Simon v. Heckler

585 F. Supp. 537, 1984 U.S. Dist. LEXIS 16816, 5 Soc. Serv. Rev. 676
CourtDistrict Court, S.D. Ohio
DecidedMay 10, 1984
DocketNo. C-1-83-1111
StatusPublished
Cited by1 cases

This text of 585 F. Supp. 537 (Simon v. Heckler) is published on Counsel Stack Legal Research, covering District Court, S.D. Ohio primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Simon v. Heckler, 585 F. Supp. 537, 1984 U.S. Dist. LEXIS 16816, 5 Soc. Serv. Rev. 676 (S.D. Ohio 1984).

Opinion

ORDER GRANTING REMAND

SPIEGEL, District Judge.

This matter came on for consideration of defendant’s motion to remand (doc. 2) and plaintiff’s opposition (doc. 3). The Secretary seeks remand of this termination case so that she may reconstruct plaintiff’s claims file.

For reasons that follow, we conclude that the Secretary’s motion should be granted. Further, we hold that where the Secretary seeks a remand of a termination case to reconstruct a claims file, the plaintiff may elect to receive continued benefits for a period beginning the month in which the remand is ordered and ending the earlier of (i) the month preceding the month in which a decision is made after such a hearing, or (ii) the month after which Congress enacts and the President signs into law new legislation governing termination cases. Should the initial decision to terminate benefits be affirmed by the Administrative Law Judge, these continued benefits shall be considered overpayments and treated in accordance with 42 U.S.C. § 423(g)(2). In the event of such new legislation, that legislation shall supercede this Order.

Plaintiff was granted Social Security disability benefits as of February, 1974. Benefits were terminated July 31, 1982. Plaintiff timely pursued her administrative remedies. Following a hearing December 8, 1982, the Administrative Law Judge (AU) before whom plaintiff appeared, affirmed the Secretary’s finding that plaintiff’s disability ceased in May, 1982 on February 9, 1983. The Appeals Council affirmed this decision on June 27, 1983, after which plaintiff timely commenced this action for judicial review pursuant to 42 U.S.C. § 405(g), July 27, 1983.

The Secretary, on the other hand, failed to respond to the complaint in any fashion for almost eight months despite her obligation to answer or seek a remand within sixty days. 42 U.S.C. § 405(g), Rule 12(a), Fed.R.Civ.P. Instead the Secretary filed her motion to remand March 12, 1984. It is not clear from her motion why the Secretary needs to reconstruct the claims file, but it is not unreasonable to assume that the tape is either lost or inaudible. In either event, the need to reconstruct a claims file constitutes good cause under 42 U.S.C. § 405(g), and thus justifies ordering a remand.

[539]*539Plaintiff, however, asks that if we grant the motion to remand, we also order that plaintiffs benefits be reinstated retroactive to August 1, 1982 and continued until a new hearing has been conducted. She points out that the Social Security Act was amended to permit a claimant whose benefits have been terminated to elect to continue receiving benefits until the decision of the AU. 1983 Amendments to § 223 of the Social Security Act, 42 U.S.C. § 423(g), effective January 12, 1983. Plaintiff notes that she did not have the opportunity to elect continued benefits pending her administrative appeal. She states that although the 1983 amendment was not in effect at the time the Secretary determined plaintiff was no longer disabled, the new legislation was the result of Congress’ recognition of the hardships posed by the Secretary’s acceleration of her continuing disability investigation program. Plaintiff argues that, given the remedial purpose of the amendment and the extreme financial hardships she has already suffered because of the delays in her case, none of which she caused, the Court should reinstate benefits pending a new hearing. Defendant has not opposed plaintiff's request.

The 1983 amendment creates a limited statutory exception to the rule that benefits are available only where a claimant has been declared eligible. It applies to those cases in which the initial termination decision was made on or after January 12, 1983, or before January 12, 1983, if there had been or could be a timely request for an administrative hearing; and before December 7, 1983. 42 U.S.C. § 423(g)(3). The amendment permits a claimant to elect to receive continued benefits for a period beginning with the first month beginning after January 12, 1983, for which such benefits are no longer otherwise payable, and ending with the earlier of (i) the month preceding the month in which a decision is made after such a hearing [i.e., one before an AU pursuant to 42 U.S.C. § 421(d) ], (ii) the month preceding the month in which no such request for a hearing or an administrative review is pending, or (iii) June 1984. 42 U.S.C. § 423(g)(1). The statutory language clearly limits the period during which such benefits may be paid to the pendency of the administrative process, and does not authorize continuation of terminated benefits pending judicial review. Thibodeau v. Heckler, 571 F.Supp. 524 (D.Me.1983).

The legislative history, reprinted at 1982 U.S.Code Cong. & Ad.News 4373, 4377-78, states that cases pending an AU decision at the time of enactment are also covered by the amendment, but in no case shall a lump sum back payment be authorized. The history also emphasizes that persons whose benefits were terminated prior to enactment of the amendment but who failed to appeal the initial adverse decision were eligible to elect continued benefits only if the time for requesting review had not expired.

Finally, the 1983 amendment provides that where the final decision of the Secretary is to affirm the initial decision to terminate benefits, any continued benefits paid shall be considered overpayments unless subject to waiver. 42 U.S.C. § 423(g)(2)(A), (B). The Committee report indicates that waivers of overpayments should be granted only if fully justified and after all other alternatives, including repayment over a period of time, have been found inappropriate. 1982 U.S.Code Cong. & Ad.News 4378.

Section 423(g) was enacted because in nearly 65% of the termination cases, benefits were being reinstated by the Administrative Law Judges. It represents Congress’ “attempt to minimize the disparate impact of wide decisional variations among the states 1 and the AUs, and to set definite limits on the temporal reach of the interim-payment relief.” Thibodeau, 571 F.Supp. at 526, discussing the legislative history.

[540]*540Although plaintiff could have elected continued benefits in January 1983 following enactment as the AU had not yet issued a decision, she would not have received such benefits as the first month for which continued benefits were available under the amendment was February, 1983, § 423(g)(1), and the AU’s decision issued in that month. Moreover, the legislative history makes it clear she could not elect benefits retroactively as Congress did not authorize lump-sum payments of back benefits.

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Cite This Page — Counsel Stack

Bluebook (online)
585 F. Supp. 537, 1984 U.S. Dist. LEXIS 16816, 5 Soc. Serv. Rev. 676, Counsel Stack Legal Research, https://law.counselstack.com/opinion/simon-v-heckler-ohsd-1984.