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WOODFIELD v. HECKLER

August 7, 1984

Geoffrey E. WOODFIELD
v.
Margaret M. HECKLER, Secretary of Health and Human Services and United States of America, Department of Health and Human Services, Social Security Administration



The opinion of the court was delivered by: WEINER

 WEINER, District Judge.

 This action was brought by plaintiff against his employer, the Social Security Administration (a component of the Department of Health and Human Services) alleging age discrimination as a result of his demotion on May 3, 1981. Plaintiff brings his action under the Age Discrimination in Employment Act of 1967 ("ADEA"), 29 U.S.C. § 621, et seq. Trial was held before this court sitting without a jury. Upon consideration of the evidence, exhibits presented at trial and the post-trial memoranda submitted by the parties, we conclude that age was not the determinative factor in plaintiff's demotion, and therefore find for the defendant.

 Plaintiff, Geoffrey E. Woodfield, was born on July 20, 1925. He was hired as a Claims Authorizer Trainee, level GS-7, by the Mid-Atlantic Program Service Center ("MATPSC") of the Social Security Administration ("SSA") on August 19, 1973. This position ultimately leads to the position of Claims Authorizer ("CA"), grade GS-10, to which the plaintiff was promoted on September 14, 1975. (See Defendant's Proposed Findings of Fact, number 1, and Plaintiff's Proposed Findings of Fact, number 1).

 The principal function of the MATPSC is to adjudicate and pay Social Security claims which cannot be handled by the local district offices. The responsibility of the CA is to review and authorize claims for benefits under Titles II and XVIII of the SSA. The position is technical in nature and requires a thorough knowledge of the Social Security Act, and applicable laws and regulations. Such expertise is required because the CA "makes the final determination on almost all categories of claims cases which directly affect the beneficiaries involved." Defendant's Trial Exhibit No. 6, Social Insurance Claims Examiner (Retirement), Part IIA.

 In his function as a CA the plaintiff was assigned to a module. A module is the basic structural office unit within the MATPSC and contains approximately fifty employees in approximately fourteen different positions. Each module, of which there are thirty, is under the direction of a module manager and two assistant managers. Six modules, all doing indentical work and support functions, compose a section. A Section Manager and a Deputy Section Manager are responsible for the direction of each section.

 At the time relevant to plaintiff's claim, he was assigned to Module 14 which was a component of Section 3. During that time, the personnel holding the above supervisory positions and their respective ages were: (1) Section 3 Manager, Harry Christopher, age 48; (2) Deputy Section 3 Manager, Nathan Soltman, age 59 (prior to his appointment as Deputy Manager, he was Manager of Module 14); (3) Manager of Module 14, George Donnelly, age 31 (Donnelly succeeded Soltman as Manager); and (4) Assistant Module 14 Manager, Elsie Walker, age 53 (Walker was assigned to Module 14 in June 1979 and was plaintiff's immediate supervisor).

 CAs are the highest ranking technical employees in the module. Allocation of work among various CAs within a module is accomplished by assigning each CA responsibility for all cases within a certain range of "terminal digits" of social security numbers. With this system one CA is left over who is referred to as a "floater." The floater's function is to take over work of any CA who is absent or whose work is "backed up." The remaining CAs get their daily work from a location called Technical Process Claims Authorization ("TPCA") which is continually replenished with new cases by clerks from an area called Module Backlog Claims Authorization ("MBCA").

 The workflow into Module 14 begins with pre-screening. Three CAs take turns performing this function on a daily basis. The pre-screener examines all incoming work and removes all high-priorities which he routes to TPCA (thus, these cases completely bypass MBCA), disposes of cases that can be completed very quickly and routes the remaining cases to the screener. This entire process takes one hour per day or less. The process was invented by George Donnelly and unique to Module 14. Plaintiff claims that he was never selected as a pre-screener by Donnelly or his assistant.

 The next level of workflow input is screening. New cases are screened every day by a CA assigned on a rotation basis. The process requires the screener to examine all incoming work and complete all cases taking five minutes or less to dispose of. This process clears 50-60% of the incoming cases. The remaining cases are routed to MBCA. The plaintiff claims that he was never selected as a screener by Donnelly or his assistant.

 The CA takes his daily work from TPCA tubs. The tubs are sorted by terminal digits which correspond to those assigned the CAs. The floater takes his cases from whichever tubs are most full.

 Review of each CA's accuracy and productivity is accomplished by means of a "sample." The section office schedules the review and informs the Module Manager of the day on which the sample is to be taken. The Manager or Assistant Module Manager picks up all work completed by the CA on that particular day and forwards it to the section office. The work is then assigned to a Claims/Recovery Technical Assistant ("CRTA") for review.

 Once certification requirements for a CA have been met, the CA is required to maintain that level of proficiency. Defendant's Exhibit No. 3, Page 12 of 44. The relevant requirements are an 86-88% range of accuracy with the completion of the equivalent of 13 to 15 routine cases in an 8 hour day. Plaintiff's Exhibit No. 2, Page 2 of 28. Defendant's Exhibit No. 3, Page 11 of 44. Cases are classified as routine, moderate or complex according to guideline set. Defendant's Exhibit No. 3, Pages 40-44.

 The CRTA produces a "Quality Evaluation -- Individual Case" form for each case contained in the sample. Defendant's Exhibit No. 3, Page 42 of 44. Each case is classified by the CRTA as routine, moderate or complex. Also notation is made if the case is especially time consuming. Id. The CRTA then evaluates each case to determine whether any deficiencies or inefficiencies are present. A deficient rating for any particular case represents an error in the process performed by the CA that "did not produce the results intended and the defective result has an adverse effect . . . on the claimant; or on the Trust Fund." Defendant's Exhibit No. 3, Page 25 of 44. Examples of such errors include: (1) incorrect payment amount; (2) incorrect potential payment amount; (3) improper or overlooked beneficiary notices; (4) incomplete or overlooked claims development required to support the claim determination; and (5) incomplete documentation. Id. An efficient rating for any particular case represents an instance "where policies or procedures associated with the adjudication, effectuation and maintenance of claims were misapplied, but the result of the process was ultimately correct or had no effect on the amount paid. . . ." Id. at 26 of 44. The major characteristic of this type error is delay or need for rehandling. Id. All such determinations are explained by the CRTA on the "Quality Evaluation -- Individual Case" form. Id. at 42 of 44.

 After each case is reviewed, the CRTA prepares a "Quality Evaluation Summary" form. Defendant's Exhibit No. 3, Page 43 of 44. The CRTA then computes an accuracy percentage for the entire sample which is derived from guideline set forth in the MATPSC Assessment Guide. Defendant's Exhibit No. 3, Pages 11-14.

 The CA is then informed of the results of the sample. This is usually done by the CA's manager within the module. Oral Deposition of Elsie Walker, Page 13. If any of the CRTA's findings are disputed, the CA can appeal to the CRTA who performed the sample or through channels to the ...


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