A 2023 court settlement aims to improve SSA’s timely processing of SSI non-disability appeals and protect claimants from undue disruption in SSI benefits. On April 3, 2023, the United States District Court for the Eastern District of New York approved a settlement agreement in Amin v. Kijakazi, 15-cv-07429 (EDNY) that provides for wide-reaching relief for SSA’s systemic failure to timely process non-disability appeals at the local office level. The case was brought by plaintiffs in New York, but the relief provided under the settlement is national.
The complaint alleged that SSA’s routine failure to accept and timely docket SSI appeals was a violation of the Due Process Clause of the Fifth Amendment, the Social Security Act, and federal regulation. Much of the relief under Amin has already been rolled out over the past 2 years, including changes to SSA’s computer systems and a significant change in policy.
Under Goldberg v. Kelly, a SSI recipient is entitled to continuing benefits if reconsideration is requested within 10 days; this 10-day deadline is codified in the regulations. See 20 CFR § 416.1336. Because SSA assumes a person received a notice five days after the date, this period is essentially 15 days from the date on the notice.
Under the Amin settlement, SSA agreed to expand the Goldberg Kelly continuing benefits period from 10 to 60 days. This was enacted in October 2021 via Emergency Message (EM) EM-21064 REV GK Benefits, which established a new 60-day time frame for ensuring the continuation of SSI benefits during the pendency of an appeal of a suspension or reduction of benefits.
The EM provides for an automatic finding of good cause for late filing where a reconsideration request is made between 10 and 60 days after receipt of the Notice of Planned Action to suspend or reduce their benefits. Good cause is still available after 65 but is not automatic.
SSA has agreed to issue POMS with this change and initiate rulemaking with a Notice of Proposed Rulemaking (NPRM) to amend the current regulation to extend the 10-day filing deadline. An NPRM has not yet been published but the proposal is on SSA’s Unified Agenda.
SSA also agreed to enhance their IT systems to improve their processing of SSI non-disability appeals. As reported in a prior EJC newsletter, some of these improvements were announced in Emergency Messages in 2021 as technical changes to two relevant SSA computer programs.
EM-21051-REV mandates the use of the Dallas Appeals Application in processing all non-medical reconsiderations. The application, also known as “Banana,” streamlines the amount of manual entry required to keep benefits continuing or to stop overpayment recovery. EM-21062 allows for better tracking and prioritizing of non-disability appeals in WorkTrack, where all submissions are reviewed and processed, by requiring these particular appeals to be profiled and coded as either non-medical or medical reconsideration requests.
SSA committed to maintain these systems for 3 years from the date of the settlement agreement, as well as committing to the maintenance of desktop faxes. SSA has also agreed to find all SSI non-disability reconsideration requests to be timely filed if the appeal was received during the field office closures between March 17, 2020 and April 7, 2022, was not yet processed, and there was otherwise no indication of filing date.
Do you have clients whose benefits are reduced or suspended despite a timely request for reconsideration for an adverse action in a SSI non-disability issue?
If a SSI recipient has filed a timely request for reconsideration, but does not continue to receive their benefits while their appeal is pending, advocates are advised to first contact the manager of their local office and reference EM-21064 REV and the Amin settlement. If this does not result in the SSI benefits being paid within 30 days of the filing of a timely reconsideration request, advocates should contact the Regional Communications Director (RCD) in SSA’s Public Affairs Office. Note that a SSI recipient’s name and Social Security number should not be sent via email to the RCD. If, after contacting the RCD, benefits are still not received, advocates should contact Amin plaintiffs’ counsel.
The case was brought by Michelle Spadafore of NYLAG, who filed the case at the end of 2015 with Ann Biddle and Ian Feldman (originally through Queens Legal Services and later the Urban Justice Center). Emilia Sicilia joined as co-counsel in 2017 (originally through UJC and later Empire Justice Center), and in 2019 Justice in Aging and pro bono law firm Arnold and Porter joined as co-counsel.