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To: Attorneys and
Advocates Interested in Hyatt
From: Class Counsel for Hyatt III
Re: Hyatt v. Barnhart - Update
Date: February 2002
This is to provide
important information to attorneys and representatives handling Hyatt
III claims and others interested in the Hyatt class action. We want to
update you on some very significant developments and issues in the case
that have occurred over the past year.
A. SETTLEMENT SUBCLASS MEMBERS TO RECEIVE FULL APPEAL
RIGHTS
As a result of a
recent agreement reached with class counsel, SSA has agreed that all settlement
subclass members will prospectively have their clams re-opened and will
receive FULL appeal rights. The settlement subclass members will now have
the same appeal rights as the primary subclass members.
Until this agreement
was reached, the settlement subclass (which consisted of all individuals
whose disability claims were finally denied or terminated by NC DDS on
or after August 6, 1990 and before November 14, 1991) received a disability
redetermination with limited appeal rights. Class counsel had identified,
and brought to the attention of SSA's counsel, numerous systemic problems
with this process. To avoid further litigation over this issue, SSA agreed
to simply do away with the subclass distinction, for all practical purposes.
This is great news
for Hyatt claimants, as those claimants with full appeal rights have a
much higher success rate in terms of reversing SSA's prior termination
or denial. This process is expected to begin immediately. This will apply
prospectively only.
B. SSA BEGINS RE-PROCESSING OF CLASS DENIALS, AS PER
THE OCTOBER 1999 COURT ORDER BY JUDGE MULLEN
For new advocates
and to refresh your memory:
Between 1994 and
1996, class counsel had identified systematic problems with SSA's implementation
of the 1994 Settlement Order with respect to class membership denials.
These issues were:
SSA's reliance
on a post-Hyatt SSA decision (an ALJ decision dated after August 6,
1990 or a DDS decision dated after November 13, 1991) to deny class
membership, even though that decision did not reopen and decide on the
merits all prior Hyatt eligible claims.
SSA's practice
of denying class membership to an individual who was fully paid as of
his amended onset date on a subsequent claim, but who was not fully
paid back to the onset date alleged in a prior Hyatt-eligible application.
SSA's practice
of denying Hyatt III class membership to an individual who timely requested
Hyatt III relief but who previously requested Hyatt II relief and then
withdrew or failed to pursue the Hyatt II claim.
After unsuccessful
attempts to negotiate with SSA, class counsel Doug Sea, Mac Sasser and
John Wester, filed motions with the federal district court to enforce
the Settlement Agreement. Judge Mullen agreed in all respects with class
counsel's position on each of these issues. As a result of Judge Mullen's
order, SSA agreed to essentially eliminate the class membership screening.
Under this proposal,
SSA is to give a Hyatt III merits review to all individuals who requested
Hyatt III relief except for those falling within these narrow exceptions:
1. Cases screened
out under codes 8 and 9 (no allegations of or conditions associated
with pain) prior to October 1, 1999.
2. Cases previously screened out that class counsel raised as improper
screen-outs, but that after negotiation, class counsel agreed with SSA's
position.
3. Cases screened out and sent to SSA for review after March 8, 1996
and to which class counsel raised no objections.
4. Cases where it is very clear that no claim was filed or denied during
the relevant time period.
The POMS and HALLEX
instructions for this new process are available on our website: www.ncjustice.org/hyatt.
C. ISSUES CLASS COUNSEL REMAINS CONCERNED ABOUT
We continue to be
concerned about how SSA is implementing the Hyatt orders, including Judge
Mullen's most recent order. These areas of concern include:
Timely Processing
of Claims: SSA still has tens of thousands of claims to process,
six years after the Hyatt Settlement Order was signed. Many claimants
have died awaiting a Hyatt review, and others have waited too long to
have their claims re-heard. We are negotiating with SSA for ways to
address this problem.
Notices of Decisions.
We have many concerns relating to notices being sent to claimants since
implementing Judge Mullen's most recent order. These concerns range
from failure to send a copy of all notices to class counsel, sending
incorrect notices, sending notices with incorrect or incomplete appeals
instructions, and failure to adequately explain that a claim was reviewed
yet again pursuant to a new court order. We have brought these issues
to the attention of SSA and are awaiting resolution.
"Fully
paid" determinations. We have concerns that SSA is using the
"Notice of No Benefits Due" notice inappropriately. While
we have received comparatively few copies of merits decisions and class
denial decisions, we have received hundreds of copies of these "fully
paid" notices. It appears that in many of these cases, this notice
is being sent after SSA is making the same type of determination that
SSA agreed to "essentially eliminate." We suspect that SSA
is not considering all Hyatt applications when making a determination
that a claimant was fully paid. Of course, this is the very issue that
caused Class Counsel to file the motion to enforce the Settlement Agreement.
We are trying to resolve this issue with SSA. If you have a client who
received one of these notices inappropriately, please let us know.
Association
of 1696s. Class counsel continues to hear from some attorneys and
advocates that SSA is not always associating the 1696 form with Hyatt
claims. SSA claims they have resolved any problems with this issue.
Please continue to provide us with examples, if you continue to face
problems.
If
you have any questions, or want more information, please contact Carlene
McNulty (919-856-2161, or carlene@ncjustice.org). For information
about Hyatt claims, contact Nicole
Dozier (919 856-2146 or nicole@ncjustice.org). Our fax number is 919-856-2175.
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