Oakland, CA – On Thursday, March 16, Judge Jon S. Tigar of the Northern District of California granted final approval of the settlement agreement in Hart v. Berryhill, a case filed on behalf of over 4,000 residents of the broader Bay Area and Central Coast whose disability benefits were denied or terminated, based on medical reports of a disqualified physician.
Morrison & Foerster LLP, Justice in Aging, and Legal Aid Society of San Mateo County filed the case against the Social Security Administration (SSA) in 2015 challenging the agency’s reliance on the medical reports of a disqualified physician to make disability eligibility decisions. The physician had been disqualified from performing medical exams for the agency after numerous complaints about their quality and accuracy, and his failure to correct his practices after warnings from the agency, yet the agency continued to rely on his reports. The parties have agreed to a settlement that will allow many plaintiffs to have their disability status redecided.
“This case should give Social Security an incentive to be more attentive to the fairness of the disability determination process,” said Elizabeth Balassone of Morrison & Foerster LLP, which represented the plaintiffs pro bono.
Who the Case Impacts
Plaintiffs number over 4,000 in the San Francisco Bay Area and as far south as San Luis Obispo County. Plaintiffs could include anyone who was examined by the now discredited doctor from 2007 through 2013, and had their disability claim denied or terminated in part or in full.
The settlement helps those individual class members whose claims may be redecided, which may result in approval of benefits, depending on the other facts relating to their disability. For example, consider a class member who applied for Social Security Disability Insurance (SSDI) benefits in 2010, saw the now-disqualified doctor in 2011, and was wrongly denied. If that person would have been determined to be disabled back to 2010 with a monthly benefit of $1200, he or she would be owed around $100,000 in back benefits.
“Many people who were wrongly denied disability benefits they desperately need for housing, food, and medical care will have a chance to establish their disability without questionable evidence from a poor quality consultative examination,” said Hope Nakamura of the Legal Aid Society of San Mateo County.
“The Social Security Administration’s disability determination process needs to work in a fair and transparent way, especially for individuals with limited resources who are less likely to be able to fight back when something goes wrong,” added Trinh Phan of Justice in Aging. “This settlement gets us closer to the kind of monitoring needed in the program, so that people with disabilities are not unfairly denied or terminated from benefits.”
About the Lead Plaintiff
Kevin Hart, a grandfather of 13, worked as a laborer, a custodian, and a house builder until he was hit by a car while biking home from work after a late shift one night.
The Social Security Administration (SSA) classified him as permanently disabled after the accident and he moved in with his mother as he now needed to rely on his small monthly benefit as his sole income. Later, the SSA sent him a notice informing him that he was no longer eligible for benefits because he was no longer disabled. This would have left him with no income at all to buy food or pay the rent. The decision to terminate his disability benefits was based on the cursory examination of a doctor that Social Security contracted with to provide exams and who failed to note that Mr. Hart required a cane to walk.
More information about the case can be found here, including the settlement agreement, and the press release announcing the settlement agreement. Additional materials will be released soon to help class members and advocates understand the settlement and how to obtain relief under the settlement.
Justice in Aging is a national non-profit legal advocacy organization that fights senior poverty through law. Formerly the National Senior Citizens Law Center, since 1972 we’ve worked for access to affordable health care and economic security for older adults with limited resources, focusing especially on populations that have traditionally lacked legal protection such as women, people of color, LGBT individuals, and people with limited English proficiency. Through targeted advocacy, litigation, and the trainings and resources we provide to local advocates, we ensure access to the social safety net programs that poor seniors depend on, including Medicare, Medicaid, Social Security, and Supplemental Security Income (SSI).
Contact: Vanessa Barrington