Arlene Mattern, on Behalf of Herself and All Others Similarly Situated v. Caspar W. Weinberger, Secretary of Health, Education and Welfare

519 F.2d 150, 1975 U.S. App. LEXIS 14392
CourtCourt of Appeals for the Third Circuit
DecidedJune 3, 1975
Docket74-1776
StatusPublished
Cited by66 cases

This text of 519 F.2d 150 (Arlene Mattern, on Behalf of Herself and All Others Similarly Situated v. Caspar W. Weinberger, Secretary of Health, Education and Welfare) is published on Counsel Stack Legal Research, covering Court of Appeals for the Third Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Arlene Mattern, on Behalf of Herself and All Others Similarly Situated v. Caspar W. Weinberger, Secretary of Health, Education and Welfare, 519 F.2d 150, 1975 U.S. App. LEXIS 14392 (3d Cir. 1975).

Opinion

OPINION OF THE COURT

HUNTER, Circuit Judge:

This appeal involves a challenge to the constitutionality of the procedure established by the Secretary of Health, Education and Welfare, pursuant to section *153 204 of the Social Security Act, 1 for the recoupment of alleged overpayments of benefits. The district court, 377 F.Supp. 906 (E.D.Pa., 1974), found the recoupment procedure violative of due process since it permitted an adjustment or reduction of social security payments without affording the beneficiary the right to a prior oral hearing. While we are in substantial agreement with the opinion of the district court, we vacate and remand for entry of a new order consistent with this opinion.

I. RECOUPMENT PROCEDURE

Section 204(a) of the Act directs the Secretary to recover overpayments of social security benefits through recoupment of future benefit payments. Section 204(b), however, requires the Secretary to “waive” recoupment under certain circumstances. It provides that there shall be no recoupment where the overpaid beneficiary is “without fault” 2 and the recoupment either would “defeat the purpose” of Title II of the Act 3 or *154 would be “against equity and good conscience.” 4 Pursuant to these statutory directives, the Secretary has promulgated regulations providing for a four-step process of administrative review: an initial determination that there has been an overpayment and that there is no basis for waiver of recovery (20 C.F.R. § 404.-905); a reconsideration of that initial determination upon request by the recipient (Id. § 404.914); an administrative hearing de novo before an administrative law judge (Id. § 404.917); and review by the Appeals Council of the Social Security Administration (Id. § 404.945). Judicial review is then available, under section 205(g) of the Act, 42 U.S.C. § 405(g), to claimants who have exhausted their administrative remedies.

While a claimant thus has a right to a full evidentiary hearing at the third step in the administrative process, such a hearing is not available until after the recoupment process has begun. When a claimant is notified of the initial adverse determination and of his right to seek reconsideration, he is given thirty days in which to submit, in writing, his reasons why he disagrees with the determination that he has been overpaid or why he seeks a “waiver” under section 204(b) of the Act. Once such a request for reconsideration or waiver has been filed, even if the thirty days has expired, the recoupment procedure is automatically deferred until such reconsideration is completed. 5 If the Secretary adheres to his initial determination, the claimant is so notified and benefits begin to be withheld. At that time, the claimant is notified of his right to seek an administrative hearing de novo, with the right to present oral testimony and to cross-examine witnesses. A request for an oral hearing, unlike a request for reconsideration, will not toll recoupment. While the record is not entirely clear, it appears that there is usually a delay of several months from the time benefits are first withheld to the time a claimant is able to obtain an oral hearing.

II. THE FACTS

• At the time this suit was filed, plaintiff Arlene Mattern was fifty-three years old and physically disabled. In 1971, she applied for disabled widow’s benefits pursuant to 42 U.S.C. § 402(e)(l)(B)(ii), on the social security earnings record of her deceased husband. Her application was approved, and she became eligible for benefits as of May 18, 1971, with a monthly entitlement of $119.30. Because of a mandatory waiting period of six months, 6 plaintiff was not scheduled to begin receiving payments until December 1971. However, when plaintiff informed the social security office that she was in financial distress, she was issued, in February 1972, a check totalling $1063.80, which covered the period from May to December 1971. This payment was improper, since it had been issued in disregard of the mandatory six-month waiting period.

*155 Plaintiff was advised of the forthcoming special check in a letter of January 28, 1972. That letter also informed her that there was a possibility of duplication of payment and that if she should receive more than one check, she should return one of them to the social security district office. Prior to the receipt of either the special check or the January 28 letter, plaintiff had received her first monthly payment of $119.30. According to records maintained by the district office, plaintiff’s sister called the office on January 26, 1972, and was told that the $119.30 check was correct but that the impending special check of $1063.80 had been erroneously issued. The records also indicate that, on January 28, a district office representative phoned plaintiff to tell her that the special cheek being mailed was incorrect and should be returned. Plaintiff never returned the check, and denies that she ever received a phone call instructing her to return it.

Several months later, on July 14, 1972, plaintiff was sent a letter advising her that she had received $1063.80 more in social security benefits than she was entitled to and that since she had failed to return the check an adjustment would be made in her forthcoming benefit payments. Plaintiff was also informed of the “reconsideration” and “waiver” provisions of the law. On August 7, 1972, plaintiff requested the Secretary to waive recoupment of overpayment by filing both a “refund” and a “without fault” questionnaire, in which she listed her monthly expenses and stated that she had no other source of income, that she had been ill, that she had spent the check on her bills and that she had never received any letter or phone call advising her that the $1063.80 check had been sent in error. The district office rejected her request for waiver, on the ground that she was not without fault in causing the overpayment. In making this initial determination, the district office relied on its letter of January 28, advising plaintiff that if she received more than one check, she should return one of them. It also relied on its records indicating that plaintiff had been notified by phone on January 28 that the $1063.80 check was incorrect and should be returned.

Plaintiff subsequently filed a request for reconsideration and, in accordance with the Secretary’s procedures, recoupment was deferred until completion of the reconsideration. On January 3, 1973, the district office reaffirmed its initial decision, and determined that her payments would be reduced by $30 per month until the full amount of the overpayment was recovered.

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Bluebook (online)
519 F.2d 150, 1975 U.S. App. LEXIS 14392, Counsel Stack Legal Research, https://law.counselstack.com/opinion/arlene-mattern-on-behalf-of-herself-and-all-others-similarly-situated-v-ca3-1975.