TN 16 (10-16)

CITATIONS: Social Security Act, Sections 202(x)(1)(A)(iv), 804(a)(2), 1611(e)(4)(A)(i), 205(j)(2)(C)(i)(V), 807(d)(1)(E), 1631(a)(2)(B)(iii)(V); 20 CFR 416.202; 416.708; 416.1339;

Martinez v. Astrue, No.08-4735 CW, a case in the U.S. District Court for the Northern District of California. See the Notice of Final Settlement In The Martinez Court Case.

A. Background on the Martinez court case settlement

1. Description of the Martinez court case

On September 24, 2009, the United States District Court for the Northern District of California approved a nationwide class action settlement agreement in the case of Martinez v. Astrue. Under its terms, the settlement was effective November 29, 2009. Generally, the Martinez settlement changes the types of felony arrest warrants used to prohibit payment of Social Security Retirement Survivors and Disability Insurance (RSDI), Supplemental Security Income (SSI), and Special Veterans Benefits (SVB).

This settlement does not affect SSA policies and procedures on cases involving unsatisfied arrest warrants for violation of probation or parole. For a list of the warrant offense codes not covered under the Martinez settlement retroactive relief process, see the first row of the chart located in GN 02613.885C.2.b.

2. Class Members of the Martinez settlement

The Martinez court defined the settlement class as:

All persons whose SSI, SVB, or RSDI benefits have been suspended or denied, or who have been notified of a proposed suspension or denial of such benefits for “fleeing to avoid prosecution or custody or confinement after conviction” for a felony or who are not permitted to serve as representative payees for SSI, SVB or RSDI benefits for “fleeing to avoid prosecution or custody or confinement after conviction” for a felony. The class does not include, and this settlement does not apply to, any individual who has received a final federal court disposition as of September 24, 2009, regarding payment or nonpayment of benefits due to fugitive felon status.

B. Terms of the Martinez court settlement

1. Prospective relief - April 1, 2009 change in SSA policy

Effective April 1, 2009, SSA suspends or denies benefits based on outstanding felony arrest warrants only for:

• escape from custody (offense code 4901);

• flight to avoid prosecution or confinement (offense code 4902); and

• flight-escape (offense code 4999).

SSA may now consider approving applications to serve as representative payees from individuals who have an unsatisfied felony arrest warrant. SSA still considers warrant information as one of several factors in deciding whether a person is suitable to serve as a representative payee. For revised representative payee selection instructions, see GN 00502.132 through GN 00502.133 and GN 00504.102.

The Martinez court settlement has no effect on the nonpayment or denial of benefits based on a warrant for a violation of probation and parole (warrants with offense codes of 5011, 5012, 8101, and 8102). If the beneficiary or recipient does not have an outstanding warrant with an offense code of 4901, 4902, 4999, 8101, 8102, 5011, or 5012, he or she is eligible for benefit payments beginning April 01, 2009, under current Social Security laws and regulations and normal case processing policies and rules.

NOTE: For a list of the warrant offense codes not covered under the Martinez settlement retroactive relief process, see the first row of the chart located in GN 02613.885C.2.b.

2. Retroactive relief categories of settlement Class Members

The settlement agreement provides relief to two broad categories of Class Members—the post-2006 group and the pre-2007 group.

3. Benefits for Class Members due post-2006 relief

In general, we will reinstate benefits and pay any previously withheld benefits back to the first month of suspension (RSDI, SSI, and SVB) or denial (SSI and SVB only). We will also repay any overpayment amounts collected from these Class Members who have been overpaid benefits based upon the previous policy.

This relief applies to Class Members:

• whose Title II benefits were suspended (S9 HRFST FUGFEL for RSDI or have an open FUGITIVE data event on the MBR) or whose SSI or SVB payments were suspended or denied (PSY N25) on or after January 1, 2007;

• who had a prior fugitive felon suspension or denial with an administrative appeal determination on or after January 1, 2007; or

• who had a prior suspension or denial with an administrative appeal (request for reconsideration, administrative law judge, or Appeals Council review) challenging the suspension or denial of benefits pending August 11, 2008.

Prior to reinstating payments for SSI Class Members, we will re-determine their non-medical eligibility criteria under our usual policies.

After reinstating benefits or payments to settlement Class Members, we may conduct continuing disability reviews under our usual policies.

We notified post-2006 Martinez settlement Class Members of these actions by mailing individual notices to the address shown on our records.

NOTE: When we reinstate payments for a fugitive felon nonpayment month under the settlement, other normal payment, nonpayment, and reduced payment rules apply. This may affect the fugitive felon nonpayment months that we reinstate.

4. Benefits for Class Members due pre-2007 relief

We will remove any remaining overpayment balances imposed based on the previous fugitive felon policy for the Class Members whose:

RSDI benefits were suspended or whose SSI or SVB were suspended or denied (S9 HRFST FUGFEL for RSDI or had an open FUGITIVE data event on the MBR and N25 for SSI and SVB), between January 1, 2000, and December 31, 2006, inclusive, and who on August 11, 2008, did not have an administrative appeal pending.

In addition, we sent a notice to those Title II Class Members who were not receiving benefits or payments as of April 1, 2009, based upon the previous fugitive felon policy. The notice advised them to contact us at 1-800-772-1213 (TTY 1-800-325-0778) about possible reinstatement of their Title II benefits. If these Class Members contacted us within six months of the date on the notice, we reinstated their Title II benefits as early as April 1, 2009. Title XVI Class Members will receive a notice advising them to contact us at 1-800-772-1213 (TTY 1-800-325-0778) to make an appointment to file a new application for benefits. If they do so within 6 months of the date on the notice, we will use an application date of April 1, 2009, as the protective filing date for the Title XVI claim.

NOTE: Class Members whose benefits were suspended or denied prior to January 1, 2000, may reapply under the new policy, but we will not mail them a class notice or provide a protective filing date of April 1, 2009. For instructions for Class Members to reapply under the new policy, see GN 02613.860B.1. in this section.

C. Schedule for Martinez settlement retroactive relief phases

We implemented the Martinez settlement retroactive relief in phases according to a progressive, orderly plan. The plan allowed us to automate many of the operational aspects of the established Martinez settlement relief plan. We listed Class Members in the Civil Action Tracking System (CATS) after we identified them for a specific phase of retroactive relief.

1. Post-2006 relief

a. Title II post-2006 relief cases

Most RSDI Class Members potentially due post-2006 relief were sent an informational notice in December 2009 informing them of the post-2006 settlement terms (see sample notice in GN 02613.867A). After we issued this notice, an automated systems operation resumed benefits to beneficiaries who are or were in fugitive felon suspension (S9 HRFST of FUGFEL or had a FUGITIVE data event open on the MBR) on 01/2007 or later. Systems sent exceptions from the automated process that required manual action to the program service center (PSC) for completion. For types of exceptions, see GN 02613.870B.

A special message of, “MARTINEZ COURT CASE – POST 2006 RELIEF APPLIES,” was automatically updated to the MBR for all affected records.

We also identified additional post-2006 Class Members with closed periods of fugitive felon suspense during the pre-2007 Martinez selection process. Processing service center (PSC) technicians can find the instructions for case processing for these additional Class Members in GN 02613.865D.

b. Title XVI post-2006 relief cases

SSI post-2006 Class Members potentially due post-2006 relief were included in the April 2010 scheduled redetermination (RZ) release and loaded into Stars and Stripes the Next Generation (SSTNG). Field offices (FOs) contacted these Class Members in order to conduct a RZ prior to resuming payment. FOs included special language in the RZ appointment letter that explained the potential relief under the Martinez settlement. Some denial cases required a medical determination before determining payment eligibility.

For Class Members that we were not able to identify in April 2010, we furnished the same relief after the Pre-2007 relief systems run.

2. Pre-2007 relief

a. Title II pre-2007 relief cases

In April 2010, we identified the Title II (Retirement, Survivors, and Disability Insurance (RSDI)) pre-2007 Class Members and sent them an informational notice explaining the pre-2007 relief. After releasing the notice, SSA forwarded the fugitive felon overpayment cases to the program service centers (PSCs) to cancel or remove any remaining fugitive felon overpayments for the pre-2007 period (i.e., January 1, 2005 – December 31, 2006).

In addition, the informational notice informed Class Members that if they were in fugitive felon suspension on April 1, 2009, they could request reinstatement of monthly benefits. Protective filing retroactive to April 1, 2009, applied to the reinstatement of benefits (for a felony offense code on the active warrant other than 4901, 4902, 4999, 5011, 5012, 8101, or 8102) if the beneficiary contacted us within 6 months of the date on the pre-2007 informational notice.

b. Title XVI pre-2007 relief cases

In September 2010 and May 2011, we identified Title XVI (Supplemental Security Income (SSI)) pre-2007 Class Members and sent them an informational notice explaining the pre-2007 relief. After releasing the notice, SSA forwarded the SSI fugitive felon overpayment cases to the servicing field offices (FOs) to identify and then cancel or remove any remaining fugitive felon overpayments for the pre-2007 period (i.e., January 1, 2000 – December 31, 2006).

In addition, the informational notice informed Class Members that, if they were in fugitive felon suspension (N25) on April 1, 2009, or were denied benefits (and the felony offense code on the active warrant is other than 4901, 4902, 4999, 5011, 5012, 8101, or 8102), they could file a new application. If the recipient contacted us within 6 months on the date of the pre-2007 informational notice, we established a protective filing date retroactive to April 1, 2009.

D. Location of the Master Control List of Martinez Class Members

1. Civil Action Tracking System (CATS) record

We added Class Members for each category of retroactive relief to CATS as we select them.

We used the following Court Case Identifiers (CCID) to indicate the category or categories of Martinez relief to which a class member is potentially eligible. The CCID indicates which informational notice(s) we sent to the class member:

CATS is no longer available to technicians based on changes made by the Office of General Counsel (OGC). Only Central Office staff has access to Martinez CATS records. If a beneficiary or recipient inquirers about Martinez relief, follow the instructions in GN 02613.885.

2. Concurrent cases (entitlement or eligibility to both Title II and Title XVI monthly benefits)

We processed the Martinez settlement actions on concurrent cases (that is entitlement and eligibility on Title II and Title XVI, respectively) independently under each title. We processed Title II Martinez cases in accordance with instructions in GN 02613.860D.1. in this section (chart, CCID Codes F1, F2, F3), and processed Title XVI Martinez cases as indicated in the instructions in GN 02613.860D.1. in this section (chart, CCID Codes F4, F5, F6, and F7).