date of Denial or Allowance
_______________
__________________ ________________
_______________
__________________ ________________
_______________
__________________ ________________
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14. IDENTIFICATION
OF SCREENER:
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COMPONENT:
PHONE NUMBER:
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DATE:
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15.
SCREENER'S SIGNATURE:
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INSTRUCTIONS FOR COMPLETING GRANT
SCREENING SHEET
Complete a screening sheet in cases where the individual has
requested relief under the Grant 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. Multiple applications during the period
covered by the court order on the same claim number should be screened
using the same screening sheet.
Fill in the identifying information as requested. Make sure
the Claim Number, BIC/ID and SSN, if different from the claim number,
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 - 8
Answer the questions based on the individual instructions
for questions 6 - 8.
Questions 6 - 15 - General
a.
In a multiple
claims case, begin screening with the earliest claim in the Grant period
and stop with the last claim in the Grant period.
Remember, a separate screening sheet must be completed for each
claim number. Multiple claims covered by the court order under the
same claim number should be screened using the same screening sheet.
b.
Read the Administrative Law Judge (ALJ)/Appeals
Council (AC) decision to answer the questions.
c.
If the OHA decision does not yield enough information
to answer the questions, look further into the file.
d.
If questions 6-8 are answered “NO,” or
questions 9-12 are answered “YES,” check the nonmember
block found in item 5.b. on the screening sheet, then enter the
appropriate screenout code in Item 5.c. as directed in question
13 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
individual filed a claim for Social Security disability or SSI benefits
and subsequently requested a hearing before an ALJ.
Question 7
Review the file and case control queries to determine if the
individual received a dismissal or less than fully favorable decision
on his or her claim(s) for title II or title XVI benefits from ALJ Russell
Rowell (subsequently referred to as the “subject ALJ”).
If information in the file or the case control queries indicate
that the individual did not receive a decision or dismissal from
the subject ALJ, the individual is not a class member eligible for
relief.
Question 8
Screen for date of decision, not date of application. Individuals
are potentially eligible for relief if they received a dismissal
or less than fully favorable decision from the subject ALJ on or
after January 1, 1985.
Question 9
Review the file and case control queries. Review all subsequent
administrative and judicial determinations to determine if the dismissal
or less than fully favorable decision referred to in Questions 7
and 8 was changed to a fully favorable decision.
Question 10
Review the file and case control queries. Determine if the
individual received a fully favorable decision on another claim
that effectively was the equivalent of 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.
NOTE
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
Grant claim back to the earliest alleged onset/entitlement date.
At the OHA level, ALJ and Appeals Council decisions that do not
consider the previously adjudicated period usually will indicate
that the claimant's request for hearing has been dismissed on the
basis of res judicata with respect to the previously adjudicated
period. These cases cannot be screened out.
Question 11
Review the file and case control queries to determine if the
individual received a new hearing and decision (whether favorable
or unfavorable), from an ALJ other than the subject ALJ, on the potential
class member claim, that considered the entire time period(s) at
issue.
Question 12
Self-explanatory.
Question 13
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
a separate screening sheet must be prepared for each claim number.
INSTRUCTIONS FOR MEMBERS
a.
Check the “MEMBER ELIGIBLE FOR RELIEF” block
in item 5 a. of the screening sheet.
b.
Sign the form and retain the original screening
sheet in the claim file.
c.
The screening component will send a copy of the
screening sheet to:
Office of Appellate Operations
One Skyline Tower,
Suite 1400
Attn: OHA Class
Action CoordinatorThe OHA Class Action Coordinator will enter the screening
sheet information into a data base and forward the screening sheet
to the Special Counsel Staff (SCS).
[SCS will retain the screening sheets received from the OHA
Class Action Coordinator and coordinate data entry into the Civil
Actions Tracking System.]
d.
Follow HALLEX I-5-4-67,
V.B.5.b.
INSTRUCTIONS FOR NONMEMBERS
a.
Check the “NONMEMBER/MEMBER NOT ELIGIBLE FOR RELIEF” block
in item 5 a. and enter the appropriate screenout code (the number
of the question that determined the individual is not a class member,
numbers 6-12, see Item 13 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 6) to the claimant with a copy to his/her representative,
if any, and class counsel. Retain a copy of the denial letter in the
claim file. Forward the claim file(s) as indicated in HALLEX I-5-4-67, V.B.5.a.
Attachment 7. Grant Notice
of Non-Class Membership/Ineligibility for Relief
Important Information
SOCIAL SECURITY NOTICE
From: Social Security Administration
____________________________ Date: ____-____-____
____________________________ Claim Number: ____________________
____________________________ DOC ___________________________
THIS NOTICE IS ABOUT YOUR PAST
CLAIM FOR SOCIAL SECURITY OR
SUPPLEMENTAL SECURITY INCOME
(SSI) BENEFITS
PLEASE READ IT CAREFULLY!
You asked us to review your case under the terms of the Grant
v. Commissioner of Social Security Administration settlement
agreement. We have looked at your case and decided that you are not eligible for a new hearing decision
under the Grant settlement agreement. The
reason you are not eligible for a
new hearing decision is checked below.
You did not file a
claim for Social Security disability or Supplemental Security Income (SSI)
disability benefits.
You did not receive a dismissal or less than fully
favorable decision issued on or after January 1, 1985 by ALJ Rowell
whose conduct was the subject of the Grant
case.
The less than fully favorable decision on your claim
was changed to a fully favorable decision following appeal, remand
or reopening.
You filed another claim which resulted in a decision
having the effect of a fully favorable decision on your Grant
claim.
Your case was remanded to another ALJ and you received
a new hearing decision that considered the entire time time period(s)
at issue in your Grant claim.
You filed a subsequent application for Social Security
disability benefits or Supplemental Security Income and received
a decision on that claim which covered the time period(s) in your Grant claim.
You have already received all the benefits you could
receive under the Grant settlement agreement.
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 Grant settlement.
IF YOU
DISAGREE WITH THIS DETERMINATION
You must write within 60 days of the date you receive this
notice to:
Office of the General Counsel (OGC)
Social Security
Administration
Attn: Grant Attorney
611
Altmeyer Building
6401 Security Boulevard
Baltimore,
MD 21235
It will be helpful if your letter tells us the reasons why
you disagree with this determination.
IF YOU
WANT MORE INFORMATION
You may contact the lawyers who brought the Grant
lawsuit. They can be reached as follows:
Grant Lawyers
Laurence E.
Norton, II, esq.
Peter Zurflieh
Community Justice
Project
118 Locust Street
Harrisburg, PA 17101
Telephone:
(800)-322-7572, ext. 217
The Grant lawyers can provide information about the lawsuit,
including the information about how to notify Social Security that
you disagree with this determination.
Si usted no entiende esta carta, llevela a la oficina de seguro
social para que se la expiquen.
Attachment 8. Route
Slip for Forwarding Grant Class Action Claim File(s) When Ineligibility
Determination is Disputed
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TO:
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Initials
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DATE
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1. OHA
Penn National Office Tower, 8th Floor
2
North 2nd Street
Harrisburg, PA 17101
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__XX_ACTION |
_____FILE |
_____NOTE AND RETURN |
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_____APPROVAL |
_____FOR CLEARANCE |
_____PER CONVERSATION |
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_____AS REQUESTED |
_____FOR CORRECTION |
_____PREPARE REPLY |
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_____CIRCULATE |
_____FOR YOUR INFORMATION |
_____SEE ME |
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_____COMMENT |
_____INVESTIGATE |
_____SIGNATURE |
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_____COORDINATION |
_____JUSTIFY |
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REMARKS
Grant Case
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Claimant: |
___________________________ |
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SSN: |
___________________________ |
We have determined that this claimant is not a Grant
class member eligible for 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 class counsel has asked to review the file. SEE HALLEX I-5-4-67, Part V.B.5.a.
Attachment
DO NOT use this form as a RECORD of approvals, concurrences,
disposals, clearances, and similar actions.
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FROM:
Office
of Hearings and Appeals
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SUITE / BUILDING
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PHONE NUMBER
_______________
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OPTIONAL FORM 41 (Rev. 7-76)
*U.S.GPO:1985-0-461-274/20020
Prescribed by GSA
FPMR (41 CFR) 101-11.206
Attachment 9. Text
for Notice of Revised Grant Class Membership/Eligibility
for Relief Determination
In an earlier letter that we sent you, we said that you were
not a class member eligible for relief under the Grant
v. Commissioner of Social Security Administration class
action. After reviewing all of the facts, we have decided that you
are a Grant class member eligible for relief.
Therefore, we will review your claim in accordance with the terms
of the Grant v. Commissioner of Social Security Administration settlement
agreement.
We have received many requests for review and it may take
several months before we take any further action on your claim.
If you think that you are disabled now, you should fill out
a new application at any Social Security office.
If you have any questions, you may call us toll-free at 1-800-772-
1213, or call your local Social Security office at XXX-XXXX. We
can answer most questions over the phone. You can also write or
visit any Social Security office. The office that serves your area
is located at:
District Office
Address
City, ST ZIP
If you do call or visit an office, please have 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.
If you have someone helping you with your claim, you should
contact him or her. You may also ask for legal help by contacting
a legal aid organization in your area.
Attachment 10. Grant Class
Action Case Flag for OAO Use
Grant Class Member Case
REDETERMINATION NECESSARY
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Claimant's name:
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___________________________
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SSN:
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___________________________
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This claimant is a Grant class member.
The attached Grant claim file was forwarded
to OAO for possible consolidation with a current claim.
The Appeals Council
has determined that the prior and current claims do not share a common
issue and, therefore, should not be consolidated.
OR
The claims have not been consolidated because [(state
reason(s))]
_______________________________________________________
_______________________________________________________
Accordingly, we are forwarding the attached alert and prior
claim file(s) to your location for any necessary Grant
action.
We are sending the alert and prior file(s) to:
_____________________________
_____________________________
_____________________________
_____________________________
(Destination code: )
Attachment 11. Routing
and Transmittal Slip for Forwarding of Grant Class Claim
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ROUTING AND TRANSMITTAL
SLIP
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DATE
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__XX_ACTION |
_____FILE |
_____NOTE AND RETURN |
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_____APPROVAL |
_____FOR CLEARANCE |
_____PER CONVERSATION |
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_____AS REQUESTED |
_____FOR CORRECTION |
_____PREPARE REPLY |
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_____CIRCULATE |
_____FOR YOUR INFORMATION |
_____SEE ME |
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_____COMMENT |
_____INVESTIGATE |
_____SIGNATURE |
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_____COORDINATION |
_____JUSTIFY |
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REMARKS
GRANT CASE
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Claimant:
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___________________________
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SSN:
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___________________________
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We have determined that this claimant is a Grant
class member entitled to relief (see screening sheet). We are forwarding
this file to the hearing
office which
should follow normal procedures for updating the file.
Attachment
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FROM:
Office
of Hearings and Appeals
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SUITE / BUILDING
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PHONE NUMBER
_______________
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