Kevin K. v. Frank Bisignano, Commissioner of Social Security

CourtDistrict Court, W.D. Virginia
DecidedApril 1, 2026
Docket5:25-cv-00067
StatusUnknown

This text of Kevin K. v. Frank Bisignano, Commissioner of Social Security (Kevin K. v. Frank Bisignano, Commissioner of Social Security) is published on Counsel Stack Legal Research, covering District Court, W.D. Virginia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Kevin K. v. Frank Bisignano, Commissioner of Social Security, (W.D. Va. 2026).

Opinion

IN THE UNITED STATES DISTRICT COURT AT HARRI F S I O LE N D B URG, VA FOR THE WESTERN DISTRICT OF VIRGINIA 04/01 /2026

Harrisonburg Division LAURA A. AUSTIN, CLERK BY: /s/ Amy Fansler KEVIN K., ) DEPUTY CLERK Plaintiff, ) Civil Action No. 5:25-cv-00067 ) v. ) REPORT & RECOMMENDATION ) FRANK BISIGNANO, ) By: Joel C. Hoppe Commissioner of Social Security, ) United States Magistrate Judge Defendant. )

In July 2025, Plaintiff Kevin K. filed a pro se complaint asking this Court to review the Commissioner of Social Security’s “final decision” denying his claim for disability insurance benefits (“DIB”) under Title II of the Social Security Act, 42 U.S.C. §§ 401–434. See Compl. 1, ECF No. 1. On October 30, the Commissioner filed a Motion to Dismiss under Rule 12(b)(6) or, alternatively, for Summary Judgment under Rules 12(d) and 56(a), ECF No. 13, and a supporting declaration with exhibits, ECF No. 13-2. The Commissioner argues that Kevin’s DIB claim is still before the Appeals Council and, as such, “there is no ‘final decision’ as required to obtain judicial review.” Def.’s Br. 1 (quoting 42 U.S.C. § 405(g)), ECF No. 13-1. On November 17, 2025, Kevin filed a “Motion to Stay Proceedings,”1 ECF No. 15, with photocopies of screenshots “from the SSA online portal” allegedly showing information about his DIB claim, see ECF Nos. 15-1 to 15-5. One screenshot indicates that SSA “made a decision to deny [Kevin’s] appeal on May 12, 2025.” Pl.’s Mot. Ex. B, ECF No. 15-3. This information appears to conflict with the Commissioner’s evidence that Kevin “requested review” of the ALJ’s unfavorable decision “[o]n May 27, 2025,” and that this request is “pending with the

1 I denied Kevin’s motion to stay, ECF No. 15, by separate order. Because Kevin is pro se, however, I will also construe this filing as Kevin’s timely filed “responsive brief and supporting documents” addressing the Commissioner’s dispositive motion, W.D. Va. Civ. R. 11(c)(1). See also W.D. Va. Roseboro Notice, ECF No. 14 (Oct. 30, 2025). Appeals Council” as of October 30, 2025. ECF No. 13-2. Kevin argues that his “appeal was properly filed, accepted, and placed under review” by the Appeals Council and that the Commissioner should “clarify the status of Appeals Council review.” Pl.’s Mot. 1. The Commissioner did not file a reply brief within the time allowed. See W.D. Va. Civ. R. 11(c).

I. Legal Framework The Social Security Act creates the exclusive path for a claimant to seek judicial review of the Commissioner’s “final decision” denying a claim for disability benefits. Smith v. Berryhill, 587 U.S. 471, 475 (2019) (citing 42 U.S.C. §§ 405(g)–(h)). Under § 405(g), [a]ny individual, after any final decision of the Commissioner of Social Security made after a hearing to which he was a party . . . may obtain a review of such decision by a civil action commenced within sixty days after the mailing to him of notice of such decision or within such further time as the Commissioner of Social Security may allow. 42 U.S.C. § 405(g) (emphasis added). This section “contains two separate elements: first, a ‘jurisdictional’ requirement that claims be presented to the agency, and second, a ‘waivable . . . requirement that the administrative remedies prescribed by the [Commissioner] be exhausted.’” Smith, 587 U.S. at 478 (quoting Mathews v. Eldridge, 424 U.S. 318, 328 (1976)). Kevin’s case “involves the latter, nonjurisdictional element of administrative exhaustion,” id. See Def.’s Br. 1 n.1 (citing L.N.P. v. Kijakazi, 64 F.4th 577, 581 (4th Cir. 2023) (explaining that a failure to exhaust under § 405(g) “is not [a] jurisdictional” bar to suit, but exhaustion is “nonetheless . . . a mandatory requirement of the Social Security Act that may be excused only in a narrow set of circumstances”)). “Modern-day claimants must generally proceed through a four-step process before they can obtain review from a federal court.” Smith, 587 U.S. at 475–76; see 20 C.F.R. § 404.900(a). “First, the claimant must seek an initial determination as to his eligibility.” Smith, 587 U.S. at 476. “Second, the claimant must seek reconsideration of the initial determination.” Id.; see 20 C.F.R. § 404.907. Third, the claimant must request and attend a hearing conducted by an Administrative Law Judge (“ALJ”). See Smith, 587 U.S. at 476; 20 C.F.R. § 404.929. The ALJ then issues a written decision explaining why the claimant is not entitled to disability benefits. See 20 C.F.R. § 404.953. Fourth, the claimant “must seek review of the ALJ’s decision by the

Appeals Council,” Smith, 587 U.S. at 476, which will “deny,” “dismiss,” or “grant the request” for review, 20 C.F.R. § 404.967.2 The Appeals Council’s decision to “deny” such request means that the ALJ’s hearing-level decision is “the final decision” of the Commissioner of Social Security. Meyer v. Astrue, 662 F.3d 700, 702 (4th Cir. 2011); see 20 C.F.R. § 404.981. “If a claimant has proceeded through all four steps on the merits, all agree, § 405(g) entitles him to judicial review in federal district court.” Smith, 587 U.S. at 476. This “statutory sequence is mandatory.” L.N.P., 64 F.4th at 584. While the Commissioner may “waive the exhaustion requirement,” id., a federal court can “excuse” a plaintiff-claimant’s failure to exhaust “only in a narrow set of circumstances,” id. at 581. See id. at 584, 586–89 (discussing Bowen v. City of New York, 476 U.S. 467 (1986)). The Supreme Court has identified

three such circumstances: (1) the plaintiff’s claims “are collateral to the claim for benefits”; (2) the plaintiff “would be irreparably injured were the exhaustion requirement now enforced”; and (3) requiring exhaustion would be “futile.” Bowen, 476 U.S. at 483–85; see L.N.P., 64 F.4th at 584. Exhaustion is an affirmative defense. L.N.P., 64 F.4th at 585–86 (citing Jones v. Bock, 549 U.S. 199, 211–12 (2007)). Thus, the burden is on the Commissioner to plead and prove that “the exhaustion requirement has [not] been satisfied” and “should [not] be excused” in the plaintiff’s case. See id.

2 Separately, “[a]nytime within 60 days after the date of a decision . . . that is subject to review under this section, the Appeals Council may decide on its own to review the action that was taken in [the claimant’s] case.” 20 C.F.R. § 404.969(a). II. Background3 Kevin applied for DIB in September 2022. Podraza Decl. ¶ 3(a); id. Ex. 1 (Sept. 6, 2022).

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Bluebook (online)
Kevin K. v. Frank Bisignano, Commissioner of Social Security, Counsel Stack Legal Research, https://law.counselstack.com/opinion/kevin-k-v-frank-bisignano-commissioner-of-social-security-vawd-2026.