Thomas v. Bowen

693 F. Supp. 950, 1988 U.S. Dist. LEXIS 9522
CourtDistrict Court, W.D. Washington
DecidedAugust 2, 1988
DocketNo. C88-312R
StatusPublished
Cited by1 cases

This text of 693 F. Supp. 950 (Thomas v. Bowen) is published on Counsel Stack Legal Research, covering District Court, W.D. Washington primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Thomas v. Bowen, 693 F. Supp. 950, 1988 U.S. Dist. LEXIS 9522 (W.D. Wash. 1988).

Opinion

ORDER VACATING AND REMANDING DECISION OF SECRETARY

ROTHSTEIN, Chief Judge.

THIS MATTER comes before the court on defendant’s motion to dismiss and plaintiffs motion to amend his complaint. Having reviewed the motions, together with all documents filed in support and in opposition, and being fully advised, the court finds and rules as follows:

I. FACTS

On May 30,1986, plaintiff Chester Thomas applied for Social Security and Supplemental Security Income disability benefits. Thomas suffers from a degenerative disease of the central nervous system, par-enchymatous cerebellar degeneration. Hearing officers for the Social Security Administration initially and on reconsideration denied Thomas’ application. Thomas appealed, and on February 17, 1987, visiting Administrative Law Judge Saul A. Wieselthier (“AU”) reviewed Thomas’ request for benefits and the prior denials. On May 29, 1987, the AU issued his decision, finding that Thomas was disabled beginning on October 6, 1986.

On July 14, 1987, Thomas filed a timely request for review of the AU’s decision with the Social Security’s Appeals Council, contesting only the AU’s finding that the onset of the disability was October 6, 1986. Thomas claimed that his disability began some three years earlier in July, 1983. For six months, from July 14, 1987 until January 11, 1988, the appeals counsel took no action on Thomas’ appeal. On January 11, 1988, however, without notice to Thomas, the Appeals Council vacated the AU’s finding of disability and remanded the entire case to the Seattle office of Hearings and Appeals. The Appeals Council as a consequence did not address the onset date of Thomas’ disability. Thomas learned of the Appeals Council’s decision on February 11, 1988, and on March 9, 1988, he filed this action for relief from the Appeals Council’s judgment. Defendant Secretary of the Department of Health and Human Services (“the Secretary”) now moves to dismiss this matter, and plaintiff moves to amend his complaint.

II. DISCUSSION

A. PROCEDURES FOR APPEALS COUNCIL REVIEW

The Secretary contends that since the Appeals Council remanded Thomas’ claim to an AU, the Secretary has not rendered a final decision on his request for benefits. As a result, according to the Secretary, 42 U.S.C. § 405 does not authorize judicial review of the Appeals Council’s decision. Thomas disputes this conclusion, arguing that the Appeals Council’s actions in his case violated his right to due process as well as applicable federal regulations. According to Thomas, the United States Supreme Court has created an exception to the requirement of a final decision, permitting review of alleged constitutional violations which are collateral to his claim for benefits. Califano v. Sanders, 430 U.S. 99, 97 S.Ct. 980, 51 L.Ed.2d 192 (1977); Mathews v. Eldridge, 424 U.S. 319, 96 S.Ct. 893, 47 L.Ed.2d 18 (1976). To evaluate both parties claims, however, the court finds it necessary first to review the regulations and procedures which govern the Appeals Council’s review of an AU’s decision, and then to determine whether the Secretary followed those procedures here.

Both the claimant and the Appeals Council may initiate review of an AU’s ruling within 60 days of receipt of the decision. If a claimant seeks review, he or she must file a written request with the Appeals [952]*952Council with the 60-day limit. 20 C.F.R. § 404.968. Conversely, if the Appeals Council initiates review, it must follow a similar procedure:

[ajnytime within 60 days after the date of a hearing decision or dismissal, the Appeals Council itself may decide to review the action that was taken. If the Appeals Council does review the hearing decision or dismissal, notice of the action will be mailed to all parties at their last known address.

20 C.F.R. § 404.969. Both claimant and Appeals Council must give written notice of their appeal within 60 days, but if the Appeals Council decides to review a case, it also “shall mail a notice to all parties at their last known address stating the reasons for review and the issues to be considered.” 20 C.F.R. § 404.973.

The Appeals Council may deny or dismiss a claimant’s request for review, or it may grant the request and either issue a decision or remand the case to an administrative law judge. 20 C.F.R. § 404.967. Once the Appeals Council decides not to review a decision, that decision becomes binding and constitutes a final decision for purposes of 42 U.S.C. § 405(g). See 20 C.F.R. § 404.981. In sum, the regulations which govern review by the Appeals Council establishes corresponding procedures, each with 60-day time limits, for initiating further review of an ALJ’s decision.

With these procedures in mind, the court finds unrefuted evidence in this matter that the Appeals Council violated its own regulations. First, the Appeals Council did not give notice within 60 days of its decision to review the entire disability decision, § 404.969, nor did it give notice of the reasons for review and the issues to be considered, § 404.973. Second, the request by Thomas for review of a limited issue— the onset date of his disability — did not authorize the Appeals Council to review the entire decision, including the underlying finding of disability. In Powell v. Heckler, 789 F.2d 176 (3rd Cir.1986), the Third Circuit examined the scope of Appeals Council review and concluded that,

the unembellished language of § 404.969 entitles claimants to notice within 60 days where the Appeals Council plans a review. There is nothing on the face of § 404.969 which absolves the Council of its selfimposed duty to provide timely notification of review simply because the claimant has previously filed for reconsideration under § 404.967. When the review anticipated by the Council is to be substantially greater than, or entirely different from that requested, such notice albeit “counternotice” of a sort, is neither redundant nor superfluous but rises to the level of necessity.

Powell 789 F.2d at 1781; see also Kennedy v. Bowen, 814 F.2d 1523, 1527 (11th Cir.1987) (notice requirement under § 404.973 applies equally to review initiated by claimant or the Appeals Council).

The Appeals Council in its order remanding case to an administrative law judge, justified its sua sponte review of the disability ruling with the following rationale:

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693 F. Supp. 950, 1988 U.S. Dist. LEXIS 9522, Counsel Stack Legal Research, https://law.counselstack.com/opinion/thomas-v-bowen-wawd-1988.