Settlement in Class Action against Social Security for Basing Disability Decisions on Disqualified Doctor’s Reports

By September 21, 2016PRESS RELEASE

Oakland, CA—A settlement has been reached on behalf of approximately 6,500 California residents, most of them in the San Francisco Bay Area. The settlement will ensure that class members have the opportunity to have disability claims that were denied or discontinued reevaluated.  If approved by the court, it will be the first-ever settlement against the Social Security Administration (SSA) to provide a large group of people with a remedy for its reliance on medical reports from a disqualified physician.

Lead Plaintiff Kevin Hart was devastated when he received notice from the Social Security Administration that he was no longer disabled after being examined by the doctor in question. “He didn’t even know me, he didn’t even look at me,” said Hart, describing the cursory examination he received that lasted less than 10 minutes and failed to note that he required a cane to walk.

The plaintiff class consists of 6,500 people who were denied Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) benefits based on exams performed by a Bay Area doctor. The suit charged that the exam reports were unprofessional, and often incomplete and inaccurate. SSA continued to use this doctor’s reports to deny disability benefits for years, even after he was disqualified for failure to comply with notices of corrective action.

”Social Security is responsible for administering disability benefits; it should have stopped relying on this doctor’s reports as soon as he was disqualified,” said Trinh Phan, a senior staff attorney at Justice in Aging who also represented Hart in his administrative appeal while at the Legal Aid Society of San Mateo County.

Hart, who had worked over the years as a janitor, a bricklayer, and a builder until his leg was shattered when he was hit by a car in 2007, relied solely on his SSI and SSDI to get by. As other complaints from beneficiaries surfaced, the same doctor was found to have examined thousands of people around the Bay Area, potentially wrongly denying benefits to countless others.

“We hope that class members who were unfairly denied disability benefits based on this doctor’s faulty reports will hear about the settlement and file their claims in time,” said Hope Nakamura, a directing attorney at the Legal Aid Society of San Mateo County.

A motion for preliminary approval of the settlement was filed Monday in U.S. District Court. The settlement agreement would give many who were examined by the now-disqualified doctor and had their benefits terminated or denied the option to have Social Security re-determine their disability claim—without using that doctor’s report.

“We are pleased that the government has agreed to give many people in the Bay Area the fair chance at getting benefits they were denied,” said Robert Petraglia of Morrison & Foerster LLP.

Under the agreement, Social Security also would review its own processes for monitoring the doctors contracted to conduct these exams in the future.

Plaintiffs are represented by Morrison & Foerster LLP, Justice in Aging, and the Legal Aid Society of San Mateo County.

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). For more information, visit our website at www.justiceinaging.org.

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Contact: Vanessa Barrington
510-256-1200 direct
vbarrington@justiceinaging.org

or Trinh Phan
510-931-4203 direct
tphan@justiceinaging.org

About Katrina Cohens

Katrina Cohens is based in Justice in Aging’s Washington, DC office and serves as the Database Manager.