Helen A. Wilson v. Secretary Of Health And Human Services

671 F.2d 673
Court of Appeals for the First Circuit·Decided March 8, 1982·No. 81-1188·Published·Cited by 3 cases

Opinion

671 F.2d 673

Helen A. WILSON, as Representative Payee for Roland D.
Wilson, Social Security # jqe-ra-xwof on behalf
of herself and all others similarly
situated, Plaintiff, Appellant,
v.
SECRETARY OF HEALTH AND HUMAN SERVICES, Defendant, Appellee.

No. 81-1188.

United States Court of Appeals,
First Circuit.

Argued Nov. 4, 1981.
Decided March 8, 1982.

James R. Crotteau, Machias, Me., with whom Hugh Calkins, Portland, Me., was on brief, for plaintiff, appellant.

Robert J. Triba, Asst. Regional Atty., Boston, Mass., with whom Richard S. Cohen, U. S. Atty., and William H. Browder, Jr., Asst. U. S. Atty., Portland, Me., were on brief, for defendant, appellee.

Before COFFIN, Chief Judge, DAVIS,* Judge, and BREYER, Circuit Judge.

BREYER, Circuit Judge.

Appellant, Helen Wilson, filed a district court action attacking the reduction of her social security benefits. She claimed that the regulation authorizing the reduction was outside the agency's statutory powers. The district court dismissed her action (and denied her request for class certification) because she had not properly exhausted her agency remedies (i.e., there was no "final" agency decision to review) and because, in any event, the agency had decided not to reduce her benefits, making this action moot. We affirm the district court's decision.

* Helen Wilson is a recipient of Supplemental Security Income (SSI) benefits under Title XVI of the Social Security Act, 42 U.S.C. § 1381 et seq. Her son Roland also applied for SSI in November 1977. He was granted benefits and a "representative payee" was appointed for him in accordance with the statute, 42 U.S.C. § 1383(a)(2),1 and the appropriate regulation, 20 C.F.R. § 416.601(a). That regulation provides:

When it appears to the Administration that the interests of a recipient of payments under Title XVI of the Act would be served thereby, certification of payment may be made by the Administration, ... to a relative or some other person (including an appropriate public or private agency) selected by the Administration as the 'representative payee' of the recipient.

In April 1978 Roland moved to live with his mother, Helen, and she was substituted as his representative payee. About a year later, Helen received a "Notice of Overpayment," indicating that she was to be held personally liable for an overpayment of $446.01 to Roland because she had failed to report his income from work the previous summer. The Bangor District Office, which sent this notice to Helen, evidently followed the provisions of the Claims Manual in determining liability:

The representative payee is personally liable for repayment to the extent that (i) the incorrect payments were not used for the support and maintenance of the recipient or (ii) the representative payee is at fault in connection with the overpayment.

C.M. § 5595.2(d)(2)(B), based on 20 C.F.R. §§ 416.551-416.553. Helen Wilson was also informed in clear language on this same notice that she could either (1) request that the repayment be waived because she was not at fault and could not afford repayment or (2) request reconsideration of the decision.

On April 27, 1979, Helen wrote to the Social Security Administration requesting that the payments be waived. Sometime before May 7, she sought and received representation from the Pine Tree Legal Assistance Office in Maine.

Subsequently, on May 10, 1979, Helen received a "Notice of Action to Recover Overpayment" reducing the amount sought to $173.47.2 The Notice reported that the Secretary had determined that Helen was at fault in connection with the overpayment and that therefore repayment could not be waived:

We have found that you must be held liable for repayment of the $173.47. You completed a review form for Roland's SSI in 7/78. You did not report that he was working, even though he started work in 6/78. That part of the overpayment was caused by your failure to report that Roland was working and must be repaid.

Helen was also told that, beginning in June, $25 per month would be withheld from her own SSI payments until the total of $173.47 was recovered. In this same notice the agency asked her to contact the office if she disagreed with the rate of recovery. It added she could request reconsideration (the first step in the internal agency review) within 60 days and that if she wanted to have her payments continued pending appeal she must request reconsideration within 10 days.

About one month later, on June 12, Helen requested reconsideration. The agency granted her a "case review."3 On June 18, 1979, the agency sent her a "Notice of Reconsideration" affirming the prior decision. Two days later, she requested a hearing before an Administrative Law Judge (ALJ), the next step in the internal agency review.

Helen's hearing before the ALJ took place on October 16, 1979. Her counsel, for the first time, began to make various due process and statutory claims, attacking the adequacy of the notice and hearing in the procedure for recoupment and also claiming that the statute did not permit recovery of overpayments from a representative payee at all. The ALJ was obviously somewhat surprised by these arguments as up to now all of the District Office decisions had merely considered whether Helen was or was not at fault for the overpayment. He therefore remanded the case to the District Office (Bangor) for consideration of the new questions presented by Helen's counsel.

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