Kevin Bubnis v. Kenneth Apfel, Commissioner of Social Security

150 F.3d 177
CourtCourt of Appeals for the Second Circuit
DecidedJuly 16, 1998
Docket1733, Docket 97-6085
StatusPublished
Cited by88 cases

This text of 150 F.3d 177 (Kevin Bubnis v. Kenneth Apfel, Commissioner of Social Security) is published on Counsel Stack Legal Research, covering Court of Appeals for the Second Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Kevin Bubnis v. Kenneth Apfel, Commissioner of Social Security, 150 F.3d 177 (2d Cir. 1998).

Opinion

JACOBS, Circuit Judge:

Plaintiff-appellant Kevin Bubnis is a recipient of federal disability payments who has also received a New York State workers’ compensation lump-sum settlement award. *179 The Social Security Act, 42 U.S.C. § 424a(a), requires in certain circumstances (which exist here) that monthly federal disability payments be offset in part by the amount of a recipient’s state workers’ compensation payments. 42 U.S.C. § 424a(a). When the state benefits are paid in the form of a lump-sum payment to replace periodic payments, the federal benefits must be reduced “in such amounts as the Commissioner of Social Security finds will approximate as nearly as practicable” the reductions had the state benefits been paid on a monthly basis. 42 U.S.C. § 424a(b). The decision of the Workers’ Compensation Board approving Bubnis’s lump-sum settlement award specified a weekly allocation rate for the award. The Commissioner of Social Security determined that that specified rate most closely approximates the reduction that would have been made in the level of federal benefits if state benefits had been paid over time rather than in a lump sum, and therefore ordered Bubnis’s monthly disability payments reduced at that rate. The rate specified in the Workers’ Compensation Board decision is referenced throughout this opinion as the “allocation rate” and the rate at which the Commissioner has offset the monthly federal disability benefit is referenced as the “offset rate.”

Bubnis contests the Commissioner’s determination, arguing principally that because of the nature of lump-sum settlement awards under New York law, the Commissioner was required to pro-rate Bubnis’s lump-sum settlement “on the basis of lifetime expectancy” in order for the monthly federal disability benefits to reflect the offset that would have been made if the workers’ compensation benefits had been paid over time.

The United States District Court for the Eastern District of New York (Spatt, /.), concluded that the Commissioner’s determination of the monthly offset rate was consistent with the Social Security Act, and granted the Commissioner’s motion for judgment on the pleadings. We agree that the Commissioner’s determination was- reasonable and consistent with both the Social Security Act and New York law, and therefore affirm.

BACKGROUND

On October 16, 1987, Bubnis injured his back on the job. Soon thereafter, he was awarded New York State workers’ compensation benefits, which were adjusted in June 1989 to $150 a week. In February 1990, Bubnis received a lump-sum settlement award of $39,000, less $4,000 in counsel fees. The Workers’ Compensation Board decision approving the award (i) found that this settlement, “agreed to by the claimant, employer and insurance earner,” was “fair and in the best interest of the claimant,” (ii) classified Bubnis as having a “permanent partial disability,” (iii) provided that “[t]he Lump Sum Award is allocated at $150.00 reduced earnings rate,” and (iv) closed the case. Bubnis suffered a second injury on October 28, 1990, for which he received a workers’ compensation award of $40 a week.

Bubnis was approved for federal disability insurance benefits on November 21, 1991, retroactive to June 1989. Under 42 U.S.C. § 424a(a), the monthly federal disability benefits must be reduced by the amount of monthly state workers’ compensation payments to the extent that the combined payments exceed either: 80% of the recipient’s “average current earnings,” as defined by the Act (essentially, predisability earnings), or the total of the recipient’s disability and family Social Security benefits. Section 424a(b) provides, inter alia, that if a federal disability benefits recipient also receives a state workers’ compensation lump-sum award as a substitute for periodic workers’ compensation payments, the monthly disability payments should be reduced at a rate that the Commissioner finds most closely approximates the reduction that would be prescribed if monthly workers’ compensation payments had been made. The relevant text of subsections (a) and (b) is set forth in the margin. 1

*180 In computing the monthly offset rate for Bubnis’s workers’ compensation lump-sum settlement award; the Commissioner followed the guidelines set forth in the Program Operations Manual System (“POMS”) at § DI 52001.555, which lists in descending order of priority three ways to compute the monthly offset rate when the workers’ compensation benefits are awarded in a lump sum as a substitute for periodic payments:

a. The rate specified in the [lump sum] award. If the [lump sum] award specifies a rate based on life expectancy, use that rate to prorate the [lump sum]....
b. The periodic rate paid prior to the [lump sum] if no rate is specified in the [lump sum] award.
e. If [workers’ compensation], the State’s [workers’ compensation] maximum in effect on the date of injury. This figure can be used if no rate is specified in the award and there was no preced- ■ ing periodic benefit.

Because the Workers’ Compensation Board decision approving Bubnis’s lump-sum award specified an allocation rate of $150 per week, the Commissioner determined (pursuant to the first POMS guideline) that the appropriate monthly offset rate following Bubnis’s October 1990 injury was approximately $750 — i.e., $134.50 a week, reflecting the lump-sum settlement, less the portion attributable to attorneys’ fees, plus $40 a week for the payments on the second workers’ compensation claim. (Prior to this second injury, the same monthly offset rate for the lump-sum award applied, totalling approximately $580 a month.) 2

On appeal, this decision was affirmed by the Administrative Law Judge (“ALJ”) and the Appeals Council. Bubnis then sued pursuant to 42 U.S.C. § 405(g), seeking review of a final administrative determination of the Commissioner. The district court concluded that the Commissioner’s determination was consistent with the, Social Security Act, and therefore granted the Commissioner’s motion for judgment on the pleadings.

*181 DISCUSSION

Section 424a(b) provides that the Commissioner must reduce monthly federal disability benefits to reflect a workers’ compensation lump-sum award only if the lump-sum award constitutes “a commutation of, or a substitute for, periodic payments.” 42 U.S.C. § 424a(b). Bubnis concedes that his New York State workers’ compensation lump-sum settlement award was a substitute for periodic payments and therefore that at least some reduction in federal monthly disability benefits was required.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Cite This Page — Counsel Stack

Bluebook (online)
150 F.3d 177, Counsel Stack Legal Research, https://law.counselstack.com/opinion/kevin-bubnis-v-kenneth-apfel-commissioner-of-social-security-ca2-1998.