Splude v. Social Security

165 F.3d 85, 1999 WL 10157
CourtCourt of Appeals for the First Circuit
DecidedJanuary 20, 1999
Docket98-1630
StatusPublished
Cited by26 cases

This text of 165 F.3d 85 (Splude v. Social Security) is published on Counsel Stack Legal Research, covering Court of Appeals for the First Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Splude v. Social Security, 165 F.3d 85, 1999 WL 10157 (1st Cir. 1999).

Opinion

BOUDIN, Circuit Judge.

It is no accident that Title 42, containing the social security laws among other statutes, *87 occupies four successive volumes of the United States Code (the Internal Revenue Code requires only two volumes). This case turns on the interplay of statutes establishing two different social security programs and several ancillary provisions. A brief primer will be helpful.

The most familiar social security program is federal old age, survivors and disability insurance, the core provisions of which were adopted as part of the New Deal in 1935. 42 U.S.C. §§ 401-433. It is based on contributions made by employees and their employers to the social security trust fund, and it primarily provides retirement income. But if an insured worker becomes disabled before retirement, scheduled benefits are payable to the employee during disability. Id. §§ 401(b), 423. The latter payments are called “social security disability” or “SSD.”

In 1972, Congress added a new social security program to provide “supplemental security income” (called “SSI”) for “aged, blind and disabled” persons of limited means regardless of their insured status. 42 U.S.C. §§ 1381a, 1382. This is a social welfare program funded out of general taxpayer revenues. SSI is available even to those who qualify for SSD, but SSD income is considered in determining whether a disabled person qualifies for SSI under the latter’s means test. Id. §§ 1382a(a)(2)(B), (b)(4)(B). A disabled person who qualifies for payments under both programs is called a “concurrent claimant.”

This case concerns two concurrent claimants, Daniel Splude and Ronald Cargill. Splude’s circumstances are illustrative. He applied in 1992 for both SSD and SSI benefits dating back to 1988. While awaiting a determination of disability by the Social Security Administration (which administers both programs), Splude received relief payments from the Maine Department of Human Services. He signed an agreement with the Social Security Administration authorizing it to deduct from Splude’s initial SSI payment that portion of the interim relief provided by Maine that was not itself funded by the federal government.

There is a broad “anti-assignment” law governing SSD payments and applicable to SSI payments by cross-reference, 42 U.S.C. §§ 407(a), 1383(d)(1), reprinted in the appendix to this opinion. However, Splude’s 1992 agreement with the Social Security Administration, committing his SSI funds to repay interim state aid, is specifically permitted by a proviso to the cross-referenced statute limiting assignment of SSI payments. Id. § 1383(g)(1). This statutory exception does not apply to SSD payments; if Splude had attempted to assign his rights to future SSD payments to the Maine agency, the Social Security Administration would not have been allowed to make such a deduction.

In addition to this relationship of federal and state payments, there is a potential interaction between SSD and SSI payments. As already noted, SSD payments due for any month are treated under the SSI means test as income that may reduce or eliminate SSI payments for the same month. One might expect that the Social Security Administration would always make both calculations at the same time, determining SSD payments due to the applicant and then reducing SSI payments to the extent required. But different information is needed for the two calculations (e.g., because SSI is means tested), and SSI is normally computed at field offices and SSD at a central Maryland office.

During the events in this ease, the Social Security Administration generally paid out whichever claim was computed first, whether SSI or SSD. Further, an applicant might not apply for disability payments as soon as entitled to do so. Thus, eventually the applicant might receive a large SSI check for back payments; and later, when SSD was calculated, the SSI payment might prove to have been overstated because the SSD payment— made later for the same period — reduced the amount of (means-tested) SSI properly due for the same period.

This overpayment problem was met by the so-called “windfall offset” provisions first added in 1980 and later amended in 1984, 42 U.S.C. § 1320a-6(a), reprinted in the appendix. Under this provision, an excess initial payment for SSI caused by the delay just described can be recaptured by the Social Security Administration by deducting the ex *88 cess when the SSD payment is later calculated and ready to be paid. In September 1995, the Social Security Administration abandoned its “pay whichever claim is calculated first” policy and now, we are told, calculates SSI and SSD benefits at the same time so as to avoid any windfall. But the old policy was in effect in April 1993 when the Social Security Administration first found that Splude was disabled and had been for a prior period.

In May 1993, the Social Security Administration advised Splude that he was entitled to $10,659.30 as an initial SSI payment for the period May 1991 through May 1993. After some miscalculations were corrected by cross payment, Maine (in accordance with Splude’s agreement) received $7,582 from the Social Security Administration for the interim assistance that Maine had provided to Splude while he was waiting for SSI to be paid, and Splude received the balance of $1,776.

In June 1993, the Social Security Administration calculated Splude’s past-due SSD benefits through April 1993. Before any required reductions, this initial payment was computed as $18,706.60. Other deductions aside (e.g., counsel fees), Splude was told that $9,349.57 would be withheld from him because the SSD payment just calculated reduced the initial SSI payment properly due to Splude; in other words, when his initial SSI payment was recalculated to take account of the SSD payment now due for overlapping months, Splude had received $9349.57 too much in SSI — which was now being recaptured for the U.S. Treasury out of his SSD payments under the windfall offset provision.

Splude immediately sought reconsideration. He argued, inter alia, that the deduction from his benefits to reimburse Maine and the deduction under the windfall offset statute were both effectively violations of the anti-assignment provision governing SSD. He included also constitutional claims shortly to be described. The Social Security Administration rejected Splude’s request for reconsideration. It followed the same course in Cargill’s case in which the facts, so far as pertinent, parallel those of Splude’s case (including a repayment to Maine for interim aid), and in which the legal claims are also similar’.

Splude and Cargill then proceeded before an Administrative Law Judge, and them cases were consolidated. In January 1996, the ALJ issued a decision favoring the claimants as regards the Maine deductions, holding that they should not have been made.

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Bluebook (online)
165 F.3d 85, 1999 WL 10157, Counsel Stack Legal Research, https://law.counselstack.com/opinion/splude-v-social-security-ca1-1999.