Mullins v. SSA

CourtDistrict Court, E.D. Kentucky
DecidedJuly 12, 2019
Docket5:16-cv-00130
StatusUnknown

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

Opinion

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF KENTUCKY

IN RE: Various Social Security Cases Affected by the Sixth Circuit Decision in Hicks v. Comm’r of Soc. Sec.1, No. 17-5206

5:16-cv-130 Clinton Ryan Mullins v. Comm’r of Soc. Sec. 5:16-cv-375 Danny Lenn Reed v. Comm’r of Soc. Sec. 6:16-cv-62 Robert L. Muncy, II v. Comm’r of Soc. Sec. 7:16-cv-73 Carolyn Lynn Bates v. Comm’r of Soc. Sec. 7:16-cv-77 Brenda Stewart v. Comm’r of Soc. Sec. 7:16-cv-90 Janie Shepherd v. Comm’r of Soc. Sec. 7:16-cv-91 Naomi Samons v. Comm’r of Soc. Sec. 7:16-cv-97 Argle Kendrick v. Comm’r of Soc. Sec. 7:16-cv-104 Matthew Slone v. Comm’r of Soc. Sec. 7:16-cv-140 Kathy Ramey v. Comm’r of Soc. Sec. 7:16-cv-149 Lenny Newsome v. Comm’r of Soc. Sec. 7:16-cv-158 Timothy Brashears v. Comm’r of Soc. Sec. 7:16-cv-163 Kathleen Campbell Curtis v. Comm’r of Soc. Sec. 7:16-cv-183 Deborah Burke v. Comm’r of Soc. Sec. 7:16-cv-185 Melissa C. Stiltner v. Comm’r of Soc. Sec. 7:16-cv-209 Ricky Casebolt v. Comm’r of Soc. Sec. 7:16-cv-212 Mary Sexton v. Comm’r of Soc. Sec. 7:16-cv-229 Amy Jayne Charles v. Comm’r of Soc. Sec. 7:16-cv-248 Eddie Reed v. Comm’r of Soc. Sec. 7:16-cv-290 Emmitt Burton v. Comm’r of Soc. Sec. 5:17-cv-262 Chessie Gray v. Comm’r of Soc. Sec. 7:17-cv-5 Chad Shepherd v. Comm’r of Soc. Sec. 7:17-cv-116 Margaret C. Copley v. Comm’r of Soc. Sec. 7:17-cv-130 Joann Holbrook v. Comm’r of Soc. Sec. 7:17-cv-158 Ranie Jo Coleman v. Comm’r of Soc. Sec. 7:18-cv-33 Martin Lee Gillespie v. Comm’r of Soc. Sec. 7:18-cv-47 Betty Robinson v. Comm’r of Soc. Sec. 7:18-cv-122 Tracy Ann Hannah v. Comm’r of Soc. Sec.

MEMORANDUM OPINION AND ORDER

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These matters are before the Court on the Commissioner’s Motions to Remand

1 Andrew Saul was sworn in as Commissioner of Social Security on July 17, 2019, during the pendency of these actions. Pursuant to Rule 25(d) of the Federal Rules of Civil Procedure, Commissioner Saul is automatically substituted as a party. pursuant to sentence six of 42 U.S.C. § 405(g) in the above-referenced cases. Several Plaintiffs have submitted responses opposing the Commissioner’s Motions to Remand, arguing that the cases should be remanded under sentence four of 42 U.S.C. § 405(g). For the reasons set forth herein, the Commissioner’s Motions to Remand pursuant to sentence six of 42 U.S.C. § 405(g) are denied, the above-referenced cases are

remanded pursuant to sentence four, and all other pending requests for relief are denied as moot. I. FACTUAL AND PROCEDURAL BACKGROUND These matters arise from the award of social security disability benefits to Plaintiffs in connection with their representation by attorney and now convicted felon Eric C. Conn. The Social Security Administration’s (“SSA”) Office of the Inspector General (“OIG”) developed reason to believe Conn, Administrative Law Judge (“ALJ”) David Daugherty, and four examining doctors, Bradley Adkins, Ph.D., Srinivas Ammisetty, M.D., Frederic Huffnagle, M.D., and David P. Herr, D.O., participated in a fraudulent scheme to obtain benefits for Conn’s clients, including the Plaintiffs in the cases at issue here.2 Hicks v.

Comm’r of Soc. Sec., 909 F.3d 786, 794 (6th Cir. 2018). The OIG investigated the suspected fraudulent conduct further and identified 1,787 individuals whose applications appeared to be implicated in the fraud. “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

2 Attorney Conn, ALJ Daugherty, and Dr. Adkins were convicted of various criminal charges arising out of this fraudulent scheme. See Lexington Criminal Action Nos. 5:16-cr-022; 5:17-cr-043; 5:17-cr-104; 5:17-cr-066; 5:18-cr-059. benefits.’” Id. On May 12, 2015, 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. 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. (internal 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 (internal 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 without this evidence, the Commissioner found that all of the Plaintiffs were ineligible for benefits. Id. at 795. The Plaintiffs and other similarly-affected individuals filed numerous lawsuits alleging the SSA’s redetermination process was unlawful. Judges in the Eastern District of Kentucky issued conflicting rulings, and the issue was appealed to the United States Court of Appeals for the Sixth Circuit where the cases were consolidated for appeal. Id. at 796. In Hicks, a split panel of the Sixth Circuit held in pertinent part that the SSA violated the “Due Process Clause of the Constitution and the Administrative Procedure Act [(“APA”)] required the SSA to allow plaintiffs an opportunity to show why the medical reports uniformly and entirely disregarded in their redetermination proceedings were not, in fact, tainted by fraud.” Id. at 813. Therefore, the Sixth Circuit held that the plaintiffs

were “entitled to summary judgment on their due-process claim.” Id. at 792. Turning to the SSA’s requirements under the APA, the Sixth Circuit explained 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. at 805 (alteration in original) (quoting 5 U.S.C. § 556(e)). Therefore, the Sixth Circuit found that those Plaintiffs “have provided evidence demonstrating that the ALJs assigned to plaintiffs’ redetermination hearings essentially rejected the only remaining medical opinions that could have established plaintiffs’ claims based on the OIG’s off-the-record determination that the records involved fraud—determinations

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