Bobola v. Sullivan

753 F. Supp. 729, 1991 U.S. Dist. LEXIS 156, 1991 WL 2091
District Court, N.D. Illinois·Decided January 8, 1991·No. 90 C 4441·Published

Opinion

ORDER

BUA, District Judge.

Plaintiff Stanislawa Bobola seeks review of a decision by defendant Secretary which denied a reopening of her benefits claim of September 9, 1986. The government moves to dismiss her complaint contending that the court lacks jurisdiction over the subject matter of the suit. For the reasons stated below, the government’s motion to dismiss plaintiff’s complaint is denied. However, the case is remanded to the Secretary with instructions that the Secretary *730 hold a hearing to determine whether Ms. Bobola suffered from a mental incapacity at the time of the hearing on her 1986 claim, which rendered her unable to assert her rights.

Since this case comes to the court on a motion to dismiss, the court will accept all well-pleaded facts in the complaint as being true. Powe v. City of Chicago, 664 F.2d 639, 642 (7th Cir.1981). At first glance, Ms. Bobola looks to have received the full panoply of reviews afforded her under the provisions of the Social Security Act, 42 U.S.C. § 301, et seq. On September 9, 1986, she filed her first claim for disability and supplemental security income benefits. Her claim was denied at that juncture and also upon reconsideration. At her request, an Administrative Law Judge (“AU”) held a hearing to review the decision. The AU denied the claim, without consideration of whether Ms. Bobola suffered from a mental impairment. Ms. Bobola appealed the AU’s determination to the Appeals Council. Once again, Ms. Bobola’s claim was denied.

Ms. Bobola brought a second claim for supplemental security income benefits on August 19, 1988. This second claim was also denied initially and upon reconsideration. At a hearing requested by Ms. Bobo-la, an AU reversed the decision on her second claim, but refused to reopen the first claim. The AU found that he was precluded from reopening the first claim by res judicata and a lack of new and material evidence. On June 6, 1990, the Appeals Council denied Ms. Bobola’s petition to review the decision of the AU and reopen the case of September 9, 1986. Ms. Bobola filed the present lawsuit on August 1, 1990.

While it appears as if Ms. Bobola received a full and fair opportunity to establish her first claim, that conclusion would be premature. In general, a district court may not review the determination of the Secretary denying a reopening of a claimant’s case. The provisions of the Social Security Act only permit judicial review of a “final decision of the Secretary made after a hearing....” § 205(g), 42 U.S.C. § 405(g). Since a decision by the Secretary not to reopen a case can be effectuated without a hearing, a denial of a petition to reopen a case does not fall into the category of cases eligible for judicial review. Giacone v. Schweiker, 656 F.2d 1238, 1243 (7th Cir.1981); Turner v. Bowen, 862 F.2d 708, 709-710 (8th Cir.1988). One of the exceptions to that general rule arises where a claimant alleges a question of constitutional significance that is unsuited to adjudication in administrative law proceedings. “[Ajccess to the courts is essential to the decision of such questions.” Califano v. Sanders, 430 U.S. 99, 109, 97 S.Ct. 980, 986, 51 L.Ed.2d 192 (1977).

Ms. Bobola raises such a claim here. In both her complaint and her response to the government’s motion, Ms. Bobola argues that she lacked a full and fair opportunity in her first AU hearing to establish entitlement to benefits. The basis of her argument is an alleged lack of mental competence at the hearing coupled with a lack of legal representation. The court finds merit in this argument. Although a claimant is not entitled to representation of counsel at a benefits hearing, the equation changes when the claimant suffers from a mental impairment. In that circumstance, the claimant may argue that she has been denied a full and fair hearing because she is unable to assert her rights due to her inability to understand the proceedings and due to her lack of counsel. Courts have concluded that a claimant cannot be bound to “an adverse ruling when [the] individual lacked both the mental competence and legal assistance necessary to contest the initial determination.” Culbertson v. Secretary of Health & Human Services, 859 F.2d 319, 323 (4th Cir.1988); Shrader v. Harris, 631 F.2d 297, 301-302 (4th Cir.1980); Blackburn v. Heckler, 615 F.Supp. 908, 913 n. 5 (N.D.Ill.1985) (refusal to reopen case may be reviewable if claimant was mentally impaired and, therefore, unable to pursue judicial review of an allegedly constitutionally deficient decision). “Instead, [they] require[] that a supplemental hearing be held to determine whether the claimant did, in fact, lack compe *731 tence at the earlier time.” Young v, Bowen, 858 F.2d 951, 954 (4th Cir.1988)

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Bobola v. Sullivan, 753 F. Supp. 729, 1991 U.S. Dist. LEXIS 156, 1991 WL 2091 (N.D. Ill. 1991).

753 F. Supp. 729 (Bobola v. Sullivan) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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