I-5-4-53.Day v. Chater

Table of Contents
I Purpose
II Background
III Guiding Principles
IV Definition of Class Entitled to Relief
V Determination of Class Membership and Preadjudication Actions
VI Processing and Adjudication
VII Case Coding
VIII Reconciliation of Implementation
IX Inquiries
Attachment 1 June 26, 1995 Order Approving Settlement, Issued by the United States District Court for the Southern District of Ohio, with attached Settlement Agreement and Privacy Act Protective Order
Attachment 2 - Sample Day Alert
Attachment 3 - Screening Flag - Within OHA
Attachment 4 - Day SCREENING SHEET
Attachment 5 - Screening Flag -- Outside OHA
Attachment 6 - Readjudication Flay for OHA Retention Cases
Attachment 7 Non-Class Membership Notice
Attachment 8 - Route Slip for Non-class Membership
Attachment 9
Attachment 10 - Readjudication Flag for No Common Issue Cases
Attachment 11 Text for Appeals Council Remand to BDD - Class Member Claim Associated with Current Claim Pending Appeals Council Review

ISSUED: June 27, 1996

I. Purpose

This Temporary Instruction (TI) sets forth procedures for implementing the parties' negotiated Settlement Agreement and Privacy Act Protective Order that the United States District Court for the Southern District of Ohio approved and filed on June 26, 1995, in the Day v. Chater class action (see Attachment 1).

Adjudicators throughout the country must be familiar with this TI because of case transfers and because Day class members who now reside outside of Ohio must have their cases processed in accordance with the requirements of the Settlement Agreement.

II. Background

Following extensive discovery and trial, the district court issued an order on November 22, 1991, with respect to multiple disability issues. This order was partially favorable to the Secretary and State defendants. Thereafter, on July 31, 1992, pursuant to the parties' requests for clarification, the district court issued another order that the parties cross-appealed to the United States Court of Appeals for the Sixth Circuit.

In an opinion issued on May 12, 1994, that was favorable to the Government on many issues, the court of appeals nonetheless determined that the title II reconsideration notice in use between October 9, 1984, and February 1990, was defective (Day v. Shalala, 23 F.2d 1052 (6th Cir. 1994)). Accordingly, the court held that the class entitled to relief consists of those individuals who: 1) detrimentally relied on the inadequate notice and filed a new application thereafter rather than continuing the appeal process; and 2) were, on or after October 5, 1987 (60 days prior to the filing of the amended class complaint), either presented by the Secretary with a claim of res judicata, and did not appeal the res judicata determination to a district court, or received less in retroactive benefits than he or she would have received had he or she successfully appealed initially. The court of appeals remanded to the district court to determine the relief to be provided. On June 26, 1995, following a fairness hearing on April 27, 1995, the district court issued an order giving final approval to the parties' Settlement Agreement and Privacy Act Protective Order.

III. Guiding Principles

Under Day, the Secretary will reopen the claim(s) of those individuals who: 1) respond to personal notice informing them of the opportunity for review; or 2) request review on their own initiative, absent personal notice, within 180 days of the date of the mass mailing of personal notices; and 3) are determined to be class members entitled to relief. In most cases, the Office of Disability and International Operations (ODIO) will screen the claims of those individuals who respond to notice or request review, and will forward class member claims to the Ohio Bureau of Disability Determination (BDD) for readjudication. However, the BDD will perform the screening when a claim is reconstructed or when a claim is pending in the BDD. Additionally, if a subsequent claim is pending or stored in OHA, OHA will perform the screening and, under the circumstances described in Part VI., will reopen and readjudicate the class member claim.

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 Entitled to Relief

Individuals entitled to relief under Day are those who:

  • filed a title II disability claim; and

  • received a denial notice at the reconsideration level from the Ohio BDD on or after October 5, 1987, and before February 1, 1990; and

  • were advised in the reconsideration notice that “If you do not request a hearing of your case within the prescribed time period, you still have the right to file another application at any time;” and

  • filed a new disability claim within two years of the date of receipt of the reconsideration notice, rather than pursuing an appeal on the first claim because of such notice; and

  • on the subsequent claim, received a res judicata denial, or received less in retroactive benefits than the individual would have received had the individual successfully appealed initially (i.e., administrative finality prevented the reopening of the defective notice claim when effectuating the subsequent favorable claim); and

  • did not receive a withdrawal of the res judicata claim from the Agency for the purpose of considering the individual's entitlement to title II benefits; and

  • did not pursue court review of the res judicata action.

    NOTE:

    An individual is not a class member entitled to relief if he or she received a substantive adjudication on any later claim covering the entire time period at issue in the defective notice claim.

V. Determination of Class Membership and Preadjudication Actions

A. Pre-Screening Actions - General

  1. Notification of Potential Class Members

    SSA sent notices to all potential class members that it was able to identify by computer run. Individuals will have 60 days from the date of receipt of the notice to request that SSA readjudicate their claims under the terms of the Day Settlement Agreement 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. An individual who returns the reply form untimely will not be considered for relief unless the individual demonstrates “good cause,” as defined in 20 CFR § 404.911. SSA's determination with respect to “good cause” is binding and not subject to further review.

    An individual who does not receive notice but who wishes to request relief must do so within 180 days of the date of the mass mailing (or meet the above “good cause” provisions). The individual may request relief by contacting an SSA field office (FO) in person, in writing or by telephone. The FO will complete a Request for Review Change of Address Worksheet. After completion, the FO will forward the worksheet to ODIO.

    In an effort to notify all interested parties of the available relief, SSA provided class counsel with a supply of posters describing the relief and will also display such posters in all SSA FOs and OHA hearing offices (HOs) in the State of Ohio until the end of the time period for response to notification. Additionally, SSA forwarded such posters to all county departments of human services in the State of Ohio with a written request for display. Further, SSA provided a media package to newspapers and television and radio stations in the State of Ohio containing information for public service announcements, and issued a press release to newspapers within the State of Ohio.

  2. Alert and Folder Retrieval Process

    ODIO will receive all response forms 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 Day alert.) ODIO will associate the alerts with any potential class member claims under its jurisdiction, and will request other alerted claims from the storage location.

  3. Alerts Sent to OHA

    If ODIO determines, through review of the OHA Case Control System (CCS), that a current claim is pending or stored at OHA, ODIO will forward the alert and prior claim file(s) to OHA for screening, consolidation consideration (if appropriate) and readjudication (if consolidated). If ODIO is unable to locate the prior claim file(s) and a current claim is pending or stored at OHA, ODIO will telephone the HO or OHA Headquarters, as appropriate, to determine if the prior claim file(s) is associated with the current claim. (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
    Suite 701
    One Skyline Tower
    5107 Leesburg Pike
    Falls Church, VA 22041-3200

    Attn: OAO Class Action Coordinator

    NOTE:

    The OAO Class Action 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).

  4. Folder Reconstruction

    After a thorough search, not to exceed 120 days, for an inactive folder, ODIO, the processing center or the Wilkes-Barre Data Operations Center will initiate reconstruction through the servicing FO. Because these components obtain all potential class member claims within the class member timeframes, or 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.

    OHA HOs will direct any necessary reconstruction requests to the servicing FO, along with a copy of the alert, documentation of attempts to locate the file and a covering memorandum requesting that the reconstructed folder be forwarded to the HO. Additionally, for CATS purposes, HO personnel will send a copy of the covering memorandum to Litigation Staff at SSA Headquarters at the following address:

    Office of the Deputy Commissioner for Programs,
       Policy, Evaluation and Communications
    Litigation Staff
    3-K-26 Operations
    6401 Security Boulevard
    Baltimore, MD 21235

    Attn: Day Coordinator

    OAO personnel will also direct any necessary reconstruction requests to the servicing FO, along with a copy of the alert, documentation of attempts to locate the file and a covering memorandum requesting that the reconstructed folder be forwarded to OAO. OAO personnel will furnish a copy of the covering memorandum to the OAO Class Action Coordinator.

    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 folder, OHA 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 on the pending claim.

  5. Class Membership Denials

    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 the notice of non-class membership to advise the Office of the General Counsel (OGC) of disagreement. In connection therewith, if class counsel requests to review the claim file or other material upon which the determination of non-class membership was based, Litigation Staff will ask the SSA component housing the folder or material to make it available at the Cincinnati, Ohio FO for a sixty-day period. If OHA is unable to release a non-class member claim file because it is needed for adjudication of the current claim, OHA will provide a copy of the claim file or other material.

    Following class counsel's review, or at the close of the sixty-day period, whichever is earlier, the FO will forward the claim file or other material as directed by Litigation Staff. If the parties are unable to resolve the dispute through negotiation, OGC will provide a written notice giving appeal rights to the district court, which must be exercised within 60 days.

B. OHA Screening Actions

  1. Pre-Screening Actions

    1. Determining Jurisdiction for Screening

      As provided in Part V. A. 3. above, if there is a current claim pending or stored at OHA Headquarters, the OAO Class Action Coordinator will receive the Day alert and related claim file(s). The Coordinator will determine OHA jurisdiction for screening and forward as follows.

      • If the claim is in an HO, the Coordinator will use Attachment 3 to forward the alert and any prior claim file(s) to the HO for screening (see Part V. B. 2. below if the claim is no longer in the HO when the alert is received).

      • If the claim is before the Appeals Council, pending court review or stored in OHA Headquarters, the Coordinator will use Attachment 3 to forward the alert and any prior claim file(s) to the appropriate OAO branch for screening (see Part V. B. 2. below if the claim is no longer in OAO when the alert is received).

      If the Coordinator (or designee) is unable to locate the current claim file within OHA, the Coordinator (or designee) will broaden the claim file search and arrange for alert transfer or claim file reconstruction, as necessary.

      NOTE:

      Do not screen pending cases in newly implemented class actions unless an alert has been received. Claimants sometimes allege class membership in connection with pending claims, after returning a response card. 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. (Cases are called up for review in the order that responses are received.) However, if class action implementation is nearly complete and a claimant with a non-alerted pending case should allege class membership, contact the Day coordinator in the Division of Litigation Analysis and Implementation (DLAI), Office of Policy, Planning and Evaluation, for assistance in responding to the claimant's allegation. DLAI's address is

      Office of Hearings and Appeals
      Division of Litigation Analysis
         and Implementation
      Office of Policy, Planning and
         Evaluation
      Suite 702
      One Skyline Tower
      5107 Leesburg Pike
      Falls Church, VA 22041-3255

      Attn: Day Coordinator

      The DLAI Day Coordinator's telephone number is (703) 305-0726.

    2. 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), or updated systems information, to determine whether:

      • there is a current claim pending at any other administrative level or in court; or

      • there are additional claims within the class dates that have not been associated.

      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 (which potentially provide a basis for screen-out or for limiting class relief); and

      • if necessary, request reconstruction of any potential class member claim files that cannot be located (see Part V. A. 4. above).

  2. 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 during the Day timeframe;

    • Follow all instructions on the screening sheet;

    • Annotate the “Remarks” section if a current claim is pending at another administrative level;

    • 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, 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.) If the screening component is an HO, forward a copy of the screening sheet directly to DLAI at the address in Part V. B. 1. a. above. HO personnel may also forward material by telefax to DLAI at (703) 305-0655. (DLAI will store all screening sheets, and will forward copies to Litigation Staff for entry into CATS.)

    If the HO receives an alert only, or one associated with a prior claim file(s) for screening, and no longer has the current claim file, it will return the material to the OAO Class Action Coordinator and advise the Coordinator of the action taken on the current claim and its destination. The Coordinator will determine the current claim file location and forward the material to that location, using Attachment 3 (within OHA) or Attachment 5 (outside OHA).

    If an OAO branch receives an alert only, or one associated with a prior claim file(s) for screening, and no longer has the current claim file, it will determine the location of the current claim file. The OAO branch will use Attachment 3 to forward the material to an OHA location or Attachment 5 to forward to a non-OHA location. The OAO branch will also advise the OAO Class Action Coordinator of its actions.

  3. Post-Screening Actions

    1. 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 7 (modify as necessary to fit the circumstances and posture of any pending claim);

        NOTE:

        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:

        Day Counsel
        Legal Aid Society of Cincinnati
        901 Elm Street
        Cincinnati, OH 45202; and
      • if the claim is not currently pending, return it to its OHA storage location.

      Pursuant to the Privacy Act Protective Order (Attachment 1), the Commissioner may disclose to class counsel information regarding class members potentially entitled to relief. Such information consists of names, addresses and claim files of potential class members, and other claimant-specific information reasonably relevant to the implementation of the settlement. The information shall be used only for the purpose of monitoring compliance with the settlement, facilitating implementation and assisting class members and potential class members with their rights.

      If class counsel makes a timely request to review the claim file (i.e., within 60 days from receipt of the notice of denial of class relief), and the file is located in OHA, DLAI will notify the OHA component housing the file to send the file to the SSA FO for class counsel's review (see Part V. A. 5. above). The component will use the pre-addressed route slip in Attachment 8 to forward the 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 time that the file can be released.

      If SSA through OGC resolves the dispute in the claimant's favor, the OHA component will take the following actions unless otherwise directed by DLAI:

      • rescreen the case;

      • send the notice of revised class membership determination in Attachment 9 (modified as necessary to fit the circumstances and posture of the current claim) to the claimant and representative, if any, and to the class counsel;

        NOTE:

        Include the address and telephone number of the servicing Social Security FO at the top of the notice.

      • proceed in accordance with Part VI. below; and

      • notify the OAO Class Action Coordinator or DLAI, as appropriate, of the revised determination by forwarding a copy of the revised screening sheet.

      If class counsel fails to make a timely request to review the claim file (i.e., within 60 days from receipt of the notice of denial of class relief), there will be no further review of the case.

    2. 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 following.

      • If a class member claim is associated with a current claim pending a hearing or Appeals Council review, the HO or the Council will proceed with processing and adjudication in accordance with the instructions in Part VI. below.

      • If a class member claim is associated with a current claim that is stored pending Appeals Council review, OAO will flag the claim for forwarding to the DDS at the close of the retention period if no appeal is filed. OAO will use the flag at Attachment 6 for this purpose.

      • If a class member claim is associated with a current claim that is stored pending court review, the OAO Court Case Preparation and Review Branch (CCPRB) will immediately notify OGC so that OGC can take appropriate action. This is true regardless of whether the claim pending in court is a subsequent or prior claim. OGC will inform the CCPRB as to how to proceed.

VI. Processing and Adjudication

SSA will readjudicate (reopen) class member claims and apply the statutes, regulations and instructions in effect at the time of the readjudication. As indicated previously, the BDD will ordinarily perform the class member readjudications. However, the following processing and adjudication procedures will apply when OHA has responsibility for screening because a current claim is pending or stored in OHA, and the claimant is determined to be a class member entitled to relief.

For purposes of this instruction, class member claim refers only to the claim in which the claimant received a defective notice, which therefore provides the basis for class membership (although to be a class member the claimant must also have filed a subsequent claim (see Part IV. for class definition)). Claims providing the basis for class membership will not be pending at the OHA level because filing an appeal on the defective notice claim is a basis for screen-out. However, a class member claim could be associated with a current claim pending or stored at OHA.

If a class member claim is associated with a current claim pending or stored at OHA and the claimant files a new claim, FOs will follow normal procedures. As appropriate, the new claim will be escalated to the OHA level.

A. Class Member Claim Is Associated with Current Claim Pending at Hearing Level

  1. Claims Have Common Issues; Hearing Scheduled or Held

    Pursuant to HALLEX I-1-708 A., if the claims are disability claims and involve disability issues, they will be considered to have common issues regardless of the period at issue or the title(s) under which the claims were filed. The current claim may be the subsequent claim in which the claimant received a res judicata denial or less than full retroactive benefits (i.e., administrative finality prevented the reopening of the defective notice claim when effectuating the subsequent (current) favorable claim), or a later claim (e.g., a claim under title XVI only).

    The appropriate HO action will depend on the ALJ's ability to consolidate the class member claim and the current claim. Pursuant to the Day stipulation (§ V.B., p. 12), SSA will use its best efforts to ensure that adjudication of the current claim is not delayed by consolidation. Therefore, to avoid having to give notice of a new issue or offer a supplemental hearing, the ALJ will consolidate common-issue claims only if the current claim and the class member claim involve the same title and the issue of disability, and if the current claim covers the entire period at issue in the class member claim. The ALJ's action on the consolidated claims may be unfavorable, partially favorable or fully favorable.

    When the ALJ consolidates Day relief with action on the current claim and the hearing has not yet been held, the ALJ should advise the claimant at the time of the hearing that the decision on the current claim will also provide relief under Day. If the hearing has already been held, the ALJ does not need to give advance notice of consolidation or offer a supplemental hearing if the above-described consolidation conditions are met.

    When the ALJ issues a decision on the consolidated claims, the ALJ will:

    1. reopen the class member claim;

    2. use the following language in the decision to notify the claimant that the decision on the current claim also resolves the class member claim:

      "Based on your claim(s) filed on _______, we previously determined you to be a member of the Day class action. Because the issues you raised in your Day class member claim(s) are identical to the issues that you have raised in your current claim, this decision resolves both claims and gives you the relief that you are entitled to under the Day class action."; and

    3. forward a copy of the decision to DLAI at the address in Part V. B. 1. a. above.

    If the ALJ is unable to consolidate the two claims (e.g., the class member claim and current claim were filed under different titles), or if the ALJ dismisses the request for hearing on the current claim, HO personnel will flag the class member claim (see Attachment 6) for forwarding to the BDD on completion of all OHA actions and expiration of any appeal period. However, HO personnel may forward the class member claim immediately if it is not needed for the adjudication of the current claim.

    NOTE:

    The ALJ may not dismiss the request for hearing on the current claim on the basis of res judicata if the class member claim, or a subsequent claim in which the claimant received a res judicata determination, forms the basis for the res judicata action.

  2. Claims Have Common Issues; Hearing Not Scheduled

    In this situation, the ALJ will dismiss the request for hearing on the current claim and forward both the current and class member claims to the BDD, for a consolidated reopening.

    EXCEPTIONS:

    The ALJ will not dismiss the request for hearing on the current claim, when a hearing has not been scheduled, if 1) the claimant has waived his or her right to an in-person hearing and the current claim is ready for an on-the-record decision; 2) the ALJ is otherwise prepared to issue a fully favorable decision on the current claim; 3) the current claim is on remand from the Appeals Council; or 4) the current claim involves terminal illness.

    If the ALJ is unable to dismiss the request for hearing on the current claim because an exception applies, the ALJ will follow the guidance in Part VI. A. 1. above.

  3. Claims Do Not Have Common Issues

    If the current claim is not the subsequent claim in which the claimant received a res judicata denial or less than full retroactive benefits (i.e., administrative finality prevented the reopening of the defective notice claim when effectuating a subsequent favorable claim), and the current claim does not have issues in common with the class member claim (e.g., the current claim involves an overpayment issue), HO personnel will retain and process the current claim separately and forward the class member claim to the BDD for readjudication without delay, using Attachment 10. However, if the class member claim is needed for adjudication of the current claim, HO personnel will flag the class member claim for forwarding to the BDD on completion of all OHA actions and expiration of any appeal period (see Attachment 6).

B. Class Member Claim Is Associated with Current Claim Pending at Appeals Council Level

  1. Claims Have Common Issues

    Pursuant to HALLEX I-1-7-8 A., if the claims are disability claims and involve disability issues, they will be considered to have common issues regardless of the period at issue or the title(s) under which the claims were filed. The current claim may be the subsequent claim in which the claimant received a res judicata denial or less than full retroactive benefits (i.e., administrative finality prevented the reopening of the defective notice claim when effectuating the subsequent (current) favorable claim), or a later claim (e.g., a claim under title XVI only). The appropriate Appeals Council action will depend on the Appeals Council's consideration of the merits and disposition of the current claim.

    1. Appeals Council Issues a Decision on Current Claim

      Pursuant to the Day stipulation, SSA will use its best efforts to ensure that adjudication of the current claim is not delayed by consolidation. Therefore, to avoid having to remand to consider a new issue (e.g., a class member claim under another title), the Council will consolidate claims only if the current claim and the class member claim involve the same title and the issue of disability, and if the current claim covers the entire period at issue in the class member claim. The Appeals Council's action on the consolidated claims may be unfavorable, partially favorable or fully favorable.

      When the Appeals Council issues a decision on the consolidated claims, the Council will:

      • reopen the class member claim;

      • use the following language in the decision to notify the claimant that the decision on the current claim also resolves the class member claim:

        "Based on your claim(s) filed on _______, we previously determined you to be a member of the Day class action. Because the issues you raised in your Day class member claim(s) are identical to the issues that you have raised in your current claim, this decision resolves both claims and gives you the relief that you are entitled to under the Day class action."; and

      • forward a copy of the decision to the OAO Class Action Coordinator at the address in Part V. A. 3. above.

        NOTE:

        If the claim was screened while it was stored pending appeal and was flagged for forwarding to the BDD (see Attachment 6), OAO personnel must remove the flag when the Appeals Council takes the consolidation action described above.

      If the Appeals Council is unable to consolidate the two claims (e.g., the class member claim and current claim were filed under different titles), OAO personnel will flag the class member claim (see Attachment 6) for forwarding to the BDD on completion of all OHA actions and expiration of any appeal period. However, OAO personnel may forward the class member claim immediately if it is not needed for the adjudication of the current claim.

    2. Appeals Council Does Not Issue a Decision on Current Claim

      In all other situations (i.e., after consideration of the merits), if the Appeals Council would otherwise dismiss or deny the request for review or remand to an ALJ, the Appeals Council will instead remand the current claim directly to the BDD, along with the class member claim, for a consolidated reopening (see Attachment 11).

  2. Claims Do Not Have Common Issues

    If the claims do not have common issues (e.g., the current claim involves an overpayment issue), and the class member claim file is not needed for adjudication of the current claim, OAO personnel will forward the class member claim file to the BDD, using Attachment 10 modified as appropriate.

    If the claims do not have common issues but the class member claim file is needed for adjudication of the current claim, OAO personnel will flag the class member claim file (see Attachment 6) for forwarding to the BDD on completion of all OHA actions and expiration of any appeal period.

VII. Case Coding

In all situations, to identify class member cases in the Hearing Office Tracking System (HOTS), HO personnel will code “DA” in the “Class Action” field. Additionally, in the OHA CCS, HO personnel will code “D” in the “SPC” field.

If the ALJ: 1) dismisses the request for hearing for the purpose of BDD readjudication; or 2) issues a decision on the current claim that is fully favorable with respect to the class member claim, HO personnel will change the hearing type on the current claim to a “reopening.” For any other ALJ action on the current claim, the hearing type, as a new request for hearing, will remain unchanged. HO personnel will code dismissal cases as “OTDI.” 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 BDD address and destination code.

VIII. Reconciliation of Implementation

At an appropriate time, Litigation Staff 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 computer-based record of OHA implementation activity (i.e., a record of alerts processed by OHA, and a record of cases screened and cases consolidated by OHA), as reported by HOs and OAO to the Coordinator. See HALLEX I-1-7-12 with respect to reporting requirements.

IX. Inquiries

Hearing office 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.

Attachment 1. June 26, 1995 Order Approving Settlement, Issued by the United States District Court for the Southern District of Ohio, with attached Settlement Agreement and Privacy Act Protective Order

 

[DATE FILED 06/26/1995]

 

UNITED STATES DISTRICT COURT
SOUTHERN DISTRICT OF OHIO
WESTERN DIVISION

ARVIL M DAY et al., ¦ Case No. C-1-87-800
  ¦  

Plaintiffs

,
¦  
  ¦  
v. ¦ ORDER APPROVING
  ¦ SETTLEMENT
DONNA E. SHALALA, et al., ¦  
  ¦  

Defendants.

¦  

A Fairness Hearing in this matter was held on the 27th day of April 1995, before The Honorable S. Arthur Spiegel, United States District Judge for the Southern District of Ohio. The purpose of the hearing was to aid the Court in determining whether the Proposed Settlement of this class action lawsuit was fair and adequate, as required by Rule 23 of the Federal Rules of Civil Procedure. The Parties recounted their settlement efforts and their reasons for believing that the agreement should be approved by the Court. The Court afforded all present the opportunity to express their support or objection to the Proposed Settlement. One objector came forward. At the encouragement of the Court, the Parties, subsequently, negotiated an accommodation for this objector. Additionally, the Parties have submitted minor corrections to the original settlement document. We have reviewed the Proposed Settlement agreement and find it to be fair and adequate. Accordingly, we approve the settlement in its final amended form of May 11, 1995.

Initially, we grant the Social Security Administration's Motion, made orally at the hearing, to Substitute the Commissioner for the Secretary of Health and Human Services as the named Defendant.

The Plaintiffs' Class brought this action to remedy the effect of a faulty notice sent out to certain individuals who were being denied Social Security benefits. The Court ordered the Social Security Administration to remedy the defect. The Sixth Circuit Court of Appeals modified the remedy and remanded for the establishment of a procedure for the reopening of denied claims applications.

 

THE PARTIES' VIGOROUS ADVOCACY

 

The Plaintiffs' Class Counsel testified to the efforts exerted on behalf of the class. The class is represented by the Legal Aid Society of Cincinnati. An extensive discovery period covered several years including more than twenty depositions, and the review of thousands of documents. The parties argued cross motions for summary judgment, and the Court entered partial judgment for the Plaintiffs.

The Parties then moved their advocacy to the Court of Appeals, which significantly narrowed our holding. In particular, the Sixth Circuit narrowed the number of claimants entitled to reopen their cases. Additionally, the Court of Appeals held that a Plaintiff must have detrimentally relied upon the faulty notice, in order to qualify for relief. Upon remand, the Parties negotiated the Proposed Settlement now before us. Under the settlement a class member who meets the negotiated criteria will be presumed to have relied upon the faulty notice. It is estimated that the class now consists of approximately 2,600 persons.

 

NOTICE TO THE CLASS

 

The Parties reported on the method of distribution of notice to the class. Actual notice will be provided to all identifiable class members, with the names and address of the potential class members to be provided by the Defendants under the terms of the mutually agreed protective order. Additionally, the settlement requires distribution of posters to all Social Security Offices in Ohio and to other state offices. Finally, public service announcements will be aired. The Plaintiffs indicated that they believe that the notice is adequate.

 

OBJECTIONS

 

The Plaintiffs' Class Counsel has reviewed all the objections filed with the Court. He reported that most of the objections are in fact not actual objections to the settlement, but notices of intent to attempt to participate in the settlement. One true objector, Carol Lanning, appeared at the Fairness Hearing through counsel. The Court expressed its hope that some accommodation could be made for Ms. Lanning. The Government has assured us that such an accommodation has been reached, and that Ms. Lansing and her counsel no longer maintain their objection. See Federal Defendant's Report to Court, at 1 & 3 (doc. 204).

 

INTERVENING REGULATIONS

 

The Government also reported to the Court that the Social Security Administration, only the day before our Fairness Hearing, promulgated Social Security Ruling 95-1p, 60 Fed. Reg. 20349 (April 26, 1995). The Government reports that this ruling:

is a nationwide Policy Interpretation Ruling concerning the finding of good cause for missing the deadline for requesting administrative review due to reliance on statements in initial or reconsideration denial notices, including the Title II reconsideration notice at issue in this case.

Federal Defendant's Report, at 2 (doc. 204). The Government reports that this ruling “provides yet another vehicle for claimants who allege that they received inadequate notices to seek redress.” Id. However, under the ruling the claimant must make an evidentiary showing of good cause. Id.

The members of this settlement class who meet the criteria specified in the Proposed Settlement “will be presumed to have relied on the notice, without the need to make any additional evidentiary showing.” Id. The Government reports that class members who do not qualify for the presumption will still have an opportunity to demonstrate their reliance under the new Social Security Ruling.

 

PRIVACY ACT PROTECTIVE ORDER

 

The settlement agreement incorporates a stipulated Privacy Act Protective Order. This order is necessary to protect the privacy of Social Security applicants, while allowing Plaintiffs' Class Counsel to view private documents in order to assure the applicant rights under the settlement. Additionally, the Protective Order allows the provision of information helpful in locating potential class members. Accordingly, at the request of the Parties, we approve the Privacy Act Protective Order dated February 6, 1995.

 

OHIO STATE DEFENDANT

 

Counsel for Defendant Leonard Herman, Director of the Ohio Bureau of Disability Determination appeared at the Fairness Hearing. The state considers the Proposed settlement to be fair and adequate to all parties.

 

REVIEW OF DISPUTED DENIALS OF RELIEF

 

The Proposed Settlement provides for an appeal process if the Social Security Administration decides that an individual who responded to the potential class relief notice or otherwise requested review is not a class member entitled to relief. See Proposed Settlement Order at 8-9, Exhibit 1 to Joint Motion for Tentative Approval of the Settlement (doc. 160). Such an individual may contact Plaintiffs' Class Counsel, who upon review may elect to carry the appeal to the Office of General Counsel, Social Security Division, Department of Health and Human Services (“OGC”). Id. If the Parties are unable to resolve the dispute at the OGC level, then the Proposed Settlement Agreement provides for appeal to the district court. Id at 9. In order to provide prompt and orderly attention to such appeals, we designate United States Magistrate Judge Jack Sherman as the arbiter of any such appeals. Magistrate Judge Sherman will render a final judgment binding upon all parties.

 

CONCLUSION

 

We have studied the Proposed Settlement. We have conducted a Fairness Hearing at which we questioned the Parties in regard to the Proposed Settlement. We are satisfied that the one class member who raised a formal objection at the Fairness Hearing has removed her objection by mutual agreement. Therefore, the Court is satisfied that the Proposed Settlement represents a fair and adequate adjudication of the rights of the Parties in this litigation. Accordingly, we hereby APPROVE the Settlement Agreement and also APPROVE the Privacy Act Protective Order.

     SO ORDERED

   
   
   

Dated: __6/23/95__

_____________/s/_______________
S. Arthur Spiegel
United States Senior District Judge

   
   
   
   

Exhibit 1

 
[[

DATE FILED 05/15/1995]

]
 

UNITED STATES DISTRICT COURT

FOR THE SOUTHERN DISTRICT OF OHIO

WESTERN DIVISION

 
 
ARVIL M. DAY, et al. )  
  )  
Plaintiffs, )  
  )  
-vs- )

Civil Action No. C-1-87-800

  )

(JUDGE SPIEGEL)

DONNA E. SHALALA, )  
Secretary of Health and )  
Human Services, et al. )  
  )  

Defendants.

)  
_________________________________ )  

ORDER

This case is before the Court on remand from the Court of Appeals for the Sixth Circuit which has directed this Court to determine procedures for reopening the claims of class members who are entitled to relief pursuant to the appellate court's May 12, 1994 decision. See Day v. Shalala, 23 F. 3d 1052, 1067 (6th Cir. 1994). Accordingly, it is hereby ORDERED as follows:

 

I

.
 

The class defined in the Court's November 20, 1991 Order was comprised of:

All persons who applied for and were denied, or were terminated from, the receipt of Title II or Title XVI disability benefits since October 9, 1984, or who will be denied or terminated from the receipt of Title II or Title XVI disability benefits, by the Ohio Bureau of Disability Determination (BDD). This class excludes persons who were denied or terminated because they have returned to substantial gainful activity or who are not eligible for disability benefits for reasons not related to disability.

On May 12, 1994, the Court of Appeals for the Sixth Circuit further restricted the definition of a class member, holding that:

[t]he class . . . excludes any claimants whose applications for reconsideration were denied more than sixty days before the filing of the amended class complaint on December 4, 1987.

Day v. Shalala, 23 F.3d 1052, 1058 (6th Cir. 1994).

The Sixth Circuit also noted that “[b]ecause plaintiffs concede that the [Title II reconsideration denial] notices used starting in February, 1990 are adequate, their challenge is only to the [Title II reconsideration denial] notices in use from October 9, 1984 until February, 1990.” Day, 23 F.3d at 1065.

 

II.

 

Class members entitled to relief are individuals:

  1. Who received at the reconsideration level a denial notice of Title II disability benefits from the BDD on or after October 5, 1987, and before February 1, 1990, which stated, in part, that:

    If you do not request a hearing of your case within the prescribed time period, you still have the right to file another application at any time;

    and;

  2. Who detrimentally relied on the above notice language. To demonstrate such reliance, a class member must have satisfied the following criteria:1

    1. Filed a new application within 2 years or receipt of the above-described reconsideration denial notice, rather than pursuing the appeal of the previous application because of such notice; and

    2. Been subsequently presented by the Secretary with a claim of res judicata on any new Title II2 benefit application, or received less in retroactive benefits then the class member would have received had the class member successfully appealed initially;

      and;

    3. If presented with a claim of res judicata pursuant to ¶ II.B.2 of the Order, the Secretary did not withdraw the res judicata claim and consider the class member's entitlement to Title II benefits, and the class member did not appeal the res judicata decision to a United States District Court.3

 

III.

 
  1. 1. To the extent practicable, SSA shall, by means of its data processing systems, immediately commence identification of the names, Social Security numbers, and last known addresses of all class members potentially entitled to relief. SSA will attempt to complete such identification within 90 days of final approval of this Order by the district court. SSA believes it can reasonably be expected to complete such identification within 90 days, but in the event that SSA experiences serious computer difficulties, or other unforeseen circumstances, SSA will immediately contact plaintiffs' counsel to prepare a revised timetable for identification of class members potentially entitles to relief.

    2. SSA will attempt to furnish draft implementation instructions to plaintiffs' counsel within 120 days of final approval of this Order by the district court. SSA believes it can reasonably be expected to provide draft implementation instructions within 120 days, but in the event that SSA cannot forward the draft implementation instructions within 120 days of final approval of this Order by the district court, SSA will immediately contact plaintiffs' counsel to prepare a revised timetable for forwarding the draft implementation instructions. Plaintiffs' counsel shall have 20 days to review the draft instructions and provide any comments thereon to SSA. SSA may, but is not required to, modify the implementation instructions based on plaintiffs' counsel's comments and SSA will attempt to issue final implementation instructions to all affected SSA personnel within 60 days after receipt of comments from plaintiffs' counsel. SSA believes it can reasonably be expected to issue final implementation instructions within 60 days, but in the event that SSA cannot forward the final implementation instructions within 60 days of receipt of comments from plaintiffs' counsel, SSA will immediately contact plaintiffs' counsel to prepare a revised timetable for forwarding the draft implementation instructions.

    3. Thirty days after the issuance of final implementation instructions by SSA under ¶ III.A.2 of this Order, or thirty days after the identification of class members pursuant to ¶ III.A.1, whichever occurs later, SSA shall send a copy of the potential class relief notice, along with a review request form and a postage prepaid return envelope by first class mail to the last known address of those individuals potentially entitled to relief as described in ¶ II of this Order.

    4. When individual notices are returned as undeliverable, SSA will attempt to obtain updated addresses by providing a computer tape to the Ohio Department of Human Services (ODHS) for the sole purpose of obtaining addresses through a computerized match with public assistance, food stamp, and/or other relevant records. SSA's attempt to obtain updated addresses is subject to the requirements of the Privacy Act, as amended by the Computer Matching and Privacy Protection Act, 5 U.S.C. § 552a (“Privacy Act”). SSA shall not be obligated to bring legal proceedings to gain access to such data system records. After completion of the data match, SSA shall mail notices to any potential class member for whom ODHS provides an updated address.

  2. 1. Any individual who receives a potential class relief notice and who wishes to request relief under this Order must mail a completed review request form in the SSA-provided franked, self-addressed envelope to SSA within 60 days of the date of receipt of the notice. No individual who fails to timely return the review request form to SSA shall receive relief under this Order unless the individual demonstrates good cause (as defined in 20 C.F.R. § 404.911) for the untimeliness.

    2. Any individual who does not receive a potential class membership notice but who wishes to request relief under this Order must notify SSA by mail, telephone, or in person at an SSA Field Office. Such individual must provide SSA with his or her name, address, Social Security number, date of birth, and his or her reason for requesting relief under this Order. The individual must notify SSA within 180 days after SSA mails the notices pursuant to ¶ III.A of this Order. If the individual fails to do so, that individual shall not receive relief, unless the individual demonstrates good cause (as defined in 20 C.F.R. § 404.911) for the untimeliness. In an effort to notify individuals described in this paragraph, SSA will provide plaintiffs' counsel with up to 400 posters 4, which describe the relief available under this Order. The posters will explain that individuals must notify SSA within 180 days after SSA mails the notices pursuant to ¶ III.A of this Order.

    SSA will also provide a media package to newspapers, television and radio stations within the state of Ohio containing information for public service announcements and will issue a press release to newspapers within the state of Ohio. As the publication or broadcast of the information provided to the media by SSA pursuant to this paragraph of this Order will be at the discretion of these media, SSA makes no representations as to whether, when, or how frequently this information will be published or broadcasted. The parties further agree that SSA is under no obligation to purchase radio time, television time or newspaper advertisements for the dissemination of the information provided to the media pursuant to this paragraph of this Order.

    3. A determination by SSA under ¶ III.B.1 and ¶ III.B.2 of this Order concerning good cause shall be binding and not subject to further review.

 

IV.

 
  1. SSA shall review the claims of individuals who timely respond to the potential class membership notice in accordance with ¶ III.B for a determination as to whether they are potentially entitled to relief. Individuals who meet the criteria set forth in ¶ II of this Order will receive the relief specified in ¶ V.

  2. If SSA determines that an individual who responded to the potential class relief notice or otherwise requested review is not a class member entitled to relief, SSA will send notice of this determination to the individual and to class counsel: John E. Schrider, Jr., Timothy Juenke, or their designee, Legal Aid Society of Cincinnati, 901 Elm Street, Cincinnati, Ohio 45202. Such individuals will be informed that if they disagree with the determination, they should immediately contact class counsel upon receipt of the notification of non-entitlement to relief.

  3. Class Counsel may, following receipt of SSA's determination denying class membership, write the Office of the General Counsel, Social Security Division, Department of Health and Human Services (OGC), Altmeyer Building, Room 611, 6401 Security Boulevard, Baltimore, MD 21235 within 60 days of receipt of the notification of non-entitlement to relief and explain any disagreement. If class counsel does not write to OGC to disagree with the SSA determination within 60 days of receipt of the notification of non-entitlement to relief, SSA's determination as to entitlement to relief shall become binding and will not be subject to further review.

  4. OGC will attempt to resolve through negotiation all disputes concerning the determination made pursuant to this subparagraph. Class counsel may request to review the folder or other material upon which the determination of non-entitlement to relief was based. SSA will make the folders or other materials available at one Social Security field office agreed upon by the parties. The file or other materials will remain at the designated SSA field office for sixty days. Class counsel will use this information solely for the purpose of pursuing the individual's claim, and in accordance with the Stipulated Privacy Act Protective Order dated _________________. If the parties cannot resolve the question of the individual's entitlement to relief through negotiation, OGC will confirm to the individual and to class counsel, in a written notice, that the dispute cannot be resolved. The notice will state that if within 60 days of receipt of OGC's written confirmation the individual does not request the district court's review of the OGC confirmation of the SSA determination, the determination will become final and not subject to further review.

  5. If OGC determines after consultation with plaintiffs' counsel that the individual is a class member entitled to relief under this settlement, SSA will provide the relief specified in ¶ V of this Order.

  6. Within 60 days of the issuance of the potential class relief notices, and every three months thereafter, SSA shall submit a written report to class counsel which includes the following information from SSA's computerized tracking system:

    1. the number of class notices sent pursuant to ¶ III.A.3 of this Order;

    2. the number of individuals responding to notices sent pursuant to ¶ III.A.3 of this Order;

    3. the number of notices sent pursuant to ¶ III.A.3 that are returned as undeliverable;

    4. the number of class notices sent pursuant to ¶ III.A.4 of this Order;

    5. the number of responding individuals who received favorable determinations at the reconsideration level by the BDD;

    6. the number of responding individuals who received unfavorable determinations at the reconsideration level by the BDD.

  7. SSA shall inform plaintiffs' counsel of the date that notices are mailed pursuant to ¶ III.A.3 and ¶ III.A.4 within two days of such mailing.

  8. SSA shall provide plaintiffs' counsel with copies of all policy statements, directives and instructions regarding identification, notification and potential relief to potential Day v. Shalala class members, within seven working days of their issuance.

 

V.

 
  1. If SSA determines that an individual who has responded to a class notice or requested relief pursuant to ¶ III.B of this Order is a class member entitled to relief, SSA will reopen the class member's Title II application which forms the basis for relief under this Order to consider whether the class member was eligible for disability insurance benefits. 5 SSA will take into account evidence in the claims file and any additional evidence submitted by the class member, which relates to an impairment that existed while the class member met the requirements of disability insured states. All claims entitled to reopening under the terms of the Order shall be readjudicated at the reconsideration level, unless consolidated pursuant to ¶ V.B of this Order.

    For claims readjudicated at the reconsideration level, SSA shall develop the record in accordance with SSA policy for development of regular claims, e.g., 20 C.F.R. §§ 404.1512-18. SSA will inform class members that they may submit new evidence pertaining to the readjudication of their claim. If SSA is unable to obtain a class member's file, SSA shall reconstruct the missing file according to the relevant POMS provisions. See GN 01201.100; DI 20510.005; DI 20510.010.

  2. 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 Order 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.

  3. Individuals whose claims are redetermined pursuant to this Order shall retain all rights to seek further administrative and judicial review in accordance with 42 U.S.C. § 405 (g) and 20 C.F.R. Part 404, Subpart J.

 

VI.

 

All disclosures under this Order shall be governed by the terms of the stipulated Privacy Act Protective Order, dated ___________________, which hereby is incorporated into this Order as if fully set forth herein in its entirety.

 

VII.

 
  1. The Sixth Circuit's May 12, 1994 decision in this case represents the full and final resolution of the claims or causes of action in connection with plaintiffs' class complaint. Accordingly, the amended class complaint hereby is dismissed with prejudice. The Court will retain jurisdiction over the case solely for purposes of reviewing a timely petition for attorney fees, enforcing the terms of this Order, reviewing requests for modification submitted by the parties pursuant to VII.B of this Order, and enforcing or granting relief from that portion of the District Court's Order affirmed by the appellate court's May 12, 1994 decision.

  2. The parties may seek modification of this Order by written agreement of all of the parties, which shall not become effective until approved by the Court.

  3. This Order shall not be construed as limiting the pre-existing rights of any class member to apply for benefits, request administrative or judicial review, or request reopening of a decision pursuant to 20 C.F.R. §§ 404.988 and 416.1488.

  4. This Order reflects the entire agreement of the parties concerning the issues addressed in this Order.

  5. Final judgment in accordance with Rules 54, 58, and 79(a), Fed. R. Civ. P., shall be entered upon the Court's entry of this Order. This Order shall become effective on the 61st day after such entry of final judgment. In the event an appeal of this Court's entry of the Order or the final judgment is filed, SSA may in its discretion delay implementation of the Order until a final determination of the appeal.

Agreed To:


____________/s/__________________
JOHN E. SCHRIDER, JR. (0014967)
TIMOTHY R. JEUNKE (00161309)
Legal Aid Society of Cincinnati
901 Elm Street
Cincinnati, OH 45202
(513) 241-9400

Attorney for Plaintiffs



___________/s/___________________
BRIAN G. KENNEDY
KAREN STWEART
U.S. Department of Justice
Room 820
901 "E" Street, N.W.
Washington, D.C. 20530
(202) 514-2849

Attorneys for Federal Defendant



__________/s/____________________
JACK W. DECKER (0021285)
Assistant Attorney General
Employment Law Section
30 E. Broad St., 23rd Flr.
Columbus, OH 43215-3428
(614) 644-7257


Attorney for State Defendants







Exhibit 2

 
 

IN THE UNITED STATES DISTRICT COURT

FOR THE SOUTHERN DISTRICT OF OHIO

WESTERN DIVISION

 
 
ARVIL M. DAY, et al., )  
  )  

Plaintiffs,

)

Civil Action No. C-1-87-800

  )  
v )

JUDGE SPIEGEL

  )  
DONNA E. SHALALA, Secretary )  
of Health and Human Services, )  
et al., )  
  )  

Defendants.

)  
_________________________________ )  
 

PRIVACY ACT PROTECTIVE ORDER

 

Pursuant to 5 U.S.C. § 552(b) (11), 42 U.S.C. § 1306 (a), and 20 C.F.R. § 401.340, IT IS HEREBY ORDERED as follows:

     1. Defendant may disclose to plaintiffs' counsel information regarding class members potentially entitled to relief under the district court's Order implementing the decision in Day v. Shalala, 23 F.3d 1052 (6th Cir. 1994), [hereinafter “Order”] that is subject to restrictions on disclosure under the Privacy Act of 1974 and the Social Security Act, without obtaining the prior written consent of the individual to whom such records pertain.

     2. The information disclosed pursuant to paragraph 1 of this Privacy Act Protective Order (“Protective Order”) shall be used only for the purposes of monitoring compliance with the Order, facilitating implementation of the Order, and assisting class members and potential class members in effectuating their rights under the Order. Except as provided in this Protective Order or otherwise ordered by the Court, access to the information disclosed under this Protective Order shall be limited to: (1) plaintiffs' counsel who are actively assisting with the implementation of the Order; (2) members of plaintiffs' counsel's staff; (3) defendant or her agents, counsel or staff; (4) the Court in this action; or (5) other persons participating in the accomplishment of the authorized purposes of disclosures as described in this paragraph of the Protective Order.

     3. Any disclosure to persons described in items (2) and (5) of the paragraph 2 of this Protective Order shall be conditioned upon such persons having read this Protective Order and acknowledged, in a written affidavit, that they understand the Order and agree to be bound by it.

     4. Plaintiffs' counsel and members of their staff shall limit the making of copies of the records disclosed under this Protective Order to those necessary to the purposes described in paragraph 2. All such copies, and any document or working paper created by plaintiffs' counsel or any member of their staff that contain information subject to the terms of this Protective Order, shall be protected from disclosure in accordance with the provisions of this Protective Order and shall be maintained in a secure place.

     5. All material filed on the public record of the court or accessible to the public shall have the names, addresses, Social Security numbers, claim numbers and other personal identifying information stricken therefrom, replacing the names with the appropriate pseudonyms if necessary. If the parties deem it necessary to utilize such information in any presentation to the court, any documents containing such identifying information shall be filed under seal and the identifying information need not be stricken.

     6. This Protective Order shall not apply to records of claimants who provide written consent to the release of confidential information subject to this Protective Order to the Legal Aid Society of Cincinnati.

     7. Plaintiffs' counsel shall destroy any documents subject to this Protective Order within ninety (90) days after the documents are no longer needed for the purposes described in paragraph 2 of this Protective Order.

     8. Nothing in this Protective Order should be construed to be the litigating position of any party regarding disclosures under state or federal privacy laws, including the Privacy Act of 1974.

     9. Upon twenty days notice to the other parties, any party may seek modification of this Order.

IT IS SO ORDERED this ________ day of ____________________, 1995.

 

 

 

By:                       /s/                            

United States District Judge

Agreed To:

___________/s/___________________
JOHN E. SCHRIDER, JR. (0014967)
TIMOTHY R. JEUNKE (00161309)
Legal Aid Society of Cincinnati
901 Elm Street
Cincinnati, OH 45202
(513) 241-9400

Attorney for Plaintiffs


___________/s/___________________
BRIAN G. KENNEDY
KAREN STEWART
U.S. Department of Justice
Room 820
901 "E" Street, N.W.
Washington, D.C. 20530
(202) 514-2849

Attorneys for Federal Defendant


____________/s/__________________
JACK W. DECKER (0021285)
Assistant Attorney General
Employment Law Section
30 E. Broad St., 23rd Flr.
Columbus, OH 43215-3428
(614) 644-7257

Attorney for State Defendants





1     Class members will not be required to make a specific showing that they were misled by the relevant notice in order to obtain relief under this Order. SSA's agreement to forego this requirement is limited to this case for purposes of settlement and should not be read as a concession by SSA that individuals who have not shown that they were misled by the relevant notice necessarily “detrimentally relied” on the notice for purposes of any other case or circumstances.

2     An application under Title XVI includes an application for all other possible benefits, including an application for Title II benefits.

3     Pursuant to ¶ IV.A of this Order, SSA will screen the claims files of potential class members to determine if the criteria set forth in ¶ II has been met. While the parties cannot anticipate all of the issues that might arise during the screening process, the parties agree that the criteria set forth in ¶ II of this Order are designed to identify, for purposes of reopening, those individuals whose decision to reapply for benefits rather than pursuing an appeal of the previous application resulted in either a total bar to benefits or a reduction in benefits.

Moreover, any individual who meets the criteria of ¶ II will not be denied relief under this Order because he/she was no longer insured on the date of the reapplication.

4     Poster notices prepared by SSA and subject to review and approval by class counsel will be publicly displayed in all SSA field offices and OHA offices in the State of Ohio until the end of the time period for response to notification. In addition, SSA will send such posters to all County Department of Human Services in the State of Ohio with a written request that they be conspicuously displayed in locations such as applicant and recipient waiting rooms.

5     SSA will apply its normal procedures for processing claim of deceased individuals. See 42 U.S.C. § 404(d); 20 C.F.R. §§ 404.503(b); 404.610(d), 404.615, 404.621(e); 404.1505; POMS DI 23510.001; GN 02301.030.

Attachment 2. - Sample Day Alert

  999____ 00000
CTWALT01 Day Court Case Flag/Alert
REVIEW OFFICE PSC DOC TOE ALERT DATE RESPONSE DATE OLD BOAN/PAN
SSN

(BOAN or PAN)

       NAME BIRTH DATE REFERENCE #
             
      FOLDER LOCATION INFORMATION  
CAN/HUN BIC/MFT CATG TITLE CFL CFL DATE ACN
             
PAYEE ADDRESS            
             
             

SHIP TO ADDRESS:

ODIO JURISDICTION Title II & CONC CLAIMS

TITLE XVI

SSA, ODIO
Class Action Section
Attention: Day Coordinator
P.O. Box 17369
Baltimore, MD 21298-0050

SPECIAL INSTRUCTIONS:

IF CLAIM IS PENDING OR STORED IN OHA HEADQUARTERS, THEN SHIP 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 THE CLAIM IS PENDING IN AN OHA HEARING OFFICE, THEN SHIP FOLDER DIRECTLY TO THAT OFFICE

Attachment 3. - Screening Flag - Within OHA

  Day Class Action Case
  SCREENING NECESSARY
   
Claimant's name: ___________________________    
       
SSN: ___________________________    

This claimant may be a Day 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 5-4-53, 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.

  TO:

__________________________________
__________________________________
__________________________________
__________________________________

     
  FROM:

__________________________________
__________________________________
__________________________________
__________________________________

Attachment 4. - Day SCREENING SHEET

CLASS ACTION CODE:

   D  A

1. CLAIMANT'S SSN

____-___-____

2. CLAIMANT'S NAME (LAST, FIRST, MI) (PLEASE PRINT)

 

 

 

3. DATE OF BIRTH (MM/DD/YYYY)

     __ __ - __ __ - __ __

 

 

4. CLAIM NUMBER

     __ __ - __ __ - __ __ __ __

 

(BIC/ID)

__ __

5. SCREENING DATE (MM/DD/YYYY)

     ____-____-____

 

 

6. a. SCREENING RESULT

 

____MEMBER ENTITLED TO RELIEF (J) ____NONMEMBER NOT ENTITLED TO RELIEF (F)

 

b. SCREENOUT CODE

    ____-____(see item 17 for screenout codes)

 

CONSIDER THE FOLLOWING SCREENING CRITERIA SEPARATELY FOR EACH DEFECTIVE NOTICE CLAIM. FOR EACH CLAIM SCREENED, ENTER THE APPROPRIATE INFORMATION IN ITEM 18.

7. Did the individual receive one or more Title II reconsideration medical denial notices from the Ohio BDD on or after October 5, 1987, and before February 1, 1990?

Remarks:

Yes___No___

If No see item 17 for screen-out code.

8. Does the reconsideration notice contain the statement that “if you do not request a hearing of your case within the prescribed time period, you still have the right to file another application at any time?” If no, see item 17. for screen-out code.

Remarks:

Yes___No___

If No see item 17 for screen-out code.

9.Did the individual pursue appeal of the determination in Question 7?

Remarks:

Yes___No___

If yes, see item 17 for screen-out code.

10. If the individual did not pursue appeal, did the individual file a new claim under either Title II or XVI, within two years of the date of receipt of the “defective” reconsideration denial notice?

Yes___No___

If no, see item 17 for screen-out code.

11.Was the new claim based on new and different impairment(s)?

Remarks:

Yes___No___

If yes, see item 17 for screen-out code.

12.Did the individual receive a favorable determination/decision under Title II or Title XVI on the subsequent claim referred to in Question 10?

Remarks:

Yes___No___

If No go to 15. If yes, go to 13.

13.If the individual received a favorable determination/decision on the subsequent claim, did the period adjudicated cover the entire time period at issue in the claim on which the determination in question No. 7 was issued?

Remarks:

Yes___No___

If yes, go to 14. If no, claimant is a class member.)

14.Was the prior claim, on which the determination in question No. 7 was issued, reopened for payment purposes?

Remarks:

Yes___No___

If yes, see item 17 for screen-out code. If no, claimant is a class member for payment effectuation purposes only. DO NOT SEND TO THE BDD

15. Did the individual receive a res judicata denial or dismissal as the final action of the Commissioner on the subsequent claim referred to in Question 10?

Remarks:

Yes___No___

If no, see item 17 for screen-out code.

16.Did the individual pursue court review of the res judicata dismissal, or receive a determination on a later claim that covered the entire time period at issue in the defective notice claim in Question 7?

Remarks:

Yes___No___

If yes, see item 17 for screen-out code. If no, claimant is a class member.

17.Enter the following screen-out codes in items 6.a. and 18. as appropriate. If there is more than one screen-out code, enter the one with the lowest numerical value in item 6.a.

Enter 07 if question 7 was answered “NO”. (Reason No. 1. of non-member notice.)

Enter 08 if question 8 was answered “NO”. (Reason No. 2. of non-member notice.)

Enter 09 if question 9 was answered “YES”. (Reason No. 3. of non-member notice.)

Enter 10 if question 10 was answered “NO”. (Reason No. 4. of non-member notice.)

Enter 11 if question 11 was answered “YES”. (Reason No. 5. of non-member notice.)

Enter 14 if question 14 was answered “YES”. (Reason No. 6. of non-member notice.)

Enter 15 if question 15 was answered “NO”. (Reason No. 7. of non-member notice.)

Enter 16 if question 16 was answered “YES”. (Reason No. 8./9. of non-member notice.)

18 .Enter the filing date of each claim screened, in order, from the oldest to the most recent. For each claim, enter either the date of the “defective” notice, the res judicata denial, or the allowance. Check the block for each defective notice claim that confers class membership, or fill in the screen-out code, as appropriate. If a claim did not receive any of the designated actions, enter the filing date only.

Date Claim Filed    Date of Notice   OR     Date of Denial or Allowance

1._______________    __________________    ________________

2._______________    __________________    ________________

3._______________    __________________    ________________

 

Print name of screener, component and telephone number:

 

Signature:

 

Date:

Day Screening Sheet Instructions

COMPLETE ONLY ONE SCREENING SHEET EVEN IF THE CLAIMANT RECEIVED MULTIPLE DETERMINATIONS WITHIN THE CLASS DATES. HOWEVER, THE SCREENING SHEET PROVISIONS MUST BE CONSIDERED SEPARATELY FOR EACH CLAIM. A CLASS MEMBER WHO RECEIVED MULTIPLE DETERMINATIONS IS ELIGIBLE FOR READJUDICATION ONLY ON THOSE CLAIMS MEETING ALL CLASS MEMBERSHIP REQUIREMENTS.

Items 1 - 5

Fill in the claimant's own 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.

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

Only disability claims medically denied under title II are eligible for class membership consideration. The determination within the appropriate timeframes must have been at the reconsideration level. Individuals who received cessation determinations, or partial awards either at the initial or reconsideration level, are not eligible for class membership because they would not have received notices from the BDD. Determine the date of denial from the latest SSA-831-U3 or other denial form.

Item 8

An individual is a potential class member only if the title II reconsideration denial notice failed to contain the admonition that “[a] new application is not the same as an appeal of this determination.” In lieu of this language, defective notices advised claimants that they had the right to file another application at any time, leaving the impression that their rights would be preserved. The court did not find that the title II initial notice of denial or the title XVI notices were “defective.” If a copy of the notice is not in file, presume that the individual received a defective notice.

Item 9

An individual is a potential class member only if he or she was misled by the faulty notice and filed a new claim rather than pursuing appeal (i.e., requested a hearing). An individual who pursued appeal could not have been misled. A request for reopening is not the same thing as pursuing appeal.

Items 10 and 11

In addition to the requirement that a potential class member must have filed a new claim, the new claim must have been filed within two years of the date of receipt of the “defective” reconsideration notice. For purposes of implementing class relief in this case, we are considering the claimant's filing of a new claim within two years, rather than pursuing appeal, to be presumptive evidence that the claimant was misled with respect to his/her appeal rights.

If the new claim was based on a new and different impairment(s), the claimant cannot be a class member.

Item 12

An individual is a potential class member as long as he or she received, in whole or in part, a favorable determination or decision under either title II or title XVI on any subsequent claim filed within the required two-year period. The date of the favorable determination or decision itself is immaterial.

Item 13

If an individual received a favorable determination on a claim subsequent to the defective notice claim, but that determination did not cover the entire time period at issue in the defective notice claim, then the individual is a class member.

Item 14

When the favorable determination/decision referenced in items 12. and 13. was effectuated, the prior claim(s), i.e., the defective notice claim(s), may or may not have been reopened, depending on the rules of administrative finality. If in effectuating the subsequent claim, the defective notice claim(s) could not be reopened for payment purposes because of the rules of administrative finality, the individual is a class member. However, because the entire time period covered by the defective notice claim(s) has already been adjudicated (see item 13.), the only action necessary is to send the defective notice claim(s) to the Office of Disability and International Operations to pay any additional payment/benefit due.

Item 15

An individual is a potential class member as long as he or she received, in whole or in part, a res judicata denial (or res judicata dismissal at the ALJ or Appeals Council levels), under either title II or title XVI on any subsequent claim filed within the required two-year period. The date of the res judicata action itself is immaterial.

Item 16

Ordinarily, an individual who receives a res judicata denial has no right to judicial review. In most cases, a district court will dismiss a complaint filed in this situation. Occasionally, however, district courts will take jurisdiction of an appeal from a res judicata denial. The Day court has specifically precluded these cases from class membership. (An individual who appealed the issue of less than full retroactive benefits (i.e., failure to reopen) ordinarily also has no right to judicial review. However, the Day court has not specifically precluded these cases from class membership.) Any questions concerning court action in these situations should be referred to the Day coordinator.

An individual who has received a determination (whether favorable or unfavorable) on a later claim (at any level) concerning the entire time period at issue in the defective notice claim, has obtained all available relief under the Day settlement.

Processing Class Member Determinations

  1. Check the “Member” block in item 6. a. of the screening sheet.

  2. Show the dates of all applications screened and the corresponding date of defective notice or date of res judicata denial or allowance, as appropriate, in item 19. of the screening sheet. Check the block for each claim that confers class membership.

  3. 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.

  4. Retain the original screening sheet in the claim file. OHA Headquarters components will send a copy of the screening sheet to:

    Office of Appellate Operations
    One Skyline Tower, Suite 701

    Attn: OAO Class Action Coordinator

    [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).]

    OHA Hearing Office (HO) components will send a copy of the screening sheet to:

    Office of Hearings and Appeals
    Division of Litigation Analysis and Implementation
    Office of Policy, Planning and Evaluation
    One Skyline Tower, Suite 702
    5107 Leesburg Pike
    Falls Church, VA 22041-3200

    Attn: Day Coordinator

    [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 Headquarters for entry into the Civil Action Tracking System.]

  5. Follow HALLEX I-5-4-53, V. B. 3. b.

Processing Non-class Member Determinations

  1. 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.

  2. Follow items b. - d. above.

  3. Prepare and issue the “Non-Class Membership Notice.” Retain a copy of it in the folder, and mail a copy to the Day class counsel and claimant's representative, if any. Forward the claim file(s) as indicated in HALLEX I-5-4-53, V. B. 3. a.

Attachment 5. - Screening Flag -- Outside OHA

ROUTING AND TRANSMITTAL SLIP

 

DATE

TO:

1.

INITIALS DATE
2.    
3.    
4.    
5.    
6.    
7.    
__XX_ACTION _____FILE _____NOTE AND RETURN
_____APPROVAL _____FOR CLEARANCE _____PER CONVERSATION
_____AS REQUESTED _____FOR CORRECTION _____PREPARE REPLY
_____CIRCULATE _____FOR YOUR INFORMATION _____SEE ME
_____COMMENT _____INVESTIGATE _____SIGNATURE
_____COORDINATION _____JUSTIFY _____OTHER

REMARKS

Day Case

Claimant: ___________________________    
       
SSN: ___________________________    

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 ODIO for screening. SEE POMS DI 12576.020A.1. or DI 42576.005.4.

 

DO NOT use this form as a RECORD of approvals, concurrences, disposals, clearances, and similar actions.

FROM:  

        Office of Hearings and Appeals
        Office of Appellate Operations
        5107 Leesburg Pike
        Falls Church, VA 22041-3200

SUITE / BUILDING

701 One Skyline Tower

 

PHONE NUMBER

(703) 305-0656

 

OPTIONAL FORM 41 (REV. 7-76)
*U.S.GOP:1985-0-461-274/20020 Prescribed by GSA
FPMR (41 CFR) 101-11-.206

Attachment 6. - Readjudication Flay for OHA Retention Cases

Day Class Action Case

READJUDICATION NECESSARY

Claimant's name: ___________________________    
       
SSN: ___________________________    

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

[Send folders to the BDD.]

NOTE::

If the claimant has filed a civil action and elected to remain in court for review of the current claim, forward the Day claim file(s) without delay to the BDD for readjudication.

Attachment 7. Non-Class Membership Notice

SOCIAL SECURITY NOTICE

 

 

Important Information

From:

Services Social Security Administration

   
  ____________________________Date:____-____-____
   
  ____________________________Claim Number:____________________
   
  ____________________________DOC:___________________________

We are writing to tell you that we received your request to review your earlier claim for disability benefits under the Day v. Chater court decision. We have looked at your case and have decided that you are not a class member entitled to relief. This means that we will not review our earlier decision. The reason that you are not a class member entitled to relief under the Day court order is checked below.

You Are Not A Day Class Member Because:

1. ___

You did not receive a Social Security Disability Insurance reconsideration denial notice from the Ohio Bureau of Disability Determination on or after October 5, 1987, and before February 1, 1990.

 

2. ___

You received the proper reconsideration denial notice advising you that filing a new claim was not the same thing as pursuing appeal.

 

3. ___

You filed an appeal of the Social Security Disability Insurance reconsideration denial notice.

 

4. ___

You did not file a new claim for Social Security Disability Insurance or Supplemental Security Income within two years after receiving the reconsideration denial notice.

 

5. ___

You filed a new claim within two years after receiving a reconsideration denial notice, but your new claim was based on a new and different impairment(s).

 

6. ___

You filed a subsequent claim after your Social Security Disability Insurance reconsideration was denied, and your prior claim was reopened.

 

7. ___

You filed a new claim within two years after receiving the reconsideration denial notice, but you did not receive a res judicata denial or dismissal as the last administrative action on this claim. (res judicata means that the issues in your new claim were the same as in your prior claim.)

 

8. ___

Your res judicata dismissal was reviewed by a Federal court.

 

9. ___

After you received a res judicata denial or dismissal, you filled another claim and received a determination covering the entire time period you alleged in your prior claim.

 

10. ___

Other: You are not entitled to relief because:

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

   

We Are Not Deciding If You Were Disabled

It is important for you to know that we are not making a decision about whether you were disabled at the time of your earlier claim. We are deciding only that you are not a Day class member.

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 Day 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 and address of the attorney are:

John E. Schrider, Jr., Esq.
Legal Aid Society of Cincinnati
901 Elm Street
Cincinnati, OH 45202
(513) 241-9400

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 Day. 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 contact your Social Security office. The address and phone number are printed at the top of this letter. If you call or visit an office, please have this notice with you. It will help us answer your questions. You may also contact your personal legal representative, if you have one, or the Day class attorney listed above.

Si usted no entiende esta carta, llévela a la Oficina de Seguro Social arriba mencionada para que se la expliquen.

cc: John E. Schrider, Jr., Esq.

Attachment 8. - Route Slip for Non-class Membership

ROUTING AND TRANSMITTAL SLIP

 

DATE

TO:

1. Cincinnati District Office

INITIALS DATE
2.    
3.    
4.    
5.    
6.    
7.    
__XX_ACTION _____FILE _____NOTE AND RETURN
_____APPROVAL _____FOR CLEARANCE _____PER CONVERSATION
_____AS REQUESTED _____FOR CORRECTION _____PREPARE REPLY
_____CIRCULATE _____FOR YOUR INFORMATION _____SEE ME
_____COMMENT _____INVESTIGATE _____SIGNATURE
_____COORDINATION _____JUSTIFY _____OTHER

REMARKS

  DAY CASE
Claimant: ___________________________    
       
SSN: ___________________________    

We have determined that this claimant is not a Day class member. (See screening sheet and copy of denial of class relief notice in the attached claim file(s).) As requested, we are forwarding the file(s) for class counsel's review. SEE POMS DI 12576.020A.2.

 

 

DO NOT use this form as a RECORD of approvals, concurrences, disposals, clearances, and similar actions.

FROM:

      Office of Hearings and Appeals

SUITE / BUILDING

 

PHONE NUMBER

_______________

 

OPTIONAL FORM 41 (Rev. 7-76)
        *U.S.GPO:1985-0-461-274/20020 Prescribed by GSA
                FPMR (41 CFR) 101-11.206

Attachment 9.

Text for Notice of Revised Class Membership Determination

SOCIAL SECURITY NOTICE

 

 

Important Information

From:

Department of Health and Human Services Social Security Administration

   
  ____________________________Date:____-____-____
   
  ____________________________Claim Number:____________________
   
  ____________________________DOC:___________________________

In an earlier notice that we sent you, we said that you were not a class member entitled to relief in the Day v. Chater class action. Upon further review of the facts in your case, we have decided that you are a class member entitled to relief. Therefore, we will review your class member claim under the Day Settlement Agreement.

We have many requests for review and it may take several months before we look at your claim file. When we start the review, we may contact you for any additional evidence or information that you may wish to submit.

If you have any questions, you may contact any Social Security office. If you have someone helping you with your claim, you should contact him or her. You or your representative may also contact the attorney in this case:

John E. Schrider, Jr.
Legal Aid Society of Cincinnati
901 Elm Street
Cincinnati, OH 45202
Tel.No. (513) 241-9400

If you call or visit a Social Security office, please have this notice 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.

Si usted no entiende esta carta, llévela a la Oficina de Seguro Social arriba mencionada para que se la expliquen.

cc: John E. Schrider, Jr.

Attachment 10. - Readjudication Flag for No Common Issue Cases

 

Day Calss Action Case

READJUDICATION NECESSARY

Claimant's name: ___________________________    
       
SSN: ___________________________    

This claimant is a Day class member. The attached Day claim file 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 [(state reason(s))]__________________________________________________________________________
    _______________________________________________________________________________.

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

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

  Bureau of Disability Determination
   
   
  (Destination code: )

Attachment 11. Text for Appeals Council Remand to BDD - Class Member Claim Associated with Current Claim Pending Appeals Council Review

 

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 Day class action and is entitled to have the final administrative denial of (his/her) application(s) dated ____________ readjudicated by the Bureau of Disability Determination under the terms of the June 26, 1995 Order Approving Settlement.

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 entitled to relief at the reconsideration level under the Day class action, the Council remands this case to the Bureau of Disability Determination for reopening of the issues raised by the (dates of applications) applications. The Bureau of Disability Determination will issue one determination covering (both or all) claims. If the Bureau of Disability Determination does not issue a fully favorable determination, it will notify the claimant of the right to request a hearing before an Administrative Law Judge.