Rice v. Heckler

640 F. Supp. 1051, 1986 U.S. Dist. LEXIS 22047
CourtDistrict Court, S.D. New York
DecidedJuly 31, 1986
Docket83 Civ. 5424 (MEL)
StatusPublished
Cited by1 cases

This text of 640 F. Supp. 1051 (Rice v. Heckler) is published on Counsel Stack Legal Research, covering District Court, S.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Rice v. Heckler, 640 F. Supp. 1051, 1986 U.S. Dist. LEXIS 22047 (S.D.N.Y. 1986).

Opinion

LASKER, District Judge.

On July 21, 1983 Trueman Rice filed this Social Security action on behalf of himself and other New York residents who, pursuant to 42 U.S.C. § 1382c(a)(3)(E) (1976), had been “ ‘grandfathered’ into the [Supplementary Security Income (“SSI”) ] program on January 1, 1974 because they had been recipients of benefits under the State of New York’s Aid to the Disabled Program.”

As the Court of Appeals for this Circuit recently explained in Wheeler v. Heckler, 719 F.2d 595 (2d Cir.1983), the classification of certain SSI recipients as “grandfatherees” arises from Congress’ enactment in October 1972 of the “Supplemental Security Income for the Aged, Blind and Disabled” program, 42 U.S.C. §§ 1381 et seq. (1976). The purpose of the new law was to *1054 unify the various federally funded state disability programs then in existence by establishing a national standard for disability. Id. at 597. In addition, to protect the rights of individuals who previously were determined to be disabled under state standards that were more favorable than the new federal standard, Congress enacted a “grandfather clause,” pursuant to which

an individual shall also be considered to be disabled for purposes of this subchapter if he is permanently and totally disabled as defined under a State plan approved under Subchapter XIV or XVI of this chapter as in effect for October 1972 and received aid under such plan (on the basis of disability) for December 1973 (and for at least one month prior to July 1973), so long as he is continuously disabled as so defined.

42 U.S.C. § 1382c(a)(3)(E).

The gravamen of the complaint in this action is that plaintiffs’ SSI benefits have been discontinued without it first being determined that they are no longer disabled under the standards of the “Aid to the Disabled” program, the New York State program that was in effect in October 1972.

In addition to challenging the alleged failure to apply the New York programs’ criteria, the complaint alleges (1) that the Secretary of Health and Human Services (“the Secretary”) failed to notify the plaintiff and the class that their impairments would be evaluated under both the State and federal programs’ criteria; (2) that 20 C.F.R. §§ 416.907 and 416.994 have been promulgated in violation of the Administrative Procedure Act because Sections 416.907 and 416.994 do not provide for review under the Aid to the Disabled Act’s standards and (3) that the Secretary’s failure to gather appropriate evidence and evaluate plaintiffs’ claims under the State criteria violates plaintiffs’ right as intended beneficiaries of the contract between the Secretary and the Commissioner of the State of New York Department of Social Services by which the Commissioner makes the determinations of disability for purposes of SSI eligibility. 1

In addition to seeking declaratory relief on the basis of the violations alleged above, plaintiffs 2 seek reinstatement of their benefits and an injunction prohibiting the Secretary from discontinuing their benefits

for purported medical reasons without (1) determining whether their impairments have improved to the extent that they are no longer disabled under the Aid to the Disabled program’s disability criteria, (2) sending the class members notices that inform them that their impairments will be evaluated under the Aid to the Disabled program’s disability criteria, and (3) securing the class members’ medical records on which the decisions were based that they were disabled under New York’s Aid to the Disabled program’s disability criteria.

Subsequent to the filing of the complaint several judicial or legislative developments have occurred which are relevant to plaintiffs’ cause of action. First, in Wheeler v. Heckler, 719 F.2d 595 (2d Cir.1983), the Court of Appeals for this Circuit has held that grandfatherees must be evaluated under the appropriate state standard regardless of the difficulty in ascertaining the state criteria:

The grandfather provision, section 1382c(a)(3)(E), unambiguously provides that those previously determined to be eligible for disability benefits are to remain eligible if they satisfy the substantive standards of either current federal *1055 law 3 or the state law in force as of October 1972.

Id. at 600.

Second, the Social Security Disability Benefits Reform Act of 1984, Pub.L. 98-460, 98 Stat. 1794 (1984) (“Reform Act”) was enacted on October 9, 1984. The Reform Act establishes a new medical improvement standard for evaluating continued disability 4 and provides that members of medical improvement classes that have been certified before September 19, 1984 are eligible for review under the Reform Act’s new criteria. 5 The Reform Act further provides that claimants whose cases are remanded may elect to receive interim benefits. 6

Third, in Schisler v. Heckler, 80 Civ. 572 (W.D.N.Y.), a medical improvement class action in the Western District of New York, see Schisler v. Heckler, 574 F.Supp. 1538, 1541 (W.D.N.Y.1983), an order was entered on December 3, 1984, which clarified the scope of a class that had been certified on August 12, 1982. See Schisler v. Heckler, 107 F.R.D. 609 (W.D.N.Y.1984), aff'd in part, rev’d in part on other grounds, 787 F.2d 76 (2d Cir.1986). It is evident from the amended order that thé plaintiffs in this litigation are members of the Schisler class. Moreover, since the class was originally certified before September 19, 1984, the class members, including the plaintiffs in the instant litigation, have had their cases remanded to the Secretary for readjudication pursuant to the Reform Act.

Finally, at various times throughout the litigation, the parties in this case have explored the possibility of settlement. At least partially as an outgrowth of the negotiations, in the Spring of 1984, the Secretary issued two amendments to the Social Security Administration Office of Hearings and Appeals Handbook (“the Handbook”), “Section 1-351-53” and “Appendix C,” together with a Social Security Administration Program Circular (“the Program Circular”).

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Cite This Page — Counsel Stack

Bluebook (online)
640 F. Supp. 1051, 1986 U.S. Dist. LEXIS 22047, Counsel Stack Legal Research, https://law.counselstack.com/opinion/rice-v-heckler-nysd-1986.