7 soc.sec.rep.ser. 76, unempl.ins.rep. Cch 15,547 Jeanne A. Jordan, Individually, and on Behalf of All Other Persons Similarly Situated v. Margaret M. Heckler, Individually, and in Her Official Capacity as Secretary of the Department of Health and Human Services, Defendant- Jeanne A. Jordan, Individually, and on Behalf of All Other Persons Similarly Situated v. Margaret M. Heckler, Individually, and in Her Official Capacity as Secretary of the Department of Health and Human Services, Defendant

744 F.2d 1397
CourtCourt of Appeals for the Tenth Circuit
DecidedJanuary 22, 1985
Docket84-1438
StatusPublished

This text of 744 F.2d 1397 (7 soc.sec.rep.ser. 76, unempl.ins.rep. Cch 15,547 Jeanne A. Jordan, Individually, and on Behalf of All Other Persons Similarly Situated v. Margaret M. Heckler, Individually, and in Her Official Capacity as Secretary of the Department of Health and Human Services, Defendant- Jeanne A. Jordan, Individually, and on Behalf of All Other Persons Similarly Situated v. Margaret M. Heckler, Individually, and in Her Official Capacity as Secretary of the Department of Health and Human Services, Defendant) is published on Counsel Stack Legal Research, covering Court of Appeals for the Tenth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
7 soc.sec.rep.ser. 76, unempl.ins.rep. Cch 15,547 Jeanne A. Jordan, Individually, and on Behalf of All Other Persons Similarly Situated v. Margaret M. Heckler, Individually, and in Her Official Capacity as Secretary of the Department of Health and Human Services, Defendant- Jeanne A. Jordan, Individually, and on Behalf of All Other Persons Similarly Situated v. Margaret M. Heckler, Individually, and in Her Official Capacity as Secretary of the Department of Health and Human Services, Defendant, 744 F.2d 1397 (10th Cir. 1985).

Opinion

744 F.2d 1397

7 Soc.Sec.Rep.Ser. 76, Unempl.Ins.Rep. CCH 15,547
Jeanne A. JORDAN, individually, and on behalf of all other
persons similarly situated, Plaintiff-Appellant,
v.
Margaret M. HECKLER, individually, and in her official
capacity as Secretary of the Department of Health
and Human Services, Defendant- Appellee.
Jeanne A. JORDAN, individually, and on behalf of all other
persons similarly situated, Plaintiff-Appellee,
v.
Margaret M. HECKLER, individually, and in her official
capacity as Secretary of the Department of Health
and Human Services, Defendant- Appellant.

Nos. 83-1636, 84-1438.

United States Court of Appeals,
Tenth Circuit.

Sept. 24, 1984.
Rehearing Denied Jan. 22, 1985 in No. 84-1438.

Laura M. Rosenthal, Greater Boston Legal Services, Boston, Mass. (Judith R. Ferber, Greater Boston Elderly Legal Services, Boston, Mass., John Fears, Legal Aid of Western Okl., Norman, Okl., Neal S. Dudovitz, Nat. Sr. Citizens Law Center, Los Angeles, Cal., with her on the briefs), for plaintiff-appellant in No. 83-1636 and plaintiff-appellee in No. 84-1438.

John W. Wojciechowski, Atty., Social Sec. Div., Dept. of Health and Human Services, Baltimore, Md., Christine R. Whittaker, Atty., Appellate Staff, Civ. Div., Dept. of Justice, Washington, D.C. (J. Paul McGrath, Asst. Atty. Gen., Richard K. Willard, Acting Asst. Atty. Gen., Dept. of Justice, Washington, D.C., Larry D. Patton, U.S. Atty., Oklahoma City, Okl., Randolph W. Gaines, Deputy Asst. Gen. Counsel for Litigation, John M. Sacchetti, Chief, Retirement and Survivors Ins. Litigation Branch, Dept. of Health and Human Services, Baltimore, Md., and William Kanter, Atty., Appellate Staff, Civ. Div., Dept. of Justice, Washington, D.C., with them on the briefs), for defendant-appellee in No. 83-1636 and defendant-appellant in No. 84-1438.

Before SETH, Chief Judge, and DOYLE and SEYMOUR, Circuit Judges.

SETH, Chief Judge.

The Social Security Act at 42 U.S.C. Sec. 405(j) provides that benefits under certain circumstances may be paid directly to the applicant or to a representative for the benefit of the applicant. Thus:

"When it appears to the Secretary that the interest of an applicant entitled to a payment would be served thereby, certification of payment may be made, regardless of the legal competency or incompetency of the individual entitled thereto, either for direct payment to such applicant, or for his use and benefit to a relative or some other person."

The "certification" is the significant act of the Secretary in this context. Procedures have been established to determine the "need" for a representative and "who" it should be with notice to the claimant.

The trial court concluded that the procedure was adequate under the statute and met due process requirements after making the evaluation under Mathews v. Eldridge, 424 U.S. 319, 96 S.Ct. 893, 47 L.Ed.2d 18, and Tidwell v. Schweiker, 677 F.2d 560 (7th Cir.). This issue was considered by this court in McGrath v. Weinberger, 541 F.2d 249 (10th Cir.).

Thus, this is the approved procedure for the determination of "need" and who is to act as a representative. The plaintiffs in the trial court contested this issue asserting that more was required. However, they did not pursue their appeal on this issue. Their appeal or cross-appeal is now directed only to claims that the person selected as a representative as above described has misapplied the funds.

In this context we should first note a significant and basic statutory provision in 42 U.S.C. Sec. 405(k) which relates to the remaining issue of misuse. This subsection reads in part:

"Any payment made after December 31, 1939, under conditions set forth in subsection (j), any payment made before January 1, 1940, to, or on behalf of, a legally incompetent individual, and any payment made after December 31, 1939, to a legally incompetent individual without knowledge by the Secretary of incompetency prior to certification of payment, if otherwise valid under this title, shall be a complete settlement and satisfaction of any claim, right or interest in and to such payment."

Under the statute the payment to the representative discharges the Secretary from any further obligation "as to such payment." The plaintiffs thus challenge the procedure followed by the Secretary in handling claims made by beneficiaries (or for them) of misuse of funds by the representative certified to receive payment as above described. The plaintiffs urge that under 42 U.S.C. Sec. 405(b) there should be a hearing and review when such a claim of misuse is made. The Secretary's position and the regulations promulgated under Sec. 405(b) is that only actions which prejudice the claimant's rights specifically provided in the Act trigger an administrative hearing and judicial review. These actions are described as "initial determinations" in the regulations. Claims as to a representative's misuse of funds are not within that category under the regulations. See Califano v. Sanders, 430 U.S. 99, 97 S.Ct. 980, 51 L.Ed.2d 192. The claimant's right to payments under Sec. 405(j) is established by the certification of payment to the representative.

Under existing procedure the agency examines the objection and makes a decision to request restitution or to take no action. There is no "hearing" on the claim. Again, the Secretary has discharged her duty upon certification and payment. A claim may be the basis for a change in the representative, but this does not have any consequences as to the dollars. There is an adequate remedy for impairment of the free use of benefits. McGrath v. Weinberger, 541 F.2d 249 (10th Cir.).

The only action that the agency can take if there appears to be a misapplication of funds by the payee is to "request" restitution and refer the incident to the General Accounting Office. Claims of this nature in this appeal have no relation whatever to a termination of benefits or to the dollars from the agency. The claims could however go against the representative as an individual with state law remedies available. The regulations provide procedures for change of representatives. Requests for a change of representative may be made at any time. The trial court on this matter of claims of misuse of funds again made an analysis under Mathews v. Eldridge, 424 U.S. 319, 96 S.Ct. 893, 47 L.Ed.2d 18, and we agree that the circumstances do not warrant the treatment of such claims as an initial determination.

As we have seen, a hearing on claims of misuse would add no statutorily required nor due process procedures. The trial court ordered that the agency require, beginning at a date in the future, periodic accountings by the representatives. The Secretary apparently has agreed to do this.

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