JON S. TIGAR, District Judge.
Before the Court is Plaintiffs' unopposed Motion for Preliminary Approval of Class Action Settlement. ECF Nos. 75, 79.
This is a putative class action about the evidence that Administrative Law Judges ("ALJs") may properly consider in determining whether claimants are entitled to disability benefits from the Social Security Administration ("SSA"). ECF No. 50. Named Plaintiffs Kevin Hart, Nina Silva-Collins, and Lee Harris represent a class of individuals who received a consultative examination ("CE") performed by Dr. Frank Chen, a physician who is now disqualified, in connection with their applications for award or review of disability benefits from the SSA. ECF No. 50; ECF No. 1 ¶¶ 13-15. Defendant Carolyn W. Colvin is the Acting Commissioner of Social Security.
To obtain benefits based on disability under the Supplemental Security Income ("SSI") or Social Security Disability Insurance ("SSDI") programs, a claimant must be unable "to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." ECF No. 1 ¶ 2 (citing 42 U.S.C. § 423(d)(1)(A)). SSA, which administers the SSI and SSDI programs, is required to "establish by regulation uniform standards which shall be applied at all levels of determination, review, and adjudication in determining whether individuals are under disabilities." 42 U.S.C. § 421(k)(1). The regulations promulgated pursuant to the Social Security Act require that claimants provide SSA with "evidence from acceptable medical sources to establish whether [an individual has] a medically determinable impairment(s)." ECF No. 1 ¶ 3 (citing 20 C.F.R. § 404.1513(a)). "Objective medical evidence of pain or other symptoms established by medically acceptable clinical or laboratory techniques . . . must be considered in reaching a conclusion as to whether [a claimant] is under a disability." 42 U.S.C. § 423(d)(5)(A).
Although SSA administers SSI and SSDI, it contracts with state agencies, such as the Disability Determination Service Division of the California Department of Social Services ("DDSD"), to make disability determinations.
SSA regulations require adjudicators to "always consider" CE reports along with the rest of the relevant evidence in making a disability determination.
Named Plaintiffs Kevin Hart, Nina Silva-Collins, and Lee Harris all sought the award or renewal of disability benefits from SSA. Dr. Frank Chen performed CEs on all of the Named Plaintiffs in connection with their applications for award or renewal of disability benefits. Named Plaintiffs allege various deficiencies with these examinations.
Plaintiff Hart suffered from "tremendous pain and limited mobility," following a 2007 car accident, as well as "diabetes and emphysema."
Plaintiff Silva-Collins suffers from "severe, chronic anemia caused by menorrhagia (abnormally heavy and prolonged menstrual bleeding), lumbar degenerative disc disease, depression, anxiety, asthma, and hypertension."
Plaintiff Harris suffers from debilitating lower back, leg, and foot pain caused by an April 2005 car accident.
Unbeknownst to claimants who were being referred to Dr. Chen for CEs during this time, DDSD had sent Dr. Chen a Corrective Action letter regarding deficiencies in his CEs in September 2011.
On February 9, 2015, Plaintiffs filed a Complaint, asking the Court to grant declaratory and injunctive relief: 1) declaring that Defendant's reliance on Dr. Chen's CE reports "violate[s] the SSA's obligations pursuant to the Social Security Act, its implementing regulations and the Due Process Clause of the United States Constitution"; 2) enjoining Defendant from relying on CE reports prepared by Dr. Chen to terminate or deny disability benefits; 3) requiring Defendant to reopen prior determinations terminating or denying benefits in reliance on CE reports prepared by Dr. Chen; and 4) requiring Defendant to provide notice to all individuals whose benefits were terminated or denied in reliance on a CE report prepared by Dr. Chen of their right to these forms of relief. ECF No. 1 at 23-24. On April 20, 2015, Defendant filed a motion to dismiss for lack of subject matter jurisdiction, contending that the Court could not exercise jurisdiction over this case pursuant to 42 U.S.C. § 405(g)
On July 31, 2015, Defendant filed her Answer to the Complaint. ECF No. 38. On August 6, 2015, Plaintiffs filed a motion for class certification, seeking to certify a class of "[a]ll persons whose SSI or SSDI benefits were either denied or terminated and for whom a consultative examination was prepared by Dr. Frank Chen," ECF No. 40 at 9. On October 14, 2015, the Court granted the motion for class certification, concluding that Plaintiffs had met the requirements of Federal Rules of Civil Procedure 23(a) and 23(b)(2). ECF No. 50. On September 19, 2016, Plaintiffs filed an unopposed motion for preliminary approval of class action settlement agreement, which motion the Court now considers. ECF No. 75.
Class certification under Rule 23 of the Federal Rules of Civil Procedure is a two-step process. First, a plaintiff must demonstrate that the four requirements of Rule 23(a) are met: numerosity, commonality, typicality, and adequacy. "Class certification is proper only if the trial court has concluded, after a `rigorous analysis,' that Rule 23(a) has been satisfied."
Second, a plaintiff must establish that the action meets one of the bases for certification in Rule 23(b). Here, because they rely on Rule 23(b)(3), Plaintiffs must establish that "questions of law or fact common to class members predominate over any questions affecting only individual members, and . . . [that] a class action is superior to other available methods for fairly and efficiently adjudicating the controversy." Fed. R. Civ. P. 23(b)(3).
The party seeking class certification bears the burden of demonstrating by a preponderance of the evidence that all four requirements of Rule 23(a) and at least one of the three requirements under Rule 23(b) are met. See
The Court has previously certified a class "consisting of all persons whose SSI or SSDI benefits were either denied or terminated and for whom a consultative examination was prepared by Dr. Frank Chen." ECF No. 50 at 19. Solely for purposes of the proposed settlement, as agreed to by the parties, Plaintiffs request that the class definition be amended to be:
ECF No. 76 at 5. Plaintiffs argue that "this is not a substantive change," and merely includes in the class, in explicit terms, "individuals who did not receive an award or benefits for the full period of their application—in other words, whose benefits were `denied or terminated' only in part."
The Ninth Circuit maintains a "strong judicial policy" that favors the settlement of class actions.
The Court's task at the preliminary approval stage is to determine whether the settlement falls "within the range of possible approval."
Preliminary approval of a settlement is appropriate if "the proposed settlement appears to be the product of serious, informed, non-collusive negotiations, has no obvious deficiencies, does not improperly grant preferential treatment to class representatives or segments of the class, and falls within the range of possible approval."
On August 17, 2015, the Court referred the parties for a Settlement Conference before Magistrate Judge Maria-Elena James, scheduled for November 2015. ECF Nos. 44-45. The parties engaged in settlement discussions in person, by phone, and by email in the intervening months. ECF No. 76 at 4. The first Settlement Conference took place on November 17, 2015. ECF No. 54. The parties subsequently had six additional Settlement Conferences with Magistrate Judge James: on December 18, 2015, April 5, 2016, April 28, 2016, May 19, 2016, July 13, 2016, and July 28, 2016. ECF Nos. 57, 62, 65, 66, 68, 71. The parties reached an agreement on September 19, 2016. ECF No. 76.
As described by Plaintiffs, "[t]he Settlement Agreement provides relief to class members through procedural mechanisms that vary depending on the status of their claims and the amount of time since their examination by Dr. Chen." ECF No. 76 at 5.
"A class member who has an `open' claim is an individual who received an unfavorable decision or determination of their claim but, as of the date of final approval of this Settlement Agreement, that decision or determination is not final."
For individuals who meet this definition, the ALJs handling their claims are required to:
"A class member who has a `closed' claim is an individual who received an unfavorable decision or determination of their claim and, as of the date of final approval of this Settlement Agreement, that decision or determination is final." ECF No. 76 at 6; ECF No. 76-1 at III.A.
Due to the fact that these class members' claims are "closed," if they are eligible for relief they will need to proceed through a readjudication process. ECF No. 76 at 6. "The person or entity responsible for readjudicating these claims will reflect the level at which each claimant received the unfavorable decision or determination."
If the DDS made the final decision at issue, the proposed settlement provides that the SSA will readjudicate those claims through its "Disability Processing Unit," without consideration of Dr. Chen's CE report.
Moreover, if the Disability Processing Unit finds that the claimant was disabled at the end of the previously-adjudicated period, the claimant may use supplemental evidence or a new CE ordered by the Disability Processing Unit to show that his or her disability has continued beyond the previously adjudicated period, up to and including the date of readjudication.
If an ALJ made the final decision at issue, a new hearing will be scheduled for reconsideration of the claim without consideration of Dr. Chen's report. ECF No. 76 at 7; ECF No. 76-1 at III.A.2.b. A claimant in this category also has the opportunity to submit supplemental evidence relating to the previously-adjudicated period, the ALJ can order a new CE within his or her discretion, and the claimant will receive back benefits or payments if found to have been disabled for all, or any part of, the previously-adjudicated period.
If class members in this category requested review by the Appeals Council or if the Appeals Council took review on its own motion, their case will be remanded, and they will have a new hearing with the same rights described above.
"A class member who has a `closed' claim, and who was examined by Dr. Chen between January 1, 2007, and December 31, 2010, will be invited by SSA to apply for SSI or DIB benefits, or both, by timely returning a claim form, indicating on the form whether he or she is currently disabled, and proceeding to file a new application within the applicable timeframe." ECF No. 76; ECF No. 76-1 at III.B.2. If the claimant is determined to be disabled upon adjudication of his or her current application, he or she will then be entitled to a "lookback assessment" for the previously-adjudicated period for which he or she were denied benefits.
Individuals in "current pay status" are currently receiving benefits, despite a past denial (or partial denial) of a claim for benefits that involved an examination by Dr. Chen.
"If SSA reviews the prior ALJ decision and determines that Dr. Chen's CE report was explicitly afforded no weight in the analysis, that individual will not be eligible for another review of his or her claim." ECF No. 76 at 8; ECF No. 76-1 at III.A.2.b; III.A.2.c.
For claimants eligible for relief who appealed their final decision to a federal court pursuant to 42 U.S.C. §§ 405(g) or 1383(c)(3) prior to the date of final approval and have a pending federal court case, "SSA will file a notice of non-opposition in response to a timely motion for remand to the agency for further proceedings if the claimant wishes to be eligible for consideration for such relief." ECF No. 76 at 8; ECF No. 76-1 at III.A.2.d. If a claimant is eligible for relief but his or her "federal court case has resulted in a final judgment affirming the final decision of the Commissioner, SSA will file a notice of non-opposition in response to a timely 60(b)(6) motion for remand to the agency for further proceedings if the claimant wishes to be eligible for consideration for such relief." ECF No. 76 at 8-9.
In addition to the relief discussed for each category of class member, Defendant will "begin a study of the processes through which it monitors the California DDS's engagement, review, and retention of empaneled consultative examiners," with the goal of identifying "mechanisms to improve the monitoring of these processes." ECF No. 76 at 9.
Defendant has also "agreed to issue a document setting out processes for notifying adjudicators when an individual CE provider previously engaged by the California DDS has been disqualified for conduct determined to undermine the reliability of that provider's reports."
Defendants will also "pay attorney's fees, both for pre-approval work already incurred and for post-approval work in the future, and reimbursement of expenses and costs by Plaintiff's counsel Justice in Aging and Legal Aid Society of San Mateo County in the amount of $490,000." ECF No. 76 at 10; ECF No. 76-1 at VII. "Plaintiffs' counsel Morrison & Foerster has agreed to waive any attorney's fees and costs incurred in connection with this action."
In exchange, "Plaintiffs agree to the dismissal of the Case with prejudice under Federal Rules of Civil Procedure 41(a)(1) and 23(e)," and agree to "release, waive, acquit, and forever discharge the United States, the Commissioner, the Social Security Administration, the California Disability Determination Service, and all of their officers, employees, and agents, from, and are hereby forever barred and precluded for prosecuting, any and all claims, causes of action, and/or requests for relief that would be barred by the doctrine of res judicata were final judgment on the merits entered on all claims asserted in this case." ECF No. 76-1 at VII-VIII.
The Court concludes that the proposed benefits to be awarded to the class fall "within the range of possible approval."
While the parties agree that the outcome of a trial is "uncertain," they do not describe Plaintiffs' claims as "not particularly strong" or weak. ECF No. 76 at 12;
In examining the means by which the parties arrived at a settlement, the Court concludes that the negotiations and agreement were non-collusive. The stipulated settlement was reached after the parties engaged in motion practice and participated in arms-length, extensive settlement negotiations overseen by an experienced and neutral third party. ECF No. 76 at 14. These assertions support the conclusion that the settlement is non-collusive and likely to benefit the class members.
Defendant Carolyn W. Colvin is Acting Commissioner of Social Security and is charged by federal law with administering and supervising the benefit programs administered by SSA. The Court agrees that her participation weighs in favor of approval.
The settlement has no obvious deficiencies. The settlement addresses Plaintiffs' central claim by providing that class members will be afforded fair process to determine their eligibility for benefits without consideration of Dr. Chen's reports. It also allows some class members to preserve Dr. Chen's report in their record by giving them the option of whether to challenge it. ECF No. 76 at 17. The Court concludes that such relief falls within the range of possible approval.
Under this factor, the Court looks at whether the settlement agreement provides preferential treatment to any class member. The named plaintiffs receive the same relief as all other class members under the agreement. The variations that are included in the different sub-classes reflect only that different class members occupy different procedural postures within SSA's administrative process. The Court agrees that the agreement provides relief through the use of procedural mechanisms most appropriate for each sub-group based on procedural posture. While such differences may result in different types of relief for the different subclasses, they are rational in this instance because some claimants' claims are "closed" while others are "open," and the September 2011 distinguishing date represents when Defendant sent Dr. Chen a corrective action letter and was officially aware of problems with his reports.
"Courts typically require less notice in Rule 23(b)(2) actions, as their outcomes do not truly bind class members."
When, for instance, "the settlement provides for only injunctive relief, and, therefore, there is no potential for the named plaintiffs to benefit at the expense of the rest of the class," notice "is not uniformly required."
In any case, the parties have proposed that notice be provided to the class. This is wise, since class members' will have to take affirmative action if they desire their claims to be reopened, and will subsequently be notified via the claim form procedure if the settlement agreement is finally approved. First, notice is to be published, at Defendant's expense, in three newspapers of general circulation. ECF No. 76 at 18. Plaintiffs' counsel will also disseminate notice of the settlement to "several organizations that are likely to interact with class members," and "provide adequate notice of the proposed class settlement so that interested parties may object to its reasonableness."
If the Court approves the settlement agreement, the parties will send notice and corresponding "Request Forms" to "individual class members based on the relief afforded to them." ECF No. 76 at 19. The Notice forms will be sent to class members' last known address, will describe their procedural status within the SSA process, apprise them of the opportunity and risks associated with reopening their claims, advise claimants that they can have a representative help with his or her claim and that the claimant may want to speak to that representative before returning the request form, and includes an option to submit a different address.
The Notice of Settlement contains a section entitled, "What Can You Do If You Object To The Settlement Or Have Other Comments?" ECF No. 76-1 at 76. Consistent with the Northern District's Procedural Guidance for Class Action Settlements,
The Motion for Preliminary Approval of Class Action Settlement Agreement is granted. The Court therefore orders as follows:
1. The Court preliminarily approves the agreement set forth in the Settlement Agreement.
2. The class certified in the Court's prior order, ECF No. 50, is modified to be defined as follows:
3. The Court sets the following dates and deadlines:
4. The Court sets the Final Approval Hearing for March 16, 2017 at 2:00 p.m.