I-5-4-67.Grant v. Commissioner of Social Security Administration

Table of Contents
I Purpose
II Background
III Guiding Principles
IV Definition of Class
V Determination of Class Membership and Eligibility for Relief and Preadjudication Actions
VI Processing and Adjudication
VII Case Coding
VIII Reconciliation of Implementation
IX Inquiries
Attachment 1 Grant Settlement and Order; Approved by the U.S. District Court for the Middle District of Pennsylvania on February 7, 2002.
Attachment 2 Privacy Act and Protective Order approved by the U.S. District Court for the Middle District of Pennsylvania on September 9, 2002.
Attachment 3 Request for Court Case Review/Change of Address Worksheet
Attachment 4 Grant Court Case Flag/Alert
Attachment 5 Route Slip/Case Flag with Alert: Possible Grant Class Action Case for Screening
Attachment 6 Grant Case Screening Sheet
Attachment 7 Grant Notice of Non-Class Membership/Ineligibility for Relief
Attachment 8 Route Slip for Forwarding Grant Class Action Claim File(s) When Ineligibility Determination is Disputed
Attachment 9 Text for Notice of Revised Grant Class Membership/Eligibility for Relief Determination
Attachment 10 Grant Class Action Case Flag for OAO Use
Attachment 11 Routing and Transmittal Slip for Forwarding of Grant Class Claim

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.

EXCEPTIONS:

A person is not a class member eligible for Grant relief if the individual:

  1. 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

  2. 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

  3. 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.

NOTE:

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

1. Notification

  1. 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.

  2. 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 I-5-4-67 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:

  1. 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.

  2. 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.

  3. The FSO in WB and the FOs will be responsible for retrieving title XVI claims except for those pending in OHA.

NOTE:

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.

NOTE:

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.

3. Folder Reconstruction

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.

B. OHA Screening Actions

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.

2. Pre-Screening Actions

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.

NOTE:

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);

      NOTE:

      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.

    NOTE:

    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:

    1. 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;

    2. 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

    3. 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)

NOTE:

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.

1. General

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.

EXCEPTION:

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.

b. Hearing Not Scheduled

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.

EXCEPTIONS:

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.

EXCEPTIONS:

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.

I-5-467-Att-1.gif

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.

    1. 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.

    2. 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.,

  I-5-467-Att-2-1.gif

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:

    1. use the information solely for the purpose described in this Order;

    2. 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;

    3. maintain the documents containing confidential information in a safe and secure location; and

    4. 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 I-5-467-Att-2-2.gif
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 I-5-467-Att-2-3.gif
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

I-5-467-Att-2-4.gif

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

  1. COURT CASE NAME: GRANT

  2. CCID: G T

  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

Claimant's name: ___________________________
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.

TO:

__________________________________

__________________________________

__________________________________

__________________________________

Attachment 6. Grant Case Screening Sheet

CLASS ACTION CODE: GT

1. CLAIMANT'S SSN: ___ ___ ___ - ___ ___ - ___ ___ ___ ___

2. CLAIMANT'S NAME (Last, First)

_____________________ _____________________

 

3. DATE OF BIRTH (Month, Day, Year)

 

4. CLAIM NUMBER:___ ___ ___ - ___ ___ - ___ ___ ___ ___

(BIC/ID)

___ ___

5. SCREENING DATE (Month, Day, Year)

___ ___ - ___ ___ - ___ ___ ___ ___

 

a. SCREENING RESULT:

___MEMBER (J)/ELIGIBLE FOR RELIEF

___NONMEMBER/MEMBER (F) NOT ELIGIBLE FOR RELIEF

c. SCREENOUT CODE

___ ___(See item 12)

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?

Yes___No___

If No, go to 12.

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)?

Yes___No___

If No, go to 12.

8. Was the dismissal or less than fully favorable decision referred to in Question 7 issued on or after January 1, 1985?

Yes___No___

If No, go to 12.

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?

Yes___No___

If No, go to 12.

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)?

Yes___No___

If No, go to 12.

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.

Yes___No___

If Yes, go to 12.

If NO, go to Question 13, Instructions for Class Members on the Screening Sheet Instructions.

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”.

No other screenout code entry is appropriate.

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

_______________ __________________ ________________

_______________ __________________ ________________

_______________ __________________ ________________

14. IDENTIFICATION OF SCREENER:

COMPONENT:

PHONE NUMBER:

DATE:

15. SCREENER'S SIGNATURE:

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

  1. 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.

  2. Read the Administrative Law Judge (ALJ)/Appeals Council (AC) decision to answer the questions.

  3. If the OHA decision does not yield enough information to answer the questions, look further into the file.

  4. 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.

  5. 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

  1. Check the “MEMBER ELIGIBLE FOR RELIEF” block in item 5 a. of the screening sheet.

  2. Sign the form and retain the original screening sheet in the claim file.

  3. 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 Coordinator

    The 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.]

  4. Follow HALLEX I-5-4-67, V.B.5.b.

INSTRUCTIONS FOR NONMEMBERS

  1. 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.

  2. Follow items b and c above.

  3. 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

TO:

Initials

DATE

  1. OHA
    Penn National Office Tower, 8th Floor
    2 North 2nd Street
    Harrisburg, PA 17101

  2.  

  3.  

  4.  

  5.  

  6.  

   
__XX_ACTION _____FILE _____NOTE AND RETURN
_____APPROVAL _____FOR CLEARANCE _____PER CONVERSATION
_____AS REQUESTED _____FOR CORRECTION _____PREPARE REPLY
_____CIRCULATE _____FOR YOUR INFORMATION _____SEE ME
_____COMMENT _____INVESTIGATE _____SIGNATURE
_____COORDINATION _____JUSTIFY  

REMARKS

Grant Case

Claimant: ___________________________
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.

FROM:

Office of Hearings and Appeals

SUITE / BUILDING

 

PHONE NUMBER

_______________

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

Claimant's name:

___________________________

SSN:

___________________________

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

ROUTING AND TRANSMITTAL SLIP

DATE

TO:

Initials

Date

1.    
2.    
__XX_ACTION _____FILE _____NOTE AND RETURN
_____APPROVAL _____FOR CLEARANCE _____PER CONVERSATION
_____AS REQUESTED _____FOR CORRECTION _____PREPARE REPLY
_____CIRCULATE _____FOR YOUR INFORMATION _____SEE ME
_____COMMENT _____INVESTIGATE _____SIGNATURE
_____COORDINATION _____JUSTIFY  

REMARKS

GRANT CASE

Claimant:

___________________________

SSN:

___________________________

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

FROM:

Office of Hearings and Appeals

SUITE / BUILDING

 

PHONE NUMBER

_______________


[1]  The class, as certified, also included future applicants for benefits, whose claims would be assigned to ALJ Rowell. There have been no members of this group in the class since ALJ Rowell died.