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DIXON v. QUERN

April 27, 1982

AMOS DIXON, ET AL., PLAINTIFFS,
v.
ARTHUR QUERN, DIRECTOR OF ILLINOIS DEPARTMENT OF PUBLIC AID, ET AL., DEFENDANTS.



The opinion of the court was delivered by: Bua, District Judge.

ORDER

This cause comes before the court on the plaintiffs' and the state defendants' cross motions for summary judgment on Count I of plaintiffs' two count complaint.*fn1 There being no contested issues of material fact, judgment is rendered as a matter of law.

FACTS

The plaintiffs allege that they are disabled and that they qualify for state and federal benefits under programs designed to aid the financially destitute, aged, blind and disabled. Each plaintiff applied for aid under the federal Supplemental Security Income (SSI) program, Title XVI of the Social Security Act, 42 U.S.C. § 1381 et seq. Each plaintiff also applied for state aid under the Supplemental Security Payments (SSP) program of the State of Illinois, Ill.Rev.Stat., ch. 23 §§ 3-1 et seq., 5-1 et seq.*fn2

Under the SSP program, Illinois makes additional financial and medical assistance available to recipients of federal Supplemental Security Income (SSI). SSP is available despite ineligibility for SSI only if the applicant's ineligibility for SSI is based on excess income. Aid to the Aged, Blind and Disabled (AABD) Categorical Assistance Manual; Policy 415.1 Dated 5/28/76. SSP is not available to one who has been denied SSI because of a Social Security Administration (SSA) finding of non-disability.*fn3

Illinois Department of Public Aid (IDPA) regulations provide that an applicant for SSP who claims to be disabled may also receive interim financial and medical assistance from the state on a presumptive eligibility basis. In order to receive assistance, the applicant must first apply for SSI benefits. Interim assistance is only available pending the SSA's initial review of the applicant's disability status, AABD Categorical Assistance Manual, Policy 430, Policy 710.1, and is terminated upon a finding of non-disability by the SSA.

The applicant whose interim assistance has been terminated because of the SSA's initial determination of non-disability, no longer enjoys presumptive eligibility status. He may ask for reconsideration or appeal the decision to terminate his interim assistance. If an appeal is requested, then the issue at the IDPA hearing is limited to whether SSA has in fact made an initial determination of non-disability and whether the notice of termination of interim assistance complied with the IDPA regulations.

Along with terminating the applicant's interim assistance, the SSA non-disability determination also effects a denial of the application for both SSI and SSP. Appeal from denial of applications for both these programs is via one appellate process in force pursuant to the federal program. After the SSA has notified the applicant of its initial disability determination, the applicant may request reconsideration. If, after reconsideration, SSA still finds the applicant to be non-disabled, he may request a full evidentiary hearing before an administrative law judge. At this hearing the merits of the applicant's disability are considered de novo. This is the only time that applicants for SSP and SSI receive a hearing on the merits of their claimed disability. If the initial determination of non-disability is affirmed, then a discretionary appeal may be taken to the SSA Appeals Council, after the decision from which, the applicant may seek judicial review. 42 U.S.C. § 1383(c)(3). If the adverse initial determination is reversed by an ALJ, the applicant is then retroactively granted both 881 and SSP under the federal and state programs. The SSA appellate process progresses to a hearing before an ALJ after delays ranging from nine to twelve months.*fn4

The plaintiffs in this case each received interim assistance from the IDPA prior to review of their claims by the SSA. Each plaintiff was found to be non-disabled in the SSA's initial determination and, as a result, had his or her interim assistance terminated. Subsequently, each plaintiff successfully appealed the initial determination and was ultimately found to be disabled, thus entitling him or her to receive retroactive SSI and SSP.

History of the Case

Count I of the complaint attacks, on statutory and constitutional grounds, IDPA's practice of terminating interim financial and medical assistance given to those who apply for federal and state disability benefits solely on the basis of an initial determination of non-disability made by the Social Security Administration. It further challenges IDPA's practice of relying on the SSA's determination of disability and appellate procedures as the basis for entitlement to and appeal from denial of SSP benefits.

The plaintiff class in Count I was certified on October 7, 1977 and consists of "all disabled persons whose assistance under AABD and Medicaid has been denied or terminated by the IDPA solely because of an initial determination by the SSA that the applicant or recipient is not disabled, without a prior to subsequent hearing." Dixon v. Quern, 76 F.R.D. 617, 620 (N.D.Ill. 1977).*fn5

On that same date plaintiffs' motion for a preliminary injunction was denied after hearing by Judge Leighton. Plaintiffs' renewed motion for preliminary injunction is currently pending before this court but a decision on that motion is obviated by our decision on the motions for summary judgment.

On February 11, 1980 this court issued an order in response to the state and federal defendants' motions to dismiss Counts I and II. The order granted the state defendants' motion to dismiss insofar as the plaintiffs' complaint purported to state a claim for denial of a hearing on the merits of their disability in connection with the termination of state interim assistance. The state defendants' motion to dismiss was denied as to plaintiffs' claim that the IDPA's delays in processing of applications for aid to the disabled violated the due process clause of the ...


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