Patricia Cassell v. Secretary, Health and Human Services

885 F.2d 871, 1989 U.S. App. LEXIS 14404, 1989 WL 109763
CourtCourt of Appeals for the Sixth Circuit
DecidedSeptember 25, 1989
Docket89-1068
StatusUnpublished

This text of 885 F.2d 871 (Patricia Cassell v. Secretary, Health and Human Services) is published on Counsel Stack Legal Research, covering Court of Appeals for the Sixth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Patricia Cassell v. Secretary, Health and Human Services, 885 F.2d 871, 1989 U.S. App. LEXIS 14404, 1989 WL 109763 (6th Cir. 1989).

Opinion

885 F.2d 871

Unpublished Disposition
NOTICE: Sixth Circuit Rule 24(c) states that citation of unpublished dispositions is disfavored except for establishing res judicata, estoppel, or the law of the case and requires service of copies of cited unpublished dispositions of the Sixth Circuit.
Patricia CASSELL, Plaintiff-Appellant,
v.
SECRETARY, HEALTH AND HUMAN SERVICES, Defendant-Appellee

No. 89-1068.

United States Court of Appeals, Sixth Circuit.

Sept. 25, 1989.

Before NATHANIEL R. JONES and MILBURN, Circuit Judges, and THOMAS A. HIGGINS, District Judge.*

PER CURIAM.

Plaintiff-Appellant Patricia Cassel married William Cassel on May 2, 1970. He died of a pulmonary embolism on November 16, 1985, survived by the appellant and their two children. Prior to his death, Mr. Cassel had been employed for at least ten years by the United States Postal Service. This employment entitled him to a pension plan but not to social security coverage. On November 25, 1985, Patricia Cassel applied for survivor's insurance benefits. Her applications were denied initially and upon reconsideration.

On August 19, 1986, a hearing was held before ALJ Theodore Stephens. Evidence presented to the ALJ included Mrs. Cassel's testimony, SSA records, and letters from the president and vice president of the Calcaterra funeral home. ALJ Stephens initially noted that in order to be eligible for mother's or child's insurance benefits, a claimant must show that the wage earner died while fully or currently insured. 42 U.S.C. Secs. 402(d)(i); 20 C.F.R. Secs. 404.350, 404.390 (1988). J.App. at 27-28. A wage earner is considered fully insured if he has earned one quarter of coverage for every year after he attained age 21 through the year before the year of his death. 42 U.S.C. Sec. 214(a); 20 C.F.R. Sec. 404.110(b)(3) (1988). For years prior to 1978, a quarter of coverage is defined as any calendar quarter in which an individual was paid $50 or more in wages. 42 U.S.C. Sec. 213(a); 20 C.F.R. Sec. 404.141(b) (1988). Since William Cassel was 38 years old at the time of his death, ALJ Stephens determined that he needed 16 quarters of coverage to be fully insured.

The ALJ then examined the amount of wages that Mr. Cassel allegedly earned. The Social Security Administration (SSA) is required to establish and maintain records of the amount of wages paid to each individual and of the periods in which such wages were paid. 42 U.S.C. Sec. 405(c)(2)(A). The absence of an entry in the earnings record for any period is evidence in any administrative or judicial proceeding that no wages were paid in that period. 42 U.S.C. Sec. 405(c)(3). After the expiration of the applicable time limitation (three years, three months, and fifteen days after the end of any calendar year in which an individual received earnings), the absence of an entry as to wages paid in any time period is presumptive evidence that no wages were paid during the period in question. 42 U.S.C. Sec. 405(c)(4); 20 C.F.R. Sec. 404.803 (1988). While this presumption can be rebutted and the earnings record can be amended to reflect that wages were actually paid during a particular period, see, 42 U.S.C. Secs. 405(c)(5)(G), (H); 20 C.F.R. Secs. 404.822(e)(4)(5) (1988), the presumption protects the government from spurious or merely inaccurate and unverifiable claims based on after-the-fact evidence. Butts v. Secretary of Health and Human Services, 706 F.2d 107, 108 (2d Cir.1983) (quoting Hollman v. Department of Health and Human Services, 696 F.2d 13, 17 (2d Cir.1982)).

SSA earnings records presented to the ALJ indicate that, from 1950 to 1968, Mr. Cassel had earned 14 quarters of coverage. J.App. at 24. He had no record of earning or coverage for 1969. The SSA entries for the contest quarters in 1970 and 1971 were as follows:

70 # NNN $34 (Regular U Warnings)

71 # NN# $88.53 (Regular U Earnings)

Appellant's Brief at 4.

In his August 19, 1986, decision, ALJ Stephens determined that Mr. Cassel was entitled to 15 quarters of coverage based on pay stubs of the deceased supplied by Mrs. Cassel. This evidence showed that Mr. Cassel was paid wages totaling $79.45 in the first quarter of 1971. J.App. at 25. However, the ALJ concluded that the letters from the Calcaterra funeral home supplied by Mrs. Cassel concerning Mr. Cassel's earnings in the last quarter of 1970 were not credible evidence and thus were insufficient to overcome the statutory presumption provided in 42 U.S.C. Sec. 405(c)(4)(B) that no wages were paid in that period. Therefore, the ALJ found that since Mr. Cassel had only 15 of the necessary 16 quarters of coverage, he was not a fully insured individual.

On October 17, 1987, Mrs. Cassel appealed the ALJ's decision and submitted an affidavit from the president of Calcaterra Funeral Home, Louis Calcaterra. Louis Calcaterra attested that he remembered hiring Mr. Cassel in October 1970 as a temporary lot guard. Although the records from the Funeral Home were no longer available, Louis Calcaterra stated that based on his investigation which included interviewing several employees, he had determined that Mr. Cassel earned $84.00 and worked 28 hours in the last quarter of 1970. Based on this newly supplied evidence, the Appeals Council granted review and remanded the matter to ALJ Carpenter for rehearing.

ALJ Carpenter did not hold another hearing but instead sent interrogatories to Paul Calceterra, the vice president of the Calcaterra Funeral Home, to clarify statements made in the previously submitted letter. In addition, ALJ Carpenter made inquiries at Century Security (formerly Star), which was under contract to supply security staff to Calcaterra during those years. Century had no records available from that time period and the SSA records showed that no wages were paid for that period.

On September 10, 1987, ALJ Carpenter denied Mrs. Cassel's application for survivor's benefits based on the findings that, although her husband kept meticulous records, there were no SSA records for the disputed timer period. ALJ Carpenter also found that the answers to interrogatories submitted by Paul Calcaterra contained errors and discrepancies in the withholding calculation, were based on mere assumption and memory and, therefore, lacked credibility.

The ALJ's determination was approved by the Appeals Council and affirmed by the district court. This timely appeal followed.

I.

Once the Secretary makes a determination regarding an issue of coverage, these findings of fact are conclusive if supported by substantial evidence. 42 U.S.C. Sec. 405(g) (1982). Judicial review is limited to determining whether there is substantial evidence in the record to support the Secretary's findings and whether the Secretary employed the proper legal criteria in reaching his decision. Garner v. Heckler, 745 F.2d 383, 387 (6th Cir.1984). Substantial evidence is "more than a mere scintilla.

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885 F.2d 871, 1989 U.S. App. LEXIS 14404, 1989 WL 109763, Counsel Stack Legal Research, https://law.counselstack.com/opinion/patricia-cassell-v-secretary-health-and-human-services-ca6-1989.