Martinez v. Saul

CourtDistrict Court, N.D. Illinois
DecidedMarch 4, 2021
Docket1:20-cv-00008
StatusUnknown

This text of Martinez v. Saul (Martinez v. Saul) is published on Counsel Stack Legal Research, covering District Court, N.D. Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Martinez v. Saul, (N.D. Ill. 2021).

Opinion

UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF ILLINOIS EASTERN DIVISION

FRANCISCO MARTINEZ, individually and on behalf of all others similarly situated, No. 20-cv-00008

Plaintiff, Judge Thomas M. Durkin

v.

ANDREW SAUL, Commissioner of the Social Security Administration

Defendant.

MEMORANDUM OPINION AND ORDER Plaintiff Francisco Martinez brings this putative class action against Andrew Saul, Commissioner of the Social Security Administration (“the SSA”), alleging that the agency uses an unlawful procedure to calculate the disability benefits of individuals who have settled their workers’ compensation claims for a lump sum payment. Commissioner Saul filed a motion to dismiss pursuant to Federal Rules of Civil Procedure 12(b)(1) and 12(b)(6), arguing, among other things, that Mr. Martinez’s claim is moot. The Court agrees, and accordingly grants the motion. Background

Mr. Martinez is a former metal fabricator and painter who became disabled as a result of injuries to his spine and left shoulder.1 He filed for disability benefits

1 The following is based on allegations appearing in Mr. Martinez’s amended complaint as well as documents attached to the SSA’s motion to dismiss. Those documents may be considered here because a court that reviews a factual attack on jurisdiction may “view whatever evidence has been submitted on the issue to through the SSA in December 2016 and had a workers’ compensation case pending at the time. The workers’ compensation case ended in June 2018 and Mr. Martinez received a lump sum settlement. A year later, in June 2019, an SSA administrative

law judge issued a decision in favor of Mr. Martinez and found that he was entitled to disability benefits. The decision did not specify the amount of benefits Mr. Martinez could expect to receive, stating instead that another office would process the decision and might ask for more information. The decision also stated that the “workers’ compensation offset provisions at 20 CFR 404.408 may be applicable,” meaning that Mr. Martinez might receive less in disability benefits as a result of his workers’ compensation settlement.

About a month later, on July 25, 2019, the SSA sent Mr. Martinez a form asking him to verify information about his workers’ compensation settlement. R. 22- 3. The form said that the settlement “affect[s] the amount of Social Security benefits we can pay you,” and also said that a completed version of the form “will ensure that we pay you the correct Social Security benefit[s].” Id. According to Mr. Martinez, he completed the form and returned it to the SSA a few days later. See R. 26 ¶ 42; R. 22-

4. Around that time, on July 28, 2019, the SSA also sent Mr. Martinez a Notice of Award, which stated that Mr. Martinez would receive $29,642.50 in retroactive pay and that his forward-looking monthly pay would be $50. See R. 26 ¶ 38; R. 22-2. Both

determine whether in fact subject matter jurisdiction exists.” Apex Digital, Inc. v. Sears, Roebuck & Co., 572 F.3d 440, 444 (7th Cir. 2009) (internal quotation marks omitted). Mr. Martinez did not dispute that the SSA could properly attach the materials to its motion to dismiss. parties agree that the amounts were incorrect. But the notice also said that “[w]hen processing your claim we found we needed more information. To decide how much your benefits will be for August 2016 through June 2019, we need proof of your

WORKERS COMPENSATION BENEFITS.” R. 22-2 (emphasis in original). The notice further stated that once the SSA received that information, it would “decide the amount of your past-due benefits and send another letter telling you how much the representative can charge. You can help us finish the work on your claim by taking the information to any Social Security office.”2 R. 22-2. Seeking to correct the amounts listed on the notice, counsel for Mr. Martinez sent a letter to the SSA office in Elgin, Illinois on August 6, 2019 and August 13,

2019. Counsel sent another letter to the Baltimore, Maryland Payment Center on September 6, 2019. Mr. Martinez then filed this lawsuit on January 2, 2020. A month later, in February 2020, the SSA issued a Notice of Change in Benefits. The notice included new retroactive and forward-looking benefit amounts. R. 22-6. More specifically, the notice said that Mr. Martinez was now entitled to receive $1,866 a month instead of $50, and that the SSA would send him tens of

thousands of dollars in back payments. Id. Mr. Martinez amended his complaint after receiving the updated notice. He does not seem to take issue with the payments he currently receives, alleging that his

2 This sentence appeared in a section of the notice titled “Information about Representative’s Fees”. The representative referred to in this section is someone who helps a claimant file a Social Security claim, such as an attorney. According to the notice, the SSA must approve the representative’s fee and will usually withhold a percentage of past-due benefits in order to pay the fee. underpayments were “remedied” in February 2020. R. 26 ¶ 47. Nevertheless, he challenges the procedure by which the SSA calculates the benefits of claimants who have settled their workers’ compensation claims for a lump sum payment. He alleges

that the SSA systematically fails to verify if and when a lump sum settlement has occurred, and also fails to appropriately factor that settlement into the reduction of disability payments. More to the latter point, Mr. Martinez contends that the SSA, when calculating a claimant’s disability benefits, inappropriately relies on the agency’s internal operating manual, whose provisions allow the SSA—in certain circumstances—to assume that a claimant is receiving the maximum amount of workers’ compensation payments allowed under state law. He argues that no portion

of the Social Security Act or applicable regulations permits the agency to make such an assumption, and further contends that the provisions found in the agency’s operating manual do not deserve deference as a matter of law. As such, Mr. Martinez’s amended complaint seeks declaratory and injunctive relief, aiming to enjoin the SSA from continuing to implement its settlement reduction policy in an unlawful manner. The complaint also seeks, among other things, an order requiring

the SSA to recalculate the settlement reduction amount for Mr. Martinez and each class member, and pay back any disability benefits that have been improperly withheld.3

3 The complaint alternatively seeks a writ of mandamus directing the SSA to fix the alleged errors in its benefit calculations. The complaint seeks this writ in the event the Court determines that Mr. Martinez failed to exhaust the administrative review process required under 42 U.S.C. § 405(g). Because the Court finds that Mr. Martinez’s claim is moot, the Court declines to reach the question of whether the administrative exhaustion requirement has been satisfied. Standard

“Federal courts lack subject matter jurisdiction when a case becomes moot.” Pakovich v. Verizon LTD Plan, 653 F.3d 488, 492 (7th Cir. 2011). Therefore, “[m]ootness is evaluated under Rule 12(b)(1)[.]” A Custom Heating & Air Conditioning, Inc. v. Kabbage, Inc., 2017 WL 2619144, at *2-3 (N.D. Ill. June 16, 2017) (citation and internal quotation marks omitted).

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