ELIZABETH M. TIMOTHY, Chief Magistrate Judge.
This case has been referred to the undersigned magistrate judge pursuant to the authority of 28 U.S.C. § 636(b) and Local Rules 72.1(A), 72.2(D) and 72.3 of this court pertaining to review of administrative determinations under the Social Security Act ("the Act") and related statutes, 42 U.S.C. § 401, et seq. It is now before the court pursuant to 42 U.S.C. § 405(g) of the Act for review of a final determination of the Commissioner of the Social Security Administration ("the Commissioner of the SSA") denying Plaintiff's request for waiver of recovery of an overpayment in disability insurance benefits ("DIB") paid under Title II of the Act, 42 U.S.C. §§ 401-34.
Upon review of the record before this court, it is the opinion of the undersigned that the findings of fact and determinations of the Commissioner are supported by substantial evidence and comport with proper legal principles. It is therefore recommended that the decision of the Commissioner be affirmed.
In January 2007 Plaintiff was granted DIB for himself and on behalf of his minor daughter (tr. 15). On October 29, 2011, the SSA informed Plaintiff that he had been overpaid $75,863
In his June 19, 2013, decision, the ALJ made the following findings (tr. 13-17):
Judicial review of the Commissioner's decision is limited to a determination of whether it is supported by substantial evidence and whether proper legal standards were applied. See
In a case such as this, where the Commissioner has determined that an overpayment has been made, the Commissioner shall: (1) require such overpaid person to refund the amount in excess of the correct amount; or (2) "decrease any payment . . . payable to his estate or to any other person on the basis of the wages and self-employment income which were the basis of the payments to such overpaid person"; or (3) obtain recovery by means of reduction in tax refunds; or (4) apply any combination of the foregoing. 42 U.S.C. § 404(a)(1)(A). However, "there shall be no adjustment of payments to, or recovery by the United States from, any person who is without fault if such adjustment or recovery would defeat the purpose of [Title II] or would be against equity and good conscience." 42 U.S.C. § 404(b) (emphasis added).
In considering whether an overpaid person is at fault, the Commissioner should take into account any physical, mental, educational, or linguistic limitation the overpaid individual may have, id., as well as his age. 20 C.F.R. § 404.507. Fault may be found in instances where, for example, the overpaid individual made an incorrect statement he knew or should have known to be incorrect, failed to furnish information he knew or should have known to be material, or accepted a payment which he either knew or could have been expected to know was incorrect. See id. Conversely, the SSA may find an individual to be without fault if he "accepts such overpayment because of reliance on erroneous information from an official source within the [SSA] . . . with respect to the interpretation of a pertinent provision of the [SSA] or regulations pertaining thereto. . . ." 20 C.F.R. § 404.510a.
Even if an individual is found to be without fault, however, waiver of overpayment can be granted only if recovery of the overpayment would either defeat the purpose of Title II or would be against equity and good conscience. 42 U.S.C. § 404(b); see also 20 C.F.R. § 404.506(a). A recovery defeats the purpose of Title II if it "deprives a person of income required for ordinary and necessary living expenses." 20 C.F.R. § 404.508(a). A recovery is against equity and good conscience if an individual "[c]hanged his position for the worse . . . or relinquished a valuable right . . . because of reliance upon a notice that a payment would be made or because of the overpayment itself. . . ." 20 C.F.R. § 404.509(a)(1).
On June 19, 2013, the date of the ALJ's decision, Plaintiff was fifty-two years of age (tr. 55), with a high school education (tr. 189) and over twenty years working as a laundry supervisor for the Department of Justice at a federal prison (tr. 184). Plaintiff stopped working in August 2006 after being diagnosed with multiple myeloma and suffering kidney failure (tr. 185-87). In a letter dated June 16, 2007, sent to the SSA Office in Fort Walton Beach, Florida, Plaintiff informed the SSA that his health had improved and he had returned to work on a trial basis (tr. 107).
The SSA sent Plaintiff a Notice of Change in Benefits dated November 2, 2007, in which he was advised that his benefits were being increased to give him credit for additional earnings that were not included when his benefits had previously been calculated (tr. 148-49). Plaintiff received similar Notices on November 7, 2008 (tr. 150-51), November 6, 2009 (tr. 152-53), and November 5, 2010 (tr. 154-55).
On February 17, 2011, Plaintiff submitted a Work Activity Report to the SSA which showed he worked for the U.S. Department of Justice from January to August 2006 and for the U.S. Army Reserve from May to June 2006, with both jobs ending by August 2006 (tr. 26). Plaintiff also reported that he earned over $3,600 per month starting in June 2007 "and every month after" through 2010 (tr. 27, 29). In a letter dated March 16, 2011, the SSA requested further information about the work Plaintiff had reported (see doc. 6-2 at 6 [Bates stamp missing]-7 & tr. 159). Attached to the letter is a Work and Earning Summary which reflects earnings for Plaintiff of approximately $42,608 in 2007; $56,424 in 2008; $57,649 in 2009; and $45,622 in 2010 (tr. 161).
A Social Security Disability Information statement dated March 30, 2011, informed Plaintiff that the evidence in his disability claim had been reviewed; the SSA found that Plaintiff's "disability was continuing"; and that the evidence showed he had "not worked in any trial work months" (tr. 162).
On April 5, 2011, Plaintiff submitted a Work Activity Report virtually identical to his Report of February 17, 2011 (tr. 32-37).
In a Notice of Proposed Decision dated August 22, 2011, the SSA advised Plaintiff that it had information about his earnings that could affect his Social Security disability payments and provided him with an opportunity to submit additional information in response (tr. 40). Plaintiff was informed that SSA records showed his nine-month trial work period—during which he could test his ability to work and still receive DIB—had been from June 2007 through February 2008 (tr. 41). The Notice further stated that the SSA likely would decide that Plaintiff's disability had ended in March 2008, with additional benefits payable only for that month and the following two months (tr. 42), because he had performed substantial work and thus was not entitled to benefits for June 2008 forward (tr. 40). On September 8, 2011, the SSA sent Plaintiff a Notice of Revised Decision stating that it had decided that his disability had ended in March 2008 and that he was not entitled to DIB payments as of June 2008 (tr. 44-46).
At the January 7, 2013, administrative hearing Plaintiff testified that he stopped working in August 2006 when he became ill, returned to work in June 2007, and had been working full-time ever since (tr. 185-87). Plaintiff also testified that he submitted Work Activity Reports to the Baltimore, Maryland, Social Security Office every year from 2008 through 2011, along with a photocopy of his June 2007 return-to-work letter, to advise the SSA he was working (tr. 171). According to Plaintiff, he submitted the Work Activity Reports in response to letters from the SSA stating their records showed additional earnings about which they required more information (tr. 172). In addition to the letters from the SSA requesting more information, Plaintiff indicated he received letters from the SSA in 2008, 2009, and 2010 stating he continued to be eligible to receive DIB (tr. 172-73, 191). The ALJ commented that he did not recall seeing such letters in the administrative file (tr. 173). Plaintiff stated that he had copies of the eligibility letters, and he agreed to provide them to the SSA (see tr. 173-76; 191).
Plaintiff also testified that on December 21, 2010, he telephoned the Fort Walton Beach SSA Office and spoke with a representative named "John" (tr. 182-83). Plaintiff stated he told John he was calling "in reference to [SSA instructions] about returning to work. He [John] told [Plaintiff] that—something [like] to disregard the fact of the work; said to call only if something changed." (tr. 183). In response to the ALJ's question regarding his state of mind when he became ill, Plaintiff indicated his concentration was not good (tr. 189). Also, when asked by the ALJ whether he questioned his continued entitlement to DIB in light of his successful return to full-time work, Plaintiff replied, "No, sir. Because the paper said something different." (tr. 191).
In his decision, the ALJ noted that he had kept the record open for several months after the administrative hearing to permit Plaintiff to supply copies of the Work Activity Reports which Plaintiff testified he had sent to the Baltimore, Maryland, Social Security Office (tr. 15). On April 20, 2013, Plaintiff responded to the ALJ's April 10, 2013, letter reminding Plaintiff to submit the documents (id.). In his letter Plaintiff stated that "[f]rom 2008 thru 2011 the Baltimore SSA Office mailed me the enclosed Work Activity Report-Employee paperwork. . . . I completed the forms, enclosed the return to work letter I mailed to the Ft. Walton Beach office on June 16, 2007, and mailed them back. Each year they mailed me back stating `your disability is continuing.'" (tr. 133). Plaintiff did not, however, enclose the "Work Activity Report-Employee paperwork" for 2008 through 2010 requested by the ALJ (tr. 15).
Plaintiff does not appear to challenge the ALJ's finding that he received an overpayment in the amount of $133,788, and the undisputed record contains substantial evidence that in fact Plaintiff did. The ALJ found there was no evidence—following Plaintiff's June 2007, letter, until February and April 2011—that the SSA received any Work Activity Reports or other correspondence from Plaintiff concerning his work activities (tr. 16).
Plaintiff challenges the ALJ's finding that he was not without fault for the overpayment. Plaintiff contends that "[o]n a yearly basis I completed the paperwork informing [the SSA] I was working full time and my income[;] I also enclosed my return to work letter and mailed it back. Each year the SSA wrote me back informing me they decided I was still eligible and to continue my disability payment." (doc. 11 at 3). In short, Plaintiff submits that he "was not at fault for any overpayment, the SSA approved my disability in 2007 and continued saying I was still entitled" (id. at 4).
The ALJ noted Plaintiff's contention that he was not at fault for the overpayment because he notified the SSA when he returned to work in June 2007 and reported his earnings every year following (tr. 16). The ALJ also referenced Plaintiff's testimony that he had copies of the Work Activity Reports he sent to the SSA in 2008, 2009, and 2010—which the administrative record did not include—but noted that Plaintiff had failed to submit these documents into evidence (id.). The ALJ noted that even if the SSA was at fault in originally making an overpayment, such fault did not relieve Plaintiff from liability for the continuing benefit overpayments. Based on Plaintiff's June 2007 return-to-work letter, his testimony that he reported his work activity to the SSA each year, and various subjective criteria,
(tr. 17).
Substantial evidence supports the ALJ's findings. As the ALJ determined, although Plaintiff contends he filed Work Activity Reports with the SSA for the years 2008, 2009, and 2010, the SSA has no record of any such Reports having been filed and Plaintiff failed to supply them. Following Plaintiff's June 2007 return-to-work letter the first Work Activity Report of record from Plaintiff is dated February 17, 2011, and the only evidence that Plaintiff attempted to call the SSA about his benefits is reportedly a contact he made in December 2010, which was over three years after Plaintiff returned to work full-time in June 2007. It matters not that the SSA may bear some responsibility for overpaying Plaintiff's DIB. "Social Security law does not ask whether SSA is at fault. Rather, in order for the Plaintiff to avoid having to return erroneously paid benefits, the burden is on him to show that he bears no fault."
Plaintiff's conduct falls short of the high degree of care generally expected by a DIB recipient. See
The ALJ also concluded that because Plaintiff was at fault in accepting the overpayment, recovery of the overpayment was not waived and Plaintiff was liable for repayment of $133,788 for the period June 2008 to February 2011 (tr. 17). Plaintiff challenges this finding, apparently contending that, in light of his financial circumstances, it would be inequitable for the SSA to recover the overpayment (doc. 11 at 3-4).
The Act allows for a waiver of an overpayment if the individual is without fault in causing the overpayment and recovering the overpayment would defeat the purposes of the Act or would be against equity and good conscience. See 20 C.F.R. § 404.506(a); 42 U.S.C. § 404(b);
For the foregoing reasons, the Commissioner's decision is supported by substantial evidence and should not be disturbed. 42 U.S.C. § 405(g);
Accordingly, it is respectfully