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HALLEX I-1-790

Office of Hearings and Appeals

Social Security Administration (S.S.A.)

Department of Health and Human Services

Volume I

Division I: General Subjects

Subject: Class Action Implementation

Chapter: I-1-700

June 30, 1994

Current through March 1997

I-1-790 EXHIBITS

1. Sample Alert

2. Sample Notice to Claimant--Class Member Claim and Subsequent (Current) Claim Have No Issues in Common

3. Case Flag--DDS Readjudication Necessary--Claims Not Consolidated

4. Sample Order of Dismissal

5. Case Flag--DDS Readjudication Necessary on Expiration of OHA Retention Period

6. Sample Notice to Claimant--Subsequent (Current) Claim and Class Member Claim Have No Issues in Common

7. Text for Appeals Council Remand to DDS--Class Member Claim(s) Associated with Current Claim on Which Appeals Council Would Take Unfavorable Action

8. Text for Appeals Council Remand to DDS--Class Member Claim Pending Appeals Council Review--Appeals Council Finds Unrelated Basis for Remand

9. Text for Appeals Council Remand to DDS--Class Member Claim Pending Appeals Council Review--Appeals Council Would Take Unfavorable Action

10. OCA Class Action Report

11. OCA Class Action Report--Rehandled Cases

Exhibit 1

Sample Alert

COURT CASE FLAG/ALERT

TITLE: CATEGORY:

REVIEW OFFICE PSC MFT DOC ALERT DATE

FUN NAME

SSN OR HUN RESP DTE TOE

000"00"0000

FOLDER LOCATION INFORMATION

TITLE CFL CFL DATE ACN PAYEE ADDRESS

SCREENING OFFICE ADDRESS:

DHHS, SSA

IF CLAIM IS PENDING IN OHA, THEN SHIP FOLDER TO:

OFFICE OF HEARINGS AND APPEALS

OFFICE OF CIVIL ACTIONS, DIVISION __

ONE SKYLINE TOWER, SUITE ___

5107 LEESBURG PIKE

FALLS CHURCH, VA 22041-3200

ATTN: SCREENING UNIT

CURRENT PAY: ________ YES ________ NO

Exhibit 2

Sample Notice to Claimant--Class Member Claim and Subsequent (Current) Claim Have No Issues In Common

On ____________, you filed a claim for benefits under ((title II) (title XVI) or (titles II and XVI)) of the Social Security Act. As you know, you have requested a hearing on that claim.

We have also received your prior claim(s) filed on ____________, for which you requested review under the ______________ class action. (We have determined that you are a member of the class.) However, we have reviewed (both or all) claims and have decided not to combine them for adjudication purposes. Therefore, we are returning your prior claim(s) to the (name of state, e.g., Tennessee) Disability Determination Service for appropriate action under the ___________ class action.

We will continue to process your request for hearing in connection with your claim of ___________ and notify you of the results of our action. (Modify the following sentence as necessary.) This office will communicate with you at a later date concerning the scheduling of a hearing.

If you have any questions concerning your prior claim(s), please contact your local Social Security Office.

Exhibit 3

Case Flag--DDS Readjudication Necessary--Claims Not Consolidated

___________ Class Action Case

READJUDICATION NECESSARY

Claimant's Name:______

SSN: ______

This claimant is a ________ class member. The attached claim file(s) was forwarded to this hearing office for possible consolidation with a current claim.

______ The Administrative Law Judge has determined that the prior and current claims do not share a common issue and, therefore, should not be consolidated.

OR

______ The claims have not been consolidated because: ______

Accordingly, we are forwarding the attached alert and prior claim file(s) to your location for any necessary readjudication action.

We are sending the alert and prior file(s) to:

___

Destination code: ______

Exhibit 4

Sample Order of Dismissal

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 reviewing the claimant's request for hearing, the undersigned has also reviewed the prior (inactive) claim(s) that the claimant requested SSA to readjudicate under the ___________ class action. The undersigned has determined that the subject claims have common issues and that consolidation at the (name of state, e.g., Tennessee) Disability Determination Service is appropriate. Accordingly, 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 (name of state, e.g., Tennessee) Disability Determination Service, which will conduct the required readjudication.

If the Disability Determination Service issues a determination that is unfavorable, either in whole or in part, it will advise the claimant of the right to file a new request for hearing.

Exhibit 5

Case Flag--DDS Readjudication Necessary on Expiration of OHA Retention Period

_____________ Class Action Case

READJUDICATION NECESSARY

Claimant's name: ______

SSN: ______

This claimant is a __________ class member. After expiration of the retention period, forward claim file(s) to the DDS for readjudication.

[Send folders to the appropriate DDS.]

[NOTE: If the claimant has filed a civil action and elected to remain in court for review of the current claim, forward the prior (inactive) claim file(s) without delay to the DDS for readjudication.]

Exhibit 6

Sample Notice to Claimant--Subsequent (Current) Claim and Class Member Claim Have No Issues in Common

On ____________, you filed a claim for benefits under ((title II) (title XVI) or (titles II and XVI) of the Social Security Act. That claim was forwarded to the ____________ Disability Determination Service for adjudication. On ____________, we notified you that you are also a class member under the ____________ class action, and indicated that we would readjudicate your claim filed on ____________. That claim has been assigned to me for a hearing.

To process your claims more expeditiously, the (name of state, e.g., Tennessee) Disability Determination Service forwarded your (insert date of subsequent (current) claim) claim to this office to consider combining it with your claim of ____________. I have reviewed (both or all) claims and have determined that the claims do not have issues in common which would permit them to be combined. Therefore, I am returning your (insert date of subsequent (current) claim) claim to the Disability Determination Service.

The Disability Determination Service will complete its adjudication of your (insert date of subsequent (current) claim) claim and notify you of the results. I will separately review your claim of ____________ and notify you of the results. (Modify the following sentence as necessary.) My office will communicate with you at a later date concerning the scheduling of a hearing.

If you have any questions concerning your new claim, please contact your Social Security Office.

Exhibit 7

Text for Appeals Council Remand to DDS--Class Member Claim(s) Associated with Current Claim on Which Appeals Council Would Take Unfavorable Action

On ___________, the claimant filed a request for review by the Appeals Council on the issues raised by ((his/her) application dated ___________.) OR (the Administrative Law Judge's dismissal action.) The claimant has also been identified as a member of the (name of class action) class action and is entitled to have the final administrative denial of (his/her) application(s) dated ___________ readjudicated by the (name of state, e.g., Tennessee) Disability Determination Service under the terms of the (enter date) (order of the U.S. District Court for the District of ___________ OR stipulation and order for settlement approved by the U.S. District Court for the District of ___________ OR other entry as appropriate). The Appeals Council has determined that the current and class member claim(s) have issues in common.

Accordingly, the Appeals Council grants the claimant's request for review, vacates the Administrative Law Judge's (decision/dismissal action) and remands this case to the (name of state, e.g., Tennessee) Disability Determination Service. The (name of state, e.g., Tennessee) Disability Determination Service will readjudicate the class member claim(s) in accordance with the terms of the (district court order or settlement agreement, or modify as appropriate). The (name of state, e.g., Tennessee) Disability Determination Service will issue one determination covering the class member claim(s) and the current claim. If the (name of state, e.g., Tennessee) Disability Determination Service does not issue a fully favorable determination, it will notify the claimant of the right to request a hearing before an Administrative Law Judge.

Exhibit 8

Text for Appeals Council Remand to DDS--Class Member Claim Pending Appeals Council Review--Appeals Council Finds Unrelated Basis for Remand

On ____________, the claimant filed a request for review by the Appeals Council on the issues raised by ((his/her) application dated ____________.) OR (the Administrative Law Judge's dismissal action.) The claimant has also been identified as a member of the (enter name of class action) class action and is entitled to have (his/her) claim readjudicated by the (name of state, e.g., Tennessee) Disability Determination Service under the terms of the (enter date) (order of the U.S. District Court for the District of ___________ OR stipulation and order for settlement approved by the U.S. District Court for the District of __________ OR other entry as appropriate).


(Discuss the Appeals Council's reasons for remand.)

Accordingly, the Appeals Council grants the claimant's request for review and vacates the Administrative Law Judge's (decision/dismissal action). Because the claimant is also eligible for relief at the Disability Determination Service level under the (enter name of class action) class action, the Council remands this case to the (name of state, e.g., Tennessee) Disability Determination Service for reopening of the issues raised by the ____________ application. If the (name of state, e.g., Tennessee) Disability Determination Service does not issue a fully favorable determination, it will notify the claimant of the right to request a hearing before an Administrative Law Judge.

Exhibit 9

Text for Appeals Council Remand to DDS--Class Member Claim Pending Appeals Council Review--Appeals Council Would Take Unfavorable Action

On ____________, the claimant filed a request for review by the Appeals Council on the issues raised by ((his/her) application dated _____________.) OR (the Administrative Law Judge's dismissal action.) The claimant has also been identified as a member of the (enter name of class action) class action and is entitled to have (his/her) claim readjudicated by the (name of state, e.g., Tennessee) Disability Determination Service under the terms of the (enter date) (order of the U.S. District Court for the District of ___________ OR stipulation and order for settlement approved by the U.S. District Court for the District of ___________ OR other entry as appropriate).

Accordingly, the Appeals Council grants the claimant's request for review, vacates the Administrative Law Judge's (decision/dismissal action) and remands this case to the (name of state, e.g., Tennessee) Disability Determination Service. The (name of state, e.g., Tennessee) Disability Determination Service will readjudicate the class member claim in accordance with the terms of the (district court order or settlement agreement, or modify as appropriate). If the (name of state, e.g., Tennessee) Disability Determination Service does not issue a fully favorable determination, it will notify the claimant of the right to request a hearing before an Administrative Law Judge.

Exhibit 10

___________ Class Action Report

OCA Division _____

Month of ___________, 199_

Opening pending ____________

Cases received ____________

Cases released ____________

Cases released to HO __________

Cases released to OAO __________

Cases released to DDS __________

Cases released to other locations __________

Closing pending ____________

Cases waiting assignment __________

10 days_____20 days_____

Cases assigned to analyst/attorney __________

10 days_____20 days_____

Cases waiting folder reqs. __________

10 days_____20 days_____

Cases waiting folders __________

10 days_____20 days_____

Cases waiting typing __________

10 days_____20 days_____

Cases waiting release __________

10 days_____20 days_____

Cases in DLAI __________

10 days_____20 days_____

FNNOTE: If more than one class action is being implemented, prepare a
separate report for each class action.

Exhibit 11

______________ Class Action Report--Rehandled Cases

OCA Division _____

Month of __________, 199_

Opening pending ____________

Cases received ____________

Cases released ____________

Closing pending ____________


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