Martin v. SSA

CourtDistrict Court, E.D. Kentucky
DecidedOctober 15, 2019
Docket7:16-cv-00111
StatusUnknown

This text of Martin v. SSA (Martin v. SSA) 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
Martin v. SSA, (E.D. Ky. 2019).

Opinion

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF KENTUCKY SOUTHERN DIVISION (at Pikeville) TIMOTHY L. HOWARD, ) ) Plaintiff, ) ) V. ) Civil Action No. 7: 16-051-DCR ) ANDREW SAUL, ) Commissioner of Social Security, ) ) Defendant, )

*** *** *** *** CAROL GRIFFITH, ) ) Plaintiff, ) ) V. ) Civil Action No. 7: 16-101-DCR ) ANDREW SAUL, ) Commissioner of Social Security, ) ) Defendant, )

*** *** *** ***

ROBERT MARTIN, ) ) Plaintiff, ) ) V. ) Civil Action No. 7: 16-111-DCR ) ANDREW SAUL, ) Commissioner of Social Security, ) ) Defendant, )

*** *** *** *** ) PATRICIA LANE RICHARDS, ) ) Plaintiff, ) ) V. ) Civil Action No. 7: 16-200-DCR ) ANDREW SAUL, ) Commissioner of Social Security, ) ) Defendant, *** *** *** ***

REGINA REED, ) ) Plaintiff, ) ) V. ) Civil Action No. 7: 16-241-DCR ) ANDREW SAUL, ) Commissioner of Social Security, ) ) Defendant, )

ROSS CLAYTON FLEMING, ) ) Plaintiff, ) ) V. ) Civil Action No. 7: 16-281-DCR ) ANDREW SAUL, Commissioner of Social ) Security, ) ) Defendant, )

*** *** *** *** ELIZABETH WRIGHT, ) ) Plaintiff, ) ) V. ) Civil Action No. 7: 17-020-DCR ) ANDREW SAUL, Commissioner of Social ) Security, ) ) Defendant, )

TERESA AKERS, ) ) Plaintiff, ) ) V. ) Civil Action No. 7: 17-031-DCR ) ANDREW SAUL, Commissioner of Social ) Security, ) ) Defendant, )

STEPHEN KIDD, ) ) Plaintiff, ) ) V. ) Civil Action No. 7: 17-035-DCR ) ANDREW SAUL, Commissioner of Social ) Security, ) ) Defendant. )

MEMORANDUM OPINION AND ORDER DENYING ATTORNEY’S FEES I. Once known as “Mr. Social Security,” former attorney Eric Conn assisted thousands of individuals in obtaining Social Security disability benefits. But Conn’s overwhelming success was too good to be true. His results were not the product of skill or hard work. Instead, he obtained benefits for a number of clients through the largest Social Security fraud in the history

of the benefits program. The scheme was not that elaborate. Beginning in at least 2004 and continuing through 2011, Conn paid a group of doctors to provide medical and psychological reports, indicating that his clients were unable to work, regardless of their actual abilities.1 To further ensure his clients’ success in obtaining benefits (and his resulting ability to collect a fee), Conn paid Administrative Law Judge (“ALJ”) David Daugherty to assign these cases to himself and then

issue favorable rulings.2 The Social Security Administration’s (“SSA”) Office of the Inspector General (“OIG”) eventually caught wind of Conn’s scheme and began to investigate. On July 2, 2014, the OIG

1 These doctors were identified as Bradley Adkins, Ph.D., Srinivas Ammisetty, M.D., Frederic Huffnagle, M.D., and David P. Herr, D.O. A jury convicted Adkins of conspiring to commit mail and wire fraud, mail fraud, wire fraud, and making false statements to the SSA. He was sentenced by the undersigned to 300 months’ imprisonment. [See Lexington Criminal Action No. 5: 16-022- DCR.] 2 Conn pleaded guilty to theft of government money and paying illegal gratuities and was sentenced by the undersigned to 144 months’ imprisonment. [See Lexington Criminal Action No. 5: 17-CR-043-DCR.] He subsequently pleaded guilty conspiring to defraud the United States, conspiring to escape, and conspiring to retaliate against a witness and was sentenced by the undersigned to 180 months’ imprisonment, to run consecutively to the 144-month sentence imposed in 5: 17-CR-043. [See Lexington Criminal Action No. 5: 18-CR-059-DCR.]

Daugherty pleaded guilty to two counts of receiving illegal gratuities and was sentenced by the undersigned to 48 months’ imprisonment. [See Lexington Criminal Action No. 5: 17-CR-066- DCR.] notified the SSA’s General Counsel that it had reason to believe that 1,787 applications submitted by Conn involved fraud. For reasons unknown, the OIG provided this information with the understanding that the SSA would not take any action against these claimants until it

received further notice from OIG. On May 12, 2015, the OIG notified the Commissioner of Social Security that the Agency could move forward with its administrative processing of the redeterminations of the 1,787 individuals whose names were previously provided by the OIG to the Agency on July 2, 2014. [See, e.g., Pikeville Civil Action No. 7: 16-051; Record No. 12-1, p. 9] The OIG specifically advised that it had “reason to believe that Mr. Conn or his firm submitted pre- completed ‘template’ Residual Functional Capacity forms purportedly from [the four doctors

identified above], dated between January 2007 and May 2011, in support of the individuals’ applications for benefits.” Id. The SSA sent letters to the affected claimants on May 18, 2015, informing them that it was required to redetermine their eligibility for benefits under 42 U.S.C. §§ 405(u) and 1383(e)(7). The SSA advised them that it was not permitted to consider any evidence submitted by the physicians believed to have been involved in the fraud. The SSA further explained that the Appeals Council had reviewed the affected cases. Many individuals still

qualified for benefits after the tainted evidence was excluded. However, the plaintiffs were all informed that, after excluding the evidence from the doctors involved with Conn, there was insufficient evidence to support a finding of disability. The plaintiffs were given time to submit additional evidence to the Appeals Council, demonstrating that they were disabled at the time their applications for benefits were initially approved. And the Appeals Council ultimately determined that there was insufficient evidence to support the prior ALJ’s findings of disability. The cases were then remanded to new ALJs for redetermination proceedings. The

redetermination proceedings included: (1) a hearing before a neutral decisionmaker; (2) an opportunity to testify and submit any evidence that was new, material, and related to the period at issue (other than evidence from the four identified providers); and (3) if requested, assistance developing records that were new, material, and related to the time period at issue. [See, e.g., Pikeville Civil Action No. 7: 16-051; Record No. 12-1, p. 3] At this point, many of the affected claimants were adjudicated disabled and continued receiving benefits. However, in the plaintiffs’ cases, the new ALJ found that there was insufficient evidence to support the original

disability determination and their benefits were terminated. The Appeals Council declined to reconsider the ALJs’ decisions, and the denials became final decisions of the Commissioner. Many of the claimants who lost their benefits, including the plaintiffs, filed suit in this Court, claiming that the SSA’s redetermination process was unlawful. The cases were randomly assigned to various judges. On October 12, 2016, then-United States District Judge Amul R. Thapar issued an opinion concluding that the SSA’s redetermination procedure violated the Due Process Clause of the Fifth Amendment to the United States Constitution.

Hicks v. Colvin, 214 F. Supp. 3d 627 (E.D. Ky. 2016). The undersigned issued a conflicting decision on November 15, 2016, rejecting the plaintiffs’ claims that the redetermination procedure violated the Equal Protection and Due Process clauses, the Social Security Act, and the Administrative Procedure Act (“APA”). Carter v. Colvin, 220 F. Supp. 3d 789 (E.D. Ky. 2016). Approximately one month later, United States District Judge Joseph M. Hood issued an opinion consistent with that of the undersigned. Perkins v. Colvin, 224 F. Supp. 3d 575 (E.D. Ky. 2016). The plaintiffs in Carter and Perkins were permitted to take an interlocutory appeal of

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Martin v. SSA, Counsel Stack Legal Research, https://law.counselstack.com/opinion/martin-v-ssa-kyed-2019.