Source: https://secure.ssa.gov/apps10/poms.nsf/lnx/1609905001
Timestamp: 2018-01-24 03:30:47
Document Index: 636571466

Matched Legal Cases: ['§ 404', '§ 14', '§ 25', '§ 25', '§ 405', '§ 405', '§ 404', '§ 25', '§ 25', '§ 25', '§ 404', '§ 404', '§ 12', '§ 25', '§ 4', '§ 5']

SSA - POMS: PS 09905.001 - All States - 09/17/2010
Effective Dates: 09/17/2010 - Present Previous | Next
PS 09905.001 All States
A. PS 10-123 Potential Conflict of Interest Involving Disability Determination Service Consultant Working For Attorney Representing Social Security Disability Claimants
A conflict of interest is “a real or seeming incompatibility between one’s private interests and one’s public or fiduciary duties.” Blacks’s Law Dictionary (8th ed. 2004). The regulations at 20 C.F.R. §§ 404.1519q and 416.919q (2009)1
B. PS 10-100 ALJ Subpoena Power - REPLY
According to information that you provided, Andrew W. H~ died in July 2009 while domiciled in Arizona. Nora S~, who lives with her child in Iowa, applied on the child’s behalf for surviving child’s insurance benefits on the decedent’s earnings record. According to Ms. S~, the Maricopa County Medical Examiner’s Office performed an autopsy on Mr. H~ and kept blood samples. In an effort to establish paternity, Ms. S~ has asked the ALJ to subpoena the Maricopa County Medical Examiner’s Office for release of “biological evidence” to a DNA testing center in Ohio. According to Ms. S~, the medical examiner’s office refuses to release the blood samples to the DNA testing center without written authorization from Mr. H~’s next of kin or a court ordered subpoena.2 She also alleges that attempts to obtain acceptable written authorization from Mr. H~’s mother for release of the blood samples have been unsuccessful.3
Under Arizona intestacy law, a child may inherit if he or she is the issue of the decedent. Ariz. Rev. Stat. Ann. § 14-2103(1). The paternity determination statute provides that a man is presumed to be the father of the child if genetic testing affirms at least a 95% probability of paternity. Id. § 25-814(3); see also id. § 25-807(D) (noting that a party may rebut this presumption only by clear and convincing evidence).4
42 U.S.C. § 405(d).5
Section 205(a) of the Act gives the Commissioner “full power and authority . . . . to adopt reasonable and proper rules and regulations to regulate and provide for the nature and extent of the proofs and evidence and the method of taking and furnishing the same in order to establish the rights to benefits hereunder.” Id. § 405(a). Consistent with the Act, the Commissioner has adopted regulations that authorize an ALJ or member of the Appeals Council to issue subpoenas on behalf of the Commissioner. However, the regulations also limit subpoena power, providing that an ALJ or member of the Appeals Council may issue subpoenas only “for the appearance and testimony of witnesses and for the production of books, records, correspondence, papers, or other documents that are material to an issue at the hearing.” 20 C.F.R. §§ 404.950(d), 416.1450(d);6 see also POMS DI 33010.050; HALLEX I-2-5-78. These regulations reflect a reasonable and permissible interpretation of the Act, and should be given deference by any reviewing court. See Barnhart v. Walton, 535 U.S. 212, 218 (2002) (citing Chevron U.S.A. Inc. v. Natural Resources Defence Council Inc., 467 U.S. 837, 842-43 (2009); United States v. Mead Corp., 533 U.S. 218, 227 (2001)).
Ms. S~ may have to enlist the help of a state court to obtain the blood samples. As in Schoenfeld v. Apfel, 237 F.3d 788 (7th Cir. 2001), which involved an ALJ’s refusal to order paternity tests,7 "it has been and continues to be within [the mother’s] power, as guardian of those children, to have those tests carried out." Id. at 799. Here, in order to facilitate DNA testing, the mother may want to consider filing suit to determine paternity. In Arizona, for example, "[p]roceedings to establish maternity and paternity have precedence over other civil proceedings. The case shall be set for trial within sixty days from the filing of an answer by the respondent." Ariz. Rev. Stat. Ann. § 25-807(A); see also id. § 25-803(A) (the mother may commence proceedings to establish paternity of a child).8 On its own motion or that of any party to the proceeding, the court can issue a subpoena to the Maricopa Medical Examiner’s Office for release of the “biological evidence” for DNA testing. Id. § 25-807(c).9
By regulation, the agency may pay for tests approved by the agency, see 20 C.F.R. § 404.1517, and “will pay physicians not employed by the Federal government and other non-Federal providers of medical services for the reasonable cost of providing [the agency] with existing medical evidence . . . .” Id. § 404.1514; see also HALLEX I-2-5-1 (same), I-2-5-68 (Obtaining Non-Medical Evidence Directly From the Source), I-2-5-14(B) (Obtaining Medical Evidence from a Treating Source or Other Medical Source), I-2-5-14(B)(5) (noting that the hearing office is authorized to pay the same amounts for reports that the State agency would pay and citing POMS DI 11010.545 (Payment for Medical Evidence of Record) and POMS DI 22505.040 (Payment for Medical Evidence of Record-DDS)); AIMS, Materiel Resources Manual 06.02.07(A)(5) (ALJ is one of the positions listed with “[a]uthority to purchased medical evidence of record necessary to adjudicate claims under the juristdiction of ODAR, not to exceed $1,000 in any transaction”). However, an ALJ can only purchase reports of paternity testing that has already been conducted and cannot purchase DNA testing through a consultative evaluation. See POMS GN 00301.210(A)(2)(c).
By /s/ Yvette G. K~
C. PS 08-066 Compliance with a Consent for Release of Information
Robert L. V. S~
D. PS 04-133 Attorney Liens on Attorney Fees Bruce J~: ~
Alfred C. S~
The two regulations are identical and apply to Title II and Title XVI cases respectively. Govern conflicts of interest involving medical consultants. The regulations provide that:
This advice appears to be based on Ariz. Rev. Stat. § 12-2294.01(B)(2), which requires a subpoena for medical records be “accompanied by a court or tribunal order that requires the release of the records to the party seeking the records . . . .”
You also informed us that Mr. H~’s mother supposedly signed an authorization form that “was provided to one office, but not to another office that requires such”; that the Maricopa County Medical Examiner’s Office refuses to release the blood samples because of this mix-up; and that Ms. S~ has been unable to contact Mr. H~’s mother again to have her sign another authorization form.
Presumably, Ms. S~ cannot satisfy any of the other three statutory requirements to establish a presumption of paternity, i.e., that she and the deceased number holder were married within the prescribed time periods, that Mr. H~ signed the child’s birth certificate, or that he acknowledged paternity in a notarized or witnessed statement. Ariz. Rev. Stat. Ann. §§ 25-814(A)(1), (3), (4). Prior to January 1, 1975, for purposes of intestate succession, paternity had to be “established by an adjudication before the death of the father or [] established thereafter by clear and convincing proof . . . .” Ariz. Laws 1973, ch. 75, § 4 (repealed by Ariz. Laws 1994, ch. 290, § 5 (1995)).
An ALJ has no independent authority to enforce a duly served subpoena, however. See 42 U.S.C. 405(e). He or she must prepare a memorandum for the Regional Chief Counsel of the Office of the General Counsel (OGC) that attaches a copy of the subpoena and any certified mail receipts, and describes in detail the circumstances of the case, the evidence or facts sought, and why the evidence or facts are essential. In turn, OGC will ask the appropriate Office of the United States Attorney to seek enforcement in federal district court. HALLEX I-2-5-82 (Noncompliance with a Subpoena).
The regulations also provide that a subpoena request must be in writing and filed with the ALJ at least five days before the hearing date, give the names of the witnesses or documents to be produced, describe the address or location of the witnesses or documents with sufficient detail to find them, state the important facts that the witness or document is expected to prove, and indicate why these facts could not be proven without issuing a subpoena. 20 C.F.R.
In this case, while appellant did not specifically request that the ALJ issue a subpoena, she argued that the ALJ failed to complete a factual record because he refused to request paternity testing. In rejecting appellant’s argument, the court noted that "[w]hile tests were not requested by the Commissioner, even appellant notes that is questionable whether such requests would have to be honored." Schoenfeld, 237 F.3d at 798.
"Proceedings to establish . . . paternity may be originated in the county of residence of the respondent . . . . The fact that the petitioner