Gerstein v. Bowen

680 F. Supp. 1200, 1988 WL 15175
CourtDistrict Court, N.D. Illinois
DecidedFebruary 23, 1988
Docket87 C 4111
StatusPublished
Cited by5 cases

This text of 680 F. Supp. 1200 (Gerstein v. Bowen) is published on Counsel Stack Legal Research, covering District Court, N.D. Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Gerstein v. Bowen, 680 F. Supp. 1200, 1988 WL 15175 (N.D. Ill. 1988).

Opinion

MEMORANDUM OPINION AND ORDER

PLUNKETT, District Judge.

There are two issues raised in this appeal from a final determination of the Secretary of the Department of Health and Human Services: (1) whether the Appeals Council may, pursuant to 20 C.F.R. § 404.988(b), reopen an Administrative Law Judge’s decision in favor of a claimant after the sixty-day period for review has passed; and (2) whether there is substantial evidence to support the Secretary’s determination that the claimant, Louis Gerstein, was not retired at any time until he reached the age of seventy, and thus not eligible for retirement insurance benefits.

Procedural History

Louis Gerstein (“Gerstein”) was born April 28, 1915. On January 28, 1980, just prior to his sixty-fifth birthday, Gerstein applied for retirement insurance benefits. He stated on the form that he was working for a corporation called 53rd St. Mr. G, Inc. (“53rd St.”). Gerstein requested benefits beginning with the earliest possible month provided there would be no permanent reduction in his ongoing monthly benefit. This simple application put in motion what can only by characterized as a procedural nightmare.

On April 28, 1982, the Secretary informed Gerstein he was not entitled to retirement insurance benefits because he was not retired. In a letter addressed to “Louise Gerstein,” the Secretary stated:

You have not satisfactorily proven that your 1982 estimate of the amount of salary you will earn (not receive) in 1982. Because you are in a position to control your reported salary, and appear to maintain control of the corporation you still own, your 1982 estimate has been determined to be $50,000 (one-half the amount reported when you owed [sic] two corporations). This determination will prevent payment of any social security benefits in 1982.

(R. 170).

On September 10, 1982, Gerstein filed a formal request for reconsideration (R. 162). The next day, Gerstein met with a social .security representative named Daily (R. 179-181). Ms. Daily wrote a report in which she believed Gerstein had demonstrated good cause for his failure to request reconsideration within sixty days. Ms. Daily went on to recommend that Ger-stein was in fact retired and should be considered eligible for benefits.

On November 5, 1982, the Secretary rejected Ms. Daily’s recommendation, and informed Gerstein that there was no good cause for reopening the adverse decision issued in April 1982 (R. 168). Nevertheless, sometime in 1982, Gerstein began receiving retirement insurance benefits. 1

On March 28, 1984, the Secretary notified Gerstein that his benefit payments had been stopped effective April 1980 (R. 159-161). The Secretary determined that Ger-stein was not retired because he was receiving remuneration for services in an amount greater than that allowed by law. The Secretary demanded reimbursement of $19,116.80 of “overpayments.”

Gerstein requested a hearing before an Administrative Law Judge (R. 268), and such a hearing was held before Administrative Law Judge William Sheridan (“AU Sheridan”) on April 16, 1985 (R. 49-94). After examining the record and hearing testimony, on June 21, 1985, AU Sheridan concluded that Gerstein was in fact retired and had been since January 1981. AU Sheridan found Gerstein therefore was eligible for retirement benefits beginning in January 1981 (R. 394-398).

On September 5,1985, Burton Blanchard, the Chief of the Reconsideration Review *1202 Section, Great Lakes Region, wrote to the Director of the Office of Appeals Operations requesting that the decision of AU Sheridan be reviewed (R. 402-403). Blanchard disagreed with the AU’s finding that Gerstein should receive benefits for 1981 and 1982. Gerstein’s attorney objected to the review on the ground that the sixty-day period for review set forth in 20 C.F.R. § 404.969 had elapsed (R. 404-05). The Appeals Council apparently agreed that the time for review has passed, and on January 8, 1986, (some 22 months after the March 1984 determination) the Appeals Council decided instead to reopen AU Sheridan’s decision under 20 C.F.R. § 404.988 (R. 430-32). The Appeals Council found that the evidence considered in the AU's decision clearly showed on its face that an error was made. The Appeals Council concluded that Gerstein was working at least through February 1982 (R. 431). The Appeals Council determined that AU Sheridan had not sufficiently addressed whether Gerstein was retired in 1982,1983, and 1984. Therefore, the Council vacated AU Sheridan’s decision and remanded the case to an AU for further proceedings.

A second hearing was held on July 7, 1986, before AU Gilbert Drucker (R. 95-154). AU Drucker considered the evidence before him, including Gerstein’s testimony, and on October 15, 1986, concluded that Gerstein was not retired at any time until he turned seventy on April 28, 1985 (R. 27-42). AU Drucker found Gerstein ineligible for retirement benefits at any time until he reached the age of seventy.

Gerstein requested a review of AU Drucker’s adverse determination (R. 6-12). This request was denied (R. 3-5), thus finalizing the Secretary’s determination. Gerstein appealed to this court, raising two substantial questions of law. We first consider whether the Appeals Council had jurisdiction to reopen Gerstein’s case in January 1986. Then we determine whether there was substantial evidence to support AU Drucker’s finding that Gerstein was not retired.

I. APPEALS COUNCIL’S AUTHORITY TO REOPEN

A. Applicable Regulations

The Secretary’s regulations differentiate between “reviewing” a decision of an AU and “reopening” such a decision. The regulations governing Appeals Council review of a decision are found at 20 C.F.R. §§ 404.969-404.983 (hereafter, unless otherwise stated all regulations cited are found in 20 C.F.R.). The regulations governing reopening of an AU’s determination are found at § 404.987-404.996. The pertinent regulations are reproduced below.

“§ 404.967. Appeals Council Review— general

“If you or any other party is dissatisfied with the hearing decision or with the dismissal of a hearing request, you may request that the Appeals Council review that action. The Appeals Council may deny or dismiss the request for review, or it may grant the request and either issue a decision or remand the case to an administrative law judge. The Appeals Council shall notify the parties at their last known address of the action it takes.

“§ 404.968. How to request Appeals Council review

“(a) Time and place to request Appeals Council review. You may request Appeals Council review by filing a written request. Any documents or other evidence you wish to have considered by the Appeals Council should be submitted with your request for review.

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Bluebook (online)
680 F. Supp. 1200, 1988 WL 15175, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gerstein-v-bowen-ilnd-1988.