Rose v. Commissioner of Social Security

202 F. Supp. 3d 231, 2016 U.S. Dist. LEXIS 105667, 2016 WL 4250302
CourtDistrict Court, E.D. New York
DecidedAugust 10, 2016
Docket13-CV-7329 (NGG)
StatusPublished
Cited by33 cases

This text of 202 F. Supp. 3d 231 (Rose v. Commissioner of Social Security) is published on Counsel Stack Legal Research, covering District Court, E.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Rose v. Commissioner of Social Security, 202 F. Supp. 3d 231, 2016 U.S. Dist. LEXIS 105667, 2016 WL 4250302 (E.D.N.Y. 2016).

Opinion

MEMORANDUM & ORDER

NICHOLAS G. GARAUFIS, United States District Judge

Plaintiff Diana Rose brings this pro se action pursuant to 42 U.S.C. § 405(g), seeking judicial review of the decision of the Social Security Administration (the “SSA”) that she was not without fault in accepting an overpayment of Title II Disability Insurance Benefits (“DIB”). (See Compl. (Dkt. 1) at 1-2.) The SSA found that Plaintiff was ineligible for a waiver of overpayment in the amount of $36,351.70 and that the overpayment occurred when Plaintiff earned income exceeding the Substantial Gainful Activity allowance. (Administrative R. (“R.”) (Dkt. 8) at 97.) Plaintiff argues that the decisions by the Administrative Law Judge (the “ALJ”) and the Appeals Council were not supported by substantial evidence and that the ALJ and Appeals Council applied the incorrect legal standards. (Compl. at 2.) Defendant, the Commissioner of Social Security (the “Commissioner”), has filed a motion for judgment on the pleadings pursuant to Federal Rule of Civil Procedure 12(c), and Plaintiff has filed an affidavit opposing the Motion. (See Mem. of Law in Supp. of Def.’s Mot. (“Def.’s Mem.”) (Dkt. 16); Pl.’s Aff. in Opp’n to Def.’s Mot. (“Pl.’s Aff.”) (Dkt. 17); Def.’s Mem. in Further Supp. of Mot. (“Def.’s Supp. Mem.”) (Dkt. 18).) For the reasons set forth below, Defendant’s Motion is DENIED, and this case is REMANDED to the Commissioner for further proceedings.

I. BACKGROUND

A. Disability Insurance Benefits

A claimant is entitled to DIB if she is unable to “engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less . than 12 months.” 42 U.S.C. § 423(d)(1)(A). An individual will not be found disabled “if [she is] working and the work [she is] doing is substantial gainful activity ... regardless of [her] medical condition or [her] age, education, and work experience.” 20 C.F.R. § 404,1520(b). Substantial Gainful Activity (“SGA”) is work activity that “involves doing significant physical or mental activities” for pay or profit. Id. § 404.1572(a)-(b). In order for work activity to qualify as SGA, the individual must receive payment or profit greater than or equal to a set amount per month, with monthly minimums set annually by the SSA. See id. § 404.1574. The monthly minimums at issue in this case are: $740 for 2001, $800 for 2003, $810 for 2004, and $830 for 2005. (R. at 123-25.)

A DIB claimant may be granted a nine-month Trial Work Period (“TWP”), of either consecutive or non-consecutive months, during which she may test her ability to work without affecting her DIB eligibility. See 20 C.F.R. § 404.1592. The first time that a claimant engages in SGA after the end of her TWP, the SSA will find that her disability has ceased. See id. § 404.1592a(a)(l). However, immediately after the TWP has concluded, the claimant may be given a 36-month reentitlement [236]*236period.1 See id. § 404.1592a. During the reentitlement period, the SSA will pay DIB for any month where the claimant could not perform SGA. See id. The reenti-tlement period ends the earlier of “the month before the first month in which [the claimant’s] impairment no longer exists or is not medically disabling” or “the last day of the 36th month following the end of [the claimant’s] trial work period.” Id. § 404.1592a(b).

B. Plaintiffs Disability Insurance Benefits Overpayments

Plaintiff applied for DIB on May 12, 1998, as a result of a July 4, 1997, car accident. (R. at 105, 130.) The SSA approved her disability claim in August 1998 and awarded her benefits from January 1998 onward. (See id. at 89.) Following the 1997 car accident, Plaintiff did not work again until February 2000. (See id. at 123.) In February 2000, Plaintiff began working for Protocol Connection and continued working there through September 2001. (See id. at 123-24.) From October 2001 through September 2003, Plaintiff remained unemployed. (See id. at 124.) In October and November 2003, Plaintiff worked briefly for Williams-Sonoma. (See id.) From November 2003 through August 2004, Plaintiff worked for AT&T. (See id.) Plaintiff also received income from AT&T from January 2005 through July 2005.2 (See id. at 125.)

The SSA granted Plaintiff a nine-month TWP covering February 2000 through October 2000. (Id. at 28.) However, Plaintiffs employment continued from November 2000 through September 2001. (Id. at 123-24.) After the conclusion of Plaintiffs TWP, she earned $1,809.77 per month from November 2000 through December 2000 and $1,258.75 per month from January 2001 through September 2001. (Id.) The Record states that from February 2001 through September 2001, Plaintiff exceeded the allowable SGA monthly income of $740.00, resulting in an overpayment of $8,115.00.3 (See id. at 89, 124.) Plaintiff then was unemployed from October 2001 through September 2003, and the SSA did not find she was overpaid again due to SGA until December 2003.4 (See id. at 90.) The SSA found that Plaintiff had been overpaid $27,331.20 from December 2003 through September 2005. (See id.) Additionally, the SSA found that Plaintiff had been overpaid $999.00 for October 2006. (See id.) Together, these overpayments amount to $36,445,20. (See id. at 89-90.) After deducting an underpayment of $93.50 for 2007, the SSA found that Plaintiff had been overpaid $36,351.70 in total.5 (See id.)

On September 7, 2006, after reviewing Plaintiffs earnings, the SSA retroactively determined that her disability had ceased in November 2000. (Id. at 27-28.) In a September 7, 2006, notice, the SSA in[237]*237formed Plaintiff that her 36-month reenti-tlement period began on November 2000; thus, her DIB were retroactively terminated, effective November 2003. (Id.) On October 5, 2006, Plaintiff submitted a request for reconsideration, stating that she had not worked since August 2004 and that she still was disabled. (See id. at 34.) In an expedited reinstatement, Plaintiff was found to have a continuing disability, and the SSA retroactively reinstated her DIB effective October 2005.6 (See id. at 30, 90.)

On February 28, 2008, Plaintiff filed a request for reconsideration of the SSA’s overpayment decision, claiming that the overpayment “was not [her] fault” and that “paying it back [would be] unfair.” (Id. at 37, 114-17.) On August 15, 2008, the SSA denied Plaintiffs claim for a waiver of overpayment (id. at 50), finding that she was “at fault” in causing the overpayment and that “recovery would not defeat the purpose of Title II” (id. at 108-09). On March 1, 2010, Plaintiff requested , a hearing before an ALJ, claiming that the SSA personnel “advised [her] and gave [her] misinformation,’.’ and that the SSA actually granted her two TWPs. (Id.

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202 F. Supp. 3d 231, 2016 U.S. Dist. LEXIS 105667, 2016 WL 4250302, Counsel Stack Legal Research, https://law.counselstack.com/opinion/rose-v-commissioner-of-social-security-nyed-2016.