Yarborough v. Gardner

283 F. Supp. 814, 1968 U.S. Dist. LEXIS 11769
District Court, E.D. North Carolina·Decided April 26, 1968·No. Civ. No. 723·Published·Cited by 1 cases

Opinion

OPINION and ORDER

LARKINS, District Judge:

This action was brought under the provisions of Section 205(g) of the So[815] cial Security Act, as amended, 42 U.S.C.A. § 405(g), to obtain judicial review of a final decision of the Secretary of Health, Education and Welfare in which the Appeals Council affirmed, as supplemented, a decision of the Hearing Examiner holding that plaintiff’s entitlement to a period of disability and disability insurance benefits had terminated.

SUMMARY OF ADMINISTRATIVE ACTION

On February 26, 1962, Raymond A. Yarborough filed an application for the establishment of a period of disability and disability insurance benefits (Tr. 68-71) under the provisions of Section 216 (i) and 223 of the Social Security Act, as amended, 42 U.S.C.A. §§ 416(i), 423. He alleged that he had become unable to work on July 18, 1961, because of “arthritis, flat feet, (and) rheumatic heart.” His application was allowed by Certificate of Social Insurance Award dated July 10, 1962 (Tr. 79), plaintiff being awarded a period of disability from July 18, 1961, and disability insurance benefits effective February 1962 (beginning after the required six months waiting period). Plaintiff’s wife and child were also awarded benefits effective February 1962 (Tr. 79). In August of 1963 plaintiff was examined for the purpose of determining continuing disability (Tr. 133-139) and was notified on September 13, 1963, that evidence in his claim had been reviewed and it was found that he was still disabled (Tr. 82); he was advised to notify the Social Security Administration of any improvement in his condition or change in his work status.

On February 9, 1965, plaintiff was interviewed in connection with another continuing disability investigation (Tr. 105-106), and it was learned that he had “bought a self-service laundrymat [sic] ”; subsequently, on March 18, 1965, he was notified that benefit payments had been stopped because “earnings have recently been credited to your social security account” (Tr. 83). Thereafter, on June 22, 1965, Yarborough was advised that since evidence in his case showed that he “became able to do substantial gainful work in September 1964,” the last disability benefit check to which he was entitled was for the month of November 1964 and, accordingly, that payments for the months of December 1964, January 1965, and February 1965 were incorrectly made and should be refunded1 (Tr. 84-85). Plaintiff requested, on July 1, 1965, a reconsideration of the termination of his benefits on the grounds that he was not working in the business which he owned (Tr. 86). The termination decision was confirmed, however, on October 19, 1965, plaintiff being advised that as a self-employed laundromat operator he had demonstrated his ability to engage in substantial gainful activity (Tr. 90-91). On that same date, plaintiff filed a request for hearing (Tr. 27) and on February 9, 1966, a hearing was held before Hearing Examiner J. C. Goodwin (Tr. 28-64). In his decision of March 14, 1966, the Hearing Examiner held (Tr. 13-24) that plaintiff’s disability ceased in September 1964, that his entitlement to a period of disability terminated as of November 30, 1964, that his entitlement to disability insurance benefits ended with the month of November 1964, and that recovery of the overpayment in the sum of $726.00 was not precluded. Thereafter, plaintiff’s request for review of the Hearing Examiner’s decision was granted by the Appeals Council (Tr. 10, 11). After development and receipt of additional evidence (Tr. 8, 9, 67), the Appeals Council, on March [816]*81624, 1967, rendered the “final decision” of the Secretary (Tr. 2-7), affirming, as supplemented, the Hearing Examiner’s decision of March 14, 1966.2

This action, seeking judicial review of the final decision of the Secretary, was commenced on May 11, 1967, following which the parties cross-moved for summary judgment.

ISSUES BELOW AND STANDARD FOR JUDICIAL REVIEW

The issues for decision below, as stated by the Appeals Council, were as follows:

“ * * * whether the claimant continues to be entitled to a period of disability and to disability insurance benefits. The specific issues are whether the claimant’s ‘disability’ has ceased, and if so, as of what date. This, in turn, depends on whether the claimant’s work activity has demonstrated a regained ability to engage in substantial gainful activity.
“If it is found that the claimant’s disability has ceased, an additional issue is presented as to whether there has been an overpayment; and if so, whether recovery of the overpayment may be waived. This depends on whether the claimant was without fault in accepting any payment incorrectly made, and if so, whether recovery of the overpayment would defeat the purpose of title II of the Act, or be against equity and good conscience.” (Tr. 2.)

Central to the determination below, of course, were the statutory and regulatory guidelines which were applied in reaching a decision as to the primary question of whether plaintiff’s “disability” had ceased. At the time of the awarding of a period of disability to the plaintiff (July 18, 1961), and of the effective date of the disability insurance benefits (February 1962), as well as the date on which Yarborough was notified that benefit payments had been stopped (March 18, 1965), the term “disability” was defined in 42 U.S.C.A. § 423(c) (2) (Disability insurance benefits) as:

“ * * * inability 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 to be of long-continued and indefinite duration.”

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Yarborough v. Gardner, 283 F. Supp. 814, 1968 U.S. Dist. LEXIS 11769 (E.D.N.C. 1968).

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