Opinion
Ca No. 96-75130
March 13, 2002
AMENDED MEMORANDUM OPINION AND ORDER
The only changes to the Memorandum Opinion and Order entered on March 7, 2002 are reflected on pages 3 and 10 of this Amended Memorandum Opinion and Order.
Pursuant to FED. R. Civ. P. 60(a), this Court hereby AMENDS its previous Memorandum Opinion and Order entered in this case on March 7, 2002.
I. FACTS
Plaintiff Lynora Ashford filed an action against the Commissioner of Social Security Administration ("Commissioner" or "Defendant") in this court on November 6, 1996 (Civil No. 96-CV-75130-DT) seeking judicial review of an adverse decision of the Commissioner of Social Security. On February 20, 1997, the Court entered a stipulated order remanding the case for further administrative action pursuant to Section 205(g) of the Social Security Act, as amended, 42 U.S.C. § 405(g). According to the Defendant, the "Appeals Council issued a decision to award benefits to plaintiff that was fully favorable."
Plaintiff submitted a new Complaint to the Court Clerk, which was marked received on May 11, 2001, given Civil No. 01-CV-71842-DT, and assigned to United States District Judge George C. Steeh. The new Complaint requested that Civil No. 96-CV-75130-DT be reopened so that Plaintiff could present evidence showing that she only received half of the amount of social security benefits owed her on June 13, 1994. The Complaint also appears to allege that the Social Security Administration denied Plaintiff benefits from 1986 through 1989. On May 14, 2001, Plaintiff filed an application to proceed in forma pauperis as to Civil No. 01-CV-71842-DT, which Judge Steeh denied on May 17, 2001. Although Civil No. 01-CV-71842-DT was identified as a possible companion case to Civil No. 96-CV-75310-DT on May 24, 2001, no transfer of the case to Judge Hood has been effectuated because Plaintiff has never paid the requisite filing fee for her new Complaint.
On August 2, 2001 Plaintiff also filed a "Complaint" under Civil No. 96-CV-75310-DT asserting that the instant case never should have been closed. Although entitled a Complaint, Plaintiff's pleading is actually a request to "reinstate" or reopen her case. Defendant filed a Response to Plaintiff's "Complaint" on September 18, 2001, arguing that Plaintiff "may not now file a new complaint' or motion in her closed case." Def's Br. at 2. Defendant further argues that "[t]o the extent plaintiff may have a dispute over a particular payment or other benefit she must file an administrative claim and exhaust all administrative remedies prior to filing suit in federal district court." According to Defendant, this court lacked subject matter jurisdiction to entertain Plaintiff's motion because the case is no longer before it in any manner. Consequently, Defendant requested that the Court refuse to entertain or, in the alternative, deny Plaintiff's "Complaint"/"Motion to Reinstate."
A hearing was held in this matter on December 3, 2001. During the hearing, it was ascertained that the remand to the Commissioner of Social Security was pursuant to Sentence Six of § 405(g) of the Social Security Act. Remands under Sentence Six require the Commissioner file with the Court any additional and modified findings of fact and decision arrived at subsequent to remand. Sentence Six further requires the Commissioner to submit a transcript of the additional record and testimony upon which the Commissioner's action in modifying or affirming was based. Because the Commissioner had not complied with the requirements under Sentence Six, the Court entered an Order on December 4, 2001, directing the Commissioner to do so within thirty (30) days.
On January 3, 2002, the Commissioner submitted the requested documents for the Court's consideration. Based on the information contained within the submitted record, Defendant has renewed its request that the Court refuse to entertain or, in the alternative, deny Plaintiff's motion. For the reasons stated below, Plaintiff's Motion to Reinstate, construed as a request for further judicial action of an appeal from an adverse decision of the Commissioner of Social Security under 42 U.S.C. § 405(g), is GRANTED. After reviewing the record of the administrative proceedings occurring subsequent to remand, however, this Court concludes that fully favorable determination of the Appeals Council must be AFFIRMED. Judgment will be entered in favor of Defendant.
The Memorandum Opinion and Order entered on March 7, 2002, stated the following: "Judgment should be entered in favor of Plaintiff"
II. STANDARD OF REVIEW
Defendant's objection to this Court's jurisdiction over Plaintiff's claim can be viewed as arguing that this Court lacks subject matter jurisdiction under FED. R. Civ. P. 12(b)(1), which requires a court to dismiss an action over which it lacks jurisdiction. Rule 12(b)(1) motions fall into two general categories: facial attacks and factual attacks. See FED. R. Civ. P. 12(b)(1); see also RMI Titanium Co. v. Westinghouse Flee. Corp., 78 F.3d 1125, 1134 (6th Cir. 1996). A facial attack challenges the pleading itself In considering this type of attack, the court must take all material allegations in the complaint as true, and construe them in the light most favorable to the non-moving party. RMI Titanium Co., 78 F.3d at 1134. Where subject matter jurisdiction is factually attacked, Plaintiff bears the burden of proving jurisdiction to survive the motion, and "the trial court is free to weigh the evidence and satisfy itself as to the existence of its power to hear the case." Id. In a factual attack of subject matter jurisdiction, "no presumptive truthfulness attaches to plaintiffs allegations, and the existence of disputed material facts will not preclude the trial court from evaluating for itself the merits of jurisdictional claims." Id.
III. ANALYSIS
A. Jurisdiction
Defendant claims that this court lacks jurisdiction to entertain Plaintiff's motion because the case is no longer before it in any manner. To the contrary, this Court has jurisdiction to decide the issues presented in this case. Because this case involves a factual attack of subject matter jurisdiction, Plaintiff bears the burden of proving jurisdiction to survive Defendant's motion to dismiss. Pro se complaints are to be held to a less stringent standard than formal pleadings by lawyers. Wells v. Brown, 891 F.2d 591, 593-94 (1991). Liberally construing Plaintiff's pro se pleadings; therefore, the Court determines that Plaintiff has presented evidence from which the Court can conclude that subject matter jurisdiction exists.
The facts indicate that the parties stipulated to remand this case to the Commissioner of Social Security for further administrative action, and the Court entered in Order to that effect on February 20, 1997. The stated purpose of the remand was "to allow the Commissioner to reopen and reconsider the plaintiffs claim of disability." See Stipulation and Order of Remand. Under the Social Security Act ("SSA"), there are two types of remands for administrative proceedings in actions seeking review of denial of benefits. Shalala v. Schaefer, 509 U.S. 292, 296 (1993); see also 42 U.S.C. § 405(g). These two types of remands, which are the only types available under the SSA, are denominated as "sentence four" and "sentence six" remands. Melkonyan v. Sullivan, 501 U.S. 89 (1991).
This case involves a Sentence Six remand. Sentence six states in pertinent part:
The court may, on motion of the Commissioner of Social Security made for good cause shown before the Commissioner files the Commissioner's answer, remand the case to the Commissioner of Social Security for further action by the Commissioner of Social Security, and it may at any time order additional evidence to be taken before the Commissioner of Social Security, but only upon a showing that there is new evidence which is material and that there is good cause for the failure to incorporate such evidence into the record in a prior proceeding.Id.
"Sentence-six remands may be ordered in only two situations: where the [Commissioner] requests a remand before answering the complaint, or where new, material evidence is adduced that was for good cause not presented before the agency." Shalala, 509 U.S. at 297. Sentence-six remands neither become final judgments upon remand, Melkonyan, 501 U.S. at 102, nor deem the plaintiff the victor in its suit challenging the Commissioner's decision. Schaefer, 509 U.S. at 301. Instead, sentence-six remands become final judgments only after the Commissioner reports back to the Court its post-remand findings and the Court subsequently enters a final judgment. The district court, which retains jurisdiction during the entirety of the Sentence Six remand, then reviews the additional information submitted by the Commissioner "only to the extent provided for review of the original findings of fact and decision." 42 U.S.C. § 405(g); see also Melkonyan, 501 U.S. at 99.
Defendant claims that the "Appeals Council issued a decision to award benefits to plaintiff that was fully favorable." See Def's Br. at 2. Plaintiff disputes this contention, claiming that she only received half of the amount of social security benefits owed her on June 13, 1994, and that the Commissioner denied her benefits from 1986 through 1989. See "Complaint." This Court retains jurisdiction to decide this issue. See Buck v. Sec. of HHS., 923 F.2d 1200, 1205 (6th Cir. 1991) ("Apparently, the remanding court always `retains jurisdiction' in the sense that it has the legal power to decide remaining issues in the case, but it may choose not to exercise that power.")
B. Administrative Proceedings
On October 25, 1990, Plaintiff filed a claim for supplemental security benefits alleging disability and inability to work since October 1990. This application was denied initially and upon reconsideration by notices dated January 16, 1991 and March 21, 1991, respectively, and at the hearing level by decision dated September 24, 1991. See Admin. Rec. at 10. Within the requisite time period of two years or on May 14, 1992, Plaintiff filed a second application for supplemental security income. Id. Therein, Plaintiff alleged disability dating back a head injury resulting from a car accident in 1986. Id. Based on this application, an Administrative Law Judge ("ALJ") found that Plaintiff was disabled as defined in the Social Security Act and granted a fully favorable decision on June 13, 1994. Id. at 9.
Specifically, the ALJ found that Plaintiff had a severe mental impairment (schizophrenia). Id. The ALJ further found that the severity of section 12.03 of the Listing of Impairments in Appendix 1, Subpart P of the Social Security Administration Regulations No. 4. Id. Thus, the ALJ's June 13, 1994 decision found Plaintiff disabled as of the date of her May 14, 1992 application. Id.
Subsequent to the May 14, 1992 determination, Plaintiff requested reopening of the earlier unfavorable decision of September 24, 1991 on her prior application dated October 25, 1990. Id. at 10. On the Sentence Six remand, the Appeal Council reopened the September 24 decision and considered the additional evidence submitted in connection with this claim. Id. Based on the additional information submitted by Plaintiff and the favorable decision on her second application for supplemental security income, the Appeals Council adopted all of the ALJ's June 13, 1994 findings except the onset date of Plaintiff's disability. Id. Instead of the onset date being May 14, 1992, the Appeals Council concluded that Plaintiff was disabled as of the date of her first application for supplemental security income, October 25, 1990. Id.
According to the Appeals Council, "[a] finding of disability as of [October 25, 1990] constitutes the earliest possible date the claimant can be found eligible to the payment of supplemental security income benefits in her case pursuant to 20 C.F.R. § 416.335." Id. 20 C.F.R. § 416.335 provides:
When you file an application in the month that you meet all the other requirements for eligibility, the earliest month for which we can pay you benefits is the month following the month you filed the application. If you file an application after the month you first meet all the other requirements for eligibility, we cannot pay you for the month in which your application is filed or any months before that month.Id.
Plaintiff disagrees with the contention that she qualified for benefits on October 25, 1990 at the earliest. On April 29, 1997, Plaintiff filed a "Request for Review of Hearing Decision/Order" asserting that she filed a claim for benefits in 1986. See Admin. Rec. at 7-8. The Appeals Council construed her request for review as a request for reopening of its decision issued on March 27, 1997. Id. at 6.
In a letter dated January 19, 1998, Administrative Appeal Judge Ira E. Ziporkin ("AAJ Ziporkin") explained that a decision on a claim for supplemental security income may be reopened within two years of the date of the notice of the initial determination if good cause is established. Id. (citing 20 C.F.R. § 416.1487-1489). Because Plaintiff's record contained no indication of a prior claim which was denied within two years of the date she filed her application dated October 25, 1990, AAJ Ziporkin concluded that no basis existed under the regulations for reopening the Council's earlier favorable decision of March 27, 1997. On February 13, 1998, less than a month after receiving the letter from AAJ Ziporkin, Plaintiff filed a letter with this Court expressing her displeasure in the Appeals Council's decision not to grant her benefits beginning in 1986, as well as the decision not to reopen the Council's decision of March 27, 2001.
As to the latter issue, the Court lacks jurisdiction. It is within the Secretary's discretion to reopen a determination or decision. 20 C.F.R. § 404.988, 416.1488. Even if the Secretary abused his discretion by failing to reopen the previous decisions, federal courts' jurisdiction under the Social Security Act is limited to the review of a "final decision of the Secretary made after a hearing." Califano v. Sanders, 430 U.S. 99, 108 (1977). Because a petition to reopen may be denied without a hearing, "Congress did not intend Section 205(g) of the Administrative Procedure Act to provide the jurisdictional predicate for judicial review of the Secretary's decision not to reopen a prior final decision." Parker v. Califano, 644 F.2d 1199, 1201 (6th Cir. 1981). Absent a colorable constitutional claim, this Court lacks jurisdiction to review the Commissioner's decision not to reopen Plaintiff's claim. No constitutional claim has been presented. Id.
Regarding Plaintiff's issue with the Appeal Council's decision not to grant her supplemental security income commencing in 1986, the Court determines that this argument is without merit. Judicial review of the Commissioner's decision is limited to determining whether the findings of fact made by the Commissioner are supported by substantial evidence and whether the Commissioner employed the proper legal criteria in reaching his conclusion. Garner v. Heckler, 745 F.2d 383 (6th Cir. 1984). A district court's review of the Commissioner's decision is not a de novo review. The district court may not resolve conflicts in the evidence. Garner, 745 F.2d at 397. The decision of the Commissioner must be upheld if supported by substantial evidence, even if the record might support a contrary decision. Smith v. Secretary of HHS, 893 F.2d at 397. An administrative decision must be affirmed if supported by substantial evidence, even if the Court might arrive at a different conclusion. Mullen v. Bowen, 800 F.2d 535, 545 (6th Cir. 1986) (quoting Baker v. Heckler, 730 F.2d 1147, 1150 (8th Cir. 1984).
Plaintiffs October 25, 1990 application states that she has "tried before to get disability [and] just had to waite (sic) a few more month's, (sic) after the accident I had in 1986." Admin. Rec. at 54. 20C.F.R. § 416.335 provides that, subject to §§ 416.340, 416.345, 416.350, "a written statement or an oral inquiry made before the filing of the application form may affect the filing date of the application.'" While Plaintiff has produced evidence showing that she was in a car accident on December 22, 1996, she has not shown a written or oral statement requesting benefits accompanied by the fulfilment of either of the provisions aforementioned. The Appeals Council's decision to declare her disabled as of the date of her October 25, 1990 application, therefore, was supported by substantial evidence.
Finally, Plaintiff alleges that, subsequent to the filing of her suit in this Court in 1996, Defendant improperly began reducing her benefits based on a change in living circumstances which she alleges never occurred. As Defendant argues, however, "[t]o the extent plaintiff may have a dispute over a particular payment or other benefit she must file an administrative claim and exhaust all administrative remedies prior to filing suit in federal district court." Def's Resp. to Pl.'s "Complaint" at 2. The Court lacks jurisdiction as to this claim because there is no indication that Plaintiff has exhausted her administrative remedies.
IV. CONCLUSION
This Court retains jurisdiction over cases remanded pursuant to Sentence Six of § 405(g) of the Social Security Act. Accordingly, Plaintiff's Motion to Reinstate must be granted. Because Plaintiff has not adequately presented an issue to this Court concerning the Appeal Council's decision after remand, however, this Court affirms the Council's fully favorable determination and will enter Judgment for Defendant.
The Memorandum Opinion and Order dated March 7, 2002 stated the following: "Because Plaintiff has not adequately presented an issue to this Court concerning the Appeal Council's decision after remand, however, this Court affirms the Council's fully favorable determination and will enter Judgment for Plaintiff in accordance therewith."
Accordingly,
IT IS HEREBY ORDERED that Plaintiff's Motion to Reinstate the Case ( Docket # 14, filed August 2, 2001) is GRANTED.
IT IS FURTHER ORDERED that the fully favorable determination of the Appeal's Council is AFFIRMED.
IT IS FURTHER ORDERED that Plaintiff's request for additional benefits is DENIED.
This Order was not included in the March 7, 2002 Memorandum Opinion and Order.
ENDNOTES
1. Section 416.340 states:
[The SSA] will use the date a written statement, such as a letter, an SSA questionnaire or some other writing, is received at a social security office, at another Federal or State office designated by us, or by a person we have authorized to receive applications for us as the filing date of an application for benefits, only if the use of that date will result in your eligibility for additional benefits. If the written statement is mailed, we will use the date the statement was mailed to us as shown by a United States postmark. If the postmark is unreadable or there is no postmark, we will use the date the statement is signed (if dated) or 5 days before the day we receive the written statement, whichever date is later, as the filing date of an application for benefits. In order for us to use your written statement to protect your filing date, the following requirements must be met: (a) The written statement shows an intent to claim benefits for yourself or for another person. (b) You, your spouse or a person who may sign an application for you signs the statement. (c) An application form signed by you or by a person who may sign an application for you is filed with us within 60 days after the date of a notice we will send telling of the need to file an application. The notice will say that we will make an initial determination of eligibility for SSI benefits if an application form is filed within 60 days after the date of the notice. (We will send the notice to the claimant, or where he or she is a minor or incompetent, to the person who gave us the written statement.) (d)(1) The claimant is alive when the application is filed on a prescribed form, or (2) If the claimant dies after the written statement is filed, the deceased claimant's surviving spouse or parent(s) who could be paid the claimant's benefits under § 416.542(b), or someone on behalf of the surviving spouse or parent(s) files an application form. If we learn that the claimant has died before the notice is sent or within 60 days after the notice but before an application form is filed, we will send a notice to such a survivor. The notice will say that we will make an initial determination of eligibility for SSI benefits only if an application form is filed on behalf of the deceased within 60 days after the date of the notice to the survivor.
Section 4 16.345 states:
[The SSA] will use the date of an oral inquiry about SSI benefits as the filing date of an application for benefits only if the use of that date will result in your eligibility for additional benefits and the following requirements are met: (a) The inquiry asks about the claimant's eligibility for SSI benefits. (b) The inquiry is made by the claimant, the claimant's spouse, or a person who may sign an application on the claimant's behalf as described in § 416.315. (c) The inquiry, whether in person or by telephone, is directed to an office or an official described in § 416.310(b). (d) The claimant or a person on his or her behalf as described in § 416.315 files an application on a prescribed form within 60 days after the date of the notice we will send telling of the need to file an application. The notice will say that we will make an initial determination of eligibility for SSI benefits if an application form is filed within 60 days after the date of the notice. (We will send the notice to the claimant or, where he or she is a minor or incompetent, to the person who made the inquiry.) (e)(1) The claimant is alive when the application is filed on a prescribed form, or (2) If the claimant dies after the oral inquiry is made, the deceased claimant's surviving spouse or parent(s) who could be paid the claimant's benefits under § 416.542(b), or someone on behalf of the surviving spouse or parent(s) files an application form. If we learn that the claimant has died before the notice is sent or within 60 days after the notice but before an application form is filed, we will send a notice to such a survivor. The notice will say that we will make an initial determination of eligibility for SSI benefits only if an application form is filed on behalf of the deceased within 60 days after the date of the notice to the survivor.
Finally, § 416.350 provides:
(a) When a person applies for benefits under title II (retirement, survivors, or disability benefits) we will explain the requirements for receiving SSI benefits and give the person a chance to file an application for them if (1) The person is within 2 months of age 65 or older or it looks as if the person might qualify as a blind or disabled person, and (2) It is not clear that the person's title II benefits would prevent him or her from receiving SSI or any State supplementary benefits handled by the Social Security Administration (b) If the person applying for title II benefits does not file an application for SSI on a prescribed form when SSI is explained to him or her, we will treat his or her filing of an application for title II benefits as an oral inquiry about SSI, and the date of the title II application form may be used to establish the SSI application date if the requirements of § 416.345(d) and (e) are met.