Jean D. Byam v. Jo Anne Barnhart, Commissioner, Social Security Administration

336 F.3d 172, 2003 WL 21634994
Court of Appeals for the Second Circuit·Decided July 11, 2003·No. Docket 01-6195·Published·Cited by 537 cases

Opinion

JO.HN M. WALKER, JR., Chief Judge.

Plaintiff-appellant Jean Byam appeals from the judgment of the United States District Court for the District of Vermont (Jerome J. Niedermeier, Magistrate Judge) granting the motion for summary judgment by the defendant-appellee Commissioner of the Social Security Administration (“the Commissioner”) and denying the cross-motion for summary judgment by the plaintiff-appellant Byam. The administrative law judge (“ALJ”) granted Supplemental Security Income (“SSI”) disability benefits dating back to June 1996, but refused to reopen three previous applications filed in 1993, 1994, and 1995 that had been denied and for which no hearing had been requested. The district court ruled that it lacked the jurisdiction to review the decision to deny Byam’s request to reopen her earlier applications for SSI disability benefits, because neither did the ALJ constructively reopen the appellant’s previous applications nor did the ALJ’s decision not to reopen the appellant’s previous applications violate due process.

We conclude that the district court erred in two respects: 1) it misapplied Stieberger v. Apfel, 134 F.3d 37 (2d Cir.1997), by focusing solely on whether Byam could “comprehend” notice of denial of disability benefits, and not whether she could “act upon notice,” id. at 40; and 2) it misconstrued the administrative law judge’s findings of facts in ruling that there was no violation of due process. Accordingly, we vacate the district court’s grant of summary judgment and remand for further proceedings on the question of whether Byam was denied due process in her previous applications for SSI benefits.

I. BACKGROUND

We first briefly describe the administrative scheme for SSI applications, and then turn to Byam’s medical and psychiatric evaluations as they developed over the course of her four applications.

A. Procedures for SSI Applications

The Social Security Act entitles disabled individuals to receive SSI benefits. See 42 U.S.C. § 1381a. The Act defines disability as an “inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.” 42 U.S.C. § 423(d)(1).

A claimant whose application has been denied may request reconsideration within sixty days of receiving the denial. 20 C.F.R. § 416.1409(a). If the claim has been denied on reconsideration, the claimant may request a hearing before an ALJ within sixty days. § 416.1433(b). Following the ALJ’s decision, the claimant may request review by the Appeals Council within sixty days. § 416.1468(a). The Appeals Council renders the agency’s determination final, and it is subject to judicial review within sixty days. § 416.1481. The claimant may request that her application be reopened within twelve months of notice of the initial determination’ for any reason, and within two years of the initial determination for good cause. § 416.1488(a)-(b). An applicant establishes “good cause” by furnishing new and material evidence; demonstrating a clerical error; or offering evidence in the administrative record that “clearly shows on its face that an error was made.” *176 § 416.1489(a). An application can be reopened at any time if the determination was obtained by “fraud or similar fault ... tak[ing] into account any physical, mental, educational, or linguistic limitations [which the applicant] may have had at the time.” § 416.1488(c). When a claimant has failed to request reconsideration, an ALJ hearing, Appeals Council Review, or review by a federal district court, Social Security Ruling 91-5p requires the agency to extend the deadlines for such requests if the claimant had good cause for missing the deadline, such as if “he or she lacked the mental capacity to understand the procedures for requesting review” or had “any mental or physical condition which limit[ed] the claimant’s ability to do things for him/herself.” Social Security Ruling (“SSR”) 91-5p, 1991 WL 208067, at *2 (S.S.A. July 1, 1991); see also Stieberger, 134 F.3d at 38.

B. Byam’s Psychiatric Background and Previous Applications

Byam, who was born in 1950, has been unable to work since June 1, 1969, which she attributes to depression, headaches, and arthritis. According to her psychiatric records, Byam has been hospitalized three times after suicide attempts in 1969, 1974, and 1981.

Byam, unassisted by counsel, first applied for SSI benefits on September 13, 1993. The application included a “Mental Residual Functional Capacity Assessment” (“MRFCA”) and a “Psychiatric Review Technique” by Dr. Gayle Frommelt. The MRFCA form begins by explaining, “Each mental activity is to be evaluated within the context of the individual’s capacity to sustain that activity over a normal workday and workweek, on an on going basis.” Similarly, the Psychiatric Review Technique uses categories established by 20 C.F.R. § 416.925 and 20 C.F.R. § 404, Subpt. P, Appendix 1, which “are so constructed that an individual with an impairments) that meets or is equivalent in severity to the criteria of a listing could not reasonably be expected to do any gainful activity.” 20 C.F.R. § 404, Subpt. P, Appendix 1, 12.00 Mental Disorders, Introduction. Thus, these evaluations focus specifically on employment.

Dr. Frommelt noted that Byam had an affective disorder, which the regulations characterize as “a disturbance of mood, accompanied by a full or partial manic or depressive, syndrome,” and a personality disorder, defined as “typical of the individual’s long-term functioning.” 20. C.F.R. § 404, Subpt. P, Appendix 1, listings 12.04 and 12.08. Dr. Frommelt checked boxes indicating that Byam had “[inflexible and maladaptive personality traits which cause either significant impairment in social or occupational functioning or subjective distress,” including “[p]ersistent disturbances of mood or affect,” “[p]athological dependence [and] aggressivity,” and “[intense and unstable interpersonal relationships and impulsive and damaging behavior.” Dr. Frommelt also checked boxes indicating that Byam was “moderately limited” in her ability to understand, remember, and carry out detailed instructions, her ability to maintain attention and concentration for extended periods, and her ability to set realistic goals or make plans on her own, in addition to other moderate work-related limitations. Dr.

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Jean D. Byam v. Jo Anne Barnhart, Commissioner, Social Security Administration, 336 F.3d 172, 2003 WL 21634994 (2d Cir. 2003).

336 F.3d 172 (Jean D. Byam v. Jo Anne Barnhart, Commissioner, Social Security Administration) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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