Joseph D. BUTTERWORTH, Plaintiff-Appellee, v. Otis R. BOWEN, Secretary of Health and Human Services, Defendant-Appellant

796 F.2d 1379, 1986 U.S. App. LEXIS 28129, 14 Soc. Serv. Rev. 290
CourtCourt of Appeals for the Eleventh Circuit
DecidedAugust 14, 1986
Docket85-8769
StatusPublished
Cited by23 cases

This text of 796 F.2d 1379 (Joseph D. BUTTERWORTH, Plaintiff-Appellee, v. Otis R. BOWEN, Secretary of Health and Human Services, Defendant-Appellant) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eleventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Joseph D. BUTTERWORTH, Plaintiff-Appellee, v. Otis R. BOWEN, Secretary of Health and Human Services, Defendant-Appellant, 796 F.2d 1379, 1986 U.S. App. LEXIS 28129, 14 Soc. Serv. Rev. 290 (11th Cir. 1986).

Opinion

*1380 CORRECTED OPINION

KRAVITCH, Circuit Judge:

This appeal, brought by the Secretary of Health and Human Services from the district court’s reversal of the Appeals Council’s decision, involves an interpretation of Social Security Administration regulations. The Appeals Council, relying on 20 C.F.R. §§ 404.987 and 404.988(a) had sua sponte reopened and revised the administrative law judge’s (ALJ) decision that claimant Joseph Butterworth was disabled. The district court held that the Appeals Council’s reopening of the ALJ decision violated the Secretary’s regulations because it occurred more than sixty days after the date of the ALJ hearing decision which is the time limit set by 20 C.F.R. § 404.969 for the Appeals Council’s own motion review of ALJ decisions. The court further held that the provisions in 20 C.F.R. §§ 404.987 and 404.988 authorizing reopening within one year of an initial determination for any reason are not to the contrary because those provisions set forth the claimants’ rights to seek reopening and revision, and do not authorize the Secretary to initiate reopening. The question presented on appeal is whether 20 C.F.R. § 404.988(a) authorizes the Appeals Council to reopen an ALJ’s decision on its own initiative after expiration of the sixty-day time limit for its own motion review. We find the Secretary’s interpretation of the regulations reasonable insofar as he contends that both the Secretary and a claimant can invoke the authority of sections 404.987 and 404.988 to reopen decisions under proper circumstances. We therefore reverse the district court’s holding that only claimants may avail themselves of the authority of section 404.988. We cannot, however, uphold the interpretation of the regulation urged by the Secretary insofar as it approves of the Appeals Council’s reopening of a case which is not properly before it. For the reasons set forth below, we find this aspect of the Secretary’s interpretation unreasonable and plainly inconsistent with the overall regulatory scheme. We conclude that the Appeals Council did not have jurisdiction to reopen this case, and we therefore affirm the district court’s judgment remanding the case for the reinstatement of disability benefits.

I. PROCEDURAL BACKGROUND

Butterworth filed his application for a period of disability arising out of emphysema, and for disability insurance benefits under 42 U.S.C. §§ 416(i) and 423 on May 20, 1983. On June 27, 1983, the Social Security Administration (SSA) issued its initial determination and denied the claim. On July 7, it issued a reconsideration determination affirming the initial determination. Butterworth requested a hearing before an AU which took place September 7, 1983. On September 28, the ALJ issued a decision based on his de novo review of the record and the evidence presented at the hearing, including Butterworth’s testimony. The ALJ found that Butterworth was entitled to a period of disability commencing May 11, 1983 because he could no longer perform his past relevant work and was limited to sedentary work. The AU found that Butterworth was fifty-eight years old at that time, had a fourth grade education, and had a work history as a drawing frame operator in a textile mill. Application of the guidelines to these factors yielded a finding of disabled. Citing Rule 201.01 of the medical-vocational guidelines, the ALJ concluded that when all relevant factors were taken into account Butterworth was disabled within the meaning of the Act.

In the notice of the AU decision, Butter-worth was advised that, under section 404.-969, the Appeals Council could, on its own motion within sixty days from the date of the AU decision (September 28, 1983), undertake a review of that decision which possibly could change it. 1 The notice of *1381 the AU decision further advised him that after the sixty day period the Appeals Council generally could only reopen and revise the decision under section 404.988 on the basis of new and material evidence, or if a clerical error had been made as to the amount of the benefits, or if there was an error on the face of the evidence on which the decision was based. 2

*1382 Six months later, on March 1, 1984, the Appeals Council sent Butterworth a letter stating that it was reopening the ALJ’s September 28th decision pursuant to section 404.988(e) [sic]. 3 The letter explained that under this section a determination may be reopened for any reason within one year of the date of the initial determination (i.e. June 27, 1983). The Appeals Council then summarized certain aspects of the record and stated that it was “prepared to find that you [Butterworth] have a severe impairment which does not meet or equal the severity of any impairment found in Appendix 1, Subpart P [of the regulations].” It added that although Butterworth’s impairment precluded him from doing his past relevant work, “the Appeals Council has concluded that you are ‘not disabled’ ” under Rule 203.11 of the medical-vocational guidelines. The letter also informed Butterworth that he or his representative could submit additional evidence or a further written statement within twenty days from the date of the letter or could inform the Council within that period when additional material could be expected. It noted that it would only consider additional evidence pertaining to Butterworth’s condition as of the date of the ALJ’s decision. It informed Butterworth that within twenty days of the date of the letter he or his representative could request, and provide the reasons for requesting, an appearance to present oral argument to the Appeals Council. It explained that the request would be granted if the Council determined that there was a significant question of law or policy presented, or that oral argument would be beneficial in rendering a proper decision. In closing, the Appeals Council stated that if Butterworth or his representative did not contact the Appeals Council within twenty days, the Council would assume he did not want to submit anything further and would then issue its decision.

The Appeals Council did not receive a response from Butterworth to this March 1st letter. On June 29, 1984, it issued a decision reversing the ALJ decision.

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Bluebook (online)
796 F.2d 1379, 1986 U.S. App. LEXIS 28129, 14 Soc. Serv. Rev. 290, Counsel Stack Legal Research, https://law.counselstack.com/opinion/joseph-d-butterworth-plaintiff-appellee-v-otis-r-bowen-secretary-of-ca11-1986.