Everhart v. Bowen

694 F. Supp. 1518, 1988 U.S. Dist. LEXIS 10104
CourtDistrict Court, D. Colorado
DecidedAugust 23, 1988
DocketCiv. A. 85-Z-2590
StatusPublished
Cited by5 cases

This text of 694 F. Supp. 1518 (Everhart v. Bowen) is published on Counsel Stack Legal Research, covering District Court, D. Colorado primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Everhart v. Bowen, 694 F. Supp. 1518, 1988 U.S. Dist. LEXIS 10104 (D. Colo. 1988).

Opinion

MEMORANDUM OPINION AND ORDER

WEINSHIENK, District Judge.

These matters are before the Court on the Social Security appeals of plaintiffs/intervenors Berline Wise and Emil S. Zwiezen. Each appeal raises separate questions involving the interpretation of certain Social Security regulations. Plaintiff/intervenor Zwiezen’s appeal involves the interpretation of 20 C.F.R. §§ 404.969 and 404.-970. Plaintiff/intervenor Wise’s appeal requires a broader review and harmonization of 20 C.F.R. §§ 404.969 and 404.987-404.-989. The issues of regulatory interpretation presented in each appeal have engendered considerable discussion and disagreement among the Circuits. Unfortunately, there appears to be no Tenth Circuit case law on either issue, and the issues are such that the Court cannot harmonize the conflicting decisions of the various Circuits. Accordingly, the Court will address the issues presented in each appeal separately, beginning with plaintiff/intervenor Zwiezen. The conclusions incorporate the Court’s analysis of the conflicting case law, the purpose of the Social Security Act, and constitutional due process considerations.

FACTUAL BACKGROUND TO PLAINTIFF/INTERVENOR ZWIEZEN’S APPEAL

Plaintiff/intervenor Zwiezen (hereinafter claimant) is a 75 year old retiree receiving Social Security retirement benefits. He originally applied for benefits in 1977. After being awarded benefits, he later returned to work and reported at least a substantial portion of his earnings in accordance with the applicable Social Security regulations. However, claimant apparently underestimated his expected earnings and received an overpayment notice on April 19, 1984. The total amount of the overpayment was approximately $9,483.87; however, the notice itself stated that the net overpayment was $5107. The reason that the notice stated the lesser amount was because the Secretary applied the so-called “netting” policy pursuant to 20 C.F. R. § 416.538 and Social Security Ruling 81-19a and began underpaying the amount of claimant’s benefits to offset the overpayment. 1 The application of this “net *1520 ting” policy reduced the overpayment amount to $5107.

Claimant then requested a hearing to determine whether he in fact had been overpaid, the amount of the overpayment, if any, the amount of any underpayment, and whether recovery of the overpayment should be waived pursuant to 20 C.F.R. §§ 404.506 and 404.508. Eventually, an Administrative Law Judge (AU) concluded that claimant was without fault in causing the $5,107 overpayment and that recovery of the $5,107 overpayment would defeat the purposes of Title II of the Social Security Act. Record at 13. Accordingly, on May 6, 1985, the AU waived recovery of the $5,107 overpayment.

Claimant attained only a partial victory from this AU ruling in that the gross overpayment amount was $9,483.87 but the AU waived only the net overpayment amount of $5,107. Consequently, on May 30,1985, claimant filed a timely request for review pursuant to 20 C.F.R. §§ 404.967-404.968, which provides that a claimant may request Appeals Council review of an AU decision within 60 days of the date claimant receives notice of its issuance. The narrow issue claimant presented for review was whether he was entitled to a refund of the $4,376.87 which the Secretary had “netted” out earlier.

The Appeals Council took no action relative to claimant’s case for approximately the next 16 months. Then, on September 24, 1986, claimant was notified by the Appeals Council that his request for review had been granted but that the Appeals Council was reviewing the entire AU decision. Record at 5.

Claimant argued that the Appeals Council’s proposal to review the entire ruling violated 20 C.F.R. § 404.969, which permits Appeals Council review of any portion of an AU decision within 60 days of the issuance of said decision. Despite the fact that approximately 16 months had elapsed since the AU decision, the Appeals Council undertook de novo review of the entire AU decision pursuant to 20 C.F.R. § 404.970(a), which imposes no time limitations according to the Secretary. Consequently, on December 19,1986, the Appeals Council ruled that the application of the “netting” policy was proper and that claimant was at fault in causing his $9483.87 overpayment. Thus, the Appeals Council not only refused to award claimant his alleged $4,376.87 underpayment, but, in addition, overturned the AU and ruled that claimant was liable for the $5,107 overpayment.

LEGAL ANALYSIS

The validity of the “netting” policy was the subject of a separate appeal which was recently decided by the 10th Circuit. 2 The question presented in this appeal is whether the Appeals Council possessed jurisdiction to review the entire AU decision when it failed to comply with the 60 day notice provision of 20 C.F.R. § 404.969. Stated differently, when a Social Security claimant makes a timely application for review of a limited issue, does the Appeals Council remain obligated to provide notice within 60 days of the AU decision of its intention to undertake broader or full review, or can the Appeals Council review, sua sponte, questions clearly beyond those framed by the claimant?

This question has generated a split of authority among the three Circuits which have considered it. For the reasons stated below, the Court finds that when a claimant files a timely request for review of a limited issue, the Appeals Council’s obligation under 20 C.F.R. § 404.969 to provide notice within 60 days of the AU ruling of its intention to undertake broader review is NOT abrogated. If the Appeals Council does not provide the requisite notice, it cannot review issues not raised by claimant. Consequently, the Appeals Council in the case at bar lacked jurisdiction to conduct a full review of the AU decision. In so ruling, the Court aligns itself with the *1521 majority view expressed by the Third and Eleventh Circuits in the well-reasoned opinions of Powell v. Heckler, 789 F.2d 176

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Related

Ciccone v. Apfel
38 F. Supp. 2d 224 (E.D. New York, 1999)
Sullivan v. Everhart
494 U.S. 83 (Supreme Court, 1990)
Mines v. Bowen
715 F. Supp. 293 (C.D. California, 1989)
Gutierrez v. Bowen
702 F. Supp. 1050 (S.D. New York, 1989)

Cite This Page — Counsel Stack

Bluebook (online)
694 F. Supp. 1518, 1988 U.S. Dist. LEXIS 10104, Counsel Stack Legal Research, https://law.counselstack.com/opinion/everhart-v-bowen-cod-1988.