Table of Contents
I |
Purpose |
II |
Background |
III |
Guiding Principles |
IV |
Definition of Class |
V |
Determination of Class Membership and Preadjudication Actions |
VI |
Processing and Adjudication |
VII |
Case Coding |
VIII |
Reconciliation of Implementation |
IX |
Inquiries |
Attachment 1 |
Privacy Act Protective Order filed October 23, 1995; Stipulation; Findings of Fact, Conclusions of Law, and Order of Settlement and Dismissal filed December 19, 1995; and Final Judgment Entered by the United States District Court for the District of Colorado on December 21, 1995. |
Attachment 2 |
Adamson Court Case Flag/Alert |
Attachment 3 |
Screening Flag - Within OHA |
Attachment 4 |
Adamson SCREENING SHEET |
Attachment 5 |
Screening Flag - Outside OHA |
Attachment 6 |
Non-Class Membership Notice |
Attachment 7 |
Route Slip for Non-Class Members Claims |
Attachment 8 |
Readjudication Flag for OHA Retention Cases |
Attachment 9 |
ALJ Dismissal to DDS |
Attachment 10 |
Notice Transmitting ALJ Order of Dismissal |
Attachment 11 |
Class Member Flag - Readjudication Necessary |
ISSUED: September 27, 1996
I. Purpose
This Temporary Instruction (TI) sets forth procedures for implementing the
Stipulation approved by the United States District Court for the District
of Colorado in its Order of Settlement and Dismissal filed December 19,
1995, in the Adamson v. Chater class action. The
court entered final judgment on December 21, 1995 (Attachment 1).
Because the Stipulation affects only individuals who still reside in the
Tenth Circuit (Colorado, Kansas, New Mexico, Oklahoma, Utah and Wyoming),
adjudicators processing Tenth Circuit cases, either as part of their
regular jurisdiction or on a case transfer basis, must be familiar with
this TI.
II. Background
On January 8, 1985, plaintiff Adamson amended his
individual complaint, that was filed on October 17, 1984, for the purpose
of proceeding as a class action. The plaintiff alleged that the Agency
had failed to acquiesce to Tenth Circuit case law regarding the weight
that should be given to the reports of treating physicians in disability
cases. Following the district court's initial denial of plaintiff's
motion for class certification, the Tenth Circuit remanded for further
proceedings on the issue. Subsequently, the district court certified a
class on March 14, 1989. Thereafter, following extensive discovery and a
September 11, 1991 hearing on the parties' objections to the magistrate
judge's report and recommendation, the court requested that the parties
engage in settlement negotiations. On December 19, 1995, after a fairness
hearing on October 13, 1995, the district court gave final approval to
the parties' proposed Stipulation.
III. Guiding Principles
Under the Adamson Stipulation, the Secretary will
readjudicate the claim(s) of those persons who: 1) respond to personal
notice informing them of the opportunity for review; or 2) respond
to public notice posted in all SSA field offices (FOs) in the Tenth
Circuit, regarding the opportunity for review; and 3) are
determined to be class members entitled to relief. In most cases, the
Office of Disability and International Operations (ODIO) or the
Mid-America Program Service Center (MAMPSC) will screen the claims of
those individuals who respond to personal or public notice, and forward
class member claims to the Disability Determination Service (DDS) for
readjudication. However, the DDS will screen reconstructed cases and cases
in which a current claim is pending in the DDS. In addition, if the
potential class member claim or another claim is located in OHA when class
membership becomes an issue, or if the claimant has a civil action
pending, OHA will perform the screening and, under the limited
circumstances described in Part VI., will perform the
readjudication.
The type of readjudication is a redetermination (see HALLEX
I-1-7-04). The class
member claim(s) will be adjudicated under current policies and procedures
and the claimant will receive normal appeal rights (i.e., Administrative
Law Judge (ALJ) hearing, Appeals Council and judicial review).
IV. Definition of Class
The Adamson class members entitled to relief
consists of individuals who, under titles II and/or XVI, while residing in
the 10th Circuit:
had a claim for disability benefits denied or terminated at the
reconsideration level, at steps 4 or 5 of the sequential evaluation
[1] , between
October 17, 1984, and July 31, 1991, inclusive, and did not pursue
appeal; or
had a claim for disability benefits denied or terminated by an ALJ or the
Appeals Council at steps 4 or 5 of the sequential evaluation, between
April 10, 1987, and June 27, 1988, inclusive, and did not pursue appeal;
or
had a request for review denied by the Appeals Council during the period
between April 10, 1987, and June 27, 1988, inclusive, based on a claim for
disability benefits denied or terminated by an ALJ at steps 4 or 5 of the
sequential evaluation, and did not pursue appeal; and
had a treating physician opinion of record regarding the individual's
medical condition that was inconsistent with the decision to deny or
terminate benefits.
An individual is not an Adamson class member
entitled to relief if he or she
had his or her prior claim(s) readjudicated pursuant to the
Luna, Peck,
Trujillo or Zebley class
actions; or
received a subsequent award of benefits on another claim with respect to
the entire time period at issue in the potential class member claim(s);
or
received a decision on the merits of a subsequent claim, covering the
entire time period at issue in the potential class member claim(s), by the
DDS after July 31, 1991, or by OHA before April 10, 1987, or after June
27, 1988.
V. Determination of Class Membership and Preadjudication Actions
A. Pre-Screening
Actions - General
Notification of Potential Class Members
SSA sent notices to certain potential class members as 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 Adamson Stipulation. Individuals will make
their requests by returning a reply form enclosed with the notice. SSA
will presume the individual's receipt of notice to be five days after
mailing, unless the individual establishes that receipt actually occurred
later. If an individual fails to respond within the required 60 days, he
or she will be denied relief absent a finding of “good cause”
as set forth in 20
CFR §§ 404.911/416.1411.
SSA also disseminated posters to all SSA FOs in the Tenth Circuit, to
inform individuals not entitled to personal notice, i.e., those whose
disability claims were denied/terminated between October 17, 1984, and
April 9, 1987, inclusive, of their right to request review under the terms
of the Stipulation. Posters will remain displayed for a period of 120
days, and potential class members must request review not later than 60
days after the poster display period has ended.
Alert and Folder Retrieval Process
ODIO will receive all response forms and requests for review and the
information will be entered into the Civil Action Tracking System (CATS).
CATS will generate alerts to ODIO. (See Attachment 2 for a sample
Adamson alert.)
ODIO will associate the alerts and response forms, and will forward them
to the appropriate component for retrieval. ODIO will retrieve title
II-only and concurrent title II/XVI folders, except those located in OHA
or a DDS (see Part V. A. 3. below). The MAMPSC will retrieve title
XVI-only folders, except those located in the Wilkes-Barre Data
Operations Center (WBDOC), OHA or a DDS (see Part V. A. 3. below).
The WBDOC will retrieve title XVI-only folders and forward them to the
MAMPSC for screening.
Alerts Sent to OHA
If ODIO determines that a current claim, i.e., either a potential class
member claim or another claim, is pending or stored at OHA, ODIO will
forward the alert, along with any other claim file(s) to OHA for
screening, consolidation consideration (if appropriate) and possible
readjudication. ODIO will also forward the alert to OHA if the potential
class member claim or another claim is pending in court. If necessary,
ODIO will obtain and forward a copy of the court transcript along with the
alert. If ODIO is unable to locate a prior claim file(s) and a current
claim is pending or stored at OHA, ODIO will telephone the hearing office
(HO) or OHA Headquarters, as appropriate, to determine if the prior claim
file(s) is associated with the claim file(s) pending or stored at OHA. (In
most cases at the OHA level, the prior claim file(s) will be associated
with the current claim.)
If the claim is located in an HO, ODIO will forward the alert and claim
file(s), if any, directly to the HO for processing. If the claim is
located in OHA Headquarters, ODIO will forward the alert and 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
Skyline Tower, Suite 701
5107 Leesburg Pike
Falls Church, VA
22041-3200
ATTN: OAO Class Action Coordinator
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 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 (see Part VIII. below).
Folder Reconstruction
After a thorough search for an inactive claim file, the search time not to
exceed 120 days from the alert date, ODIO or the MAMPSC will initiate
reconstruction through the servicing FO. The MAMPSC will also initiate
reconstruction for title XVI-only folders that the Wilkes-Barre DOC is
unable to retrieve.
Because ODIO or MAMPSC will obtain all potential class member claims
within the class member timeframes, or otherwise arrange for their
reconstruction, prior to forwarding cases for screening, OHA requests for
reconstruction of potential 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 particular
claim would not confer class membership and, therefore, make
reconstruction unnecessary.
OHA (the HO or the OAO branch) will direct any necessary reconstruction
requests to the FO servicing the claimant's address. The request will be
made by memorandum and will include the alert and any accompanying claim
file(s) (if the claim file(s) is not needed for adjudication purposes) as
attachments. The request will also include documentation of the attempts
to locate the file. The memorandum will request the FO to send the
reconstructed file to OHA after it completes its reconstruction action.
HOs and the OAO branches will route any reconstruction requests directly
to the FO servicing the claimant's address. The OAO branches will also
route copies of the reconstruction 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:
Office of the Deputy Commissioner
for Programs and Policy
Litigation Staff
3-K-26 Operations Building
6401 Security
Boulevard
Baltimore, MD 21235
Attn: Adamson Coordinator
HO personnel and the OAO branch will identify in the reconstruction
request the OHA location of any existing claim file(s) being retained for
adjudication purposes, and the date(s) of the claim(s) involved.
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 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
taken on the formerly pending claim. For additional information on
reconstruction procedures, see the Class Action Implementation
instructions in HALLEX
I-1-7-05C.
Class Membership Denials
The screening component will hold all non-class member claim files for 90
days pending potential review by class counsel. However, because potential
class member claims that are screened in OHA are either associated with
pending claims or stored pending appeal, the OHA screening component will
return the denied claim to, or hold the denied claim in, its normal
location. 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 notice
of the class membership denial to notify the Regional Counsel of SSA's
Office of the General Counsel, Region VIII, of disagreement. Upon timely
request by class counsel (i.e., within 60 days of receipt of the notice
of class membership denial) to review claim files, SSA has 30 days from
receipt of the request to make the claim file available. Accordingly,
Litigation Staff will request the storage component to forward the
relevant claim files to the designated FO in each Tenth Circuit state.
The claim file will be available for class counsel's review for a period
of 30 days. Upon review of the files, class counsel will have an
additional 30 days, if necessary, to contact the Office of the General
Counsel (OGC) directly to resolve any remaining class membership disputes.
If the parties are unable to resolve any dispute, class counsel may
submit the issue to the Adamson court for final
resolution, within 30 days of Regional Counsel's written affirmation of
the determination of non-eligibility for relief. If class counsel fails to
act within the 30 days, SSA's class membership determination will become
final and not subject to further review.
B. OHA
Screening Actions
Pre-Screening Actions
Determining Jurisdiction for Screening
As provided in Part V. A. 3. above, if there is a current claim
pending or stored at OHA Headquarters, or if a civil action has been
filed, the OAO Class Action Coordinator will receive the
Adamson alert and related claim file(s). The OAO
Class Action Coordinator may also receive alerts (forwarded in error) for
cases in which there is no current claim pending or stored at OHA
Headquarters. The Coordinator will determine which OHA component has the
pending or stored claim and forward for screening as follows.
If the current claim is pending in an HO, the Coordinator will forward the
alert and any prior claim file(s) located in OHA Headquarters to the HO
for screening, using Attachment 3. (Part V. B. 2. below provides
instructions to 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 pending before the Appeals Council, or located in
an OAO branch mini-docket or in the OAO Docket and Files Branch (DFB), the
Coordinator will forward the alert and any prior claim file(s) to the
appropriate OAO branch for screening, using Attachment 3. (Part V. B.
2. below provides instructions to the OAO Branches regarding the
action to be taken if they receive an alert package but no longer have a
current claim pending.)
If a claim, either the alerted claim or a subsequent or prior claim, is
pending in court, the Coordinator will forward the alert and any
accompanying claim file(s) or court transcripts to the appropriate OAO
Court Case Preparation and Review Branch (CCPRB) for screening, using
Attachment 3.
If the Coordinator (or the designee) is unable to locate the current claim
file within OHA, the Coordinator (or the designee) will broaden the claim
file search and arrange for alert transfer or claim file reconstruction,
as necessary.
Do not screen pending cases unless an alert has been received. The
presence of an alert is evidence that the claimant has timely responded to
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 Adamson
coordinator in the Division of Litigation Analysis and Implementation
(DLAI) for assistance in determining the claimant's status and responding
to the claimant's allegation. DLAI's address is
Office of Hearings and Appeals
Division of Litigation Analysis
and
Implementation
One Skyline Tower, Suite 702
5107 Leesburg
Pike
Falls Church, VA 22041-3255
Attn: Adamson Coordinator
The DLAI Adamson coordinator's telephone number
is (703) 305-0726.
Preparing the Case for Screening
Prior to screening an individual case, the screening component will obtain
and place in the claim file appropriate systems information (if not
already in file) to determine whether:
there is a current claim pending at any administrative level or in court;
or
there are additional claims within the class dates that have not been
associated; or
the claimant has received a determination/decision on a subsequent claim
that is fully favorable with respect to the entire time period at issue in
the potential class member claim and thus provides a basis for
determining that the claimant is not a class member eligible for class
relief; or
the claimant has received a merits determination/decision during certain
timeframes on a subsequent claim that may provide a basis for determining
that the claimant is not a class member eligible for class relief.
The screening component will also:
obtain the files for all unassociated claims that fall within the class
dates, as well as any inactive claims that postdate the class period (that
potentially provide a basis for screen-out or for limiting class relief);
and
if necessary, request reconstruction of any potential class member files
for claims that cannot be located (see Part V. A. 4. above).
Screening
The screening component 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 4) as follows:
Consider all applications denied/ceased during the
Adamson timeframes; and
Annote the “Remarks” section if another subsequent claim is
pending at any administrative level; and
Follow all instructions on the screening sheet and the screening sheet
instructions; and
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 or an HO,
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 sheets into a database and will forward
the screening sheets to DLAI.) HO personnel may also forward material by
telefax to the Coordinator at (703) 05-0655. (DLAI will retain a copy of
each screening sheet received from the Coordinator and will forward
copies to Litigation Staff for entry to CATS.)
If the HO receives an alert only, or an alert associated with a prior
claim file(s) for screening, and no longer has the current claim file, it
will send the alert and 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 claim and its destination. The
Coordinator will determine the current claim file location and forward
the alert and any accompanying prior claim file(s) to that location for
screening using Attachment 3 (within OHA) or Attachment 5 (outside
OHA).
If an OAO branch receives an alert only, or an alert associated with a
prior claim file(s) and no longer has the current claim file, 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 material to the OHA location. If the file(s) is no longer in
OHA, the OAO branch will use Attachment 5 to forward the material to the
non-OHA location. The OAO branch will also advise the OAO Class Action
Coordinator of its actions.
Post-Screening Actions
Class Members Not Entitled to Relief
If the screening component determines that the individual is not a class
member eligible for relief, the component will:
notify the individual, and representative, if any, of non-eligibility for
class relief using Attachment 6 (modified as necessary to fit the
circumstances and posture of the case when there is a current claim);
Include the address and telephone number of the servicing Social Security
FO at the top of the notice.
retain a copy of the notice in the claim file;
send a copy of the notice to:
Adamson Counsel
Law Offices of R. Eric Solem, P.C.
Division of Litigation
Analysis
3333 South Bannock St.
Suite 910
Englewood, CO 80110;
and
if the claim is not currently pending, return it to its OHA storage
location.
If class counsel makes a timely request to review the claim file and the
file is located in OHA, DLAI will notify the OHA component housing the
claim file to send it to the SSA FO for class counsel's review (see
Part V. A. 5. above). The component will use the route slip in
Attachment 7.
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 the file is needed for adjudication purposes and cannot be immediately
released, the OHA component will either forward a copy of the file or
provide an explanation to DLAI of the reason for the delay and the
expected timeframe within which the file can be released.
If SSA through OGC, Region VIII, resolves the dispute in the claimant's
favor:
OGC will notify the claimant or representative, if any, and class counsel,
and will alert Litigation Staff to prepare a revised screening sheet;
OHA-jurisdiction cases will proceed in accordance with Part VI.
below;
Litigation Staff will notify DLAI of the revised determination by
forwarding a copy of the revised screening sheet to DLAI; and
DLAI will coordinate with the OAO Class Action Coordinator as
necessary.
If class counsel fails to review the claim file, it will be assumed that
review is no longer desired, and SSA's determination of non-eligibility
for class relief will become final and not subject to further review.
Class Members Entitled to Relief
There is no class member notice. If the screening component determines
that the individual is a class member entitled to relief, it will proceed
based on the instructions in Part VI. below unless a claim is
pending in court. If a claim is pending in court, the CCPRB will
immediately contact OGC, which will determine the action to be taken.
This is true whether the claim is the potential class member claim or
another claim.
VI. Processing and Adjudication
A. Cases
Reviewed by the DDS
The DDS will usually conduct the Adamson review.
An exception will apply for cases consolidated at the OHA level (see
Part VI. D.). The DDS determination will be a reconsideration
determination, regardless of the administrative level at which the class
member claim(s) was previously decided, with full appeal rights (i.e.,
ALJ hearing, Appeals Council and judicial review). (See Part VI.
B. below.) However, the following processing and adjudication
procedures will apply when OHA has responsibility for screening, i.e.,
when a potential class member claim or another claim is pending or stored
in OHA, and when the claimant is a class member.
B. OHA
Adjudication of Class Member Claims
The following instructions apply to consolidation cases in which the ALJ
or Appeals Council conducts the Adamson
readjudication and to DDS readjudication cases in which the claimant
requests a hearing or Appeals Council review. Except as noted herein, HOs
and OHA Headquarters will process Adamson class
member cases according to all other current practices and procedures
including coding, developing evidence, routing, etc.
Type of Review and Period to Be Considered
Pursuant to the Adamson stipulation, 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 that was at issue
in the administrative determination or decision(s) that formed the basis
for Adamson class membership. (Under the
Stipulation, claimants may submit additional medical evidence that relates
to the relevant period of time.)
If the redetermination results in a favorable decision, the adjudicator
will determine whether the individual's disability has been continuous
through the date of the redetermination or to the date of the most recent
allowance.
If the evidence establishes that disability began only at some point
after the administrative determination(s) that forms the basis for
Adamson class membership, the class member must
file a new application to establish eligibility. The OHA decision should
advise the claimant of the opportunity to file a new claim, but should
not make a formal finding with respect to disability after the date of
the review period.
Disability Evaluation Standards
Adjudicators must use the disability evaluation standards contained in the
statute, regulations and Rulings.
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 a claim file (either a class member or another disability 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. (The OAO Class Action Coordinator will
coordinate the necessary actions, as explained in Part V.). (See
Part V. B. 3. a., 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 an
Adamson class member flag (see Attachment 8), to
the outside of the file and forward the claim file(s) to the DDS for
review of the Adamson class member claim.
If less than 120 days have elapsed, OAO will attach an
Adamson class member flag (see Attachment 8) to
the outside of the file to ensure that the case is routed to the DDS
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 component will monitor the retention period and, if the
claimant does not seek further administrative or judicial review, route
the file(s) to the DDS in a timely manner.
D. Processing
and Adjudicating Class Member Claims in Conjunction with Current Claims
(Consolidation Procedures)
Claims subject to consolidation should be consolidated only to the extent
practicable. Thus, if consolidation would unreasonably delay a decision on
the current claim, consolidation is not required.
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
Adamson class member claims with the current
claim at the level at which the current claim is pending. Because the
receipt of a determination or decision during certain timeframes on a
subsequent claim that covered the entire time period at issue in the
Adamson claim is a basis for screen-out, there
should be few class member claims associated with current claims at the
OHA level. Examples would be when the current claim involves a later
onset date or, for Appeals Council purposes, when the ALJ dismissed the
request for hearing on the current claim.
Current Claim Pending in the Hearing Office
Hearing Has Been Scheduled or Held, and All Remand Cases
Except as noted below, if an Adamson 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, including
court remands, the ALJ will consolidate the
Adamson case with the appeal on the current
claim.
The ALJ will not consolidate the claims if
the current claim and the Adamson 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.
Hearing Not Scheduled
Except as noted below, if an Adamson class member
has a request for hearing pending on a current claim and the HO has not
yet scheduled a hearing, the ALJ will not consolidate the
Adamson claim and the current claim at the OHA
level. Instead, the ALJ will dismiss the request for hearing on the
current claim and forward both the Adamson claim
and the current claim to the DDS for further action (see Part VI. D. 2. d.
below).
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
favorable with respect to all the issues raised by the application that
makes the claimant an Adamson 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.
Actions If Claims Consolidated
When consolidating an Adamson claim with any
subsequent claim, and the two claims involve overlapping periods at issue,
the issue is whether the claimant was disabled at any time from the
earliest alleged onset date through the present or to the date of the most
recent allowance (or through the claimant's date last insured, if
applicable and earlier). Accordingly, in effect, consolidation will result
in a reopening of the Adamson claim through the
time period at issue in the current claim.
However, if the period to be adjudicated in the current claim does not
overlap the period to be adjudicated in the
Adamson claim, the two claims should be
considered separately. Nevertheless, if the claimant is found to be
disabled within the timeframe of the Adamson
claim, the claim will be reopened through the date at issue in the
current claim. If the ALJ decides to consolidate the current claim with
the Adamson 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 Adamson claim raises any additional issue(s)
not raised by the current claim;
offer the claimant a supplemental hearing if the ALJ has already held a
hearing and the Adamson claim raises an
additional issue(s), unless the ALJ is prepared to issue a fully
favorable decision with respect to the Adamson
claim;
issue one decision that addresses both the issues raised by the current
request for hearing and those raised by the
Adamson claim (the ALJ's decision will clearly
indicate that the ALJ considered the Adamson
claim pursuant to the Adamson stipulation);
forward a copy of the decision directly to DLAI at the address in Part
V. B. 1. a. above.
Action if Claims Not Consolidated
If common issues exist but the ALJ decides not to consolidate the current
claim with the Adamson claim because the hearing
has not yet been scheduled, the ALJ will:
dismiss the request for hearing on the current claim without prejudice,
using the language in Attachment 9 and the covering notice in Attachment
10; and
send both the Adamson claim and the current claim
to the DDS for consolidation and further action.
If the ALJ decides not to consolidate the current claim with the
Adamson 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 Adamson claim for DDS review using
Attachment 11; immediately route it to the DDS for readjudication
(photocopies of any relevant material from either file should be made and
placed in the other file before shipping) and retain a copy of Attachment
11 in the current claim file;
take the necessary action to complete the record and issue a decision on
the current claim.
Current Claim Pending at the Appeals Council
The action the Appeals Council takes on the current claim determines the
disposition of the Adamson 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 Adamson claim.
Appeals Council Intends to Dismiss, Deny Review or Issue a Denial Decision
on the Current Claim
In this instance, the Appeals Council will proceed with its intended
action on the current claim. OAO staff will attach an
Adamson case flag (Attachment 11; appropriately
modified) to the Adamson claim, immediately
forward the Adamson claim to the DDS for
adjudication, and retain a copy of Attachment 11 in the current claim
file. 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.
Appeals Council Intends to Issue a Favorable Decision on the Current Claim
-- No Adamson 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 an
Adamson class member, the Appeals Council should
proceed with its intended action. In this instance, the Appeals Council
will consolidate the claims, reopen the final determination or decision on
the Adamson claim and issue a decision that
adjudicates both applications. The Appeals Council's decision will clearly
indicate that the Appeals Council considered the
Adamson claim. OAO staff will forward a copy of
the decision, for coordination with DLAI, to the OAO Class Action
Coordinator at the address in Part V. A. 3. above.
Appeals Council Intends to Issue a Favorable Decision on the Current Claim
-- Adamson Issue(s) Will Remain Unresolved
If the Appeals Council intends to issue a fully favorable decision on a
current claim and this decision would not be fully favorable with respect
to all issues raised by the Adamson 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 DDS 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:
"Adamson court case review needed -- following
effectuation forward the attached combined folders to the DDS."
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 Adamson claim with the action on
the current claim pursuant to the instructions in Part VI. D. 2.
a. above.
The Appeals Council will not direct the ALJ to consolidate the claim
if
the current claim and the Adamson 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
Adamson class member claim to the DDS, for
separate review. The case flag in Attachment 11 should be modified to
indicate that the Appeals Council, rather than the ALJ, is forwarding the
Adamson class member claim for separate
processing.
VII. Case Coding
In all situations, to identify class member cases in the Hearing Office
Tracking System (HOTS), HO personnel will code “AD” in the
“Class Action” field. Additionally, in the OHA Case Control
System, HO personnel will code “A” in the “SPC”
field.
If the Adamson claim is consolidated with a
current claim already pending at the hearing level, HO personnel will not
code the prior claim as a separate hearing request. Instead, HO personnel
will change the hearing type on the current claim to a
“reopening.” HO personnel will code dismissal cases as
“OTDI” in the “DSP” field. HOTS users will need
to bypass the automated case routing capability and manually route
dismissal cases through the special case disposition/routing function.
Only the systems administrator can access this function. The individual
will need to enter the DDS address and destination code.
VIII. Reconciliation of Implementation
At an appropriate time, the Litigation Staff at SSA Central Office will
request SSA components to reconcile their screening activity and
disposition of class member claims with information available on CATS.
Within OHA, the OAO Class Action Coordinator is responsible for
maintaining a personal computer-based record of OHA implementation
activity (i.e., a record of alerts processed by OAO), and a record of
cases screened and consolidated by OHA (as reported by HOs and OAO to the
Coordinator after screening and/or consolidation). See HALLEX
I-1-712 with respect to reporting requirements.
IX. Inquiries
HO personnel should direct any questions concerning this instruction to
their Regional Office. Regional Office personnel should contact the
Division of Field Practices and Procedures in the Office of the Chief
Administrative Law Judge at (703) 305-0022. OHA Headquarters personnel
should contact DLAI at 305-0708.
[DATE FILED 12/21/1995]
IN UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF COLORADO
Civil Action No. 84-S-2024
GERALD K. ADAMSON, et al., individually and as representative of all
persons similarly situated,
Plaintiffs,
and
FREDDIE BYNUM, BARBARA
McGOWEN, DANNY PHILLIPS
and
DOROTHY COSGROVE,
Plaintiffs/Intervenors,
v.
SHIRLEY S. CHATER, Commissioner of Social Security, Defendant
__________________________________________________________________________
FINAL JUDGMENT
__________________________________________________________________________
By order dated March 14, 1989, this District Court certified a class
comprised of:
All persons who are Tenth Circuit residents (Colorado, Kansas, New Mexico,
Oklahoma, Utah, and Wyoming) who have filed or will file applications for
Social Security Title II disability benefits (excluding applicants for
widow's, surviving divorced wife's or widower's disability benefits) or
SSI disability benefits, who had or will have their claims for disability
benefits evaluated by the Defendant under the Defendant's regulations,
policies, and practices, who have been found not disabled by Defendant on
or after one year and 60 days prior to filing this class action, either in
an initial determination, reconsideration determination, administrative
law judge determination, or Appeals Council determination, who have
presented claims to the Defendant and, in which the (holdings of the Tenth
Circuit) concerning the weight given to treating physicians' opinions was
not applied. The class also includes those people who have been or will
be found eligible for disability benefits and have had or will have those
benefits terminated on or after one year and 60 days prior to filing this
class action in a continuing disability review and in which the
[Tenth Circuit] standard concerning the weight given to treating
physicians' opinions was not applied, and who have presented claims to
the Defendant.
In accordance with the Order of Settlement and Dismissal entered
December 19, 1995, by the Honorable Daniel B. Sparr, United States
District Judge, and Rules 23(c) (3), 54, 58, and 79(a) of the Federal
Rules of Civil Procedure, it is now
ORDERED that final judgment is entered as to
all members of the above-described class and to the defendant, in
accordance with the terms and conditions of the Stipulation approved by
the Court in its Order of Settlement and Dismissal.
DATED at Denver, Colorado this 21st of December, 1995.
[DATE FILED 12/19/1995]
IN UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF COLORADO
Civil Action No. 84-S-2024
GERALD K. ADAMSON, et al., individually and as representative of all
persons similarly situated,
Plaintiffs,
and
FREDDIE BYNUM, BARBARA McGOWEN, DANNY PHILLIPS, and DOROTHY COSGROVE,
Plaintiffs/Intervenors,
v.
SHIRLEY S. CHATER, Commissioner of Social Security
Defendant.
__________________________________________________________________________
FINDINGS OF FACT, CONCLUSIONS OF LAW, AND
ORDER OF SETTLEMENT AND
DISMISSAL
__________________________________________________________________________
SPARR, J.
On October 13, 1995, the Court held a
hearing in this case pursuant to Fed. R. Civ. P. 23(e). In accordance with
Fed. R. Civ. P. 52(a), the Court enters the following findings.
A. FINDINGS OF FACT
On May 31, 1995, upon the joint motion of all the parties to conduct
proceedings pursuant to Rule 23 (e) and in consideration of the proposed
Stipulation for settling this case, this Court entered an order approving
the Notice of Proposed Settlement in Social Security Lawsuit tendered on
April 24, 1995.
After examining the Notice of Proposed Settlement, the Court finds that it
explains and gives information regarding:
the general requirements for class membership;
how notice will be given to the potential class members after the approval
of the Stipulation;
the responsibility of potential class members specifically to ask the
Social Security Administration to redetermine previously denied disability
claims;
the circumstances in which the Social Security Administration will
reexamine the claims and the general criteria to be used in redetermining
the claims;
the type of notice to be given to people who request redetermination but
who are not eligible for relief under the terms of the Stipulation;
what will occur if the redetermination results in a favorable decision;
and
the appeal rights that are available if the redetermination is
unfavorable.
Thus, the Notice of Proposed Settlement “ 'fairly apprise
[d]' the class members of the terms of the proposed settlement
and of their options.” Gottlieb v. Tiles,
11 F.3d 1004, 1013 (10th Cir. 1993).
The Court finds the parties used their best efforts to disseminate the
Notice of Proposed Settlement to interested persons. The Notice was
published on July 30, 1995, in the Rocky Mountain News,
Wichita Eagle, Albuquerque Journal, Daily
Oklahoman, Salt Lake City Tribune, and Casper
Star-Tribune. Notice was also posted in all Social Security
Administration field offices in the six states of the Tenth Circuit and
in numerous other locations identified in Advisement of Posted Notice
Pursuant to Federal Rule of Civil Procedure 23(e), which is part of the
record in this case.
No class member filed an objection to the settlement or objected to the
settlement at the hearing on October 13, 1995.
The record shows that there were significant issues in this case
concerning liability and damages. Had the matter gone to trial, the
litigation would have been protracted and there would have been a high
likelihood of appeal.
The Court finds that the counsel for both the government and the
plaintiffs have energetically and effectively litigated the matter. The
Court is acquainted, by reputation, with counsel for both the government
and the class.
The parties have entered into settlement in good faith and after
substantial and lengthy arm's-length negotiations. They agree that the
settlement is fair and reasonable.
The attorneys' fees of $57,539.67 specified in the Stipulation are clearly
fair and reasonable based upon an examination of the file and the efforts
of class counsel, and constitute payment in full for both past and future
representation. The fees paid to plaintiffs' counsel in no wise diminish
the recovery of any member of the class or the class as a whole.
The Court finds that the settlement is fair, reasonable, and adequate.
See Gottlieb, 11 F.3d at 1014.
B. CONCLUSIONS OF LAW
The Notice of Proposed Settlement to all class members in all respects is
proper and adequate and complies with the appropriate requirements of due
process.
The terms of the settlement of this action as set forth in the Stipulation
are hereby adjudged to be fair, reasonable, and adequate
Accordingly, it is hereby:
ORDERED that the Stipulation settling this
case is approved. It is further
ORDERED that the Complaint and this civil
action are dismissed, each party to pay its own costs.
The Clerk of the Court is directed to enter
the Stipulation and this Order of Settlement and Dismissal and also to
enter a final judgment pursuant to Fed. R. Civ. P. 23(c)(3), 54, 58, and
79(a), substantially in the form as appended.
DATED at Denver, Colorado, this 19th day of December,
1995.
Civil Action No. 84-S-2024
GERALD K. ADAMSON, et al.,
Plaintiffs,
and
FREDDIE BYNUM, BARBARA
McGOWEN, DANNY PHILLIPS
and
DOROTHY COSGROVE,
Plaintiffs/Intervenors,
v.
SHIRLEY S. CHATER, ¹
Commissioner of Social Security,
Defendant.
__________________________________________________________________________
STIPULATION
__________________________________________________________________________
WHEREAS, on March 14, 1989, the Court
certified a class in this action, and
WHEREAS, the parties wish to avoid further
litigation and wish amicably, fully, and finally to resolve all disputes
that have been asserted in this action,
THEREFORE, all parties in this civil action,
by their undersigned counsel, hereby agree, subject to approval by the
Court, to the settlement of the plaintiffs' claims in accordance with the
following terms and conditions:
Individuals who shall be entitled to seek relief under this Stipulation
shall include, subject to the exclusions provided in Paragraph 2, those
residents of Wyoming, Utah, Colorado, Kansas, Oklahoma, and New Mexico
(Tenth Circuit) who, while residing in the Tenth Circuit, had a claim for
disability insurance benefits (DIB) under Title II of the Social Security
Act, or a claim for supplemental security income (SSI) disability benefits
under Title XVI of the Social Security Act, or a concurrent DIB and SSI
disability benefits claim, denied or terminated (denied/terminated),
because it was decided that the claimant could engage in past relevant
work or other work (step 4 or 5 of the sequential evaluation
process)²; and in addition, who meet the criteria following in (a),
(b), and (c) of this Paragraph:
The denial/termination decision on the claim was made:
by a State Disability Determination Service (DDS), at the reconsideration
level of administrative review, during the period beginning October 17,
1984, and ending July 31, 1991; or
by an administrative law judge (ALJ), during the period beginning April
10, 1987, and ending June 27, 1988; or
by the Appeals Council, during the period beginning April 10, 1987, and
ending June 27, 1988, either as a denial/termination at step 4 or 5 of the
sequential evaluation process or as a denial of review of an ALJ decision
that denied/terminated disability benefits at step 4 or 5 of the
sequential evaluation process; and
The individual did not obtain further administrative or judicial review of
the denial/ termination decision; and
The individual's claims file contains an opinion from a treating physician
regarding the individual's medical condition that is inconsistent with
the decision to deny or terminate benefits. For purposes of this
Stipulation, a treating physician opinion means a medical opinion, as
defined in 20
C.F.R. §§ 404.1527(a) (2) and 416.927(a) (2), from a
treating source that is an acceptable medical source, as defined in
20 C.F.R.
§§ 404.1513(a) and
416.913(a).
No individual shall be entitled to seek relief under this Stipulation
if:
that individual's claim has been readjudicated under the
Luna, Trujillo,
Peck, or Zebley class
actions; or
that individual has already received a subsequent award of benefits with
respect to the same period of time at issue in the class claim; or
that individual reasserted a claim in a subsequent application or request
for reopening, covering the same period of time as the class claim, and an
administrative decision on the merits of that claim was issued by a DDS
after July 31, 1991, or was issued by the Office of Hearings and Appeals
before April 10, 1987, or after June 27, 1988.
To the extent practicable, within 120 days of the effective date of this
Stipulation, the Social Security Administration (SSA) shall, by means of
its data processing systems, identify the names, Social Security numbers,
and last known addresses of those class members who are potentially
entitled to seek relief, in accordance with the criteria set forth in
Paragraphs 1 and 2. In order to identify class members described in
Paragraphs 1(a) (ii) - (iii), SSA shall identify those individuals whose
claims were denied/terminated at step 4 or 5 of the sequential evaluation
process at the reconsideration level, who appealed those
denials/terminations, and whose claims were then denied/terminated during
the period beginning April 10, 1987, and ending June 27, 1988, at the
requisite level of administrative review described in Paragraphs
1(a)(ii)-(iii). Upon completion of identification, SSA shall provide
plaintiffs' counsel with two lists of the persons identified as class
members who are potentially entitled to seek relief: (1) one alphabetical,
by last name, and (2) one by state. The lists will set forth each
person's name, SSN or claim number (or both where available), and most
current address available to SSA. The list may be supplied on computer
tape or other method agreed to by the parties.
Within 180 days of the effective date of this Stipulation, SSA shall send
a notice (Attachment A) by first class mail to the last known address of
each identified class member described in Paragraphs 1(a) (ii)-(iii) and
of those identified class members described in Paragraph 1(a) (i) whose
claims were denied/terminated on or after April 10, 1987, through July 31,
1991. The notice will inform class members of their possible entitlement
to a redetermination of their claims, and will further inform such
individuals that they must return an enclosed pre-addressed and postage
prepaid postcard or form, within 60 days of receipt of the notice, in the
event that such redetermination is desired. Should individual notices be
returned as undeliverable, SSA will attempt to obtain updated addresses by
providing a computer tape to the State Department of Social Services or
corresponding agency in each State within the Tenth Circuit for the sole
purpose of obtaining addresses through a computerized match with public
assistance, Food Stamp, and/or other relevant records. SSA's attempts to
obtain updated addresses are subject to the requirements of the Privacy
Act, as amended by the Computer Matching and Privacy Protection Act, 5
U.S.C.A. § 552a. SSA shall not be required to institute legal
proceedings to gain access to State data system records or to reimburse or
compensate States for searching such records. SSA shall mail notices to
potential class members within 60 days of receipt of an updated
address.
If a potential class member receives a notice referred to in Paragraph 4
and does not respond within the required 60 days, he or she will be denied
relief under this Stipulation, absent a finding of “good
cause” as set forth in
20 C.F.R.
§§ 404.911 and
416.1411. Any
responder not found to have “good cause” for an untimely
response will be so notified by SSA, with a copy of the notification sent
contemporaneously to class counsel.
SSA will also prepare and disseminate posters (Attachment B) to all SSA
field offices in the Tenth Circuit, for posting in such offices, informing
those class members described in Paragraph 1(a) (i) who are not entitled
to notice by mail,³ of their potential right to review of their
disability claims under the terms of this Stipulation. Posters will remain
displayed in the SSA field offices for a period of 120 days, and class
members will be required to advise SSA of their desire to have a
redetermination of their claims no later than 60 days after the poster
display period in the SSA field offices has ended. SSA will also provide
to class counsel a supply of posters, equal in number to those placed in
SSA's field offices, for posting in locations that class counsel determine
would best reach potential class members. Those class members described
in Paragraph 1(a) (i) who are not entitled to notice by mail and who do
not advise SSA of their desire to have a redetermination of their claims
within 60 days after the poster display period has ended, will be denied
relief under this Stipulation, absent a finding of “good
cause”. Any responder not found to have “good cause”
for an untimely response will be so notified by SSA, with a copy of the
notification sent contemporaneously to class counsel.
The claims files or other relevant SSA records of those individuals who
timely respond to the posters and mail notices will be screened to
determine if they are class members entitled to relief. To assess whether
the criteria in Paragraph 1(c) are met, the individual's claims file will
be reviewed to determine if the personalized denial notice, the residual
functional capacity form, the Psychiatric Review Technique Form, or a
separate rationale evidences the existence of a treating physician opinion
that is inconsistent with the decision to deny or terminate disability
benefits. If those documents do not indicate the existence of such an
opinion, the individual will be determined not entitled to relief under
this Stipulation. If the existence of an inconsistent opinion is
indicated, the claims file will be further screened to determine the
nature of the opinion. If the opinion is brief, conclusory, and
unsupported by the evidence, the individual will be determined not
entitled to relief. If the opinion is not brief, conclusory, and
unsupported by the evidence, the individual will be determined entitled to
relief, provided the other criteria in Paragraphs 1 and 2 are met.
Those individuals who are determined not to be class members entitled to
relief under this Stipulation will be notified in writing of such
determination and will be further informed of their right to a review, in
accordance with the procedures set forth in Paragraph 9 of this
Stipulation. Copies of said notices shall be sent contemporaneously to
class counsel.
Individuals who disagree with a finding that they do not meet the criteria
for class members entitled to relief may contact or write class counsel
for additional review. In turn, class counsel may, within 60 days of the
date of the notice referred to in Paragraph 8, notify in writing an
individual to be designated in the Office of the Chief Counsel, Region
VIII, Office of the General Counsel, Social Security Administration, Room
327, Federal Building, 1961 Stout Street, Denver, CO 80294-3538, that
review is desired of the individual's claims file or other records relied
upon by SSA in making the determination of non-entitlement to relief.
Subject to the requirements of the Privacy Act and other applicable
privacy statutes or regulations, within 30 days of receipt of class
counsel's written request to review such records, SSA will make that
individual's records available at an SSA field office convenient to class
counsel, and will notify class counsel in writing of file availability.
Such records will be available for review by class counsel for a period of
30 days. At the expiration of the 30 days, if class counsel still has not
reviewed the records, it shall be assumed that review is no longer
desired, and SSA's determination of non-entitlement to relief shall become
final and not subject to further review.
If class counsel's review of the relevant SSA records establishes that
there is a dispute as to whether the individual is a class member entitled
to relief, class counsel will notify the Office of the Chief Counsel,
Region VIII, by telephone or in writing, within 30 days of such review.
Both parties will then attempt to resolve the dispute. In the event the
parties are unable to resolve the dispute, class counsel may submit any
unresolved dispute to the Court in Adamson for
final resolution, by proper motion made within 30 days of the written
reaffirmation by the Office of the Chief Counsel of the prior
determination of non-entitlement to relief, and the defendant shall have
the opportunity to respond consistent with federal and local court rules.
Failure of class counsel to request a judicial determination within the
aforesaid 30-day period shall render final, and not subject to further
review, SSA's determination of non-entitlement to relief.
Those individuals who are found to be class members entitled to relief
under this Stipulation will be given a redetermination of their claims to
ascertain if the previous denial or termination was proper. If the file
evidence is inadequate to assess the individual's impairment(s) during the
time period covered by the previous denial or termination, SSA shall
attempt to secure and/or develop any further evidence that may be
necessary, in accordance with normal claims development procedures. SSA
also shall consider any additional medical evidence the class member may
submit that relates to the relevant period of time.
SSA shall evaluate the individual's claim in accordance with the statutes,
regulations, and instructions in effect at the time of the
redetermination. Should this review result in a finding that the previous
denial/termination was improper and that the individual should have been
found disabled, the claim of such individual will be reopened, with the
individual's claim of entitlement to benefits being determined through the
date of the new determination rendered. Upon such reopening, SSA shall
attempt to obtain updated medical records, and the individual shall
cooperate in this regard in accordance with the requirements of
20 C.F.R.
§§ 404.1512-.1519p and 416.912-.919p.
Except as noted in Paragraph 15 of this Stipulation, all redeterminations
shall be conducted at the reconsideration level of administrative review,
with determinations being appealable to an ALJ upon request made pursuant
to the procedures set forth at
20 C.F.R.
§§ 404.933 and
416.1433. Appeal
of an ALJ decision will be to the Appeals Council, upon request made
pursuant to the procedures set forth at
20 C.F.R.
§§ 404.968 and
416.1468. Class
members afforded relief under this Stipulation will retain rights to
judicial review as provided in 42 U.S.C.A. §§ 405(g) and 1383(c)
(1) and (3).
When processing redeterminations under this Stipulation, the DDS will give
such redeterminations no greater or lesser priority than other claims
processed by the DDS. Upon conclusion of the redetermination, SSA will
notify each class member of the outcome of the redetermination.
At the option of SSA, class members with subsequent disability claims
active and simultaneously pending at any administrative level of review at
the time the class claim is being evaluated may have all claims covered
by this Stipulation consolidated and reviewed with the current claim. SSA
will use its best efforts to ensure that adjudication of the current
claim is not delayed by such consolidation.
SSA shall use its best efforts to maintain by computerized tracking system
a record of the following information:
the number of class notices mailed;
the number of individuals responding to the notices;
the number of notices returned as undeliverable;
the number of individuals responding to the posters;
the number of individuals determined to be entitled to a redetermination
of their claims;
the number of individuals determined not to be entitled to a
redetermination of their claims;
the number of individuals who received favorable determinations by the
DDS;
the number of individuals who received unfavorable determinations by the
DDS.
SSA shall provide reports containing the information maintained in this
computerized tracking system to plaintiffs' counsel once every three
months commencing 180 days after the effective date of this Stipulation.
Upon request, plaintiffs' counsel will be provided with a random sample of
DDS decisions on class members' claims for inspection at a mutually
agreed upon SSA field office. Once the claim redeterminations required by
this Stipulation have been substantially completed and input into this
computerized tracking system, SSA shall so advise plaintiffs' counsel by
providing him with a final report.
The defendant agrees to pay attorneys' fees to class counsel in the total
amount of $57,539.67. Class counsel agrees to accept said payment as full
and final settlement of all attorneys' fees in this case for all time
incurred in the past and to be incurred in the future. Class counsel shall
require no further compensation for any additional work regardless of the
circumstances. Class counsel represents and warrants that he will
distribute the fees received among respective counsel involved in this
case now and in the past and will hold the defendant, her administrators,
and any department, agency, or establishment of the United States harmless
from any dispute over the proper allocation of attorneys' fees.
The terms set forth in this Stipulation shall be in full settlement and
satisfaction of any and all claims and demands, of whatever nature, the
plaintiffs had or may hereafter acquire against the defendant named in
this action, and her administrators or successors, and any department,
agency, or establishment of the United States and any officers, employees,
agents, or successors of any such department, agency, or establishment on
account of and with respect to the incidents, claims, or circumstances
giving rise to and/or alleged in the above-entitled action and as more
particularly set forth in the pleadings filed herein. Upon the Court's
approval of this Stipulation, the Complaint herein and any amendments
thereto and claims included therein shall be dismissed, with prejudice,
and the Court shall retain continuing jurisdiction in this action only
over matters relating to compliance with and enforcement of the terms of
this Stipulation.
Since this Stipulation is entered by agreement of the parties, as a means
of avoiding further litigation, the terms of this Stipulation shall not be
cited as precedent in any other case. This Stipulation is not and shall
not be construed as an admission by the defendant of the truth of any
allegation or the validity of any claim asserted in this action or of the
defendant's liability therein, nor is it a concession or an admission of
any fault or omission in any act or failure to act, or in any statement,
communication, report, instruction, rule, regulation, or other document
made or maintained by the defendant, nor shall it be construed by anyone
for any purpose whatsoever as an admission or presumption of any
wrongdoing on the part of the defendant. This Stipulation is not an
admission or finding that the position of the defendant was not
substantially justified or that the defendant is liable as a matter of law
for the payment of any attorneys' fees, expenses or costs.
Class counsel, by signing below, warrants and guarantees that he is sole
counsel to the plaintiff class and that he is duly authorized to stipulate
to the settlement of issues in this action on behalf of the plaintiff
class. Counsel for the defendant, by signing below, represents that he is
authorized to stipulate to the settlement of the issues in this action.
The entry of this Stipulation and accompanying Order, and the Clerk's
entry of final judgment in accordance with Rules 54, 58, and 79(a) of the
Federal Rules of Civil Procedure, shall be a condition precedent to any
obligation of any party pursuant to this stipulation. This Stipulation
shall become effective on the 61st day after such entry of final judgment;
provided however, that this Stipulation shall not be effective if an
appeal of the Court's entry of the Order or final judgment is filed, in
which event the Stipulation shall be effective only upon the expiration of
all the appeal periods subsequent thereto.
[DATE FILED:10/23/1995]
IN UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF COLORADO
Civil Action No. 84-S-2024
GERALD K. ADAMSON, et al.,
Plaintiffs,
and
FREDDIE BYNUM, BARBARA McGOWEN,
DANNY PHILLIPS and DOROTHY COSGROVE,
Plaintiffs/Intervenors,
v.
SHIRLEY S. CHATER,
Commissioner of Social Security,
Defendant.
__________________________________________________________________________
PRIVACY ACT PROTECTIVE ORDER
__________________________________________________________________________
Pursuant to 5 U.S.C.A. § 552a(b)(11),
42 U.S.C.A. § 1306(a), and 20 C.F.R. § 401.340, IT IS
HEREBY
ORDERED, that:
The defendant may disclose to plaintiffs' counsel information required to
be disclosed to them under the Stipulation executed by the parties in this
case that is subject to restrictions on disclosure under the Privacy and
Social Security Acts and other Federal law without obtaining the prior
written consent of the individual to whom such records pertain, for the
purposes of monitoring compliance with the Stipulation, facilitating
implementation of the Stipulation, and assisting class members and
potential class members in effectuating their rights under the
Stipulation. Such information consists of names, addresses, and claims
files of potential class members, and other claimant-specific information
reasonably relevant to the implementation of the Stipulation. In
accordance with the confidentiality requirements of 42 U.S.C.A. §
290dd-2 disclosure permitted under this paragraph does not extend to the
disclosure of patient drug and alcohol treatment records, unless the
affected claimant provides specific written consent to the disclosure of
such records.
Plaintiffs' counsel shall use the information disclosed pursuant to
paragraph 1 of this Order only for the purposes described above. Except as
provided in paragraph 4 of this Order, plaintiffs' counsel shall not make
disclosures of such information except: (1) to each other; (2) to
non-attorney members of the staff of plaintiffs' counsel; (3) to the
defendant or her agents or counsel; (4) to the Court in this action; or
(5) to other persons participating in the accomplishment of the purposes
described in paragraph 1. Any disclosure to persons described in items (2)
and (5) of the preceding sentence shall be conditioned upon such persons
having read this Order and acknowledged in writing that they understand
the Order and agree to be bound by it. Additionally, plaintiffs' counsel
may disclose information pertaining to particular class members or
potential class members to those particular individuals or to
representatives acting on behalf of such individuals.
Plaintiffs' counsel and members of their staff shall limit the making of
copies of the records disclosed pursuant to paragraph of this Order to
those necessary to the purposes described in paragraph 1. All such copies,
and any documents created by plaintiffs' counsel or any member of their
staff that contain information disclosed pursuant to paragraph 1, shall be
kept confidential, consistent with the Rules of Professional Conduct. All
such copies and documents concerning individuals who do not individually
engage class counsel's assistance shall be destroyed upon the completion
of implementation of the Stipulation.
Nothing in this Order shall prejudice the rights of plaintiffs' counsel to
use the information that they receive pursuant to the Stipulation in this
action that is not subject to restrictions on disclosure contained in the
Privacy and Social Security Acts, or their rights to use information
obtained outside of the context of the Stipulation.
Failure to comply with this Order shall subject the responsible individual
and/or his or her attorney to appropriate sanctions by the Court,
including a finding of contempt.
This Order does not constitute any agreement or ruling as to the
discoverability or admissibility of any record or information.
Case No. 84-S-2024
CERTlFICATE OF MAILING
I hereby certify that a copy of the PRIVACY ACT PROTECTIVE ORDER signed by
Judge Daniel B. Sparr and filed on October 23, 1995, was mailed on
October 24, 1995, to the following:
R. Eric Solem1 Esq.
3300 East First Avenue
Suite
370
Denver, CO 80206
Chalk S.
Mitchell
Assistant
U.S. Attorney
Carol S. Prescott
Assistant
Regional Counsel HHS
1106 Byron G. Rogers Building
Denver,
CO 80294
Kade McClure, Esq.
Legal Aid
of Western Oklahoma, Inc.
621 D Avenue
Lawton,
OK 73501
Perry Franklin, Esq.
Legal
Services in Southeast Kansas
P.O. Box 1509
Pittsburgh,
KS 66762
Magistrate Judge 0. Edward
Schlatter
Attachment A
SOCIAL
SECURITY Important
Information
NOTICE________________________________________________________
From:
The Social Security Administration
READ CAREFULLY - PLEASE RESPOND TO THIS NOTICE WITHIN 60 DAYS
We are writing to let you know about a Federal court case called
Adamson v. Chater affecting individuals whose
claims for disability benefits were denied or terminated while they lived
in Wyoming, Utah, Colorado, Kansas, Oklahoma, or New Mexico. Because of
this case, you may ask us to review our earlier decision denying your
claim for disability benefits.
You can ask us to look at your claim again. If you want us to do so, you
must fill out the enclosed reply form and send it to us within 6 days. If
you do not return the form within 60 days, we may not review your claim
unless you have good cause for not returning it on time. If we find that
you qualify, we will review your case again and send you a notice about
the results of your review. We will also let you know if you do not
qualify for a review.
IF YOU NOW GET MONEY FROM SOCIAL SECURITY
Even if you now get money from Social Security, we still may owe you more
for an earlier claim for disability which was denied or terminated. Return
the reply form within 60 days if you want us to look at your prior claim
and determine whether you qualify for a review of the earlier
decision.
IF YOU HAVE QUESTIONS
If you have any questions, you may contact your local Social Security
office. The address and phone numbers are printed at the top of this
notice. If you call or visit a Social Security office, please take this
notice with you. It will help us answer your questions.
Additionally, if you have or had someone helping you with your claim, you
should contact him/her for assistance. You also may contact one of the
Legal Aid offices in your area or you may contact the lawyer in this
case:
R. ERIC SOLEM
Law Offices of R. Eric Solem, P.C.
3300 East First
Avenue, Suite 370
Denver, CO 80206
Tel: (303) 321-5544
Enclosures:
Reply Form and Envelope
Si usted no entiende esta informacion relacionada con sus beneficios de
incapacidad, piadle a un representante que se la traduzca.
Attachment B
A SPECIAL NOTICE FROM SOCIAL SECURITY TO PEOPLE WHO WERE DENIED DISABILITY
BENEFITS WHILE THEY LIVED WYOMING, UTAH, COLORADO, KANSAS, OKLAHOMA, OR
NEW MEXICO ANY TIME BETWEEN OCTOBER 17, 1964 AND APRIL 9,1987
You may be entitled to disability benefits from Social Security because of
a court case called Adamson v. Chater (D. Colo.)
The court-approved settlement in the Adamson
case provides that Social Security may review your claim IF:
between October 17, 1984, and April 9, l987, Social Security decided you
were able to return to work and turned down your request for
reconsideration of:
the denial of your application for Social Security or Supplemental
Security Income (SSI) disability benefits, OR
the decision to terminate your Social Security or Supplemental Security
Income disability benefits, AND
there was an opinion in your claims file from your doctors or other
acceptable medical source saying that you were disabled, AND
you did not appeal the reconsideration decision to an Administrative Law
Judge
If you think you meet these requirements and qualify for review of your
claim, contact your nearest Social Security office by ________199_. Tell
them you think you might be an Adamson class
member. Have your Social Security number ready to give them. If you have a
letter from Social Security denying your claim or stopping your benefits,
take it with you. If you are eligible for a review or your claim and
Social Security decides that you were or are disabled, you may receive
back benefits.
This notice does not fully describe all of the rights or limitations which
exist under the Adamson case. You may obtain
further information by contacting your nearest Social Security office,
local legal aid office, or class counsel. Any Social Security office can
give you this information.
IMPORTANT. It's up to you to notify Social Security if you think you might
be eligible for review of your claim
DON'T WAIT. ACT NOW.
Si usted no entiende esta informacion relacionada con sus beneficios de
incapacidad, pidale a un representante que se la traduzca.
Destruction
Date: (120 days from issuance)
¹Pursuant to Pub. L. No. 103-296, the Social Security Independence
and Program Improvements Act of 1994, the function of the Secretary of
Health and Human Services in Social Security cases was transferred to the
Commissioner of Social Security effective March 31, 1995. In accordance
with section 106(d) of Pub. L. No. 103-296, Shirley S. Chater,
Commissioner of Social Security, should be substituted for Donna E.
Shalala, Secretary of Health and Human Services, as the defendant in this
action. No further action need be taken to continue this suit. Id.
²For ease of reference in this Stipulation, the term “step 4 or
5 of the sequential evaluation process” also refers to cases where
disability benefits were terminated because the claimant could engage in
past relevant work or other work. The ability to engage in past relevant
or other work is actually assessed at step 7 or 8 of the sequential
evaluation process used in continuing disability review cases.
³Class members described in Paragraph 1(a) (i) who are not entitled
to notice by mail include those whose claims were denied/terminated
between the dates of October 17, 1984, and April 9, 1987.
A separate screening sheet must be prepared for each claim number noted
above.
PAYEE ADDRESS
SHIP TO ADDRESS:
Office of Disability Determinations
State of Claimant's
Residence
SPECIAL INSTRUCTIONS:
IF CURRENT CLAIM IS PENDING OR STORED IN OHA HEADQUARTERS OR FEDERAL
DISTRICT COURT, THEN SHIP FOLDER(S) TO:
Office of Hearings and Appeals
Office of Appellate Operations
(OAO)
One Skyline Tower, Suite 701
5107 Leesburg Pike
Falls
Church, VA 22041-3200
ATTN: OAO Class Action Coordinator
(Case locator code 5007)
IF CURRENT CLAIM IS PENDING IN AN OHA HEARING OFFICE, THEN SHIP FOLDER(S)
DIRECTLY TO THAT OFFICE
This claimant may be an Adamson class member. The
attached folder location information indicates that a current claim file
is pending or stored in your office. Accordingly, pursuant to
HALLEX Temporary Instruction 5-4-55, we are forwarding [the
attached alert] or [the attached alert and prior claim
file(s)] for association, screening for class membership,
consolidation consideration if appropriate and possible
readjudication.
Adamson Screening Sheet Instructions
General Instructions
A separate screening sheet must be prepared for each claim number
identified on the alert. Make sure that the claim number, BIC/ID and SSN
are the same as on the alert, to ensure proper case clearance.
Consider all title II and XVI claims (denials/cessations) finally
decided during the period October 17, 1984, through July 31, 1991,
inclusive, that are covered by the class.
If the claim file has been destroyed or declared lost, determine if the
case may be screened out solely on the basis of information shown on the
queries.
EXAMPLE 1: SSIRD shows title XVI claim(s) denied for excess income and
resources. FACT shows title II claim denied because insured status not met
at any time, or alleged onset date occurred more than one year after
insured status was last met (disallowance code 90). The claim would be
screened out at question No. 7. because the individual did not receive a
medical denial.
EXAMPLE 2: SSIRD shows title XVI claim was denied initially but
subsequently allowed at the reconsideration or OHA level with no change in
date of eligibility. The claim would be screened out at question No. 7.
if it were allowed at the reconsideration level, and question No. 10. if
it were allowed at the OHA level or above.
Any case that cannot be conclusively screened out on the basis of
the queries must be sent to the FO for reconstruction.
Items 1 - 5
Fill in the claimant's SSN, regardless of whether it is the SSN under
which the claimant applied for or received benefits. Also fill in the SSN
under which the claimant pursued benefits, along with the BIC or ID (i.e.,
the claim number) from the alert package. If the claimant's name has
changed since the original application(s) was adjudicated, indicate the
claimant's former name in parentheses. Obtain the claimant's date of birth
from the alert package.
Item 6
Complete this item after case screening. Check one block in item 6. a.
and, if appropriate, enter the two-digit screen-out code in item 6. b.
Item 7
The certified class excludes applicants for widow's, surviving divorced
spouse's or widower's disability benefits under title II. Any other
disability claim medically denied or ceased under titles II and/or XVI, is
eligible for class membership consideration. A claimant may meet any of
three thresholds for the receipt of a final
determination/decision. At the DDS level, the determination within the
appropriate timeframes must have been at the reconsideration
level. Determine the date of the DDS denial from the date on the
SSA-831/833-U3. At the OHA level, a claimant may have received either a
decision or an Appeals Council denial of review within the appropriate
timeframes. A dismissal at the OHA level, or an Appeals Council remand (if
they are the only OHA actions within the OHA timeframes) will not
establish class membership. However, in the case of a dismissal, the
claimant may be eligible for class membership on the basis of the
reconsideration determination, i.e., the claimant has received a
“final” adjudication (as long as it was received during the
class timeframes).
Item 8
The claimant must have been a resident of the 10th Circuit at the time the
determination/decision was issued. Some OHA hearing offices outside of
the 10th Circuit have jurisdiction to hear claims of 10th Circuit
residents. Determine residency by review of the claimant's mailing
address. However, if there is any indication in the file that the
claimant actually resided outside of the 10th Circuit when the potential
class member claim(s) was decided, residency must be developed. Telephone
contact with the potential class member may resolve any residency issue
or, if necessary, the field office should be asked to investigate.
Item 9
The claimant must have received a determination/decision which required
the evaluation of residual functional capacity (RFC) (i.e., a
determination/decision at step 4 or 5 of the sequential evaluation) (for
cessation cases, a similar determination/decision occurs at step 7 or 8.)
Review the SSA-831-U3 (item 22), other denial form or the ALJ's or Appeals
Council's decisional findings to determine the basis for denial. On the
SSA-831-U3, look for basis denial codes for title II of H1, H2, J1 and J2;
for title XVI of N31, N32, N42 and N43. If potential class membership is
based on Appeals Council denial of review, the ALJ decision for which
review was denied must have been based on step 4 or 5 (or step 7 or 8 for
cessation cases).
Item 10
This class relief exception applies only if the individual has received
all benefits to which he or she could be entitled based on all potential
class member claims. Review the file to determine whether benefits were
subsequently allowed or continued from the earliest alleged onset date or
cessation date for each claim decided within the timeframes for class
membership. The allowance or continuance could have been either on the
same or a subsequent claim.
Item 11
Claimants who: 1) filed a subsequent claim; and 2) received a
determination/decision during certain time periods may not be eligible for
class relief if the determination/decision covered the entire time period
at issue in all potential class member claims. The determination/decision
need not have been made at step 4 or 5 of the sequential evaluation
(i.e., the denial could have been based on steps 1 or 2.) However, a
subsequent determination at the DDS level may be a basis for screen-out
only if it was issued under the CE/MER regulations (i.e., on or after
August 1, 1991). A subsequent decision at the OHA level may be a basis
for screen-out if it was issued prior to April 10, 1987, or after June
27, 1988. Do not check “Yes” for item 13 unless the answer is
“Yes” for all claims being screened.
Item 12
Examine the entire file(s) for any evidence that the claimant is or could
be a member of the Luna,
Peck, Trujillo or
Zebley class actions (e.g., a reply form,
screening sheet or alert). Any readjudication under another class action
must have covered the entire time period at issue in
Adamson for the screen-out to apply.
For cases decided at the DDS level, review block 34 on the SSA-831 for a
remark concerning readjudication as a result of other class action
reviews. In addition, the SSIRD carries an indicator of “ZEB”
in the AP line that identifies claims readjudicated under
Zebley.
If screening or readjudication under the subject class actions is pending,
such screening and/or readjudication, as necessary, will be completed at
the same time as action on the Adamson claim.
(Review HALLEX
I-1-7-08 ff for
applicable consolidation instructions.) Contact the
Adamson coordinator in Litigation Staff if
information is needed concerning a claimant's membership or prospective
membership in the subject class actions.
A denial of class membership under the above-mentioned class actions does
not constitute a basis for screen-out under
Adamson.
Item 13
Review the file(s) to determine if the personalized denial notice, RFC
form, Psychiatric Review Technique Form or a separate rationale indicates
the existence of a treating physician opinion that is inconsistent with
the determination/decision to deny or terminate benefits. If those
documents do not indicate the existence of such an opinion, the individual
is not eligible for relief. If there is such an opinion, review it to
determine its nature. If the opinion is brief, conclusory and
unsupported by the evidence, the claimant is not entitled to relief. Any
question with respect to whether the opinion is brief, conclusory and
unsupported by the record should be resolved in favor of the claimant;
that is, the claimant should be found entitled to relief.
A treating physician's opinion dated after the date of the final
determination/decision on the potential Adamson
claim, i.e., the opinion was not considered when the potential
Adamson claim was adjudicated, is not qualifying
for class membership consideration.
Processing Class Member Determinations
Be sure to check the “Member” block in item 6. a. of the
screening sheet.
In item 15. of the screening sheet, show the date of each application
screened and the corresponding date and level of adjudication. Check the
block for each claim that confers class membership.
Sign and date the screening sheet. Enter the name of the screening
component, e.g., OHA, OAO, Branch XX, and the screener's phone number.
Retain the original screening sheet in the claim file. OHA Headquarters
components and hearing offices will send a copy of the screening sheet
to:
Office of Hearings and Appeals
Office of Appellate Operations
One
Skyline Tower, Suite 701
5107 Leesburg Pike
Falls Church, VA
22041-3200
Attn: OAO Class Action Coordinator
HO components may also forward screening sheet copies to DLAI by telefax
to (703) 305-0655.
[The Class Action Coordinator will enter the screening sheet
information from the screening sheet into a data base and forward the
screening sheet to the Division of Litigation Analysis and Implementation
(DLAI). DLAI will retain a copy of each screening sheet received from the
OAO Class Action Coordinator or an HO and forward a copy to the
Litigation Staff at SSA Central Office for entry into the Civil Action
Tracking System.]
Follow HALLEX I-5-455, Part VI.
Processing Non-class Member Determinations
Be sure to check the “Nonmember/Member Not Entitled to
Relief” block in item 6. a. of the screening sheet and enter the
screen-out code in item 6. b.
Follow items b. - d. above.
Prepare and issue the “Non-Class Membership Notice”
(Attachment 6). Retain a copy of it in the claim file, and mail a copy to
the Adamson class counsel and claimant's
representative, if any. Forward the claim file(s) as indicated in
HALLEX I-5-455, Part V. B. 3. a.
REMARKS
OHA received the attached alert [and prior claim file(s)] for
screening and no longer has the current claim file. Our records show that
you now have possession of the current claim. Accordingly, we are
forwarding the alert and any accompanying prior claim file(s) for
association with the current claim. After associating the alert with the
current claim, please forward to the DDS for screening and possible
readjudication. SEE POMS DI 42534.010 OR DI 12534.005A.3.
and/or HALLEX I-5-455, Part V. B. 2.
DO NOT use this form as a RECORD of approvals, concurrences, disposals,
clearances, and similar actions.
OPTIONAL FORM 41 (Rev. 7-76)
*U.S.GPO:1985-0-461-274/20020
Prescribed by GSA
FPMR
(41 CFR) 101-11.206
You asked Social Security to look again at your prior claim for disability
benefits. We have looked at your case. You are not eligible for review
under the Adamson court case for the reason given
below. This means that we will not review your claim.
You are not entitled to review under Adamson
because:
We Are Not Deciding If You Are Disabled
It is important for you to know that we are not making a decision about
whether you are disabled. We are deciding only that you are not eligible
for review under Adamson v. Chater.
If You Do Not Agree With This Determination
If you want us to review our determination that you are not entitled to
relief under the Adamson case, you may contact
the class attorney, who will answer your questions about class
membership. If the attorney thinks this determination is incorrect, he
has 60 days from the date of this letter to ask us to look at your case
again. The name, address and telephone number of the attorney are:
R. Eric Solem, Esq.
Law Offices of R. Eric Solem, P.C.
3333 South
Bannock Street
Suite 910
Englewood, CO 80110
Telephone: (303) 761-4900
If You Think You Are Disabled Now
If you think you are disabled now, you may file a new application. A new
application is not the same as asking us to review your claim under
Adamson. In the new application you may not be
able to receive disability benefits for the period of time you asked for
in your prior claim. If you decide to file a new application, contact any
Social Security Office.
If You Have Any Questions
If you have any questions, you may call us toll-free at 1-800-772-1213, or
call your local Social Security Office. The address and phone number are
printed at the top of this letter. We can answer most questions over the
phone. You can also write or visit any Social Security Office.
If you 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. You may also contact your personal legal representative, if you
have one, or the Adamson attorney listed
above.
Si usted no entiende esta informacion relacionada con sus beneficios de
incapacidad, pidale a un representante que se traduzca.
cc: R. Eric Solem, Esq.
REMARKS
Adamson Case
We have determined that this claimant is not eligible for
Adamson class relief. (See screening sheet and
copy of notice of non-eligibility for relief in the attached claim
file(s).) SEE POMS DI 12534.010 As requested, we are
forwarding the file(s) for class counsel's review.
DO NOT use this form as a RECORD of approvals, concurrences, disposals,
clearances, and similar actions.
Colorado
888 West Ithaca
Englewood, CO 80110
Kansas
1201 Van Buren
Topeka, KS 66612-1336
New Mexico
1911 Fifth Street
Santa Fe, NM 87505
Oklahoma
Shepherd Mall
2615 Villa Prom
Oklahoma City, OK 73107
Utah
Room 2410
Second Floor Federal Building
324 25th Street
Ogden,
UT 84402
Wyoming
Room 2001
100 East B Street
Casper, WY 82601
Adamson Class Action Case
READJUDICATION NECESSARY
This claimant is an Adamson class member. After
expiration of the retention period, forward claim file(s) to the DDS for
readjudication.
[Send folders to the DDS.]
If the claimant has filed a civil action and elected to remain in court
for review of the current claim, forward the
Adamson claim file(s) without delay to the DDS
for readjudication.
This case is before the Administrative law Judge pursuant to a request for
hearing filed on _____________ with respect to the application(s) filed
on ______________.
In accordance with the Stipulation of the parties and an order of the
United States District Court for the District of Colorado in the case of
Adamson v. Chater, No. 84-S-2024 (D. Colo.
December 21, 1995), the claimant has requested readjudication of the
final (determination/decision) on the prior applications filed on
____________. The claimant has been identified as an
Adamson class member and is entitled to have the
final administrative denial of the prior application(s) reviewed under
the terms of the Stipulation. Because the claimant's current claim shares
certain issues in common with the prior claim, the undersigned hereby
dismisses without prejudice the request for hearing.
The claimant's current application(s) will be associated with the prior
claim(s) and forwarded to the Disability Determination Service, which will
conduct the Adamson readjudication. The
Disability Determination Service will notify the claimant of its new
determination and of the claimant's right to file a new request for
hearing.
Claimant's Name
Address
City, State Zip
Enclosed is an order of the Administrative Law Judge dismissing your
request for hearing and returning your case to the Disability
Determination Service, which makes disability determinations for the
Social Security Administration. Please read this notice and Order of
Dismissal carefully.
What This Order Means
The Administrative Law Judge has sent your current claim and your
Adamson class member claim back to the Disability
Determination Service for further processing. The enclosed order explains
why.
The Next Action on Your Claim
The Disability Determination Service will contact you to tell you what you
need to do. If you do not hear from the Disability Determination Service
within 30 days, contact your local Social Security Office.
Do You Have Any Questions?
If you have any questions, contact your local Social Security Office. If
you visit your local Social Security Office, please bring this notice and
the Administrative Law Judge's Order with you.
Enclosure
cc:
(Name and address of representative, if any)
(Social Security Office (City, State))
This claimant is an Adamson class member. The
attached Adamson claim file was forwarded to this
hearing office for possible consolidation with a current claim.
Accordingly, we are forwarding the attached alert and prior claim file(s)
to your location for any necessary Adamson
readjudication action.
We are sending the alert and prior file(s) to: