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Pact Calls for Review of SSI Benefit Denials
New York Law Journal
The disability benefit cases of an estimated 4,000 people will be reviewed for possible legal and factual errors by administrative law judges for the Social Security Administration in Queens under a federal court agreement.
Advocates for the disabled say the proposed settlement provides a means to redress what they contend has been years of faulty decision-making and abusive behavior toward clients and their attorneys by five of the eight ALJ's hearing cases in Queens.
The Social Security Administration "took the allegations quite seriously and we are grateful that they embraced reform rather than dig in their heels," said Jim Walden, who helped represent the plaintiffs for Gibson, Dunn & Crutcher. "Instead of simply litigating for years, they agreed to a combination of forms of relief that are intended to solve the problem. And if it doesn't, this gives them the tools that they need to get rid of these ALJs once and for all."
While Gibson Dunn's involvement was pro bono, the settlement agreement provides for the payment of $125,000 in legal fees to the Urban Justice Center, which is also representing the claimants.
The Social Security Administration did not admit wrongdoing. Neither its regional director nor the Department of Justice, which defended the agency, had any comment.
The settlement in Padro v. Astrue, 11-cv-1788, was sent to Eastern District Magistrate Judge Roanne Mann (See Profile) on Jan. 11 for review. Judge Carol Bagley Amon (See Profile) will make the final decision on whether to approve or reject it.
The action claims that 10 named plaintiffs and others similarly situated were wrongfully denied Social Security Income (SSI) and Social Security Disability (SSD) benefits in matters heard beginning in 2005 by the Social Security Administration's Office of Disability Adjudication and Review in Queens.
The suit contends that while 72 percent of disability claims were granted by administrative law judges nationwide from 2005 to 2008, four of the Queens ALJs named in the suit granted 31 percent to 45 percent of the claims. The other ALJ approved 61 percent of the petitions before her (NYLJ, Sept. 6, 2011).
According to the plaintiffs, the ALJs sometimes ignored established law, disregarded the testimony of medical experts and "bullied" clients and their attorneys.
The suit identified the ALJs as Michael Cofresi, Seymour Fier, Marilyn Hoppenfeld, David Nisnewitz and Hazel Strauss. By law, ALJs employed by federal agencies must be attorneys.
Under the settlement agreement, the Social Security Administration will grant a new hearing to all applicants who received unfavorable decisions from the five ALJs from Jan. 1, 2008, until the present. "Unfavorable" for purposes of the settlement means applicants were denied SSI or SSD benefits, or received awards at lower levels than they sought.
While no final list of eligible applicants has been provided by the Social Security Administration (SSA), Walden said the agency believes the number is about 4,000 based on claims typically rejected by the Queens office.
SSA staff will review decisions for, among other things, whether ALJs properly considered evaluations by medical professionals, properly developed the record of each case and adequately assessed the credibility of the witnesses and evidence before them.
New hearings will be held before an ALJ other than one of the five named in the lawsuit.
Applicants whose cases are decided by any of the five named ALJs for 30 months after the settlement is approved will have their claims reviewed by a special unit within the SSA. If a new hearing is granted, it will be held before a different ALJ.
The SSA also agreed to conduct training programs to instruct experienced ALJs on properly adjudicating cases and provide mentors to veteran ALJs. The complaint filed in 2011 sought a reopening of the cases before the five ALJs as well as to compel the agency not to assign any of the five to other SSI or SSD cases in the future. But Walden said SSA personnel rules prohibited the implementation of that demand.
Carlotta Wells, an attorney for the U.S. Justice Department's Civil Division, defended the SSA.
Emilia Sicilia, Ann Biddle and Ian Feldman represented the Urban Justice Center.
"This settlement provides historic relief for our clients and all class members," Sicilia, director of the Disability Advocacy Project at the Urban Justice Center's Mental Health Project, said in a statement. "For years, these biased ALJs have used every rationale to deny eligible claimsmany class members have been forced to rely on friends, family or public assistance simply to afford necessities while their claims languished, only to be unfairly denied by these ALJs. Some even became homeless when they were unable to pay their rent. We are thrilled that these vulnerable individuals will now receive fair hearings in Queens."
The press release announcing the settlement noted that since the filing of the lawsuit denial rates in Queens have fallen significantly and are now more in line with national averages.
Walden, Oliver Olanoff, Adam Jantzi, and Karin Reiss were the primary lawyers handling the litigation for Gibson Dunn.
The named plaintiffs in the case are Lorraine Padro, Leslie Bailey, Marie Thelot, Sarah Rodriguez, Dhanasar Raman, Carmen Duran, John Edwards, Ernesta Gutierrez and Julia Juan. In addition, Toby Marlow is a named plaintiff who is a court-appointed guardian for Judith Blumensohn.
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