Tafoya v. Social Security Administration

CourtDistrict Court, D. New Mexico
DecidedJanuary 4, 2022
Docket1:20-cv-00588
StatusUnknown

This text of Tafoya v. Social Security Administration (Tafoya v. Social Security Administration) is published on Counsel Stack Legal Research, covering District Court, D. New Mexico primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Tafoya v. Social Security Administration, (D.N.M. 2022).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW MEXICO

CHERYL T., on behalf of M.G.T., a minor,

Plaintiff,

v. Civ. No. 20-588 MV/GBW

KILOLO KIJAKAZI, Acting Commissioner of the Social Security Administration,

Defendant.

PROPOSED FINDINGS AND RECOMMENDED DISPOSITION THIS MATTER comes before me pursuant to the Court’s Order of Reference (doc. 32) and Plaintiff’s Motion to Reverse and to Remand for Review on the Merits (doc. 36) the Social Security Administration (“SSA”) Appeals Council’s denial of her request to allow late filing of her appeal of the SSA’s decision to terminate M.G.T.’s child disability benefits. For the reasons discussed below, I recommend DENYING Plaintiff’s Motion and AFFIRMING the Appeals Council’s decision to dismiss Plaintiff’s request for review. I. PROCEDURAL HISTORY On September 7, 2011, the SSA determined that Plaintiff’s thirteen-month-old daughter, M.G.T., was disabled, and it approved Plaintiff’s claim for Supplemental Security Income (“SSI”) on M.G.T.’s behalf. Administrative Record (“AR”) at 104-112; see also AR at 218-224. On July 20, 2016, when M.G.T. was six years old, the SSA

determined that her disability had ceased because she showed significant medical improvement, and it terminated her eligibility for SSI. AR at 114, 118-19. After a disability hearing officer affirmed that determination, AR at 140-47, Plaintiff requested a

hearing before an Administrative Law Judge (“ALJ”), AR at 157. The ALJ held two hearings1 and issued a decision adverse to Plaintiff on June 11, 2019. AR at 13. The 60-day period for Plaintiff to file an appeal of the ALJ’s decision, see 20 C.F.R.

§ 416.1468(a),2 ended on August 15, 2019, without Plaintiff having filed an appeal or a request for an extension of time to appeal. AR at 8, 10. On October 17, 2019—132 days after the ALJ’s decision—Plaintiff filed a request for review with the SSA Appeals Council, which it dismissed as untimely. AR at 5-10. On June 18, 2020, Plaintiff filed

suit in this Court, seeking reversal and remand of the Appeals Council’s dismissal of her appeal.3 Doc. 1. II. STANDARD OF REVIEW

1 The first hearing, held in July 2018, was continued so that Plaintiff could seek legal representation. AR at 65. Plaintiff remained unrepresented at the second hearing held in November 2018. AR at 50. 2 The Court cites to Part 416 of Title 20 of the Code of Federal Regulations, as Plaintiff applied for Supplemental Security Insurance for M.G.T. under Title XVI of the Social Security Act. See AR at 104. The content of Part 416 mirrors the content of Part 404 of Title 20 of the Code of Federal Regulations, which provides for the adjudication of applications for Social Security Disability Insurance under Title II of the Social Security Act. Therefore, some of the caselaw that the Court cites interprets provisions of Part 404 rather than Part 416. 3 The Appeals Council granted Plaintiff an extension of time to file the instant action through June 18, 2020, the date Plaintiff filed her complaint. AR at 2; see generally doc. 1. After an ALJ holds a hearing and issues an adverse merits-based ruling on a claim for benefits under the Social Security Act, a claimant may request review by the

SSA Appeals Council, “the agency’s final decisionmaker.” Smith v. Berryhill, 139. S. Ct. 1765, 1771-72 (2019); 20 C.F.R. § 416.1467. To request Appeals Council review, claimants must file a written request within 60 days of receiving notice of the ALJ’s

decision, unless the Appeals Council extends the deadline for good cause shown in writing.4 20 C.F.R. § 416.1468(a). If a claimant does not file a request for review within 60 days and the Appeals Council has not granted an extension, it will dismiss the

appeal. Id. § 416.1471. Following the Supreme Court’s decision in Smith v. Berryhill, such a dismissal is deemed a “final decision … made after a hearing” for purposes of § 405(g) of the Social Security Act, which provides for judicial review of SSA final decisions. See 139. S. Ct. at 1774.

Pursuant to 42 U.S.C. § 405(g), a court may review the Commissioner’s overall conclusions for an abuse of discretion and findings of fact for whether they are supported by substantial evidence. Id. at 1779 n.19. “In reviewing the ALJ’s decision,

[the Court] neither reweighs the evidence nor substitutes [its] judgment for that of the agency.” Bowman v. Astrue, 511 F.3d 1270, 1272 (10th Cir. 2008) (internal quotation marks omitted). Substantial evidence is “more than a mere scintilla. It means such

4 A claimant is deemed to have received notice five days after the date on the notice unless the claimant shows that she did not receive it within five days. 20 C.F.R. § 416.1401. relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Casias, 933 F.3d at 800. “The possibility of drawing two inconsistent

conclusions from the evidence does not prevent [the agency’s] findings from being supported by substantial evidence.” Lax v. Astrue, 489 F.3d 1080, 1084 (10th Cir. 2007). When the Appeals Council’s dismissal rests on procedural grounds, a court

generally should “restrict its review to the procedural ground that was the basis for the Appeals Council dismissal and (if necessary) allow the agency to address any residual substantive questions in the first instance.” Smith, 139 S. Ct. at 1780. III. ANALYSIS

Plaintiff does not dispute that her request for Appeals Council review was untimely. See doc. 36 at 3. Rather, she argues that the Appeals Council abused its discretion in finding that she failed to show good cause for her failure to file a timely

appeal. See id. at 6-8. In the alternative, she asks the Court to exercise its discretion to apply equitable tolling and remand her claim for a hearing on its merits by the Appeals Council. See id. at 8-9.

A. Good Cause

The procedure for requesting an extension of the deadline to request Appeals Council review is set forth in 20 C.F.R. § 416.1468, which states: The request for an extension of time must be in writing. It must be filed with the Appeals Council, and it must give the reasons why the request for review was not filed within the stated time period. If [the claimant] shows that [she] had good cause for missing the deadline, the time period will be extended. To determine whether good cause exists, [the Appeals Council] use[s] the standards explained in § 416.1411.

20 C.F.R. § 416.1468(b). The standards in 20 CFR § 416.1411

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Mathews v. Eldridge
424 U.S. 319 (Supreme Court, 1976)
Bowen v. City of New York
476 U.S. 467 (Supreme Court, 1986)
Clymore v. United States
245 F.3d 1195 (Tenth Circuit, 2001)
Hall v. United Parcel Service, Inc.
101 F. App'x 764 (Tenth Circuit, 2004)
Williams v. Barnhart
178 F. App'x 785 (Tenth Circuit, 2006)
Fleming v. Evans
481 F.3d 1249 (Tenth Circuit, 2007)
Lax v. Astrue
489 F.3d 1080 (Tenth Circuit, 2007)
Bowman v. Astrue
511 F.3d 1270 (Tenth Circuit, 2008)
Moore v. Astrue
274 F. App'x 719 (Tenth Circuit, 2008)
Phuong Doan v. Michael Astrue
464 F. App'x 643 (Ninth Circuit, 2011)
Menominee Indian Tribe of Wis. v. United States
577 U.S. 250 (Supreme Court, 2016)
Bell v. Colvin
645 F. App'x 608 (Tenth Circuit, 2016)

Cite This Page — Counsel Stack

Bluebook (online)
Tafoya v. Social Security Administration, Counsel Stack Legal Research, https://law.counselstack.com/opinion/tafoya-v-social-security-administration-nmd-2022.