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Complaint Alleges Claims under Privacy Act and FTCAFiled June 24, 2009
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IN THE UNITED STATES DISTRICT COURTEASTERN DISTRICT OF NORTH CAROLINA
WESTERN DIVISION
CIVIL NO. 5:09-CV-235-FL
)PAMELA MELVIN )
) Plaintiff, )
)vs. )
) COMPLAINTSOCIAL SECURITY ADMINISTRATION )and the UNITED STATES OF AMERICA ) )
Defendants. )________________________________________)
I. INTRODUCTION
A. SSA's Administrative Review Process
1. The regulations of the Social Security Act provide a four-step process
for the administrative review and adjudication of disputes regarding disability benefits
and overpayments. First, SSA makes an adverse decision concerning an individual's
disability claim. Second, if the individual is dissatisfied with that decision, he may
appeal. Third, if the individual receives a second adverse determination, he is entitled to
an evidentiary hearing by an administrative law judge. Finally, if the individual is
dissatisfied with the administrative law judge's decision, he may appeal to the Appeals
Council.
2. An individual's failure to submit to SSA a written appeal to any one of
the last three steps of the four-step process legally binds him to the last decision made by
SSA; the individual is barred from seeking a judicial review of the adverse decision, the
court will dismiss any action filed by the individual and mistakes regarding the decision
can not be corrected.
3. An individual's written appeals are the only means by which he obtains
access and the opportunity to: (1) SSA's last three steps of the administrative review
process; (2) the due process of by both the Social Security Act and the Constitution of the
United States; and (3) a judicial review of the adverse decision where he may possibly
obtain three additional opportunities outside the administration to reverse SSA's adverse
decision.
4. Therefore, the written appeals are vital documents and their importance
constitute a need for them to be properly and accurately maintained in a record
concerning an individual in order to assure the individual fairness, opportunities, benefits
and guaranteed Constitutional rights.
5. This is a civil action for monetary and injunctive relief under the
Privacy Act, 5 U.S.C. § 552a, as amended. This is also a civil action for monetary relief
under the Federal Tort Claim Act.
B. Jurisdiction and Venue
6. Venue is proper in this district pursuant to the provisions of 5 U.S.C. §
552a (g)(5), (4)(B) and 28 U.S. C. Sec. 1402.
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7. This court has jurisdiction over plaintiff's first five claims for relief against
SSA pursuant to 5 U.S.C. Sec. 552a (e)(5), (g)(1)(C), (d)(1), (g)(1)(B) and
5 U.S.C. Sec. 552a (4)(F).
8. This Court has jurisdiction over plaintiff's sixth claim for relief,
Intentional Infliction of Emotional Distress, against the United States of America
pursuant to 28 U.S.C. § 1346(b) and § 2671 et. seq. which arises out of SSA's intentional
failure and refusal to carry out, to follow and to obey instructions ordered by this Court
in case # 5:06-CV-306 on April 10, 2007 and depriving plaintiff of rights that are
guaranteed by the Due Process Clause of the Fifth Amendment of the United States
Constitution. This claim is so related to plaintiff's first claim for relief against SSA that it
forms part of the same case.
9. On June 30, 2008, via certified mail, plaintiff presented to the SSA's
Office of General Counsel in Baltimore, Maryland a claim for her injuries on Standard
Form 95 in the amount of two million dollars.
10. On August 1, 2008, plaintiff signed for and received via U.S. Postal
Service certified mail #70070220000088781567 a letter dated July 23, 2008, from
SSA's Office of General Counsel that denied the administrative tort claim of Mindy Zied-
Campbell and Dennis Campbell of Philadelphia, Pennsylvania, in the amount of one
million dollars. (Exhibit A )
11. By letter dated August 4, 2008, plaintiff informed SSA's Office of General
Counsel that on August 1, 2008, she received a certified letter denying an administrative
tort claim of a Mindy Zied-Campbell of Philadelphia, Pennsylvania and not a letter
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regarding her administrative tort claim. (Exhibit B ) To date, plaintiff has received no
response to her letter dated August 4, 2008.
12. On November 6, 2008, plaintiff sent to SSA's Office of General Counsel
a letter inquiring the status of her administrative tort claim. On November 26, 2008, via
first class mail, SSA's Office of General Counsel sent plaintiff a letter dated July 23,
2008, denying plaintiff's administrative tort claim. SSA asserted that the letter dated July
23, 2008, had been mailed to plaintiff's former home address. (Exhibit C)
13. On January 14, 2009, plaintiff sent John Carlo, director of SSA's Office
of General Counsel, an email requesting a copy of the certified mail receipt and the return
requested green card receipt required for SSA to have sent plaintiff the letter denying her
administrative tort claim as asserted in SSA's letter dated November 26, 2008. Plaintiff
also sent this written request to John Carlo via first class mail. (Exhibit D)
14. On January 15, 2009, in response to plaintiff's email request to John
Carlo, SSA's Office of General Counsel sent plaintiff via certified mail a letter stating
that the enclosed certified mail receipt for certified mail #70070220000088781567
reflects plaintiff's receipt of SSA's decision to deny her claim under the Federal Tort
Claim Act and that according to the "green card" plaintiff received the denial of her claim
on August 1, 2008.
15. In addition, on January 15, 2009, SSA's Office of General Counsel sent
to plaintiff a copy of the certified receipt and green card for certified mail
#70070220000088781567 that plaintiff signed on August 1, 2008 to receive the written
denial of Mindy Zied-Campbell; a copy of the denial of plaintiff's tort claim dated July
23, 2008; and four additional letters that pertained to the denial of the administrative tort
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claim of Mindy Zied-Campbell of Philadelphia, Pennsylvania. Among these four letters
was another copy of the July 23, 2008, written denial of the administrative tort claim of
Mindy Zied-Campbell. (Exhibit E)
16. SSA's letter denying plaintiff's administrative tort claim was mailed to
plaintiff via first class mail on November 26, 2008 and by certified mail on January 15,
2009. SSA did not mail to plaintiff a letter denying her administrate tort claim before
November 26, 2008. Plaintiff is required to file suit in court before or on May 26, 2009.
C. Parties
17. Plaintiff is a citizen and resident of the United States and of Cumberland
County, State of North Carolina. In December 1995, SSA determined that plaintiff was
disabled and entitled to SSA disability benefits beginning March 1995. In 2000, plaintiff
returned to work and in October 2001, SSA terminated plaintiff's entitlement and
determined that plaintiff was overpaid $7453.
18. By letter dated May 24, 2004, SSA determined that plaintiff was never
disabled and was overpaid $54,628.20. In July 2006, SSA again determined that
plaintiff was disabled and entitled to disability benefits beginning October 2005. SSA
recovered from plaintiff benefits that she was entitled to receive between October 2005
through July 2006 in the amount of $9465.30. Since December 2006, SSA has withheld
from plaintiff all monthly disability benefits to recover the alleged overpayments totaling
$62,081.20 and has done so while depriving plaintiff access and opportunity to SSA's
administrative review process.
19. Defendant SOCIAL SECURITY ADMINISTRATION ("SSA"), is an
independent agency within the Executive Branch of the United States Government. SSA
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is an agency within the meaning of 5 U.S.C. § 552(f), established by statue and charged
with responsibility for the administration of federal programs with respect to social
security programs and benefits.
20. SSA has the responsibility of maintaining records concerning plaintiff
that include but are not limited to documents and files that pertain to plaintiff's disability
claim, monthly disability benefits, appeals, overpayments, and Medicare insurance.
21. SSA has possession and control of the records, memoranda, reports,
documents and similar papers and files sought by plaintiff in this action and is
responsible for fulfilling plaintiff's FOIA and Privacy Act requests.
22. All divisions, agents, employees and representatives of the SSA were
acting within the scope of their agency or employment while making any of the
statements and committing any of the acts alleged herein. SSA and any of its respective
divisions, agents, employees and representatives each acted as the agent or representative
of each other in committing any of the acts or making any of the statements alleged
herein.
23. Defendant UNITED STATES of AMERICA consist of, maintain,
supervises, operates and/or governs 14 Cabinet departments in the United States
executive branch, including, but not limited to, SSA. Pursuant to the Federal Tort Claim
Act 28 U.S.C. 1346(b)(1), the United States is being held liable for wrongful acts or
omissions of the employees and representatives of SSA that were committed within the
scope of their employment or office.
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24. The inclusion of Defendant Untied States of America is necessary in
order to afford complete relief, and to avoid multiple actions and the possibility of
inconsistent results.
FACTUAL ALLEGATIONS
II. SSA RECEIVES PLAINTIFF'S FIVE APPEAL LETTERS
A. Plaintiff's First Written Appeal
25. By letter to plaintiff dated October 22, 2001, SSA informed plaintiff of
its determination that plaintiff was overpaid $7,453.00 from the March 1995 entitlement
to disability benefits. SSA's letter further informed plaintiff of her right to appeal this
decision within 60 days of the date that she receives the notice.
26. By letter to SSA dated December 20, 2004, plaintiff appealed SSA's
decision that she was overpaid $7,453.00. On December 20, 2001, plaintiff hand
delivered her appeal letter to Mrs. Lallie, an employee of the SSA office in Fayetteville,
North Carolina.
27. To date, SSA has not acted on plaintiff's appeal.
B. Plaintiff's Second Written Appeal
28. In July 28, 2003, plaintiff submitted to SSA a completed Request for a
Waiver application for the alleged overpayment of $7,453.00.
29. By letter to plaintiff dated January 6, 2004, SSA informed plaintiff of its
decision to deny plaintiff's request for a waiver. To date, this decision is the only
decision made on plaintiff's 2003 Request for a Waiver application of the alleged
overpayment of $7,453.00. SSA notice failed to inform plaintiff of the right to appeal
this decision.
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30. Despite SSA's failure, by letter to SSA dated March 5, 2004, plaintiff
appealed SSA's decision to deny her request for a waiver of the overpayment of
$7,453.00. The SSA office in Raleigh, NC received plaintiff's appeal letter on March 8,
2004, via certified mail #70033110000524736020.
31. By letter to plaintiff dated August 20, 2004, Ms. E. Dillard, an employee
of the SSA office in Raleigh, NC, acknowledged receipt of plaintiff's appeal letter dated
March 6, 2004, and instructed plaintiff to complete and to submit the enclosed form
HA501 to request a hearing.
32. On September 21, 2004, plaintiff hand delivered to the SSA office in
Raleigh, North Carolina the completed form HA501 dated September 1, 2004.
33. To date, since receiving SSA's letter of August 20, 2004, acknowledging
receipt of plaintiff's appeal and form HA501, plaintiff has received no further response
regarding her appeal. SSA has failed to act on plaintiff's appeal.
C. Plaintiff's Third Written Appeal
34. By letter to plaintiff dated May 24, 2004, SSA informed plaintiff of its
decision that plaintiff no longer qualify for disability benefits beginning March 1995 and
was overpaid $54,628.20. SSA's letter also informed plaintiff that she has the right to
appeal this decision within 60 days of receiving the notice.
35. By letter to SSA dated July 19, 2005, plaintiff appealed SSA's decision
dated May 24, 2004. On July 23, 2004, the SSA office in Baltimore, MD received
plaintiff's appeal letter via certified mail #70040750000050904948.
36. To date, SSA has not acted on plaintiff's appeal.
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D. Plaintiff's Fourth Written Appeal
37. On June 28, 2006, plaintiff submitted to SSA a completed Request for a
Waiver application for the alleged overpayment amount of $47,175.20, which defendant
SSA had written on the application prior to sending the application to plaintiff by mail.
38. By letter to plaintiff dated July 12, 2006, SSA informed plaintiff that her
request for a wavier of the $47,175.20 was denied and that plaintiff has the right appeal
this decision within 60 days of receiving the notice.
39. By letters to SSA dated July 17, 2006, plaintiff appealed defendant SSA's
decision to deny her request for a waiver of the alleged overpayment of $47,175.20. In
one of plaintiff's appeal letters she requested (1) reconsideration; (2) to continue receiving
benefits pending reconsideration pursuant to 20 CFR Ch. III 404.1597; and (3) that the
amount on her June 28, 2006 request for a wavier application be changed from
$47,175.20 to $53.500.00. All appeal letters were hand delivered to the SSA office in
Raleigh, North Carolina on July 17, 2006.
40. By letter to plaintiff dated July 20, 2006, SSA's employee, Carolyn L.
Simmons, Associate Commissioner of Central Operations, acknowledged receipt of
plaintiff's request to continue receiving benefits pending reconsideration.
41. To date, SSA has not acted on plaintiff's appeal, has denied receiving the
appeal letters, but has change the amount of $47,175.20 to $53.500.00 as plaintiff
requested in her appeal letter.
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E. Plaintiff's Fifth Written Appeal
42. By letter to plaintiff dated May 4, 2007, SSA informed plaintiff of its
decision to stop plaintiff's Medicare insurance. Defendant SSA's letter also informed
plaintiff that she has the right to appeal this decision.
43. Because SSA's employee, Carolyn L. Simmons, the employee who has
been assigned to plaintiff's disability case since the summer of 2006, sent the letter to
plaintiff's post office box address in Raleigh, NC and not to plaintiff's physical address in
Apex, NC, plaintiff received SSA's letter dated May 4, 2007 on May 13, 2007.
44. By letter to SSA dated July 13, 2007, plaintiff appealed defendant's
decision to stop her medical insurance. The SSA office in Raleigh, NC received
plaintiff's appeal letter and enclosed FOIA reques, by certified mail # 70070220
000060263838,
45. To date, SSA has failed to act on plaintiff's appeal. SSA has denied
receiving the appeal letter and plaintiff's FOIA request.
III. THE HONORABLE LOUISE FLANAGAN ORDERS SSA TO PROCEED TO EXPEDITED APPEALS WITH PLAINTIFF BEING AFFORDED ALL DUE PROCESS RIGHTS
A. The Court Instructs SSA To Proceed to Expedited Administrative Review of Plaintiff's Appeals with All Appropriate Rights of Due Process
46. On August 2, 2006, plaintiff filed civil action case # 5:06-CV-306 in the
United States District Court of the Eastern District of North Carolina. In the complaint,
she alleged that SSA began recovering from her the alleged overpayments without
providing (1) adequate information regarding the May 24, 2004 decision; (2) documents;
and (3) a pre-recoupment hearing as required by federal regulations.
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47. In November 2006, SSA motioned for a dismissal of the case arguing
that plaintiff had not appealed SSA's decisions dated January 6, 2004 and July 12, 2006,
to deny plaintiff's two requests for waivers of the overpayments and that plaintiff has not
yet exhausted her administrative remedies and, therefore, this court lacks subject matter
jurisdiction.
48. SSA also repeatedly stated in its pleadings to the court that it would
proceed to an expedited determination of the July 12, 2006 decision to deny plaintiff's
request for a wavier with plaintiff being afforded all appropriate rights of due process:
…… should the Court agree that a dismissal of the plaintiff's complaintis warranted, the defendant will consider the filing the complaint in this action to have represented a protective filing of her administrative appeal, and will proceed to an expedited determination of that appeal, with the plaintiff being afforded all appropriated rights of due process as set forth in the Commissioner's regulations.
49. On April 10, 2007, the court agreed with SSA's pleadings and dismissed
the case. In the Honorable Louise Flanagan's order, she stated that the appeal procedure
remain a viable avenue for plaintiff to obtain relief, that plaintiff had not exhausted the
administrative remedies available to her, and that SSA had repeatedly stated in its
pleading that it would proceed to an expedited administrative review of SSA's decision of
July 12, 2006.
The appeals procedure remains a viable avenue for plaintiff to obtain relief. Serving as evidence of this fact, defendant's pleadings have repeatedly stated that this action will be treated as an appeal for reconsideration and the matter will receive an expedited review. Accordingly, the court finds that plaintiff has not exhausted the administrative remedies available to her, that the Commissioner's decision to recoup overpayment of benefits is not yet final, and therefore, the court lacks subject matter jurisdiction under 42 U.S.C.
50. On page 13 of the order, the Honorable Louise Flanagan issued the
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following specific instructions to SSA and its Commissioner:
The court instructs defendant to treat plaintiff's filing of complaint in this action to have represented a protective filing of the administrative appeal reference in the July 12, 2006 notice, and to proceed to an expedited administrative review of that and any other pending appeal(s) filed by plaintiff, with plaintiff being afforded all appropriate rights of due process as set forth in the Commissioner's regulations.
51. By letter to plaintiff dated May 21, 2007, (Exhibit F), SSA requested
plaintiff's Social Security number in order to act on the instructions issued in Judge
Flanagan's order. Attached to the May 21, 2007, letter was a copy of the court order.
52. By letter to SSA dated May 31, 2007 (Exhibit G), plaintiff informed
SSA of her Social Security number and enclosed and sent with her letter the court order
with her social security number written on it and copies of her four appeals letters that
SSA had already received dated December 20, 2001, March 5, 2004, July 19, 2004, and
July 17, 2006.
53. In addition, plaintiff requested in her letter that SSA expeditiously
process her four appeals as the court had instructed and, in the event that she is forced to
seek judicial reviews, that her written appeals and other letters be filed and maintained in
a record at all times.
54. On June 4, 2007, defendant SSA received plaintiff's letter dated May
31, 2007, the court order with plaintiff's Social Security number written on it and the
enclosed four appeal letters.
55. To date, more than two years have past since the court instructed SSA to
proceed to an expedited administrative review of plaintiff's appeals with plaintiff being
afforded all appropriate rights of due process. However, SSA has failed to and refused
to act on the court ordered instructions and plaintiff's appeals.
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B. SSA Informs Plaintiff That It Has Neither Her Written Appeals Nor The Instructions Issued In The Court Order In Its Record
56. Having received neither decisions from SSA regarding her four appeals
nor a response regarding her last appeal letter dated July 13, 2007, on August 10, 2007,
four months after Judge Flanagan issued the court order on April 10, 2007, plaintiff
began contacting SSA and requesting the status of her five appeals.
57. During each of these contacts, the SSA employees whom plaintiff talked
with told plaintiff that SSA's record indicates that SSA had not made decisions on her
five appeals, that SSA does not have a record of her five appeals, that plaintiff does not
have any pending appeals, that SSA does not have in its record SSA's assertion to the
court that it would expeditiously process an appeal of the July 12, 2006 decision and that
SSA does not have in the record information regarding the court's instructions to SSA to
expeditiously process plaintiff's pending appeals.
58. On August 17, 2007, plaintiff went to the SSA office in Raleigh, North
Carolina and talked with Robert Flournoy, district manager of that office. Plaintiff
explained to Mr. Flournoy that she had submitted several written appeals to SSA, that his
office had received three of her appeals and that according to other SSA employees, SSA
does not have a record of the written appeals. Plaintiff asked Mr. Flournoy to tell her
what had happened to her written appeals and her FOIA request dated July 13, 2008.
Plaintiff further asked whether SSA plans to expeditiously process her appeals as the
court instructed in the order of her civil case.
59. Mr. Flournoy explained to plaintiff SSA's procedure of filing written
appeals in claimants' records when SSA receives written appeals. He ended his
explanation by stating that the reason plaintiff's written appeals are not in SSA's record is
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because SSA did not receive her written appeals. Mr. Flournoy further stated that SSA
did not receive a court order and explained that all requests for documents from a
disability claim file should be sent to the Freedom of Information Office in Baltimore,
that he is not authorized to produce documents and that when he receives FIOA requests,
he sends them to that office.
60. While terminating the conversation, plaintiff asked Mr. Flournoy to find
out what had happened to her written appeals, who had destroyed the appeals and SSA's
letters acknowledging receipt of the appeals and to check to determine whether he had
forward plaintiff's FOIA request to the Freedom of Information Office in Baltimore. She
further requested that he forward to her in writing his findings.
61. Mr. Flournoy agreed.
62. To date, plaintiff has received no response from Mr. Flournoy and other
employees and representatives with respect to her five appeals and FOIA request.
IV. The Adverse Impact of SSA's Improper Maintenance of Plaintiff's Record, Intentional Deprivation of Plaintiff's Due Process Right and Violation of the April 10, 2007 Court Order
A. Personal and Financial Hardship: Inability To Meet The Needs Required To Sustain Life
63. After Judge Flanagan issued the order on April 10, 2007, plaintiff began
suffering and continues to suffer devastating and extreme emotional distress, personal
and financial hardship, including, but not limited to, the inability to obtain and sustain
adequate medical treatment, medication, shelter, food and transportation.
64. Plaintiff was unable to pay rent to maintain shelter and was evicted from
her apartment home on July 14, 2008. She currently owes $6519.49 to Camden Lake
Pines Apartments of Apex, North Carolina. The eviction forced plaintiff to give away
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personal property such as furniture and clothing that she wanted to keep but could not
pay expensive storage charges.
65. At one point, plaintiff was homeless and lived in her vehicle while
suffering the illnesses, including, but not limited to, the illnesses warranting her July
2006 entitlement to SSA's disability benefits. At one point, plaintiff lived in a shelter in
Durham, North Carolina. Because the shelter was only available to her from 7:30 p.m.
to 7:30 a.m. each day, plaintiff lived in her vehicle 12 hours during day.
66. Plaintiff was forced to accept and is currently residing in an apartment
that is:
i. located in the Bonnie Doone Community which is the highest crime area in Fayetteville, North Carolina, where plaintiff lives in constant fear of becoming a victim to theft, robbery, home invasions, sexual assaults and murder; ii. unfit and unsafe for living: lacks stove and refrigerator, has severely defective plumbing, has an uncontrollable pest problem, and the building structure is severely defective;
iii. unable to accommodate plaintiff's medical needs , including, but not limited to, lacks adequate bathing facility deprivingplaintiff of the ability to take long hot baths as required two ormore times per week to help reduce her pain, inflammation, and chronic low peripheral body temperature; and
vi. a devastating contrast to the apartment and environment from which plaintiff resided prior to defendant SSA's conduct.
B. Personal and Financial Hardship: Inability To Obtain Medical Care
67. Plaintiff has rheumatoid arthritis (RA), a chronic, painful, inflammatory
and destructive disease, which requires treatment provided by a rhuematologist. The
charged for the initial visit with a rhuematologist ranges from $385 to about $600. After
the initial visit, the charge ranges from $120 to $240.
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68. The initial blood test and x-rays required by a rhuematologist consist of
information that pertains to all relevant body functions and organs and are required to
determine treatment as well as set the basis in which to compare future conditions. The
cost of the initial blood test can range from $240 to $400. Afterwards, the average cost is
about $120. The cost of x-rays ranges from about $200 to $2000.
69. Plaintiff has had physical, mental and emotional health problems
requiring treatment from different medical specialists, including, but not limited to:
a. an allergist to treat allergic reactions including angioedema, caused mainly by various medications;
b. a podiatrist to treat the present deformities and to prevent additional deformities of the feet caused by RA;
c. an orthopedist to provide treatment to prevent and to correct the changes of plaintiff's musculosketetal system;
d. an ear, nose and throat specialist to treat plaintiff's esophagitis;
e. a psychiatrist to treat the emotional distressed caused by the acts of federal government employees and PTSD and Military Sexual Trauma which development while serving in the U.S. Army; and
f. a rheumatologist to treat RA and osteoarthritis.
70. Plaintiff has been unable to afford and to receive the medical treatment,
including, but not limited to, those listed above from specialists nor from non-specialists
resulting in an increase in her suffering mentally, emotionally, and physical pain and
discomfort as well as an increase in the destruction of her joints.
71. On a few occasions plaintiff has attempted to receive treatment from
physicians who are not specialists but are employed by the state and/or county.
However, during each attempt, the physicians advised plaintiff that they are unable to
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provide the treatment that plaintiff's illnesses require and that plaintiff has to receive
treatment from specialists such as a rhuematologist, allergist, podiatrist and a psychiatrist.
72. On several occasions, plaintiff received treatment at the emergency
rooms of the local county hospitals in North Carolina for chest pains, allergic reactions
and RA. As a result, she has accumulated more than $25,000 in medical debt.
73. Though a disabled veteran, plaintiff is unable to receive medical care
from VA. In 2000, VA doctors and hospital authorities refused plaintiff's numerous
requests to change her RA medication that was causing serious allergic reactions,
plaintiff refused to continue taking the medication, and VA terminated her from receiving
treatment at the Durham VA Medical Center. The termination left plaintiff without
access to treatment provided by a rheumatologist resulting in joint deformities and the
progression of her disease.
74. VA later agreed to provide plaintiff treatment again but destroyed all
prior medical records of its previous diagnoses of RA and changed its previous diagnoses
of RA, a disease that causes joint deformities, to Lupus and an undifferentiated white
connected-tissue disorder, diseases that do not cause joint deformities.
75. Because VA's treatment for the latter two diseases causes destruction of
joints, progression of RA as well as hides the progression of RA, plaintiff objected to
VA's diagnoses, treatment and documented symptoms, which were contrived to support
the incorrect diagnoses and treatment. Consequently, plaintiff was terminated on two
additional occasions, the last occurring by letter dated November 20, 2006. Since
receiving the notice, she has unsuccessfully attempted to receive proper medical
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treatment from VA and was denied treatment at the emergency rooms of the VA hospitals
in and near her residing cities.
C. Personal And Financial Hardship: Inability To Work To Sustain Life
76. On September 17, 2007, plaintiff was again told by an employee of SSA
that SSA had not made decisions on any of plaintiff's five appeals, SSA does not have a
record of her five appeals, that plaintiff did not have any pending appeals and that SSA
did not have a record of the court ordered instructions to SSA.
77. The following day, September 18, 2007, plaintiff continued to suffer
financial hardship and in order to obtain income to obtain or maintain the basic needs to
sustain life, she attempted to work while suffering the illnesses that warranted her July
2006 entitlement to SSA disability benefits.
78 During a seven-month period, from September 18, 2007 through April
23, 2008, plaintiff unsuccessfully attempted to work eight different jobs.
79. Plaintiff worked at three different jobs for three to six days before she
was terminated. After missing one day of work due to her illness, the employers
removed plaintiff from their existing schedules and refused to place her on all future
schedules.
80. Plaintiff was able to work about 15 days for four different employers.
She worked at another job for a few months. There she was scheduled to work 4 to 5
hours a day, mainly two days per week. While at this job, plaintiff's supervisor
repeatedly threatened to terminate her for failing to report to work and the inability to
perform certain tasks, both caused by her illnesses.
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81. Plaintiff's last job was with CSA, one of the four jobs she was able work
about 15 days. As a result of SSA officially declaring that plaintiff owe thousands of
dollars to the federal government for SSA overpayments, plaintiff was prohibited from
obtaining jobs with the U.S. Federal government and private companies supporting the
U.S. government in the U.S and overseas. However, in February 2008, plaintiff was
having problems with VA when federal attorneys, including SSA attorneys, arranged for
CSA to offer plaintiff a position overseas.
82. CSA offered excellent pay and health insurance both of which plaintiff
desperately needed. Plaintiff accepted the position thinking that both VA and SSA
understood her illnesses and limitations. She began working for CSA on April 4, 2008.
83. During the three days prior to April 23, 2008, plaintiff worked while she
was seriously ill. On April 23, 2008, she was subdued by the illness. She reported to her
supervisors that she was in dire need of medical treatment and that it was impossible for
her to work the next day. She was to complete training the next day, April 24, 2008.
84. After reporting her illness, plaintiff was given two Tylenols by a CSA
nurse to treat her fever; told by the nurse that plaintiff could only receive medical
treatment at a pre-determined clinic and that CSA does not have the name, address and
phone number of the clinic; told by one training supervisor that the best medical
treatment that plaintiff can receive is from VA; and told by a higher ranking training
supervisor that if she failed to complete training the next day, she would be terminated.
85. On April 24, 2008, plaintiff was too ill to complete training and was
terminated. She was paid $3 for working the last two weeks of her employment with
CSA and was left without sufficient income to pay air fair back home from the middle
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east. She requested and received assistance from the American Embassy in Kuwait,
which forced CSA to pay plaintiff's air fair back home.
86. Other CSA's employees who failed to complete training during the first
try, were given a second opportunity to complete training before termination. Other
employees who required medical treatment during training were taken to pre-designated
medical clinics by a CSA supervisor and received treatment.
V. Plaintiff's Requests For Documents
A. Plaintiff's FOIA Request
87. By letter dated July 13, 2007 (Exhibit H, referred to hereinafter as
"plaintiff's FOIA request"), pursuant to the Freedom of Information Act (FOIA), plaintiff
requested that defendant SSA produce the following documents:
(1) Copies of all documents in Pamela Melvin' SSA file fromOctober 1994 to this day.
(2) Copies of all transcripts of Pamela Melvin's hearings with an ALJ from October 1994 to July 1998.
(3) Copies of all tape-recordings of those hearings.
(4) Copies of all document including logs, reports, notices and computer records regarding Pamela Melvin.
(5) Copies of documents that SSA sent York Stenographic Services, Inc regarding the transcribed hearings of Pamela Melvin.
(6) Copies of all documents including logs, reports, notices and computer records that show the date SSA sent to York Stenographic Services, Inc the tape-recording of Pamela Melvin' May 28, 1998 hearing with Administrative Law Judge Richard E. Quellette and all other hearings. Include documents SSA received from Youk Stenographic Services, Inc. indicating it had received the tapes.
(7) Copies of all documents including logs, reports, notices and computer records that show the date SSA received from York Stenographic
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Services, Inc. the tape-recordings and written transcriptions of Pamela Melvin's May 28, 1998 hearing with Administrative Law Judge Richard E. Quellette and all other hearings.
(8) Copies of all documents including logs, reports, notices and computer records that show the dates and times the tape-recording of Pamela Melvin's May 28, 1998 hearing was received by, transferred to and checked out of SSA's different offices and/or buildings.
(9) Copies of all documents including logs, reports, notices and computer records that show the amount York Stenographic Services, Inc, charged for transcribing Pamela Melvin's May 28, 1998 hearing-tape, the date SSA paid, and the date of the charge.
(10) Copies of SSA regulations and procedures on appeals, reconsideration and withholding benefits.
(11) Copies of all documents regarding the search/investigation of the missing tape recording of hearings of Pamela Melvin and SSA's file on Pamela Melvin.
(12) A copy of Administrative Law Judge Richard E. Quellette to York Stenographic Services, Inc. report of the missing file and tape recordings of Pamela Melvin's hearing.
88. Under the FOIA, SSA was required to notify plaintiff within 20
working days (excluding Saturdays, Sundays and legal holidays) of its determination
whether or not to fulfill plaintiff's request and plaintiff's right to appeal the agency's
determination. According to plaintiff's calculation, the twentieth day fell on August 14,
2007.
89. To date, plaintiff has received no response with respect to her FOIA
request dated July 13, 2007.
90. By letter dated February 19, 2009, plaintiff appealed SSA's refusal to
produce documents implied by SSA's failing to respond to her request and presented with
the appeal letter a revised FOIA request that specifically identified the documents of
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plaintiff request of July 13, 2007. (Exhibit J) To date, plaintiff has received neither a
response to her appeal nor initial FOIA request.
91. The statutory time limit for SSA to respond to Plaintiff's requests has run
out and plaintiff has constructively exhausted the applicable administrative remedies.
B. Plaintiff's Privacy Act Request Pursuant to 5 U.S.C. 552a (d)(1)
92. By letter to SSA's Commissioner Michael Astrue dated November 6,
2008 (Exhibit J , referred to hereinafter as "plaintiff's Privacy Act Request), plaintiff
requested the following:
(1) copies of all documents that are and should be in my SSA file including computerized documents and medical records of doctors whom SSA paid in 2006 to evaluate mydisabilities;
(2) if SSA did not destroy my written appeals and has the written appeals in its possession, send me copies of the written appeals; and
(3) send copies of the documents via certified mail and within 20 days.
C. Defendant's Inadequate Responses to Plaintiff's Privacy Act Request
93. By letters to plaintiff dated November 18, 2008 and November 20, 2008,
(Exhibit K), defendant SSA responded to plaintiff's requests for documents dated
November 6, 2008 and November 10, 2008, stating in writing the following:
Your records are currently in our Office of Disability Operations. We are referring your inquiry to that office. The officials therewill look into the situation you described and reply directly to you. You should hear from them soon.
94. By letter to plaintiff dated December 5, 2008, (Exhibit L), SSA's
Freedom of information Office acknowledged receipt of plaintiff's request for documents
stating in writing the following:
We have received your request for records and will process
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it as soon as possible. If you need to contact us about yourrequest, please be sure to refer to the above control number.If you have not heard from us in 30 days and wish to checkon the status of your request, you may call 410-965-1727. Lease a message and your telephone number. Someonewill return your call as soon as possible.
95. Having received no further response to her request for documents,
plaintiff, by letter to defendant SSA dated January 30, 2009, (Exhibit M), requested that
within 7 days of the date of her letter, defendant SSA sent to her by certified mail the
documents that she had requested in her letter dated November 6, 2008 and in her FOIA
request dated July 13, 2007.
96. On February 6, 2009, plaintiff received from SSA a letter dated January
26, 2009, (Exhibit N), stating in pertinent part:
Your requested access to all documents that are or should be in your SSA file. Because we have many different systems of records, we need more information to know where to search.
If you have applied for Social Security benefits and want information from your claim file, write to the programservice center or other office that has your records.
You may contact your local Social security office to resubmityour inquiry.
97. By letter dated February 19, 2009 (Exhibit I), plaintiff appealed SSA's
implied refusal to produce documents and included in the appeal letter a specific request
for documents of her Social Security disability claim record.
98. On March 4, 2009, plaintiff received from SSA a letter dated March 7,
2009, (Exhibit O), that stated in pertinent part:
You asked for copies of medical records we used in yourDisability Insurance claim. We reviewed the records. We decided that we must give them to someone you
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choose who will review and discuss the information withyou. You may name any responsible individual who iscapable of explaining the medical information to you.
Please give the name and address of the person you want to receive your medical records.
99. To date, plaintiff has received no documents from SSA. Defendant
SSA has not claimed unlawful exemptions from disclosure. SSA's four responses are
inadequate. Defendant SSA has wrongfully withheld documents from plaintiff.
100. Plaintiff has exhausted the applicable administrative remedies.
FIRST CLAIM FOR RELIEFVIOLATION OF THE FIFTH AMENDMENT OF THE UNITED STATES
CONSTITUTION: DEPRIVATION OF PROPERTY INTEREST (FAILURE TO MAINTAIN WRITTEN APPEALS AND COURT
INSTRUCTIONS IN RECORD)
101. Plaintiff realleges and incorporates by reference all preceding
paragraphs.
102. The Due Process Clause of the Fifth Amendment of the United States
Constitution prohibits SSA from depriving plaintiff of a protected property interest
without opportunity to SSA's administrative review process and to a hearing. Plaintiff
has a protected property interest in receiving SSA disability benefits and Medicare
insurance.
103. SSA maintains records within one or more Privacy Act Systems of
Record that pertain to plaintiff and identified and retrievable by plaintiff's Social Security
number and name.
104. In violation of 5 U.S.C. Secs. 552a(e) (5 and (g) (1) (C), among other
provisions of the Privacy Act, defendant SSA willfully and intentionally failed to
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maintain in its record concerning plaintiff, plaintiff's four appeal letters that it received
for the second time on June 2, 2007, dated December 20, 2001, March 5, 2004, July 19,
2004, and July 17, 2006 and plaintiff's appeal letter dated July 13, 2007 that it received
on July 16, 2007.
105. In violation of 5 U.S.C. Secs. 552a(e) (5 and (g) (1) (C), among other
provisions of the Privacy Act, defendant SSA willfully and intentionally failed to
maintain in its record concerning plaintiff, Judge Flanagan's instructions issued in the
order dated April 10, 2007 which instructed SSA to treat plaintiff's filing of the complaint
in that action (civil case # 5:06-CV-306) to have represented a protective filing of the
administrative appeal reference the July 12, 2006 notice, and to proceed to an expedited
administrative review of that and any other pending appeal(s) filed by plaintiff, with
plaintiff being afforded all appropriate rights of due process of the administration.
106. As a result of SSA failing to maintain plaintiff's five appeal letters and
Judge Flanagan's court ordered instructions in its record concerning plaintiff, defendant
SSA willfully and intentionally failed to maintain its record with such accuracy,
relevance, timeliness, and completeness as is and was necessary to assure fairness in any
determination relating to the qualifications, character, rights, or opportunities of, or
benefits to plaintiff that were made on the basis of said record, and consequently a
determination was made which is adverse to plaintiff.
107. SSA adversely determined to withhold and to recover from plaintiff
monthly SSA disability benefits totally $62081.20 and Medicare insurance, and adversely
denied plaintiff the right and opportunity to SSA's administrative review process and to a
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hearing to rebut SSA's five initial adverse determinations that pertain to the
overpayments and Medicare insurance.
108. Defendant SSA has deprived and continues to deprive plaintiff of SSA
disability benefits and Medicare insurance to which she is entitled, without due process of
law.
109. Defendant SSA has violated plaintiff's constitutional rights.
110. As a proximate cause of SSA's conduct described above, plaintiff has
suffered and continues to suffer adverse and harmful effects, including, but not limited to,
mental distress, emotional and psychological trauma, personal and financial hardships,
and physical pain and discomfort.
SECOND CLAIM FOR RELIEFVIOLATION OF THE FIFTH AMENDMENT OF THE UNITED STATES
CONSTITUTION: DEPRIVATION OF PROPERTY INTEREST (ALTERNATIVE TO FIRST CLAIM FOR RELIEF)
111. Plaintiff realleges and incorporates by reference all preceding
paragraphs.
112. In the event that defendant SSA has made a decision on one or more of
plaintiff's five appeals, plaintiff alleges the following.
113. Between June 30, 2008, the date that SSA received plaintiff's
administrative tort claim on Standard Form 95, and the date that SSA or the United States
of America (which ever files first) files in this court a response or an answer as a
defendant in this action, SSA made an adverse decision on one or more of plaintiff's five
appeals, documented the decisions in the form of written notices addressed to plaintiff,
added to the written notices dates that had past in time prior to the actual date the
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decisions were made and the written notices were created, and filed and is maintaining in
its record concerning plaintiff the written notices and adverse decisions.
114. To date, plaintiff has received no decision with respect to her five
appeals. SSA has intentionally failed to send plaintiff written notices of adverse
decisions.
115. The Due Process Clause of the Fifth Amendment of the United States
Constitution prohibits SSA from depriving plaintiff of a protected property interest
without (1) providing plaintiff written notice of the adverse decisions; (2) providing
plaintiff the right and opportunity to appeal the decisions and to SSA's administrative
review process; and (3) proving plaintiff hearings.
116. In violation of 5 U.S.C. Secs. 552a(e) (5 and (g) (1) (C), among other
provisions of the Privacy Act, defendant SSA willfully and intentionally filed and is
maintaining in its record concerning plaintiff one or more adverse decisions: (1) that SSA
made on one or more of plaintiff's five appeals letters, (2) that SSA have not sent to
plaintiff via written notices; and (3) that consist of incorrect dates.
117. In violation of 5 U.S.C. Secs. 552a(e) (5 and (g) (1) (C), among other
provisions of the Privacy Act, as a result of SSA maintaining one or more adverse
decisions in its record concerning plaintiff, that consist of incorrect dates and that was not
sent to plaintiff in the form of a written notice, SSA has willfully and intentionally failed
to maintain its record concerning plaintiff with such accuracy, relevance, timeliness, and
completeness as is necessary to assure fairness in any determination relating to the
qualifications, character, rights, or opportunities of, or benefits to plaintiff that may be
27
made on the basis of said record, and consequently a determination was made which is
adverse to plaintiff.
118. SSA adversely determined to: (1) withhold from plaintiff disability
benefits and Medicare insurance and (2) refuse and fail to afford plaintiff rights to
receive written notice of the decisions, to appeal the decisions, administrative reviews
and hearings with respect to the decisions as required by the Social Security Act and the
Due Process Clause of the Fifth Amendment of the United States Constitution.
119. Defendant SSA has deprived and continues to deprive plaintiff of SSA
disability benefits and Medicare insurance to which she is entitled, without due process of
law.
120. Defendant SSA has violated plaintiff's constitutional rights.
121. As a proximate cause of SSA's conduct described above, plaintiff has
suffered and continues to suffer adverse and harmful effects, including, but not limited to,
mental distress, emotional and psychological trauma, personal and financial hardships,
and physical pain and discomfort.
THIRD CLAIM FOR RELIEFVIOLATION OF THE FIFTH AMENDMENT OF THE UNITED STATES
CONSTITUTION: DEPRIVATION OF PROPERTY INTEREST
122. Plaintiff realleges and incorporates by reference all preceding
paragraphs.
123. In July 2006, SSA determined that plaintiff was disabled and entitled to
disability benefits.
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124. In the event that defendant SSA has made a decision to terminate
plaintiff's entitlement to SSA disability benefits, to date, plaintiff has receive no written
notice of this decision and alleges the following.
125. The Due Process Clause of the Fifth Amendment of the United States
Constitution prohibits SSA from depriving plaintiff of a protected property interest
without: (1) providing plaintiff written notice of the adverse decision; (2) providing
plaintiff the right and opportunity to appeal the adverse decision and to SSA's
administrative review process; and (3) providing plaintiff a hearing.
126. In violation of 5 U.S.C. Secs. 552a(e) (5 and (g) (1) (C), among other
provisions of the Privacy Act, defendant SSA willfully and intentionally maintained in its
record concerning plaintiff a decision to terminate plaintiff's entitlement to disability
benefits and document(s) indicating that this decision was sent to plaintiff in a written
notice. Plaintiff has received no written notice of SSA's decision to terminate her
entitlement to disability benefits.
127. In violation of 5 U.S.C. Secs. 552a(e) (5 and (g) (1) (C), among other
provisions of the Privacy Act, as a result, SSA has willfully and intentionally failed to
maintain its record concerning plaintiff with such accuracy, relevance, timeliness, and
completeness as is necessary to assure fairness in any determination relating to the
qualifications, character, rights, or opportunities of, or benefits to plaintiff that may be
made on the basis of said record, and consequently a determination was made which is
adverse to plaintiff.
128. SSA adversely determined to recover and to withhold from plaintiff
disability benefits and Medicare insurance and determined to deny plaintiff rights to
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receive written notice of its decision to terminate plaintiff's entitlement to disability
benefits, to appeal this decision, to SSA's administrative review process and to a hearings
with respect to the decision.
129. Defendant SSA has deprived and continues to deprive plaintiff of SSA
disability benefits and Medicare insurance to which she is entitled, without due process of
law.
130. Defendant SSA has violated plaintiff's constitutional rights.
131. As a proximate cause of SSA's conduct described above, plaintiff has
suffered and continues to suffer adverse and harmful effects, including, but not limited to,
mental distress, emotional and psychological trauma, personal and financial hardships,
and physical pain and discomfort.
FOURTH CLAIM FOR RELIEF Violation of The Freedom of Information Act
132. Plaintiff realleges and incorporates by reference all preceding
paragraphs.
133. Plaintiff properly asked for records within SSA's control.
134. To date, plaintiff has received no document and hearing tape from SSA.
Plaintiff is entitled by law access to the documents requested under the FOIA, some of
which should have been treated as a Privacy Act Request.
135. Defendant SSA has not made explicit and justified statutory exemption
claims.
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136. Therefore, defendant SSA has violated the FOIA and Privacy Act's
mandate to release agency records to the public by failing to release the records as
plaintiff specifically requested.
FIFTH CLAIM FOR RELIEF Violation of The Privacy Act Request
137. Plaintiff realleges and incorporates by reference all preceding
paragraphs.
138. Plaintiff properly asked for records within SSA's control.
139. To date, plaintiff has received no document and hearing tape from SSA.
Plaintiff is entitled by law to access to the documents requested under the Privacy Act.
140. Defendant SSA has not made an explicit and justified statutory
exemption claim.
141. Therefore, defendant SSA has violated the Privacy Act's mandate to
release agency records to plaintiff by failing to release the records as plaintiff specifically
requested.
SIXTH CLAIM FOR RELIEFINTENTIONAL INFLICTION OF EMOTIONAL DISTRESS CAUSED BY THE INTENTIONAL VIOLATION OF AND TOTAL DISREGARD FOR THE COURT ORDERED INSTRUCTIONS ISSUED BY JUDGE LOUISE
FLANAGAN ON APRIL 10, 2007
144. Plaintiff realleges and incorporates by reference all preceding
paragraphs.
145. In March 2004 and July 2006, plaintiff submitted to SSA written
appeals of SSA's two decisions to deny her two requests for waivers of the overpayments
of $7453 and $47,175.
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146. By letter dated July 30, 2006, SSA informed plaintiff of its determination
that plaintiff is disable and is entitled to SSA disability benefits beginning October 1995.
SSA's letter also indicated that SSA had withheld benefits that plaintiff was entitled to
receive from October 1995 through July 2006 in the amount of $9465.30.
147. On August 2, 2006, plaintiff filed civil action case # 5:06-CV-306 in the
United States District Court of the Eastern District of North Carolina alleging that SSA
failed to provide plaintiff information, documents, and a pre-recoupment hearing as
required by the Federal Code of Regulations.
148. In November 2006, SSA motioned to dismiss the case pleading that:
a. plaintiff had not requested reconsideration of SSA's July 12, 2006 decision to deny her request for a wavier;
b. plaintiff has not yet exhausted administrative remedies;
c. therefore, the court lacks subject matter jurisdiction;
d. should the Court dismiss the case, SSA will consider the filing of the complaint as an protective filing of her administrative appeal,
and will proceed to an expedited determination of that appeal, with the plaintiff being afforded all appropriated rights of due process as set forth in the Commissioner's regulations.
149. On April 10, 2007, the court dismissed the case and in Judge Flanagan's
order, she issued the following specific instructions to SSA and to its Commissioner:
The court instructs defendant to treat plaintiff's filing of complaint in his action to have represented a protectivefiling of the administrative appeal reference in the July 12, 2006 notice, and to proceed to an expedited administrative review of that and any other pending appeal(s) filed by plaintiff, with plaintiff being afforded
all appropriate rights of due process as set forth in the Commissioner's regulations.
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150. After successfully obtaining a dismissal of plaintiff's case, SSA's
employees, Commissioner and representative acted in concert and conspired to and
intentionally and willfully did:
a. failed and refused to proceed to an administrative review of the July 12, 2006 decision;
.b. failed and refused to proceed to an administrative review of plaintiff's
other three appeals dated December 20, 2001, March 5, 2004, and July 19, 2004;
c. failed and refused to afford plaintiff all appropriate rights of due process as set forth in the Commissioner's regulations;
d. failed and refused to afford plaintiff all appropriate rights of due process as required by the Due Process Clause of the Fifth Amendment of the United States Constitution;
e. deprived plaintiff of SSA benefits without due process of the law; and
f. committed the above acts with the intent of inflicting upon plaintiff emotional distress.
151. In January 2006, plaintiff applied for disability benefits for illnesses that
included, but not limited to: (1) rheumatoid arthritis, a crippling, degenerate and painful
disease and (2) Post Traumatic Post Disorder and Military Sexual Trauma both of which
resulted from the terrorizing stalking, physical and sexual assaults and misconduct of
males, mainly male superiors, while serving in the U.S. Army. As a result of plaintiff's
illnesses, in July 2006, SSA determined that plaintiff was disabled and entitled to
disability benefits.
152. SSA and SSA's employees, Commissioner and representatives knew and
should have known that plaintiff had a propensity to suffer emotional distress and would
suffer emotional distress as a result of the conduct described above.
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153. SSA's conduct described above, committed through and via its
employees, Commissioner and representative, is atrocious, intolerable and so extreme
and outrageous that it exceeds the bounds of decency.
154. As a proximate cause of the conduct described above, plaintiff has
suffered and continues to suffer serious and substantial emotional distress. The
emotional distress was and is so severe that no reasonable person could be expected to
endure it.
PRAYER FOR RELIEF
WHEREFORE, plaintiff requests that the Court award her the following relief:
(1) On the First Claim for Relief, award plaintiff damages against defendant SSA in
the amount of $4,000,000 .00 (four million dollars);
(2) On the Second Claim for Relief, award plaintiff damages against defendant SSA
in the amount of $10,000,000 .00 (ten million dollars);
(3) On the Third Claim for Relief, award plaintiff damages against defendant SSA in
the amount of $10,000,000 .00 (ten million dollars);
(4) On the Fourth Claim for Relief, order defendant SSA to immediately send to
plaintiff all documents and items requested in plaintiff's FOIA request dated July
13, 2007 and amended FOIA request dated February 19, 2009;
(5) On the Fifth Claim for Relief, order defendant SSA to immediately send to
plaintiff all documents requested in plaintiff's letter dated November 6, 2008;
(6) On the Sixth Claim for Relief, award plaintiff damages against defendant United
States of America in the amount of $2,000,000 .00 (2 million dollars);
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(7) Pursuant to 5 U.S.C. § 552a(a)(4)(F), order a disciplinary investigation of SSA's
refusal to provide plaintiff documents of her FOIA and Privacy Act requests;
(8) Award plaintiff reasonable attorney fees in this action; and
(9) Grant such other relief as the Court may deem just and proper.
Respectfully submitted this the 26th day of May 2009.
__________________________________
Pamela Melvin, Pro Se 4949 Fieldcrest Drive
Fayetteville, North Carolina Phone: 919-673-3425
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