|Definition of Class|
|Determination of Class Membership and Eligibility for Relief and Preadjudication Actions|
|Processing and Adjudication|
|Reconciliation of Implementation|
|Grant Settlement and Order; Approved by the U.S. District Court for the Middle District of Pennsylvania on February 7, 2002.|
|Privacy Act and Protective Order approved by the U.S. District Court for the Middle District of Pennsylvania on September 9, 2002.|
|Request for Court Case Review/Change of Address Worksheet|
|Grant Court Case Flag/Alert|
|Route Slip/Case Flag with Alert: Possible Grant Class Action Case for Screening|
|Grant Case Screening Sheet|
|Grant Notice of Non-Class Membership/Ineligibility for Relief|
|Route Slip for Forwarding Grant Class Action Claim File(s) When Ineligibility Determination is Disputed|
|Text for Notice of Revised Grant Class Membership/Eligibility for Relief Determination|
|Grant Class Action Case Flag for OAO Use|
|Routing and Transmittal Slip for Forwarding of Grant Class Claim|
ISSUED: August 12, 2003
This Temporary Instruction (TI) sets forth the procedures for implementing the parties' joint Settlement Agreement and Order, approved by the United States District Court for the Middle District of Pennsylvania on February 7, 2002, in the Grant v. Commissioner of the Social Security Administration class action involving allegations of misconduct by an Administrative Law Judge (ALJ).
Adjudicators throughout the country must be familiar with this TI because of case transfers and because Grant class members who now reside outside of Pennsylvania and Washington D.C. must have their cases processed in accordance with the requirements of the joint Settlement Agreement and Order.
On August 12, 1988, plaintiffs filed a class complaint alleging bias on the part of ALJ Russell Rowell (also referred to as the “subject ALJ”) who worked in the Harrisburg, Pennsylvania, and Washington D.C., Hearing Offices (HOs) of the Office of Hearings and Appeals. On February 21, 1990, the U.S. District Court for the Middle District of Pennsylvania certified a class consisting of all claimants for Social Security disability benefits or Supplemental Security Income disability benefits, who received an adverse decision from the subject ALJ on or after January 1, 1985, and all disability claimants whose claims were assigned to the subject ALJ for a decision. The subject ALJ died on September 25, 1994.
On September 20, 2001, the parties entered into a settlement agreement. On February 7, 2002, the District Court issued an Order granting final approval of the parties' settlement agreement (Attachment 1). On September 9, 2002, the District Court approved the Privacy Act and Protective Order agreed to by the parties (Attachment 2).
Pursuant to the terms of the Settlement, SSA's Office of Acquiescence and Litigation Coordination (OALC) will send individual notices to potential class members informing them of their opportunity to request review of their claims. With the exception of cases consolidated with a current claim pending at the Appeals Council level for the purpose of issuing a fully favorable decision (see Part VI.B.3.c. below), class members who are found eligible for relief will receive an opportunity for a new hearing decision on their claims.
Under Grant, the Commissioner will redetermine the title II and title XVI disability claims of those persons who: 1) respond to the notice informing them of the opportunity for review; and 2) are determined, after screening, to be class members eligible for relief (see Parts IV. and V. below). OHA will screen the claims of all potential class members and will perform the necessary redeterminations. In most cases, the HO nearest to the claimant's residence will perform the required redeterminations.
Except for cases processed at the Appeals Council level pursuant to Part VI.B.3.c., cases redetermined under the terms of the settlement will be processed at the ALJ hearing level regardless of the final level at which the claim was previously decided. The type of review will be a redetermination (see Part VI. below). Class members who receive adverse redetermination decisions will have full appeal rights (i.e., Appeals Council and judicial review).
Except as noted below, for purposes of implementing the terms of the Settlement and Order, the Grant class potentially eligible for relief consists of all individuals:
Who filed a claim for disability benefits pursuant to title II and/or title XVI of the Social Security Act; and
Who requested a hearing decision by an ALJ on that claim or any issues arising from that claim; and
Whose request was dismissed by or who received a less than fully favorable decision on the claim from the subject ALJ; and
Whose dismissal or decision by the subject ALJ was dated on or after January 1, 1985.
A person is not a class member eligible for Grant relief if the individual:
Successfully appealed an adverse decision of the subject ALJ and ultimately received all of the benefits sought in the claim before the subject ALJ, or
Appealed an adverse decision of the subject ALJ and was granted a remand for a new hearing before another ALJ based on the same claim that was considered by the subject ALJ; or
Did not appeal an adverse decision of the subject ALJ, but later reapplied and was found eligible or ineligible for disability benefits (on the merits and not on res judicata grounds) on a subsequent application and the subsequent application covered the same time period that was covered by the application considered by the subject ALJ.
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.
SSA shall send an individual notice to the last known address of every individual who has been identified by computer run as a potential class member. Individuals will have 90 days from the date of the notice (or of the date of the mailing of the second copy of the notice, as described below), unless extended for good cause, to request that SSA redetermine their claims under the terms of the Grant Settlement and Order. SSA will presume receipt of the notice within five days after the date of notice, unless the notice is returned as undeliverable or the individual establishes that receipt actually occurred later. Office of Central Operations (OCO) will enter replies into the Civil Action Tracking System (CATS). CATS generates court folder alerts. The alerts will be used to locate and retrieve Grant claim files. An individual who does not receive the potential class member notice but believes that he/she is eligible for relief, may request a review of his/her Grant claim(s) by contacting any SSA office within 90 days of the most recent date that SSA mails the notices to the system-identified potential class members (see below explanation of second mailing after updated addresses are received).
Undeliverable potential class member notices will be returned to OCO to update CATS. If mailed notices are returned as undeliverable, SSA shall provide to class counsel a list of those persons and their last known addresses. Class counsel shall have 180 days after receipt of such names to furnish current addresses for such listed individuals. Upon timely receipt of such addresses from class counsel, SSA shall mail a second copy of the class member notice to those class members potentially eligible for relief at the updated addresses.
OCO screens for the timeliness of the reply form. OCO will notify the servicing FO of untimely responses and request that the FO develop for possible evidence of good cause for the untimely response. Good cause determinations will be based on the standards in 20 CFR §§ 404.909, 404.911, 416.1409 and 416.1411. If good cause is established, the FO will forward the good cause determination and any folders currently in the FO, to OCO. The FO will retrieve any prior title XVI folder from the Folder Servicing Operation in Wilkes Barre (FSO in WB), Pennsylvania. All title XVI only folders, including current claim folders currently reading into the FO will be associated with the alert/query package. The FO will then ship the alert/query package with all folders to the OHA Class Action Coordinator for distribution for screening (see I-5-4-67 V.A.2.C. for the address). If good cause is not established, the FO will send the individual a good cause denial notice.
All response forms and requests for relief including those filed by individuals who did not receive the potential class member notice (i.e., individuals who contact SSA by telephone, in person, or in writing) should be entered into CATS. If a request for relief is received by an office that does not have access to CATS, it should forward the request to a FO or OCO and should refer a claimant who has contacted an office without CATS access to a FO. Requests for change of address (filed using Attachment 3) should also be entered into CATS. CATS will generate folder alerts for all reply forms. See Attachment 4 for a sample Grant alert. The computer-generated alerts will be associated with available title II and concurrent title II and title XVI potential class member claim file(s).
The following identifies which component is responsible for folder retrieval after an individual requests review:
OCO will be responsible for retrieving OCO jurisdiction title II only and concurrent title II/title XVI claims covered by the Grant timeframes as well as subsequent claims except for those pending in OHA. OCO will forward all other alert/query packages to the appropriate component for folder retrieval.
The Program Service Centers (PSCs) will be responsible for retrieving PSC jurisdiction title II only and concurrent title II/title XVI claims covered by the Grant timeframes except for those pending in OHA.
The FSO in WB and the FOs will be responsible for retrieving title XVI claims except for those pending in OHA.
Once the claim files and alerts have been associated, OCO, the PSCs, FOs or FSO in WB will forward the alert and claim files to the OHA Class Action Coordinator at the following address (Case locator code Y46):Office of Hearings and Appeals
The OHA Class Action Coordinator will code receipt of any claim files into the case control system and enter information concerning the claim into an internal OHA database and will forward the alert package and folder search results to the Grant Screening Unit. If the folder retrieval component determines that the potential class member has a claim (the potential class claim or a subsequent claim) that is pending or stored at OHA Headquarters or in an HO, the folder retrieval component will send the alert, along with any claim file(s) not in OHA's possession, to the OHA Class Action Coordinator for association with the pending or stored claim file and screening. If the claim is located in a HO or the Office of Appellate Operations (OAO), the OHA Class Action Coordinator will coordinate retrieval/case transfer of the file for screening at OHA Headquarters by the Grant Screening Unit in such a manner that would not delay the current claim pending at OHA.
The OHA Class Action Coordinator is responsible for controlling and reconciling the disposition of class alerts and claim files shipped to OHA Headquarters for screening. The Coordinator will maintain a record of all alerts and claim files received and the location, if any, to which they are transferred. The Coordinator will periodically enter this information into CATS. The information will be necessary to do the final class membership reconciliation.
When claim folders cannot be located, the folder retrieval component will forward any information it has on cases that need to be reconstructed with a reconstruction request to the servicing FO along with a copy of the alert and documentation of attempts to locate the file, and will request that the reconstructed file be forwarded to the OHA Class Action Coordinator for coordination of final screening and assignment to a HO for redetermination if eligible for relief. To avoid unnecessary requests for reconstruction, the OHA Class Action Coordinator will provide the folder retrieval component information concerning the OHA location of any existing potential class member claim file(s) being retained for adjudication purposes, and the date(s) of the claim(s) involved. For control and informational purposes, the FOs or the FSO in WB will forward a copy of each reconstruction request to the OHA Class Action Coordinator at the address listed above.
In cases where an alert has been generated but the claim file(s) cannot be located, systems queries will be obtained and utilized to attempt to determine whether the individual in question is a class member potentially eligible for relief. However, if information contained in the queries or otherwise obtained clearly indicates that the claimant is not a class member potentially eligible for relief, reconstruction efforts will not be initiated. In such cases, the alert and the information/evidence obtained up to that point should be sent to the OHA Class Action Coordinator for coordination with the Grant Screening Unit. If all the missing claims cannot be screened out via queries, class membership will be presumed and the claim file(s) will be reconstructed based upon available information.
The OHA Class Action Coordinator will coordinate with HOs and OAO in cases where there is a current claim pending at the OHA level. The HO or OAO will not delay action on a pending claim when a prior claim is being reconstructed for screening purposes, unless the prior claim is needed for the adjudication of the pending claim. If OHA completes action on the pending claim prior to receipt of the reconstructed file, the HO or OAO, as appropriate, will forward a copy of the action on the pending claim to the OHA Class Action Coordinator who will associate the pending claim information with the class action material, including the alert and claim files, if any, and forward the entire package to the Grant Screening Unit upon receipt of the reconstructed file from the FO which has responsibility for initiating all file reconstruction. If, in reconstructing the file, the FO finds evidence of substantial gainful activity during the Grant period by the claimant, the FO will include that information in the claim file.
Individuals who receive a notice of non-class membership have 60 days from receipt of the notice to dispute the determination. The OHA Class Action Coordinator will hold for 90 days all claim files of individuals to whom SSA sends notice of non-class membership and ineligibility for relief, pending review by claimants, claimant's representative or class counsel. If an individual wishes to dispute SSA's class membership/eligibility for relief determination, he or she must give timely written notice of the disagreement to the Office of the General Counsel (OGC) (i.e., within 60 days of receipt of notice that the individual is not a class member eligible for relief). Upon request, claimant, claimant's representative or class counsel, subject to the Privacy Act Protective Order entered into in this case, will be given reasonable and timely access to potential class members' claim files for the purpose of resolving class membership disputes. Upon request, the OHA Class Action Coordinator will forward the claim files or documentation used to deny class membership to the Harrisburg HO.
Because the relief offered in Grant is a new hearing decision (or an Appeals Council decision if the claim is consolidated with a current claim pending at the Appeals Council level and a decision fully favorable to the Grant claim is issued), all claims will be screened at the OHA level. The screening will be performed at OHA Headquarters by the Grant Screening Unit.
If a current claim is before the Appeals Council or pending in a HO, the Coordinator will forward the alert and any prior claim file(s) to the Grant Screening Unit for screening. The Coordinator will also notify the appropriate OAO branch or the HO that there is a potential Grant claim pending. The Grant Screening Unit will notify the OHA Class Action Coordinator and the OAO branch or the HO of the outcome of the screening.
Do not screen pending cases unless an alert has been received. The presence of an alert is evidence that the claimant has responded to the notice of potential class membership and that his or her case is ready for review. However, if a claimant with a non-alerted pending case should allege class membership, contact the Grant coordinator in the Special Counsel Staff (SCS) for assistance in determining the claimant's status. SCS's address is:Special Counsel Staff
If the OHA Class Action Coordinator receives an alert for a claimant who has a civil action pending, either on the alerted case or on a subsequent or prior claim, the Coordinator will forward the alert and any accompanying claim file(s) to the Grant Screening Unit for screening. The Coordinator will also notify the appropriate OAO Court Case Preparation and Review Branch (CCPRB) that there is a potential Grant claim. The Grant Screening Unit will notify the OHA Class Action Coordinator and the CCPRB of the outcome of the screening. See Part V.B.4. below for special screening instructions when a civil action is involved.
If a claim file (either a class member or a subsequent claim) is located in OHA Headquarters but there is no claim actively pending administrative review, i.e., Headquarters is holding the file awaiting potential receipt of a request for review or notification that a civil action has been filed, the OHA Class Action Coordinator will retrieve that claim file and forward it to the Grant Screening Unit (using Attachment 5) which will associate the alert with the file and screen for class membership and eligibility for relief. If the Screening Unit determines that the individual is not a class member eligible for relief and the individual does not dispute the denial of eligibility for relief, the Screening Unit will return the file to the OHA Class Action Coordinator. (The OHA Class Action Coordinator will coordinate the necessary actions, as explained in Part V.) (See Part V.B.5., below, for non-class member processing instructions.)
The following instructions are applicable to claims in which the individual requested relief after receiving a written notice.
The Grant Screening Unit will perform the screening for all potential class member claims. The Screening Unit will associate the alert and any prior claim file(s) with the claim file(s) in its possession and then complete a screening sheet (see Attachment 6) as follows:
Consider all applications denied/ceased or other determinations/decisions adverse to the claimant issued during the Grant timeframe ( on or after January 1, 1985);
Follow all instructions on the screening sheet;
Sign and date the original screening sheet, place it in the claim file (on the top right side of the file); and
Forward a copy of the screening sheet to the OHA Class Action Coordinator at the address in Part V.A.2. above. (The Coordinator will enter information from the screening sheet into CATS and the Grant OHA database and will forward the screening sheet to SCS).
As noted in Part V.B.1. above, the Grant Screening Unit will screen all requests for relief. However, if a civil action is involved, after screening, the Grant Screening Unit will forward the claim file(s) to the CCPRB for appropriate action. The screening determination will dictate the appropriate post-screening action.
If the claim pending in court is the potential class member claim or a subsequent claim that involves unresolved Grant issues, the CCPRB will immediately notify OGC (as appropriate, OGC will then notify the Assistant United States Attorney (AUSA)) so that OGC (or the AUSA) can notify the claimant of the option to agree to a remand of the case for readjudication under Grant. If the claim pending in court is not the class member claim and does not involve any Grant issues, the CCRB will not take any additional actions.
If the Grant Screening Unit determines that the individual is a class member eligible for relief, it will forward the claim, using Attachment 11, to the appropriate HO for redetermination. The Screening Unit will identify the HO, based on the claimant's residence, that will perform the redetermination and will note the address of the HO on the Grant Flag/Alert used to forward the claim (Attachment 11). Should the HO need to develop evidence concerning the period that was before the subject ALJ it should follow normal procedures. Once the development has been completed, the HO will then proceed with processing in accordance with the instructions in Part VI. below.
If the Grant Screening Unit determines that the individual is not a class member eligible for relief, the Screening Unit will:
Notify the individual and representative, if any, (with copies to class counsel and the OHA Class Action Coordinator) of that determination using Attachment 7 which will state that the claimant has 60 days to request OGC to review the determination (modified as necessary to fit the circumstances and posture of the case when there is a current claim);
Include the date and claim number at the top of Attachment 7 in the spaces indicated.
Retain a copy of the notice in the claim file;
Send a copy of the notice to Grant class counsel:Community Justice Project
And retain the claim file(s) for 90 days pending a possible class membership dispute.
An individual who wishes to dispute a determination of non-class membership and ineligibility for relief should do so directly, or through his/her representative of record.
If class counsel makes a timely (i.e., within 60 days of claimant receiving the not eligible for relief notice) request to OGC to review the claim file which contains the information used by the Screening Unit, the Screening Unit will send the file to the HO in Harrisburg, PA (Office Code Y10) using the pre-addressed route slip in Attachment 8. The HO in Harrisburg will notify the claimant, claimant's attorney, and class counsel when it has the file available to review.
The Harrisburg HO should hold the file for a maximum of 60 days following the review by class counsel, claimant's attorney and/or claimant. If at any time during this 60-day period the file is requested by OGC, the HO will forward the claim file by priority mail to the OGC Grant attorney. If at the end of the 60-day period, no request for the file is made by the OGC Grant attorney, the HO will return the file to its normal storage facility. If the OGC Grant attorney requests the file, (s)he will, if the dispute is being resolved in the claimant's favor, send the file by priority mail back to the Harrisburg HO and will notify the Grant Screening Unit of the determination. If the dispute is not resolved in the claimant's favor, the OGC Grant attorney will, after notifying the claimant of the determination, retain the file during the period regarding court review described below. Once the court appeal period or court action is over, the OGC Grant attorney can send the file back by priority mail to the OHA Class Action Coordinator who will return the folder to its normal storage facility.
If SSA, through OGC, resolves the dispute in the claimant's favor:
The Grant Screening Unit will prepare a revised screening sheet and send notice of the revised class membership/eligibility for relief determination (Attachment 9) to the claimant, and representative, if any; class counsel, and to the Harrisburg HO;
The Grant Screening Unit will notify the OHA Class Action Coordinator of the revised determination by forwarding a copy of the revised screening sheet to the Coordinator; and
The Harrisburg HO will forward the claim file to the appropriate HO for redetermination and the case will proceed in accordance with Part VI. below.
If the dispute is not resolved in the claimant's favor, OGC will send the claimant and class counsel a written notice of OGC's determination that the person is not eligible for a new hearing. The notice will also inform the claimant that he/she will have 60 days to request that the court review the class membership/eligibility for relief determination. The Harrisburg HO will, if it still retains the claim file, send it to the OGC Grant attorney. The OGC Grant attorney will retain the file for 90 days pending possible court action. If at the end of the 90 day period there is no court action, or at the conclusion of any court action, the OGC Grant attorney will send the file back by priority mail to the OHA class action coordinator who will return the file to its normal storage facility, and will make a notation in the file that no request for court review was received.
All of the Grant redeterminations will be conducted at the OHA level. In some instances, such as consolidation cases, the Appeals Council will conduct the Grant redetermination. In cases redetermined at the ALJ level, the individual will receive a de novo hearing from an ALJ on the record that was before the subject ALJ, with any necessary development of evidence related to the period under review. Grant class members who receive new hearing decisions will have full appeal rights (i.e., Appeals Council and judicial review). Except as noted herein, HOs and OHA Headquarters will process Grant class member cases according to all other current practices and procedures including coding, developing evidence, routing, etc. However, the notice of hearing should include the following statement:
The hearing will be held pursuant to the Grant settlement Agreement and Order approved by the United States District Court for the Middle District of Pennsylvania on February 7, 2002.
Pursuant to the Grant Settlement and Order, regardless of whether the claim under review is an initial claim or a cessation case, the type of review to be conducted is a redetermination. The redetermination shall be a de novo evaluation of the class member's eligibility for benefits based on all evidence in his or her file including newly obtained evidence relevant to the period at issue. The period at issue begins with the onset date that was alleged before the subject ALJ (now deceased ALJ Rowell) and ends with the date of the subject ALJ's decision. If the claimant is found not disabled, this will end the inquiry. If the claimant is found disabled, then the claim will be further developed and reopened and considered through the present time.
Individuals who meet the criteria listed earlier in section IV. will have the opportunity to request review of their prior claims.
If the class member claim is the only claim at the OHA level and the case has been screened in as a class member eligible for relief, the Screening Unit will forward the case to the appropriate HO for development, and redetermination as described in Part V.B.5.b. above.
Even claims subject to consolidation should be consolidated only to the extent practicable. For example, if consolidation would unreasonably delay a decision on the current claim, consolidation would not be appropriate.
If a class member has a current claim pending at the OHA level and consolidation is warranted according to the guidelines below, the appropriate component will consolidate all Grant class member claims with the current claim at the level (hearing or Appeals Council) at which the current claim is pending.
If the class member has a current claim pending at the DDS level and the ALJ or the Appeals Council determines that consolidation is warranted and would not unduly delay action on the current claim, the DDS will forward the current claim to OHA for consolidation with the Grant claim(s) pending at the OHA level (hearing or Appeals Council levels).
Except as noted below regarding current and Grant cases with issues in common, if a Grant class member has a request for hearing pending on a current claim, and the ALJ has either scheduled or held a hearing, and in all remand cases, the ALJ will not consolidate the Grant case with the appeal on the current claim.
If the ALJ is prepared to issue a fully favorable decision on the current claim, and this decision would also be fully favorable with respect to all the issues raised by the application that makes the claimant a Grant class member, the ALJ will consolidate the claims and issue a favorable decision.
If the claims are consolidated, follow Part VI.B.2.c. below. If the claims are not consolidated, follow Part VI.B.2.d. below.
Except as noted below, if a Grant class member has a request for hearing pending on a current claim and the HO has not yet scheduled a hearing, the ALJ will consolidate the Grant claim and the current claim (see Part VI.B.2.d. below). However, the ALJ should not consolidate the claims if consolidation would delay processing of the current claim.
The ALJ will not consolidate the claims if:
the current claim and the Grant claim do not have any issues in common, or
a court remand contains a court-ordered time limit, and it will not be possible to meet the time limit if the claims are consolidated.
If the claims are consolidated, follow Part VI.B.2.c. below. If the claims are not consolidated, follow Part VI.B.2.d. below.
When consolidating a Grant claim with any subsequent claim, the issue is whether the claimant was disabled during the period(s) at issue in the Grant claim and the period(s) at issue in the subsequent claim. If the ALJ decides to consolidate the current claim with the Grant claim(s), the HO will:
issue one decision that addresses both the issues raised by the current request for hearing and those raised by the Grant claim (the ALJ's decision will clearly indicate that the ALJ considered the Grant claim pursuant to the Grant Settlement and Order).
If the ALJ decides not to consolidate the current claim with the Grant claim because:
1) the claims do not have any issues in common, or
2) there is a court-ordered time limit, the ALJ will:
take the necessary action to complete the record and issue a decision on the current claim.
schedule the hearing and issue a decision that redetermines the Grant claim.
If the ALJ decides not to consolidate the Grant claim with a current claim elevated by the FO or DDS or the claim(s) at issue in another class action, the ALJ will return the current non-Grant claim(s) to the FO or the DDS where the current non-Grant claim(s) was pending.
If there is a current claim pending at the Appeals Council, the Grant Screening Unit will forward the claim file(s) and the completed screening sheet to the appropriate OAO Disability Program Branch. The action the Appeals Council takes on the current claim determines the disposition of the Grant claim. Therefore, OAO must keep the claim files together until the Appeals Council completes its action on the current claim. The following sections identify possible Appeals Council actions on the current claim and the corresponding action on the Grant claim.
This will usually arise when the current claim duplicates the Grant review claim, i.e., the current claim raises the issue of disability and covers the entire period adjudicated in the Grant claim. In this instance, the Appeals Council will consolidate the claims and proceed with its intended action. The Appeals Council's order, decision or notice of action will clearly indicate that the ALJ's or Appeals Council's action resolved or resolves both the current claim and the Grant redetermination claim.
This will usually arise when the current claim does not duplicate the Grant claim, e.g., the current claim raises the issue of disability but does not cover the entire prior period adjudicated in the Grant claim. In this instance, the Appeals Council will proceed with its intended action on the current claim. OAO staff will attach a Grant case flag (Attachment 10) to the Grant claim, immediately forward the Grant claim to the appropriate HO (see Part V.B.5.b. above), for action, and retain a copy of Attachment 10 in the current claim file. The current claim should not be forwarded with the Grant claim unless the appeal period for the current claim has expired. OAO will indicate on Attachment 10 that the Appeals Council's action on the current claim does not resolve all Grant issues and that the Grant class member claim is being forwarded for separate redetermination processing. OAO staff will include copies of the ALJ's decision and Appeals Council's decision or order or notice of denial of request for review on the current claim and the exhibit list used for the ALJ's and for the Appeals Council's decision. If, upon receipt of the Grant claim, the HO determines that additional development (medical or non-medical) for the period at issue is required, the HO will follow standard procedures (see Part V.B.5.b. above).
If the Appeals Council intends to issue a favorable decision on a current claim, and this decision would be fully favorable with respect to all issues raised by the application that makes the claimant a Grant class member, the Appeals Council should proceed with its intended action. In this instance, the Appeals Council will consolidate the claims, reopen the final decision on the Grant claim and issue a favorable decision that adjudicates both applications. The Appeals Council's decision will clearly indicate that the Appeals Council considered the Grant claim pursuant to the Grant Stipulation and Order.
If the Appeals Council intends to issue a favorable decision on a current claim and this decision would not be fully favorable with respect to all issues raised by the Grant claim, the Appeals Council will proceed with its intended action. In this situation, the Appeals Council will request the effectuating component to forward the claim files to the appropriate HO (see Part V.B.5.b. above), after the Appeals Council's decision is effectuated. OAO staff will include the following language on the transmittal sheet used to forward the case for effectuation: “Grant court case review needed — following effectuation forward the attached combined folders to the designated Hearing Office for further action.” If the HO determines that additional development (medical or non-medical) for the period at issue is required, the HO will follow normal procedures using Attachment 11(see Part V.B.5.b. above).
If the Appeals Council intends to remand the current claim to an ALJ, it will proceed with its intended action unless one of the exceptions below applies. In its remand order, the Appeals Council will direct the ALJ to consolidate the Grant claim with the action on the current claim pursuant to the instructions in Part VI.B.2.a. above.
The Appeals Council will not direct the ALJ to consolidate the claim if:
the current claim and the Grant claim do not have any issues in common, or
a court remand contains a court-ordered time limit and it will not be possible to meet the time limit if the claims are consolidated.
If the claims do not share any common issues or a court-ordered time limit makes consolidation impractical, OAO will forward the Grant class member claim to the HO, for separate redetermination review. If the HO determines that additional development (medical or non-medical) for the period at issue is required, the HO will follow normal procedures using Attachment 11 (see Part V.B.5.b. above).
HO personnel will code prior claims into the Hearing Office Tracking System (HOTS) and the OHA Case Control System (OHA CCS) as “redeterminations.” If the prior claim is consolidated with a current claim already pending at the hearing level (see Part VI.B.2.c. above), HO personnel will not code the prior claim as a separate hearing request.
To identify class member cases in HOTS, HO personnel will code “GT” in the “Class Action” field. No special identification codes will be used in the OHA CCS.
At an appropriate time, the OHA Class Action Coordinator will reconcile information concerning alerts, reconstruction of files and medical development with information available on CATS. The Class Action Coordinator is also responsible for maintaining a personal computer-based record of OHA implementation activity (i.e., a record of cases screened by the Grant Screening Unit and the alerts processed by OAO, and a record of cases screened and redetermined by OHA), as reported by HOs, the Screening Unit and OAO to the OHA Class Action Coordinator directly or through SCS, after screening and/or readjudication/redetermination.
HO personnel should direct any questions to their Regional Office. Regional Office personnel should contact the Division of Field Practices and Procedures in the Office of the Chief Administrative Law Judge at (703) 605-8500. OHA Headquarters personnel should contact the Special Counsel Staff at 605-8250.
 The class, as certified, also included future applicants for benefits, whose claims would be assigned to ALJ Rowell. There have been no members of this group in the class since ALJ Rowell died.