|Processing and Adjudication|
|Titus v. Chater Stipulation; Approved and Entered by the District Court on April 12, 1996.|
|Published version of the Regional Program Circular, dated June 7, 1996.|
ISSUED: August 15, 1997
This Temporary Instruction (TI) incorporates into HALLEX the parties' stipulation and consent order in the Titus v. Chater class action complaint that the United States District Court for the Southern District of Iowa approved, on April 12, 1996, by order of settlement and dismissal. On June 11, 1996, the OHA Associate Commissioner disseminated to OHA adjudicators having jurisdiction for Iowa disability claims an advance informational copy of the parties' stipulation and consent and its attached Regional SSA Program Circular entitled Determination of Duration of Disability; Explanation of Current Policy. This TI distributes to all OHA adjudicators an informational copy of the stipulation and consent order and published version of the Program Circular. The Program Circular clarifies issues regarding the determination of the duration of an impairment or combination of impairments of adult claimants alleging disability under Title II and Title XVI of the Social Security Act.
The requirements of the stipulation and consent order became effective prospectively on April 12, 1996, and apply to disability claims filed by Iowa residents.
However, adjudicators nationwide should become familiar with the Program Circular because it states the Agency's policy for determining the duration of disability pursuant to 20 CFR §§ 404.1509 and 416.909.
On January 14, 1991, plaintiffs filed a class action complaint challenging the Commissioner's disability duration policy promulgated in the Program Operation Manual System (POMS) at §§ DI 25505.015 and 25505.020 and Social Security Ruling 82-52 (Titles II and XVI: Duration of the Impairment). The complaint alleged that the policy, as applied by the Iowa Disability Determination Service (DDS) in its development and notice practices, violated the Social Security Act and regulations because it required that a claimant's inability to work last at least 12 months, rather than that the claimant's impairment alone last at least 12 months. Plaintiffs had requested declaratory and injunctive relief, including reopening and readjudication of all class member claims denied at any time based in whole or in part on the duration policy.
At that time, plaintiffs defined potential Titus class members as Iowa residents:
who have claimed or are claiming disabled workers benefits (OASDI) or [Supplemental Security Income] disability benefits under the [Act]; and
whose claims were denied or were terminated by [SSA] in whole or in part on the grounds that the impairment has not or is not expected to keep the claimant from working for a continuous period of more than 12 months; and
excluding claimants who have appealed the denial or denials and who have received a favorable decision at a higher administrative or court level, or who were denied because they returned to substantial gainful activity or who were not eligible for disability benefits for reasons not related to disability.
(Plaintiffs amended their complaint, on March 1, 1994, to name additional plaintiffs and allege additional facts.)
On September 9, 1991, the district court dismissed plaintiffs' complaint for failure to state a claim on which relief could be granted, and for lack of jurisdiction based on failure to exhaust administrative remedies. On October 31, 1991, plaintiffs filed a notice of appeal of the court's order of dismissal.
On September 1, 1993, the United States Court of Appeals for the Eighth Circuit affirmed the district court's dismissal of plaintiffs' first claim for relief on grounds of failure to state a claim upon which relief could be granted. Further, the court of appeals found no merit in plaintiffs' allegation that their first claim for relief was a misapplication claim as well as a policy challenge. With respect to plaintiffs' remaining three claims for relief, the court of appeals reversed the district court's dismissal, which was based on jurisdictional grounds. The court of appeals disagreed with the district court's finding that plaintiffs failed to show that the Commissioner had a secret policy of not adequately developing cases to determine duration of impairment at the initial and reconsideration levels, and held that the lower court had erred in basing its dismissal on the absence of a finding of a secret policy. On November 5, 1993, the court of appeals denied, without comment, the Commissioner's October 15, 1993 petition for rehearing and suggestion for rehearing en banc.
On June 28, 1995, while the parties were considering settlement options, the district court issued an order giving the parties notice of the court's intent to dismiss the lawsuit if the parties did not file a scheduling and discovery plan within 20 days of the date that the order was filed. On July 24, 1995, the parties complied with the order by filing a scheduling order, discovery plan and anticipated trial date.
However, on April 9, 1996, the parties filed with the district court a joint motion seeking dismissal of the class complaint and approval of a proposed settlement. On April 12, 1996, the parties filed a proposed stipulation and consent order of their settlement agreement, which the court approved on the same day. On June 7, 1996, in accordance with the parties' stipulation, SSA issued a Regional Program Circular to clarify its policy on the duration requirement. As indicated above, on June 11, 1996, OHA's Associate Commissioner provided OHA adjudicators who have jurisdiction for Iowa disability claims with an advance informational copy of the Program Circular.
The parties have agreed that the Iowa DDS will follow the clarification provided in the Program Circular when applying the regulations and other written guidelines to disability claims involving the issue of duration.
In compliance with the stipulation and consent order,SSA disseminated the Program Circular to affected personnel within 60 days after the district court issued its approval.
The Program Circular does not supersede current regulations, rulings or other written policy guidelines, and remains effective for two years after issuance, unless Federal law, regulations or rulings require SSA to revise it. SSA will monitor, pursuant to 20 CFR §§ 404.1603 and 416.1003, the Iowa DDS' determinations for compliance with the regulations, POMS, other written guidelines and the stipulation and consent order and Program Circular.
The district court did not certify a class in Titus. However, individuals expressly subject to consideration under the Titus stipulation and consent order and Program Circular are adult claimants alleging disability under Title II and Title XVI of the Social Security Act, whose claims are based in whole or in part on the issue of duration and whose claims are before the Iowa DDS for an initial or reconsideration determination of disability.
The stipulation and consent order, Program Circular and thus, this TI, are inapplicable to claims that may be denied on grounds other than an insufficient duration of disability.
Plaintiffs in Titus focused their allegations on the DDS' obligation to develop issues regarding duration of an impairment. "Relief" is prospective, from April 12, 1996, and only requires that DDS and SSA personnel "who have any responsibility for adjudicating, consulting on, overseeing, or reviewing disability determinations for cases in Iowa" apply the Agency's standard of review as set forth in the Program Circular for the purpose of clarifying the issue of duration when adjudicating adult Title II and Title XVI claims. There is no need to identify cases, via computer coding or other methods, that are subject to such review.
Therefore, to comply with this TI, OHA adjudicators need only ensure that their interpretation and application of the pertinent sections of the Social Security Act and regulations to issues of duration of impairment are consistent with the clarification provided in the Program Circular. In other words, Titus cases should be processed and adjudicated under the Agency's current standards.
It is not necessary, for purposes of complying with this TI, to enter a special identification code into the OHA Case Control System (OHA CCS) or into the Hearing Office Tracking System (HOTS).
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. Headquarters personnel should direct questions to the Division of Litigation Analysis and Implementation at 305-0708.