In re Various Soc. Sec. Cases Affected By the Sixth Circuit Decision in Hicks V. Berryhill

392 F. Supp. 3d 784
CourtDistrict Court, E.D. Kentucky
DecidedJuly 11, 2019
DocketCivil Case Nos. 0:16-cv-062-JMH; 5:16-cv-128-JMH; 5:16-cv-351-JMH; 5:17-cv-169-JMH; 6:16-cv-184-JMH; 6:16-cv-298-JMH; 6:17-cv-006-JMH; 7:16-cv-035-JMH; 7:16-cv-076-JMH; 7:16-cv-096-JMH; 7:16-cv-167-JMH; 7:16-cv-171-JMH; 7:16-cv-181-JMH; 7:16-cv-194-JMH; 7:16-cv-233-JMH; 7:16-cv-245-JMH; 7:16-cv-270-JMH; 7:16-cv-272-JMH; 7:16-cv-286-JMH; 7:16-cv-287-JMH; 7:16-cv-298-JMH; 7:17-cv-016-JMH; 7:17-cv-022-JMH; 7:17-cv-092-JMH; 7:17-cv-107-JMH; 7:17-cv-129-JMH; 7:17-cv-131-JMH
StatusPublished
Cited by2 cases

This text of 392 F. Supp. 3d 784 (In re Various Soc. Sec. Cases Affected By the Sixth Circuit Decision in Hicks V. Berryhill) is published on Counsel Stack Legal Research, covering District Court, E.D. Kentucky primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
In re Various Soc. Sec. Cases Affected By the Sixth Circuit Decision in Hicks V. Berryhill, 392 F. Supp. 3d 784 (E.D. Ky. 2019).

Opinion

Joseph M. Hood, Senior U.S. District Judge

These matters come before the Court on the Commissioner's motions to remand pursuant to sentence six of 42 U.S.C. § 405(g) in the above-captioned cases. For the following reasons, the Court will deny the Commissioner's motions to remand pursuant to sentence six of 42 U.S.C. § 405(g) and remand the above-captioned cases under sentence four of 42 U.S.C. § 405(g).

*786I. FACTUAL AND PROCEDURAL BACKGROUND

The above-captioned cases arise from the plaintiffs, with the assistance of former attorney Eric C. Conn, being awarded Social Security disability benefits. Subsequently, the Social Security Administration's ("SSA") Office of the Inspector General ("OIG") developed reason to believe Conn, Administrative Law Judge David Daugherty, and four examining doctors, Bradley Atkins, Ph.D., Srinivas Ammisetty, M.D., Frederic Huffnagle, M.D., and David P. Herr, D.O., had participated in a fraudulent scheme to obtain benefits for Conn's clients, including the plaintiffs in the above-captioned cases.1 Hicks v. Comm'r of Soc. Sec. , 909 F.3d 786, 794 (6th Cir. 2018). On May 12, 2015, after the OIG investigated the suspected fraudulent conduct further and identified 1,787 individuals whose applications appeared to be tainted by fraud, the OIG advised the SSA that it could move forward with redetermining the affected claimants' eligibility for benefits under 42 U.S.C. §§ 405(u) and 1383(e)(7)(A)(i). Id. "In particular, the OIG ... 'ha[d] reason to believe that Mr. Conn or his firm submitted pre-completed 'template' Residual Functional Capacity ["RFC"] forms purportedly from [the four doctors identified above], dated between January 2007 and May 2011, in support of the individuals' applications for benefits.' " Id.

On May 18, 2015, the Commissioner sent letters to the plaintiffs in the above-captioned cases, and approximately 1,500 similarly situated individuals, explaining:

[T]he SSA needed to redetermine plaintiffs' eligibility for benefits because "there was reason to believe fraud was involved in certain cases involving [Adkins, Ammisetty, Huffnagle, and Herr]," one or more of these doctors "provided evidence" in plaintiffs' cases, and the ALJ (i.e., Daugherty) "previously used that evidence to find [plaintiffs] disabled."

Id. (citations omitted). "The letters further explained that during the redetermination process, the SSA 'must disregard any evidence from one of the medical providers above when the information was submitted by representative Eric C. Conn or other representatives associated with Mr. Conn's law office.' " Id. at 794-95. "Notably, in redetermining plaintiffs' eligibility for benefits, the SSA excluded all evidence submitted by Adkins, Ammisetty, Huffnagle, and Herr-not just the RFC forms that the OIG had identified as possibly fraudulent in its referral to the SSA." Id. at 795 (footnote and citations omitted). "Beyond the RFC forms, the four doctors had submitted evidence detailing their examinations of plaintiffs, including any testing that they had performed and behavioral observations they had made." Id. Upon redetermination, the Commissioner found the plaintiffs were not eligible for benefits. Id. at 795.

The plaintiffs and many similarly affected individuals filed lawsuits alleging the SSA's redetermination process was unlawful. Judges in this Court issued conflicting rulings, and the issue was appealed to the United States Court of Appeals for the Sixth Circuit. Id. at 796. In Hicks , a split panel of the Sixth Circuit held in pertinent part, "The Due Process Clause of the Constitution and the Administrative Procedure Act required the SSA to allow plaintiffs an opportunity to show why the medical reports uniformly and entirely disregarded *787in their redetermination proceedings were not, in fact, tainted by fraud." Id. at 813. Furthermore, the Sixth Circuit held, "[T]he plaintiffs are entitled to summary judgment on their due-process claim." Id. at 792.

Specifically regarding the SSA's requirements under the Administrative Procedures Act ("APA"), "[T]he APA provides that '[w]hen an agency decision rests on official notice of a material fact not appearing in the evidence in the record, a party is entitled, on timely request, to an opportunity to show the contrary.' " Id.

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392 F. Supp. 3d 784, Counsel Stack Legal Research, https://law.counselstack.com/opinion/in-re-various-soc-sec-cases-affected-by-the-sixth-circuit-decision-in-kyed-2019.