Common use of For Group Clause in Contracts

For Group. 1 claimants whose Unfavorable decision or determination or Partially Favorable decision or determination was rendered at the ALJ level: As part of the readjudication process for Group 1 claimants who timely request readjudication relief and whose pertinent Unfavorable decision or determination or Partially Favorable decision or determination was rendered at the ALJ level, SSA will review the prior ALJ decision to assess whether Dr. Xxxxx Xxxx’x CE report was explicitly afforded no weight in the analysis. A new hearing will not be scheduled for a claimant if Xx. Xxxx’x report was explicitly afforded no weight by the adjudicator, or if the decision was rendered for failure to meet non-medical criteria; the readjudication process will conclude for such a claimant. A hearing will be scheduled for all other claimants. For any claimant for whom a new hearing is scheduled, the claimant will be provided forms that provide him or her with the opportunity to submit supplemental evidence relating to the claim of disability that was previously denied. Such supplemental information and evidence may include a re-articulation of the nature of the impairment(s) that existed during the previously-adjudicated period, the disclosure of medical providers who have information that bears on the claimant’s condition during the previously-adjudicated period, and medical or other evidence that relates to his or her condition during the previously-adjudicated period. Within 60 days of the date of final approval, SSA will provide to Class counsel a draft copy of the forms for submission of supplemental evidence. Within three business days of receiving these draft forms, Class counsel may provide comments on these draft forms to SSA, and SSA will consider those comments in good faith, but shall have no obligation to implement or accept any comments or changes from Class counsel. No Group 1 claimant will be obliged to provide any additional information in order to receive a new hearing, and if a Group 1 claimant elects not to provide additional information, he or she may proceed on the record that was created during his or her previous application process, as further described in this paragraph. At the same time, should the Group 1 claimant allege that he or she is disabled at the date of the readjudication, the claimant will be asked to provide updated disability information pertaining to his or her current condition as well. At the hearing, the ALJ will have the discretion to take evidence for both the previously-adjudicated period and the current period (or any part thereof), should the ALJ find that most efficient in light of the circumstances of the case. The ALJ also may exercise his or her usual discretion to engage a vocational expert, procure a CE report, engage a medical expert, and the like. If, as a result of the readjudication, the Group 1 claimant is found to have been disabled for the previously-adjudicated period, or any portion thereof, he or she will receive the appropriate award of back benefits or payments for the period of disability demonstrated. If the Group 1 claimant is found to have been disabled for the previously-adjudicated period (but not for a closed period of disability that is within the previously-adjudicated period and whose end date is before the end date of the previously-adjudicated period), should that Group 1 claimant also successfully demonstrate that his or her disability continues forward through the date of the readjudication decision, he or she will receive the appropriate award of back benefits or payments from the end of the previously-adjudicated period through the date of the readjudication decision, as well as appropriate current benefits or payments (subject to continuing disability reviews, reporting responsibilities, and any other rules and procedures generally applicable to recipients of DIB or SSI). Likewise, if the Group 1 claimant successfully demonstrates that his or her disability continues forward, but only for a closed period that does not continue forward to the date of the readjudication decision, he or she will receive the appropriate award of back benefits or payments from the end of the previously-adjudicated period to the end of the closed period demonstrated. Notwithstanding the foregoing, to the extent that the Class Member has an application for DIB or SSI pending at the time of the readjudication, SSA will not consider the period of disability alleged in that pending application in the readjudication.

For Group. 1 claimants whose Unfavorable decision or determination or Partially Favorable decision or determination was rendered at the ALJ DDS level: As part of the readjudication process for Every Group 1 claimants claimant who timely request requests readjudication relief and whose pertinent Unfavorable decision or determination or Partially Favorable decision or determination was rendered at the ALJ level, SSA will review the prior ALJ decision to assess whether Dr. Xxxxx Xxxx’x CE report was explicitly afforded no weight in the analysis. A new hearing will not be scheduled for a claimant if Xx. Xxxx’x report was explicitly afforded no weight by the adjudicator, or if the decision was rendered for failure to meet non-medical criteria; the readjudication process will conclude for such a claimant. A hearing will be scheduled for all other claimants. For any claimant for whom a new hearing is scheduled, the claimant will be provided with forms that will provide him or her with the opportunity to submit supplemental evidence relating to the claim previously-adjudicated period within sixty (60) days from receipt of disability the forms. The forms shall include a notification that was previously denieda Group 1 claimant may, prior to the expiration of the 60-day period, request a reasonable extension of time to submit supplemental evidence relating to the previously-adjudicated period. Such supplemental information and evidence may include a re-articulation of the nature of the impairment(s) that existed during the previously-adjudicated period, the disclosure of medical providers who have information that bears on the claimant’s condition during the previously-adjudicated period, and medical or other evidence that relates to his or her condition during the previously-previously- adjudicated period. Within 60 days of the date of final approval, SSA will provide to Class counsel a draft copy of the forms for submission of supplemental evidence. Within three business days of receiving these draft forms, Class counsel may provide comments on these draft forms to SSA, and SSA will consider those comments in good faith, but shall have no obligation to implement or accept any comments or changes from Class counsel. No Group 1 claimant will be obliged to provide any additional information in order to receive a new hearingreadjudication, and if a Group 1 claimant elects not to provide additional information, he or she may proceed exclusively on the record that was created during his or her previous application process, as further described in this paragraph. At Through its Disability Processing Unit, SSA will readjudicate claims by considering the same time, should original record and any supplemental information or evidence submitted by the Group 1 claimant allege Class Member that he or she is disabled at the date of the readjudication, the claimant will be asked relates to provide updated disability information pertaining to his or her current condition as well. At the hearing, the ALJ will have the discretion to take evidence for both the previously-adjudicated period and period, but without considering the current period (or any part thereof), should the ALJ find that most efficient in light consultative examination report prepared by Dr. Xxxxx Xxxx. No consultative examinations will be purchased by SSA with respect to readjudication of the circumstances of the case. The ALJ also may exercise his or her usual discretion to engage a vocational expert, procure a CE report, engage a medical expert, and the likepreviously-adjudicated period. If, as a result of the readjudication, the Group 1 claimant Class Member is found to have been disabled for the previously-adjudicated period, or any portion thereof, he or she will receive the appropriate award of DIB or SSI back benefits or payments for the period of disability demonstrated. If In addition, the Group 1 claimant is Class Member, if found to have been disabled for the previously-adjudicated period (but not for a closed period of disability that is within the previously-adjudicated period and whose end date is before the end date of the previously-adjudicated period), should may attempt to demonstrate that Group 1 claimant also his or her disability continues to exist into the period after the previously-adjudicated period, up to and including the date of the readjudication, through use of supplemental evidence; as part of this process of demonstrating continuing disability into the period after the previously-adjudicated period, if SSA in its discretion deems it appropriate, SSA may order a consultative examination to assess the Class Member’s current medical condition. If the Class Member successfully demonstrate demonstrates that his or her disability continues forward through the date of the readjudication decision, he or she will receive the appropriate award of back benefits or payments from the end of the previously-previously- adjudicated period through the date of the readjudication decision, as well as appropriate current benefits or payments (subject to continuing disability reviews, reporting responsibilities, and any other rules and procedures generally applicable to recipients of DIB or SSI). Likewise, if the Group 1 claimant Class Member successfully demonstrates that his or her disability continues forward, but only for a closed period that does not continue forward to the date of the readjudication decision, he or she will receive the appropriate award of back benefits or payments from the end of the previously-adjudicated period to the end of the closed period demonstrated. Notwithstanding the foregoing, to the extent that the Class Member has an application for DIB or SSI pending at the time of the readjudication, SSA will not consider the period of disability alleged in that pending application in the readjudication.