Ermano VALENTE, Plaintiff-Appellant, v. Louis SULLIVAN, M.D., Secretary of Health and Human Services, Defendant-Appellee

897 F.2d 54, 1990 U.S. App. LEXIS 2632
CourtCourt of Appeals for the Second Circuit
DecidedFebruary 21, 1990
Docket626, Docket 89-6124
StatusPublished
Cited by7 cases

This text of 897 F.2d 54 (Ermano VALENTE, Plaintiff-Appellant, v. Louis SULLIVAN, M.D., Secretary of Health and Human Services, Defendant-Appellee) is published on Counsel Stack Legal Research, covering Court of Appeals for the Second Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Ermano VALENTE, Plaintiff-Appellant, v. Louis SULLIVAN, M.D., Secretary of Health and Human Services, Defendant-Appellee, 897 F.2d 54, 1990 U.S. App. LEXIS 2632 (2d Cir. 1990).

Opinion

FEINBERG, Circuit Judge:

This case arising under the Social Security Act (the Act), comes to us for the second time. In our prior opinion, Valente v. Secretary of Health and Human Services, 733 F.2d 1037 (2d Cir.1984) (Valente I), we directed further administrative proceedings. Ermano Valente now appeals from a judgment of the United States District Court for the Eastern District of New York, I. Leo Glasser, J., entered after such further proceedings, in favor of appellee Louis Sullivan, M.D., Secretary of Health and Human Services (the Secretary). The district court held that there was substantial evidence to support the determination of the Secretary that Valente was not entitled to a waiver of an overpayment of $19,859.60 in disability benefits, and that the Secretary properly refused to determine whether Valente was entitled to benefits during any portion of the overpayment period. For reasons set forth below, we conclude that our mandate in Valente I was not completely followed, and we reverse in part and affirm in part.

Background

We refer the reader to Valente I for a fuller discussion of the background and prior proceedings in this case. See Valente I, 733 F.2d at 1038-41. Briefly, Valente became disabled in 1975 with a serious heart condition and thereafter began receiving disability benefits. Valente has worked only intermittently since then: For example, he was employed from February 1976 to June or July 1977, when he again became disabled; he was out of work between June or July 1977 and October 1978; and he returned to work in October 1978. Throughout this period, however, the Social Security Administration (SSA) continued to send Valente disability benefits.

In 1980, the SSA determined that Va-lente’s disability had actually ended in October 1976, and that, as a result, Valente had received benefits to which he was not *56 entitled during the 35-month period from February 1977 to January 1980. This alleged overpayment amounted to $19,859.60.

Although there is evidence in the record that a good portion of this delay in discovery of the overpayment was due to error on the part of the SSA, see, e.g., Va-lente I, 733 F.2d at 1039, the Secretary for a number of years refused to waive any part of this overpayment. The Secretary has maintained until recently that Valente was not entitled to a waiver of any overpayment under the Act, because he was not “without fault” in causing the overpayment, and because requiring Valente to repay would not be against equity or good conscience and would not defeat the purposes of the Act. See 42 U.S.C. § 404(b); 20 C.F.R. § 404.506.

In Valente I, we reversed the district court’s prior judgment that Valente was entitled to waiver of recovery of the over-payments, and we remanded for further administrative proceedings. See Valente I, 733 F.2d at 1038. We held that the district court had improperly resolved credibility issues, on which the Secretary should make further findings, and had used an improper legal standard in awarding judgment to Valente. However, we did not direct judgment for the Secretary; we concluded that even applying the proper statutory standard, the Secretary’s ruling against Va-lente could not be sustained on the record then before us.

We reached this conclusion for three reasons. First, the Administrative Law Judge (ALJ) “did not consider Valente’s physical condition and made no effort to determine whether Valente was entitled to benefits for some of the 35 months in question,” id. at 1046, for example, the period June 1977 through October 1978, when Valente was not working and was, in fact, hospitalized for some time. See id. at 1043. Second, the AU “did not consider a pertinent regulation of the Secretary that may exonerate Valente from fault for the entire 35-month period,” id. at 1046, i.e., 20 C.F.R. § 404.510a, which provides that a person is without fault with respect to an overpayment if that person “accepts such overpayment because of reliance on erroneous information from an official source within” the SSA. Third, the AU “made no finding as to Mrs. Valente’s credibility, which was a factor critical to any determination of fault.” Valente I, 733 F.2d at 1046. We thus remanded to the Secretary with directions to the AU to “consider all of these matters” and to “develop[ ] the record fully.” Id.

On remand, however, the AU did not follow our instructions completely. He did pass on the credibility of Mrs. Valente, rejecting as “inconceivable” Mrs. Valente’s account that she had received wrong information from employees of the SSA. Nevertheless, he refused to determine Va-lente’s physical condition from June 1977 to October 1978 and whether Valente was entitled to benefits for this period, on the ground that Valente had failed to file an application for disability benefits for this period and was therefore barred from receiving them. The AU thus concluded that Valente was required to repay the entire 35-month overpayment.

The Appeals Council adopted the AU’s decision, which became the final decision of the Secretary. Thereafter, Valente filed this renewed action in the district court to reverse the decision of the Secretary not to waive recovery. While review was pending in the district court, Valente and the Secretary entered into a stipulation, under which the Secretary agreed to waive recovery of overpayment for the period February 1977 through September 1978; however, the Secretary would continue to seek recovery of benefits for the period October 1978 through December 1979.

In its decision, the district court took notice of the stipulation, which narrowed the issue before it to the overpayments from October 1978 through December 1979, amounting to $9,165.20. The court held that there was substantial evidence to support the determination of the AU that Valente was not entitled to a waiver of an overpayment for these remaining months. The court also rejected Valente’s claim that the AU had ignored our direction to consider whether Valente was entitled to benefits during the period June 1977 to October 1978, ruling that the AU properly found *57 that Valente’s failure to file an application for disability benefits for this period barred him from receiving those benefits.

Discussion

On this second appeal to this court, it appears to us that the AU (and therefore the Secretary) has not followed a significant portion of our prior mandate, which goes to the heart of this appeal. As indicated above, the very first issue we directed the AU to consider was Valente’s “physical condition” during the period for which he allegedly received overpayments. The most important portion of this period clearly was from June 1977 to October 1978, when Valente claims to have been disabled.

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Bluebook (online)
897 F.2d 54, 1990 U.S. App. LEXIS 2632, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ermano-valente-plaintiff-appellant-v-louis-sullivan-md-secretary-of-ca2-1990.