Ila P. BISSON, Plaintiff-Appellant, v. SECRETARY OF HEALTH AND HUMAN SERVICES, Defendant-Appellee

787 F.2d 181, 1986 U.S. App. LEXIS 23605, 13 Soc. Serv. Rev. 205
CourtCourt of Appeals for the Sixth Circuit
DecidedMarch 31, 1986
Docket85-1171
StatusPublished
Cited by9 cases

This text of 787 F.2d 181 (Ila P. BISSON, Plaintiff-Appellant, v. SECRETARY OF HEALTH AND HUMAN SERVICES, Defendant-Appellee) is published on Counsel Stack Legal Research, covering Court of Appeals for the Sixth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Ila P. BISSON, Plaintiff-Appellant, v. SECRETARY OF HEALTH AND HUMAN SERVICES, Defendant-Appellee, 787 F.2d 181, 1986 U.S. App. LEXIS 23605, 13 Soc. Serv. Rev. 205 (6th Cir. 1986).

Opinion

GUY, Circuit Judge.

In this action plaintiff alleges violation of 42 U.S.C. § 405(h) 1 and jurisdiction under 28 U.S.C. § 1361. 2 Plaintiff requests an *182 order compelling the Secretary to process plaintiffs social security application as ordered by the Administrative Law Judge (ALJ). For the reasons stated below, we reverse the order of the district court granting the Secretary’s motion for summary judgment, and remand the case to be dismissed for lack of subject matter jurisdiction.

I.

Plaintiff filed her application for social security disability benefits on July 23,1982. After administrative denials of her application, a hearing was conducted by an ALJ on July 1,1983. Plaintiff’s earnings record showed that she was insured under the requirements of the Social Security Act through June 30, 1977, but not after that time. Testimony regarding plaintiff’s earnings in 1978 through 1982 was taken at the hearing. Based on this testimony, the ALJ found that plaintiff’s insured status extended past June 30, 1977. In his October 11, 1983 decision, the ALJ stated that he was returning the case to the Social Security Administration to have plaintiff’s earnings record corrected and to have a decision rendered regarding plaintiff’s disability based on the medical evidence. Plaintiff received notice of this decision.

In November, 1983, the District Office of the Social Security Administration in Muskegon, Michigan, reviewed the AU’s decision and decided that the AU erred in concluding that plaintiff’s coverage was extended. A memorandum sent to the Secretary’s Office of Hearings and Appeals (Appeals Council) stated, in substance, that the AU was in error, no medical decision was necessary, and that the case should remain “a technical denial.” Plaintiff first learned of this action only after she inquired why there was no further action on her application.

On March 29, 1984, plaintiff filed suit in the district court, alleging that she had exhausted her administrative remedies, and was seeking mandamus relief to enforce the AU’s decision. Plaintiff’s motion for mandamus was filed June 1, 1984.

On July 17, 1984, in response to the urgings of the United States Attorney for the district, the Appeals Council issued a letter to plaintiff which stated, in summary, that it was reopening the October 11, 1983 decision of the AU under the authority of regulations contained in 20 C.F.R. § 404.988(b) and § 404.989(a)(3). 3 Plaintiff was informed that the Appeals Council was “prepared to find” that the AU made “an error on the face of the evidence” and that plaintiff could submit additional evidence and request oral argument within 20 days. The Secretary’s motion for summary judgment was filed two days later, on July 19, 1984.

II.

The Secretary asserted in her summary judgment motion that the district court is without subject matter jurisdiction until plaintiff exhausts her administrative remedies, and that neither federal question nor mandamus jurisdiction is available, as there has been no final decision by the Secretary regarding plaintiff’s claim by virtue of the reopening of her case by the Appeals Council. Plaintiff argued that the case may be reopened only by the claimant, and that the Appeals Council’s failure to review the AU’s decision within 60 days constitutes final action pursuant to 20 C.F.R. § 404.-969. 4

*183 The district court concluded that the primary issue before it was whether the Appeals Council can reopen a decision after its 60-day period to initiate review has expired by utilizing the reopening regulations in § 404.987 et seq. The court found the reasoning of the court in Munsinger v. Schweiker, 709 F.2d 1212 (8th Cir.1983), persuasive, and found the reopening regulation available to the Secretary. The district court granted the Secretary’s motion for summary judgment, finding that, since the case is reopened, plaintiff has an administrative opportunity to pursue her claim. Plaintiff’s complaint was dismissed without prejudice, and the court stated that it assumed that plaintiff would have 20 days from the date of the order to begin pursuing her administrative remedies.

This court finds that the district court improperly considered the merits of the reopening issue, since the court did not have subject matter jurisdiction to consider plaintiff’s claims once her administrative case was reopened.

The recent Supreme Court case of Heckler v. Ringer, 466 U.S. 602, 104 S.Ct. 2013, 80 L.Ed.2d 622 (1984), clearly mandates a finding of lack of jurisdiction in the present case whether under the federal question, mandamus, or social security statutes. In Ringer, four Medicare claimants brought suit raising various challenges to the Secretary’s policy as to the payment of medical benefits known as bilateral carotid body resection (BCBR). The district court dismissed the complaint for lack of jurisdiction, holding that plaintiffs were, in essence, claiming entitlement to benefits for the BCBR procedure, that any challenges to the Secretary’s procedure were “inextricably intertwined” with plaintiffs’ claims for benefits, and that, therefore, the plaintiffs must exhaust their administrative remedies pursuant to 42 U.S.C. § 405(g) before pursuing their action in federal court. 5 The Court of Appeals for the Ninth Circuit reversed, holding that to the extent respondents were seeking to invalidate the Secretary’s procedure for determining entitlement to benefits, those claims were cognizable under the federal question and mandamus statutes without complying with the administrative exhaustion requirements of § 405(g). The Supreme Court reversed the court of appeals, agreeing with the district court that the “procedural” claims were “inextricably intertwined” with the plaintiffs’ claims for benefits.

The particulars of the Ringer plaintiffs’ procedural claims were similar to Bisson’s claims in the present case:

They contend that requiring them to pursue administrative remedies in order to obtain BCBR payment violates their rights to prompt administrative action under 5 U.S.C. § 555(b) and § 706(2)(A). Finally, they argue that the Secretary violated the rulemaking requirements of the APA, 5 U.S.C.

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787 F.2d 181, 1986 U.S. App. LEXIS 23605, 13 Soc. Serv. Rev. 205, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ila-p-bisson-plaintiff-appellant-v-secretary-of-health-and-human-ca6-1986.