I-5-4-19.Prue/Weathers, et al. v. Sullivan

A. Non-OHA Actions

1. Notification

   On February 18, 1994, SSA sent notices to all potential class members identified by computer run. Individuals have 60 days from the date of receipt of the notice to request that SSA readjudicate their claims under the terms of the Prue/Weathers Stipulation and Order.

   The Office of Disability and International Operations (ODIO) sendS untimely responses to the servicing Social Security field office (i.e., district office or branch office) to develop good cause for the untimely response. Good cause determinations are based on the standards set forth in 20 CFR §§ 404.911 and 416.1411 and SSR 91-5p. If good cause is established, the field office will forward the claim for screening.

   EXCEPTION:

   If a mental impairment (now or in the past) is alleged, ODIO will deem good cause for the untimely response and proceed with screening for class membership.

2. Alert and Folder Retrieval Process

   All response forms and undeliverable notices will be returned to ODIO where they will be entered into the Civil Action Tracking System (CATS). CATS will generate folder alerts to ODIO for all response forms. See Attachment 2 for a sample Prue/Weathers alert.

   In most instances, ODIO will associate the computer-generated alerts with any claim file(s) that it has within its jurisdiction or that it retrieves from another location. ODIO will then forward class member files to the appropriate office for readjudication.

3. Alerts Sent to OHA

   If ODIO determines that a current claim, i.e., either a potential class member claim or a subsequent claim, is pending appeal or stored at OHA, it will forward the alert to OHA, along with any prior claim file(s) not in OHA's possession, for screening, consolidation consideration and readjudication (if consolidated).

   ODIO will send all alerts potentially within OHA jurisdiction and related prior claim file(s), if any, to the Office of Appellate Operations (OAO), at the following address (case locator code 5007):

   Office of Hearings and Appeals
   Office of Appellate Operations
   One Sky Tower Suite 701
   5107 Leesburg Pike
   Falls Church, VA 22041-3200
   
   ATTN: OAO CLass Action Coordinator

   NOTE:

   The OAO Class Action Coordinator is responsible for controlling and reconciling the disposition of class alerts shipped to OHA Headquarters for association with pending or stored claims. The OAO Class Action Coordinator will maintain a record of all alerts received and the location, if any, to which they are transferred. This information will be necessary to do the final class membership reconciliation.

4. Folder Reconstruction

   Generally, ODIO will initiate any necessary reconstruction of prior claim files through the servicing FO. Consequently, OHA requests for reconstruction of potential Prue/Weathers class member cases should be rare. Prior to requesting reconstruction, OHA will determine whether available systems data or other information provides satisfactory proof that the claim would not confer class membership. However, if it becomes necessary for OHA to request reconstruction, the OHA component (the HO or the OAO Branch) will forward the alert and any accompanying claim file(s) (if the claim file(s) is not needed for adjudication purposes) to the servicing FO, along with documentation of attempts to locate the file and a covering memorandum requesting that the reconstructed file be forwarded to OHA. HOs will route any reconstruction requests directly to the servicing FOs. The OAO branch will route requests to the servicing FO and send copies of all requests to the OAO Class Action Coordinator. For CATS purposes, HO personnel and the OAO Class Action Coordinator will forward a copy of the reconstruction request memorandum to Litigation Staff at the following address:

   Litigation Staff
   Office of Policy and Planning
   3-K-26 Operations Building
   6401 Security Boulevard
   Baltimore, MD 21235
   
   ATTN: Prue/Weathers Coordinator

   The HO or OAO will not delay action on a pending claim when a prior claim is being reconstructed for screening purposes, unless the claim is needed for the adjudication of the pending claim. If OHA completes action on the pending claim prior to the receipt of the reconstructed file, the HO or OAO, as appropriate, will forward the class action material, including the alert, unneeded claim files, if any, and the reconstruction request to the OAO Class Action Coordinator, along with a copy of the action on the pending claim. For additional information on reconstruction procedures, see the Generic Class Implementation Instructions, HALLEX I-1-7-5C.

5. Class Membership Denials

   ODIO or OHA will hold all non-class member claim files pending review by class counsel. If an individual wishes to request SSA's further consideration of a class membership denial determination, he or she must do so through class counsel. Class counsel has 60 days from receipt of the notice of non-class membership to notify the Office of the General Counsel (OGC) of their disagreement. Upon timely written request by class counsel (i.e., within 60 days of receipt of the notice of non-class membership) to review the files, Litigation Staff will coordinate with ODIO or OHA to forward the claim files within 30 days of the request, to:

   SSA District Office
   2100 M Street, N.W.
   Washington, D.C. 20203

   NOTE:

   The files may also be sent to another mutually acceptable location.

   Class counsel will then have 30 days to review the file. If class counsel's review establishes that there is a dispute, they must notify OGC. If the parties are unable to resolve a dispute, OGC will so notify class counsel. Class counsel may submit any unresolved dispute to the court for final resolution by proper motion made within 30 days of the date of written notice by OGC.

B. OHA Actions

1. Pre-Screening Actions

   1. Current Claim in OHA

      As provided in Part V.A.3. above, if there is a current claim pending or stored at OHA, the OAO Class Action Coordinator will receive the alert and related Prue/Weathers claim file(s). The OAO Class Action Coordinator will determine OHA jurisdiction for screening and forward as follows.

      • If the current claim is in an HO, the Coordinator will use Attachment 3 to forward the alert and prior claim file(s) to the HO for screening. (Part V.B.2.a. below provides instructions to the HOs regarding the action to be taken if they receive an alert package but no longer have a current claim pending.)

      • If the current claim is before the Appeals Council, or is located in an OAO branch mini-docket or in the OAO Docket and Files Branch, the Coordinator will use Attachment 3 to forward the alert and prior claim file(s) to the appropriate OAO branch for screening. (Part V.B.2.a. below provides instructions to the OAO branches regarding the action to be taken if they receive an alert package from the OAO Class Action Coordinator but no longer have a current claim pending.)

      If the Coordinator (or designee) is unable to locate the current claim file within OHA, the Coordinator (or designee) will broaden its claim file search and arrange for alert transfer or file reconstruction, as necessary.

   2. Current Claim Pending in Court

      If the OAO Class Action Coordinator receives an alert for a claimant who has a civil action pending, either on the alerted case or on another claim, the Coordinator will forward the alert and any accompanying claim file(s) to the appropriate Court Case Preparation and Review Branch (CCPRB) for screening using Attachment 3. See Part V.B.2.b. below for special screening instructions when a civil action is involved.

2. Screening

   1. General Instructions

      The screening component will associate the alert, if any, and any prior claim file(s) with the claim file(s) in its possession and complete the screening sheet (see Attachment 4) as follows.

      NOTE:

      If the claim pending at OHA is the only potential Prue/Weathers claim, then the individual is not entitled to relief under Prue/Weathers (see Part IV. above). Complete the screening sheet and follow the instructions in Part V.B.3.a. below for processing non-Prue/Weathers claims.

      • Consider all applications denied (including res judicata denials/dismissals) during the Prue/Weathers timeframe;

        NOTE:

        Although not the “final decision of the Secretary,” an Appeals Council denial of a request for review is the last action of the Secretary, and the date of such a denial controls for class membership screening purposes.

      • Follow all instructions on the screening sheet and the screening sheet instructions;

      • Sign and date the original screening sheet; place it in the claim file (on the top right side of the file); and

      • If the screening component is an OHA Headquarters component, forward a copy of the screening sheet to the OAO Class Action Coordinator at the address in Part V.A.3. above. (The Coordinator will enter information from the screening sheet into a database and forward a copy of the screening sheet to the Division of Litigation Analysis and Implementation (DLAI)). If the screening component is an HO, forward a copy of the screening sheet directly to DLAI at the following address:

        Office of Hearing and Appeals
        Division of Litigation Analysis and Implementation
        One Skyline Tower, Suite 702
        5107 Leesburg Pike
        Falls Church, VA 22041-3255

        HO personnel may also forward material by telefax to DLAI at (703) 305-0655. (DLAI will retain a copy of each screening sheet and forward a copy to the OAO Class Action Coordinator and to Litigation Staff.)

      If the HO receives an alert only, or an alert associated with a prior claim file(s), and the HO no longer has the current claim file, it will return or forward the alert and any prior claim file(s) to the OAO Class Action Coordinator (see address in Part V.A.3. above) and advise the Coordinator of the action taken on the current claim and its destination. The Coordinator will determine the current claim file location and, if it is located in OHA Headquarters, will forward the alert and any accompanying prior claim file(s) to the responsible OAO Branch for screening, using Attachment 3. If the file(s) is no longer in OHA, the Coordinator will use Attachment 5 to send the alert and any accompanying prior claim file(s) to the non-OHA location and request that the file(s) be forwarded to the appropriate DDS for screening.

      If an OAO branch receives an alert only, or an alert associated with a prior claim file(s), and the branch no longer has the current claim file (and it is not located in an OAO branch mini-docket or in the OAO DFB), it will determine the location of the current claim file. If the current claim file is located within OHA, the OAO branch will use Attachment 3 to forward the alert and any accompanying prior claim file(s) to the current OHA location. If the file(s) is no longer in OHA, the OAO branch will use Attachment 5 to forward the alert and any accompanying prior claim file(s) to the non-OHA location and request that the file(s) be forwarded to the appropriate DDS for screening. The OAO branch will also advise the OAO Class Action Coordinator of its actions.

      NOTE:

      Final determinations or decisions made after March 4, 1984, on a subsequent claim filed by a potential Prue/Weathers class member may have adjudicated the entire timeframe at issue in the Prue/Weathers claim. Instead of applying the doctrine of administrative res judicata to the Prue/Weathers claim, these claims should be denied class membership.

   2. Special OAO Screening Instructions if a Civil Action Is Involved

      As noted in Part V.B.1.b. above, the CCPRB will screen for Prue/Weathers class membership when a civil action is involved. The CCPRB's class membership determination will dictate the appropriate post-screening action.

      • If the claim pending in court was adjudicated in accordance with SSR 85-28 and resolved all Prue/Weathers issues, the claimant is not a Prue/Weathers class member. The CCPRB will follow the instructions in Part V.B.3.a. below for processing non-class member claims.

      • If the claim pending in court was adjudicated in accordance with SSR 85-28, but did not resolve all Prue/Weathers issue(s), e.g., there is a prior (inactive) Prue/Weathers claim and the claim pending in court did not include the entire period covered by the Prue/Weathers claim, and the claimant elects to have the case remanded to the Commissioner for a redetermination (instead of proceeding in court), the CCPRB will forward the Prue/Weathers claim to the District of Columbia DDS for readjudication. The CCPRB will modify the case flag in Attachment 9 to indicate that the pending court case does not resolve all Prue/Weathers issues and that the Prue/Weathers class member claim is being forwarded for separate processing. The CCPRB will notify the OAO Class Action Coordinator of this action.

      • If the final administrative decision on the claim pending in court was not adjudicated in accordance with SSR 85-28 or is legally insufficient for other reasons, the CCPRB will initiate voluntary remand proceedings and consolidate the claims.

3. Post-Screening Actions

   1. Non-Class Member Cases

      If the screening component determines that the individual is not a class member, the component will:

      • notify the individual, and representative, if any, of non-class membership using Attachment 6 (modified as necessary to fit the facts and posture of the case when there is a current claim);

      NOTE:

      Include the address and telephone number of the servicing Social Security field office at the top of Attachment 6.

      • retain a copy of the notice in the claim file;

      • send a copy of the notice to:

        Michael Schuster, Esq.
        Legal Counsel for the Elderly
        601 E. Street, N.W.
        Washington, D.C. 20049

      • retain the claim file(s) for 90 days pending a possible class membership dispute;

      • if the screening component is not an OHA Headquarters component, and the file(s) is not needed for adjudication, forward the file(s) for storage to OAO at the address in Part V.A.3. above; and

      • if class counsel makes a timely request for review, send the non-class member claim file(s) to the District of Columbia field office (or other mutually acceptable location) using the pre-addressed route slip in Attachment 7.

        NOTE:

        Photocopy any material contained in the prior file that is relevant to the current claim and place it in the current claim file before shipping the prior file.

      • if SSA, through OGC, resolves the dispute in the claimant's favor: 1) the original screening component or Litigation Staff will prepare a revised screening sheet; 2) OHA jurisdiction cases will proceed in accordance with Part VI. below; and 3) the rescreening component will notify DLAI, at the address in Part V.B.2. above, of the revised screening determination by forwarding a copy of the revised screening sheet to DLAI; and 4) DLAI will coordinate with the OAO Class Action Coordinator, as necessary. OGC will notify class counsel of the reversal of class membership, and class counsel will notify the claimant.

      An individual who wishes to appeal a determination of non-class membership may do so only through class counsel, as explained in the notice (Attachment 6).

   2. Cases Determined To Be Class Members

      If the screening component determines that the individual is a class member, it will proceed with processing and adjudication in accordance with the instructions in Part VI. below.

A. Cases Reviewed by the DDS

The District of Columbia DDS will conduct the first Prue/Weathers review, except for cases consolidated at the OHA level (see Part VI.D. below) and cases in which a face-to-face review is appropriate (see the exception in Part III. above). The DDS determination will be a reconsideration determination regardless of the administrative level at which the class member's claim(s) was previously decided with full appeal rights (i.e., ALJ hearing, Appeals Council and judicial review).

Except as otherwise noted in this instruction, ALJs should process and adjudicate requests for hearing on Prue/Weathers DDS review cases in the same manner as for any other case.

B. OHA Adjudication of Class Member Claims

The following instruction applies to both consolidation cases in which the ALJ or Appeals Council conducts the Prue/Weathers readjudication and to DDS readjudication cases in which the claimant requests a hearing or Appeals Council review. Except as noted herein, HOs and Headquarters will process Prue/Weathers class member cases according to all other current practices and procedures including coding, scheduling, developing evidence, routing, etc.

1. Type of Review and Period To Be Considered

   1. Pursuant to the Prue/Weathers Stipulation and Order, regardless of whether the claim under review is an initial claim or cessation case, the type of review to be conducted is a redetermination. The readjudication shall be a de novo reevaluation 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 that was at issue in the administrative decision(s) that forms the basis for Prue/Weathers class membership

   2. If the readjudication results in a favorable decision, the adjudicator will determine, under the medical improvement standard, whether the class member's disability has continued through the date of the readjudication (or through the date of onset of disability established in any allowance on a subsequent application)

   3. If the evidence establishes that disability began only at some point after the administrative determination(s)/decision(s) that forms the basis for Prue/Weathers class membership, the class member must file a new application to establish eligibility

2. Step Two of the Sequential Evaluation

   Prue/Weathers does not require any change in OHA's current adjudicatory policies or practices with respect to step two of the sequential evaluation. Effective with the enactment of the 1984 Amendments to the Social Security Act, OHA's adjudicators have considered the combined effect of individual “not severe” impairments in evaluating disability claims at step two. ALJs and the Appeals Council may, if appropriate, continue to deny or cease the disability claims of District of Columbia residents in accordance with 20 CFR §§ 404.1520(c), 404.1521, 404.1523, 416.920(c), 416.921 and 416.923 as well as SSR 85-28. The Acting Associate Commissioner's memorandum, dated February 21, 1991 (Attachment 8), regarding the proper standard for adjudicating claims at step two, remains in effect.

3. Class Member Is Deceased

   If a class member is deceased, the usual survivor and substitute party provisions and existing procedures for determining distribution of any potential underpayment apply.

C. Claim at OHA but No Current Action Pending

If the 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, OAO will associate the alert with the file and screen for class membership. (See Part V.B.3., above, for non-class member processing instructions.)

• If the 120-day retention period for holding a claim file after an ALJ decision or Appeals Council action has expired, OAO will attach a Prue/Weathers class member flag (see Attachment 9) to the outside of the file and send the claim file(s) to the District of Columbia DDS (or to the appropriate DDS if the exception in Part III. above applies) for review of the Prue/Weathers class member claim.

• If less than 120 days have elapsed, OAO will attach a Prue/Weathers class member flag (see Attachment 10) to the outside of the file to ensure that the case is routed to the District of Columbia DDS (or to the appropriate DDS if the exception in Part III. above applies) after expiration of the retention period. Pending expiration of the retention period, OAO will also:

  • return unappealed ALJ decisions and dismissals to DFB, OAO; and

  • return unappealed Appeals Council denials to the appropriate OAO minidocket.

The respective OAO components will monitor the retention period and, if the claimant does not seek further administrative or judicial review, route the file(s) to the District of Columbia DDS (or the appropriate DDS if the exception in Part III. above applies) in a timely manner.

D. Processing and Adjudicating Class Member Claims in Conjunction with Current Claims (Consolidation Procedures)

1. General

   If a class member has a current claim pending at any administrative level and consolidation is warranted according to the guidelines below, the appropriate component will consolidate all Prue/Weathers class member claims with the current claim at the level at which the current claim is pending.

2. Current Claim Pending in the Hearing Office

   1. Hearing Scheduled or Held and all Remand Cases

      Except as noted below, if a Prue/Weathers 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 consolidate the Prue/Weathers case with the appeal on the current claim.

      EXCEPTIONS:

      The ALJ will not consolidate the claims if

      • the current claim and the Prue/Weathers 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.D.2.c. below. If the claims are not consolidated, follow Part VI.D.2.d. below.

   2. Hearing Not Scheduled

      Except as noted below, if a Prue/Weathers class member has an initial request for hearing pending on a current claim and the HO has not yet scheduled a hearing, the ALJ will not consolidate the Prue/Weathers claim and the current claim. Instead, the ALJ will dismiss the request for hearing on the current claim and forward both the Prue/Weathers claim and the current claim to the District of Columbia DDS (or to the appropriate DDS if the exception in Part III. above applies) for further action (see Part VI.D.2.d. below).

      EXCEPTION:

      If the hearing has not been scheduled because the claimant waived the right to an in-person hearing, and 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 issues raised by the application that makes the claimant a Prue/Weathers class member, the ALJ will consolidate the claims.

      If the claims are consolidated, follow Part VI.D.2.c. below. If the claims are not consolidated, follow Part VI.D.2.d. below.

   3. Action if Claims Are Consolidated

      If the ALJ decides to consolidate the current claim with the Prue/Weathers claim(s), the HO will:

      • give proper notice of any new issue(s) as required by 20 CFR §§ 404.946(b) and 416.1446(b), if the Prue/Weathers claim raises an additional issue(s) not raised by the current claim;

      • offer the claimant a supplemental hearing if the ALJ already has held a hearing and the Prue/Weathers claim raises an additional issue(s), unless the ALJ is prepared to issue a fully favorable decision with respect to the Prue/Weathers claim; and

      • issue one decision that addresses both the issues raised by the current request for hearing and those raised by the Prue/Weathers claim (the ALJ's decision will clearly indicate that the ALJ considered the Prue/Weathers claim pursuant to the Prue/Weathers Stipulation and Order).

   4. Action if Claims Not Consolidated

      If common issues exist but the ALJ decides not to consolidate the current claim with the Prue/Weathers claim because a hearing has not yet been scheduled, the ALJ will:

      • dismiss, without prejudice, the request for hearing on the current claim, using the language in Attachment 11 and the covering notice in Attachment 12; and

      • send both the Prue/Weathers claim and the current claim to the District of Columbia DDS (or to the appropriate DDS if the exception in Part III. above applies) for DDS consolidation and further action.

   If the ALJ decides not to consolidate the Prue/Weathers claim with the current claim because: 1) the claims do not have any issues in common; or 2) there is a court-ordered time limit, the ALJ will:

   • flag the Prue/Weathers claim for DDS review using Attachment 13; immediately route it to the District of Columbia DDS (or to the appropriate DDS if the exception in Part III. above applies) for readjudication; and retain a copy of Attachment 13 in the current claim file; and

   • take the necessary action to complete the record and issue a decision on the current claim.

3. Current Claim Pending at the Appeals Council

   The action the Appeals Council takes on the current claim dictates the disposition of the Prue/Weathers claim. Therefore, OAO must keep the claim folders together until the Appeals Council completes its action on the subsequent claim. The following sections identify the possible Appeals Council actions on the current claim and the appropriate corresponding action on the Prue/Weathers claim.

   1. Appeals Council Intends to Dismiss, Deny Review or Issue a Denial Decision on the Current Claim — No Prue/Weathers Issue(s) Will Remain Unresolved

      This will usually arise when the current claim duplicates the Prue/Weathers review claim, i.e., the current claim raises the issue of disability and covers the entire period adjudicated in the Prue/Weathers claim, and the current claim has been adjudicated in accordance with the provisions of SSR 85-28 and the current severity regulations, i.e., 20 CFR §§ 404.1520(c), 404.1521, 404.1523, 416.920(c), 416.921 and/or 416.923. 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 Prue/Weathers claim.

   2. Appeals Council Intends To Dismiss, Deny Review or Issue a Denial Decision on the Current Claim — Prue/Weathers Issue(s) Will Remain Unresolved

      This will usually arise when the current claim does not duplicate the Prue/Weathers claim, e.g., the current claim raises the issue of disability but does not cover the entire period adjudicated in the Prue/Weathers claim. For example, the Prue/Weathers claim raises the issue of disability for a period prior to the period adjudicated in the current claim. In this instance, the Appeals Council will proceed with its intended action on the current claim.

      OAO staff will attach a Prue/Weathers case flag (Attachment 9) to the Prue/Weathers claim, immediately forward the Prue/Weathers claim to the District of Columbia DDS (or to the appropriate DDS if the exception in Part III. above applies) for adjudication, and retain a copy of Attachment 9 in the current claim file. OAO will modify Attachment 9 to indicate that the Appeals Council action on the current claim does not resolve all Prue/Weathers issues and that the Prue/Weathers class member claim is being forwarded for separate processing. OAO staff will include copies of the ALJ's or 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 or Appeals Council's decision.

   3. Appeals Council Intends To Issue a Favorable Decision on the Current Claim — No Prue/Weathers Issue(s) Will Remain Unresolved

      If the Appeals Council intends to issue a fully 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 Prue/Weathers class member, the Appeals Council will proceed with its intended action. In this instance, the Appeals Council will consolidate the claims, reopen the final determination or decision on the Prue/Weathers claim, and issue a decision that adjudicates both applications.

      The Appeals Council's decision will indicate clearly that the Appeals Council considered the Prue/Weathers claim pursuant to the Prue/Weathers Stipulation and Order.

   4. Appeals Council Intends To Issue a Favorable Decision on the Current Claim — Prue/Weathers 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 Prue/Weathers 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 District of Columbia DDS (or to the appropriate DDS if the exception in Part III. above applies) 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: “Prue/Weathers court case review needed — following effectuation forward the attached combined files to the District of Columbia Disability Determination Service [address] (or to the appropriate DDS if the exception in Part III. above applies).”

   5. Appeals Council Intends To Remand the Current Claim to an ALJ

      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 Prue/Weathers claim with the action on the current claim pursuant to the instructions in Part VI.D.2.a. above.

   EXCEPTIONS:

   The Appeals Council will not direct the ALJ to consolidate the claim if

   • the current claim and the Prue/Weathers 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 a common issue or a court-ordered time limit makes consolidation impractical, OAO will forward the Prue/Weathers class member claim to the District of Columbia DDS (or to the appropriate DDS if the exception in Part III. above applies) for separate review. The case flag in Attachment 9 should be modified to indicate that the Appeals Council, rather than an ALJ, is forwarding the Prue/Weathers class member claim for separate processing.