I-5-4-63.Laird v. Stilwill
| Purpose | |
| Background | |
| Definition of the Class | |
| Processing Instructions | |
| Inquiries | |
| Final Order Approving Settlement; Filed with the United States District Court for the Northern District of Iowa on April 2, 1999 and Approved by the Court on November 10, 1999. |
Issued: November 3, 2000
I. Purpose
This Temporary Instruction advises OHA adjudicators of the Final Order entered by the United States District for the District of Iowa on November 10, 1999, approving the parties' settlement agreement in the Laird v. Stilwill class action. The Laird class action involved alleged deficiencies by the Iowa Disability Determination Services (DDS) regarding its actions and procedures in processing disability cases.
The final settlement order does not require OHA to process cases any differently. However, we are providing these instructions for informational purposes. Program Operation Manual System instructions have been printed and distributed to advise field office and Disability Determination Service adjudicators of their responsibilities under the Laird settlement agreement.
II. Background
On February 15, 1995, plaintiffs filed a statewide class action complaint against the director of the Iowa DDS and challenged the standards, policies and procedures that the defendant uses in determining disability for Social Security purposes. Specifically, plaintiffs alleged that the Iowa DDS: 1) did not properly evaluate the claimant's subjective complaints under 20 CFR §§ 404.1529 and 416.929 and Polaski v. Heckler, 739 F.2d 1320, 1322 (8th Cir. 1984), supplemented, 751 F.2d 943, 948 (8th Cir. 1984); 2) did not give the proper weight to the well-supported opinion of the treating physician, contrary to 20 CFR §§ 404.1527 and 416.927 and Ghant v. Bowen, 930 F.2d 633 (8th Cir. 1993); and 3) did not utilize the services of a qualified vocational specialist in evaluating the claimant's claim contrary to 20 CFR §§ 404.1569a(d) and 416.969a(d), McCoy v. Schweiker, 683 F.2d 1138 (8th Cir. 1983) and Social Security Ruling (SSR) 83-14. Plaintiffs requested declaratory relief, a preliminary and permanent injunction and redeterminations for all class members.
On April 24, 1995, the court denied the State defendant's motion to dismiss. The court held that it had subject matter jurisdiction over plaintiffs' claims under 42 U.S.C. § 1983, despite provisions for appeal and review of individual disability determinations and Federal oversight of the State agency. On April 25, 1995, the court held a hearing on plaintiffs' motion for class certification and conditionally certified a class. On May 22, 1995, the court granted SSA's motion to intervene and found that plaintiffs' request for a preliminary injunction was moot. Following this decision, the parties commenced discovery and plaintiffs deposed various SSA officials.
On April 24, 1996, plaintiffs filed an amended complaint to delete the second allegation listed in the original complaint and to add allegations that the DDS: 1) did not make express credibility determinations and set forth inconsistencies in the record which led it to reject the claimant's complaints of pain and 2) assessments of residual functional capacity were not documented to support a conclusion concerning what the claimant could perform in a work setting, were not fully responsive to the claimant's statements and did not contain detailed assessments of an individual's capacity to perform and sustain activities critical to work performance contrary to 20 CFR §§ 404.1545-46 and 416.945-46 and SSR 85-16 and SSR 82-53. The amended complaint also added a new plaintiff and noted several facts that had changed since the filing of the additional complaint (e.g., the award of benefits to Paula Laird, the conditional certification of the class and the Commissioner's intervention).
In 1997, both parties filed motions for summary judgment. On June 12, 1997, the district court issued an opinion and order concerning the parties' summary judgment motions. In its opinion, the court found evidence that the Iowa DDS did not properly evaluate plaintiffs' subjective complaints and did not follow Polaski v. Heckler and Social Security Ruling 96-7p (Titles II and XIV: Evaluation of Symptoms in Disability Claims: Assessing the Credibility of an Individual's Statements). The court also found that although it appeared that the DDS did not make express credibility determinations in the past, it was unknown what impact SSRs 96-7p and 96-8p (Titles II and XVI: Assessing Residual Functional Capacity in Initial Claims) (which were published on July 2, 1996) would have on the manner the DDS makes credibility determinations in the future. Further, the court found that a genuine issue of fact existed as to whether the individuals who evaluate disability claims and make vocational determinations are “vocational specialists” and are qualified to perform their assigned jobs and whether DDS employees prepare adequate residual functional capacity forms. The court ordered SSA to conduct several studies to help resolve these issues. The court also found that defendants had not offered a legitimate reason for following a nonacquiescence policy. On August 18, 1997, the Federal defendant filed a memorandum in support of its motion for reconsideration of the court's June 1997 order which dealt with plaintiffs' claim that the State defendant failed to properly evaluate subjective complaints of pain in making disability determinations.
On October 27, 1997, the court issued a decision on the State and Federal defendants' motions to reconsider its prior order in which it found that it had jurisdiction and to reconsider its prior order which granted partial summary judgment to plaintiffs. The court found that it had no ground in which to alter, amend or reverse its prior rulings. The court concluded that even in light of Blessing v. Freestone, 117 S. Ct. 1353 (1997), titles II and XVI of the Social Security Act do not, on the basis of their remedial schemes or Federal oversight of State agency determinations, preclude an action pursuant to 42 U.S.C. § 1983 to enforce proper standards under the Act. (In Blessing, the Supreme Court held that a plaintiff cannot bring an action under 42 U.S.C. § 1983 and sue a State defendant for its systematic failure to apply the Federal regulations and laws of a Federally funded program.) Furthermore, the court reaffirmed its conclusion that the Agency's regulations are internally inconsistent in the treatment of evidence of subjective pain in disability determinations, and thus, do not state the standard dictated by the decisions of the Eighth Circuit. The court also reaffirmed its conclusion that there is no genuine issue of material fact that the State defendant does not follow the proper standard in evaluating subjective pain evidence.
On April 2, 1999, the parties filed a jointly negotiated settlement proposal with the court. The proposal provided that, subject to certain exceptions, class members whose claims were denied by the Iowa Disability Determination Service at steps four or five of the sequential evaluation process, on or after December 17, 1994 and before January 1, 1999 and who did not appeal to OHA will receive a redetermination of their claims. On July 27, 1999, the court gave its preliminary approval to the parties' settlement agreement. Notice of the pending settlement agreement was published in The Des Moines Register. In addition, SSA posted notice of the proposal in the district offices where The Des Moines Register is not delivered. In addition, the district court posted the notice along with the proposed settlement agreement and amendment to the agreement on its website. On November 8, 1999, the court conducted a hearing on the fairness of the proposal, and, on November 10, 1999, the court finally approved the settlement agreement (see attachment).
III. Definition of the Class
Subject to the exclusions in Part III B., Laird class members eligible to request relief are:
All Iowa residents who:
received a final medical-vocational denial at step four or five of the sequential evaluation process in 20 CFR §§ 404.1520 and 416.920 by the Iowa DDS on or after December 17, 1994 through December 31, 1998 and
apply for title II and/or title XVI disability benefits within one year of January 9, 2000 (the effective date of the settlement order); and
receive a medical allowance on their application.
NOTE:
The settlement agreement became final on January 9, 2000. The last date to file an application for title II and/or title XVI disability benefits under this settlement agreement is January 9, 2001.
any Iowa resident who has a claim for title II and/or title XVI disability benefits pending at any administrative level or in Federal court on January 9, 2000, who subsequently receives a medical allowance on that claim, and who had a prior application that meets the requirements in Part III. A. 1. (first bullet); or
any Iowa resident currently receiving title II and/or title XVI disability benefits on January 9, 2000 and who had a prior application that meets the requirements in Part III. A. 1. (first bullet); or
any Iowa resident who applies for title II and/or title XVI disability benefits within one year of January 9, 2000 and whose application is denied as res judicata at any administrative level and who had a prior application that meets the requirements in Part III. A. 1. (first bullet).
A person is not a Laird class member eligible to request relief if he or she:
has already received a final subsequent award of benefits with respect to the same time period at issue in the class claim (Although the period at issue in the class claim can be prior to December 17, 1994, the adjudication of the class claim only had to occur on or after December 17, 1994 through December 31, 1998); or
appealed the denial of his/her class claim to an Administrative Law Judge (ALJ), the Appeals Council (AC) or to Federal court; or
received a subsequent disability determination after December 31, 1998 that adjudicated the same time period covered by the class claim; or
applied for childhood disability benefits, regardless of whether he or she applied under title II and/or title XVI; or
is not eligible for relief for reasons unrelated to disability.
IV. Processing Instructions
At the OHA level, the Laird settlement agreement does not require any difference in the processing of class member claims. OHA should follow the normal processing and adjudication procedures. In addition, unlike other class action processing instructions, OHA does not have any screening responsibilities pursuant to the settlement agreement and the consolidation of Laird claims with subsequent claims should not arise.
If the potential class member has a claim pending at any administrative level or in Federal court on January 9, 2000, and that claim is subsequently allowed, the potential class member will later be sent a notice that he or she may be entitled to a redetermination of the Laird period denial. The notice will include a reply card to request the redetermination.
V. Inquiries
Hearing Office personnel should direct any questions to their Regional Office. Regional Office personnel should contact the Division of Field Practices and Procedures in the Office of the Chief Administrative Law Judge at (703) 605-8530. OHA Headquarters personnel should contact the Special Counsel Staff at 605-8250.