Roesch v. Apfel

17 F. Supp. 2d 1080, 1998 U.S. Dist. LEXIS 13692, 1998 WL 557524
CourtDistrict Court, D. Nebraska
DecidedSeptember 1, 1998
Docket4:CV96-3464
StatusPublished
Cited by2 cases

This text of 17 F. Supp. 2d 1080 (Roesch v. Apfel) is published on Counsel Stack Legal Research, covering District Court, D. Nebraska primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Roesch v. Apfel, 17 F. Supp. 2d 1080, 1998 U.S. Dist. LEXIS 13692, 1998 WL 557524 (D. Neb. 1998).

Opinion

MEMORANDUM AND ORDER

KOPF, District Judge.

This is a social security case, albeit a complex and unusual one. The question in this ease is not whether the plaintiff is disabled, but when her payments should start. Proee-durally, this case comes to me as if on cross motions for summary judgment. (Filing 5.)

Rosalie A. Roesch (Roesch) makes two arguments. They are: (1) the Appeals Council erred when it reversed the ALJ’s decision to reopen a prior application and award her benefits starting on March 2, 1993; (2) Roesch is entitled to benefits starting before March 2, 1993, and the ALJ and the Appeals Council erred in not awarding her a start-date prior to March 2,1993.

Pursuant to 42 U.S.C. § 405(g), the Commissioner concedes that the court has jurisdiction to review the decision of the Appeals Council regarding the March 2, 1993 start-date for benefits. (Filing 13 ¶ 3.) The Commissioner denies that the court has subject matter jurisdiction under section 405(g) to review whether Roesch is entitled to a start-date prior to March 2,1993.

I will reverse and order the Commissioner to award benefits starting March 2, 1993. I also find that the court lacks subject matter jurisdiction under 42 U.S.C. § 405(g) to review Roesch’s claim that she is entitled to benefits starting before March 2, 1993, and that the Appeals Council erroneously refused to remand for the appointment of a medical advisor to prove that point. To the extent the plaintiff also claims that the Commissioner violated her constitutional rights when the Appeals Council refused to remand for the appointment of a medical advisor, I find that the court has jurisdiction over that question but the argument is meritless.

I. Facts and Procedural History

In this section of the opinion I provide background. I then provide a more detailed chronology of the facts and procedural history.

A. Background

In order to understand this case, it is helpful to know that there were two applications for SSI benefits. It is also helpful to know that there were two “reopenings.”

A 1992 application for SSI benefits was denied at the administrative level and never appealed. A 1994 application for SSI benefits was ultimately granted, with benefits starting on March 2, 1993. In the course of deciding the 1994 application, the ALJ reopened the 1992 application. The ALJ’s decision was not appealed by the plaintiff or the Commissioner within the time stipulated for review, but the ALJ’s decision was later reopened and amended by the Appeals Council.

It is the ALJ’s decision on the second application, involving the reopening of the first application, and the later decision of the Appeals Council to reopen the ALJ’s decision, thereby denying Roesch the March 2, 1993 start-date for payments, which forms the grounds for dispute. Related to that issue is the decision of the Appeals Council not to remand for the appointment of a medical advisor. The remand was sought by the plaintiff to obtain a start-date that was even earlier than the March 2, 1993 date found by the ALJ.

B. Chronology

With the foregoing introduction in mind, a more specific chronology of what happened will further illuminate the issues in this ease. I provide that chronology next.

*1083 Roesch applied for SSI on August 11,1992. (Tr. 98-100.) Her application was denied on December 4, 1992. (Tr. 102-05.) Despite being provided with notice and an opportunity to seek further review, Roesch admits that she did not seek further review.

In the first application, Roesch said that she was disabled because she had hernias, angina, and low blood pressure. (Tr. 106.) The Commissioner considered various reports from doctors, including treating doctors, and hospitals in arriving at the decision to deny the application. The Commissioner ultimately concluded that Roesch could do her past relevant work as a waitress. (Tr. 116.)

Roesch applied for SSI again on June 13, 1994. (Tr. 132-35.) As she had in her first application (Tr. 98), Roesch claimed that her disability began in 1991. (Tr. 132.) As she had in her first application, Roesch claimed that she suffered from numerous physical problems. (Tr. 160.) She also added new complaints of mental problems. (Id.)

This second application was initially denied on September 1, 1994. (Tr. 137) Upon reconsideration, however, on March 20, 1995, it was determined that the plaintiff was disabled as of April of 1994 and that the plaintiff was entitled to payments starting with her second application. (Tr. 141.) The Commissioner determined that Roesch was suffering from dysthymia and depression sufficient to disable her and that such disability started in April of 1994. (Tr. 200-01; 220.) The Commissioner did not attempt to reopen the earner 1992 application. (Id.)

Because Roesch thought that she was disabled “earlier than April 1994[,]” on May 10, 1995 she requested a hearing before an ALJ. (Tr. 145.) At the time she made this request, and at all times thereafter, Roesch was represented by her present lawyer. (Id.) Roesch explicitly requested reopening of the first application in a letter to the ALJ dated February 13,1996. (Tr. 417.)

Various hearings were held before an ALJ, and the judge issued her opinion on May 31, 1996. (Tr. 38.) The ALJ found that Roesch had filed an application for SSI on August 11, 1992 that was denied on December 4, 1992. The ALJ, citing “Section 404.1688(b)” (Tr. 28) and then “Section 416.1488(b)” (Tr. 37) decided to reopen the 1992 application because of “new” and “material” evidence relating to Roesch’s mental status. (Id.)

This evidence showed that Roesch had mental problems dating back to 1983 and that by March 2, 1993 she was clearly disabled as a result of these problems. (Tr. 32-34.) The Commissioner does not dispute that the evidence was both “new” and “material” when compared to the 1992 application.

Once reopened, the ALJ found that Roesch was in fact disabled prior to April of 1994. The ALJ believed that Roesch became disabled on March 2, 1993 as opposed to April 22, 1991, as claimed by Roesch. (Tr. 36.) The ALJ found that the plaintiff suffered from “bipolar disorder with depression, status post single vessel coronary artery bypass graft (1983), and status post left inguinal hernia repair.” (Id.) The bipolar disorder with depression was found to be disabling within the meaning of the Social Security laws. (Tr. 37.) The ALJ awarded benefits “commencing March 2,1993.” (Tr. 38.)

The ALJ concluded that Roeseh was disabled as of March 2, 1993 because on that date an objective psychological test (the MMPI) unmistakably revealed that Roesch could not work in any competitive setting. (Tr. 35.) .The ALJ also found that before March 2, 1993 there was no persuasive evidence to show that Roesch’s mental problems disabled her. (Id.) Although she suffered from medical problems, none of these, singly or collectively, were severe enough to disable Roesch at any time.

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Cite This Page — Counsel Stack

Bluebook (online)
17 F. Supp. 2d 1080, 1998 U.S. Dist. LEXIS 13692, 1998 WL 557524, Counsel Stack Legal Research, https://law.counselstack.com/opinion/roesch-v-apfel-ned-1998.