Doherty v. Heckler

588 F. Supp. 115, 1984 U.S. Dist. LEXIS 24834
CourtDistrict Court, E.D. New York
DecidedJuly 25, 1984
DocketCV83-1834
StatusPublished
Cited by1 cases

This text of 588 F. Supp. 115 (Doherty v. Heckler) is published on Counsel Stack Legal Research, covering District Court, E.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Doherty v. Heckler, 588 F. Supp. 115, 1984 U.S. Dist. LEXIS 24834 (E.D.N.Y. 1984).

Opinion

MEMORANDUM AND ORDER

WEXLER, District Judge.

This is an action brought pursuant to Section 205(g) of the Social Security Act, as amended, 42 U.S.C. Section 405(g), (Act) to review a final determination of the Secretary of Health and Human Services (Secretary) denying plaintiff’s request to waive recovery of an overpayment of $5,264.85 in Supplemental Social Security Income (SSI) benefits. Plaintiff and defendant cross-move for judgment on the pleadings pursuant to Rule 12(c), Fed.R.Civ.P.

I.

Plaintiff, Elizabeth Doherty, currently a sixty-seven year old widow, applied for SSI and widow’s benefits on March 6, 1974. She began receiving SSI benefits in October 1974 and widow’s benefits in January 1975. From these dates through February 1976, Mrs. Doherty received, at various times, duplicate checks and incorrect retroactive drafts. All checks were made out in her name, however, many were issued using similar looking but incorrect, social security numbers. Generally, the numbers were off by a digit.

In late 1975, plaintiff’s daughter Lorraine contacted the Social Security Administration (SSA) to inquire about these checks. According to her affidavit, Lorraine was advised by an unidentified source that “they would take care of it.” In January 1976, Elizabeth Doherty visited the SSA offices to fill out a routine questionnaire about her benefits. No mention was made of these checks. In April 1976 plaintiff was told by the SSA that she had been overpayed in the amount of $5,448.30. This figure was later adjusted to $5,264.85, the amount now in question. At this point, plaintiff began proceedings to have repayment waived. She contacted the Legal Aid Society and was briefly represented by Joan Beranbaum of that office.

After an initial review of the case, on February 28, 1977, an Administrative Law Judge (AU) remanded it for administrative reconsideration, clarification or dismissal. On May 26, 1977, the Appeals Council vacated that decision and remanded the ease for a new hearing. No new action appears to have been taken until March 8, 1982, when Mrs. Doherty appointed Michael Gel- *117 fan, a paralegal assistant at the Legal Aid Society of New York, to handle her case. Several hearings were then scheduled and postponed because Mrs. Doherty was adjudged by doctors to be too ill to attend. On July 15, 1982, Mr. Gelfan was alerted by HHS staff attorney Arthur Klein that AU Spielman wished to resolve this matter by August 1982 and suggested that Mr. Gelfan forward all papers to AU Spielman. Accordingly, Mr. Gelfan obtained affidavits, albeit brief and unhelpful ones, from plaintiff, her daughter Lorraine and Mrs. Beranbaum. On September 17, 1982, Mr. Gelfan waived the right to have Mrs. Doherty appear at any further hearing and requested that the AU base his decision solely on the record, including the papers submitted by Mr. Gelfan (Tr. 102). On November 16, 1982, the AU determined that plaintiff was “not without fault”, the applicable standard in overpayment actions and so denied waiver of repayment.

If substantial evidence exists on the record in support of the AU’s conclusion that plaintiff was, indeed, “not without fault”, this Court must affirm the Secretary’s decision. However, because of the total inadequacy of the record before us, the reliance on certain unsupported assumptions and conclusions made by the AU, and the failure of the AU to take into account plaintiff’s mental and physical condition in determining plaintiff to be “not without fault”, the Court remands this matter for further evidentiary proceedings.

II.

The Secretary’s decision that plaintiff is “not without fault” is conclusive if supported by substantial evidence on the record. Substantial evidence has been defined as “more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Richardson v. Perales, 402 U.S. 389, 401, 91 S.Ct. 1420, 1427, 28 L.Ed.2d 842 (1971).

In order for overpayment to be waived, the individual must be deemed “without fault,” as defined by 20 C.F.R. Sections 416.552, 416.553. Only actions by the individual are considered, any action by the SSA in causing the overpayment is irrelevant. In addition, all the individuals need not be judged equally; the SSA or the 'AU can consider the individual’s comprehension of the reporting requirements, and her ability to comply with these requirements. After all circumstances of the particular case are considered, an individual is without fault only when none of the following are true:

1. the individual fails to furnish information regarding such overpayment which she knew or should have known was material.

2. the individual makes an incorrect statement regarding such overpayment which she knew or should have known was incorrect.

3. the individual does not return a payment which she knew or could have been expected to know was incorrect.

20 C.F.R. Sections 416.552, 416.553.

Secondly, it must be shown that recovery would defeat the purposes of the Act, is against equity or good conscience or would impede efficient administration of the Act. 42 U.S.C. Section 1383(b). It is conceded by both sides that plaintiff’s case meets this second criterion. Accordingly, our examination is limited to whether there is substantial evidence to support the AU’s determination that plaintiff is “not without fault.”

III.

The ordered hearing was never held in this case. Indeed, the majority of the problems encountered by this Court in attempting to review the Secretary’s determination on appeal stem from the lack of hearing and the testimony and evidence it would have produced. As stated earlier, Mrs. Doherty was represented by Michael Gelfan, a non-attorney. Such representation is allowed, but is not comparable to representation by legal counsel. While it is analogous to plaintiff appearing pro se, it is perhaps a less effective means of *118 presenting and protecting plaintiffs case. The AU must do everything in his power to develop a complete record and inform the pro se plaintiff of her rights in order to assure that plaintiff receives full and fair treatment. Cutler v. Weinberger, 516 F.2d 1282, 1286 (2d Cir.1980). Yet, a cursory look at the record shows its inadequacy. If it were the product of representation by an attorney, the Court would be disposed to accept it as is. However, claimant’s representation by a paralegal representative leaves the Court uneasy, especially where the paralegal waived plaintiff’s right to a hearing.

The right to a hearing, to present evidence and testimony and cross-examine witnesses, is an important right that should not be lightly waived. It allows for full development of the facts and a basis for the AU to assess credibility.

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Bluebook (online)
588 F. Supp. 115, 1984 U.S. Dist. LEXIS 24834, Counsel Stack Legal Research, https://law.counselstack.com/opinion/doherty-v-heckler-nyed-1984.