I-1-7-14.Eligibility for Class Relief

Last Update: 9/14/05 (Transmittal I-1-56)

A. Questions About Eligibility

Questions about eligibility for class relief often arise, for example, because of residency changes or because of the complexity of a class definition or the nature of class relief. Questions may arise during the screening process, after sending notice of non-class membership or ineligibility for relief to a claimant or after forwarding a class member case to an HO or DDS.

A claimant may contact SSA to inquire about class relief, either independently or in connection with a current claim, and the claimant did not receive a notice of potential class membership. (These claimants may sometimes be identified as “walk-ins.”) When another OHA component receives a question concerning eligibility for class relief from a claimant who did not receive a notice, that component will refer the question to OCALJ or OAO, whichever component has the lead in OHA for coordination with the Office of Program Law (OPL) in OGC. Generally, if a claimant failed to receive a notice, either because his or her claim was not identified or because the notice was undeliverable, the claimant will be given an opportunity to establish eligibility for class relief.

B. Resolution of Questions Within OHA

Within OHA, OCALJ or OAO, depending on the focus of the impact of the class action, will resolve eligibility for class relief issues that arise during the screening process or after forwarding a class member case to an HO or DDS. The OHA Headquarters screening component or HO personnel may consult informally with the lead component which will determine the need for a written referral for class membership or eligibility for class relief guidance. In resolving eligibility for relief issues, the responsible component will consult with OPL, as necessary.

C. Challenges to Eligibility Determinations

After providing for notice of non-eligibility for membership in a class or ineligibility for relief to a class claimant, a class action court order or settlement agreement usually provides for formal review, i.e., a specified time period within which an individual can contest the class membership or relief eligibility determination. There can also be a special arrangement with plaintiffs' counsel for routine, informal review of a challenge to the eligibility determination. In the latter circumstance, when the non-class member claim is pending or stored in OHA, OPL will coordinate the review through the lead OHA component.

In the absence of either mechanism for review, the lead component will review all class membership relief questions from a claimant or other source unless the issue involves an obvious oversight, e.g., the screener overlooked a claim filed within the class member timeframes. If necessary, the lead OHA component will consult with OPL . The screening component receiving the class membership question will forward the inquiry, along with the relevant claim file(s), to the lead OHA component and will take such further action as directed.

Unless the class action court order or settlement agreement provides otherwise, there are no time limits for correcting (in the claimant's favor) erroneous non-class or non-relief eligibility determinations. If a subsequent review reveals that a claimant is eligible for class relief, the reviewing component should arrange for the preparation of a revised notice of eligibility and afford class relief.

D. Irreversibility of Class Membership Determination Following Readjudication

When a claim has been screened and a claimant has been determined eligible for class relief and his or her claim has been reviewed at any level, the class membership or eligibility for relief determination may not be reversed even if it is later proven to be erroneous. Thus, for example, if on appeal of a DDS readjudication an ALJ finds that class membership or eligibility for relief was conferred in error, HO personnel may not rescreen the case for the purpose of finding that the claimant is not a class member or not eligible for class relief, and the ALJ may not reverse the erroneous class membership or eligibility for relief determination. However, when OHA has jurisdiction for review and determines prior to giving notice of the review that a claimant was improperly screened in as a class member, OHA may rescreen the case and send the notice of non-eligibility for relief.