JOHN E. STEELE, District Judge.
This matter is before the Court on consideration of the Magistrate Judge's Sealed Report and Recommendation (Doc. #40), filed December 22, 2016, recommending that the Commissioner's Opposed Motion to Dismiss Pursuant to Rule 12(b)(1) of the Federal Rules of Civil Procedure (Doc. #19) be granted and the case be dismissed for lack of subject matter jurisdiction. Plaintiff Charles W. Bauer (plaintiff or Bauer), proceeding pro se, filed Objections (Doc. #43) on April 5, 2017.
Plaintiff Charles W. Bauer (plaintiff or claimant) applied for and began receiving early retirement benefits from the Social Security Administration (the SSA). There has never been any question about plaintiff's eligibility for such benefits. Almost twelve years later, plaintiff became convinced that the amount of his retirement benefits was improperly computed, and asked the SSA to correct the computation, pay the correct monthly amount, and pay past-due benefits. Plaintiff ultimately was given an administrative hearing before an Administrative Law Judge (ALJ), who agreed that plaintiff's retirement benefits were improperly computed. (Doc. #19-1, Exh. 1.) The SSA Appeals Council disagreed, retroactively dismissed plaintiff's request for a hearing as untimely, and deemed the ALJ's decision to have "no effect." (Doc. #19-1, Exh. 4.)
Plaintiff challenges the Appeals Council's decision in federal district court. The Commissioner of Social Security (the Commissioner) asserts that the SSA has never made a "final decision" after a hearing, as required by 42 U.S.C. § 405(g), and therefore a district court lacks subject matter jurisdiction. The magistrate judge agreed with the Commissioner, and recommends dismissal of the case for lack of subject matter jurisdiction.
For the reasons set forth below, the Court accepts much of the Report and Recommendation, but declines to accept the magistrate judge's finding that the court lacks subject matter jurisdiction. The motion to dismiss is denied because the record establishes that federal district court does have subject matter jurisdiction in this case.
The Court adopts the "Factual and Procedural Background" portion of the Report and Recommendation. (Doc. #40, pp. 5-12.) In sum:
Plaintiff served four years of active duty in the United States Air Force and then thirty-three years as a military reservist, dual status air technician for the Air National Guard. Plaintiff's employment was thus under the control of the United States Department of Defense from January 1969 through June 1995, when he was honorably discharged from his position as a military reservist.
In 2001, plaintiff applied for early old age retirement benefits at the age of sixty-two. It is undisputed that plaintiff was eligible for these retirement benefits. The SSA computed plaintiff's retirement benefits utilizing the Windfall Elimination Provision (WEP), 42 U.S.C. § 415(7)(A), which reduces Social Security retirement benefits when a claimant simultaneously receives both SSA benefits and a pension based on employment not covered by Social Security.
In 2012, plaintiff was informed by a non-official source that he was exempt from the WEP formula because of his prior employment as a military reservist, dual status technician with the Air National Guard. Later in 2012, plaintiff contacted the local Social Security office in Fort Myers, Florida and the SSA office in Birmingham, Alabama in order to have the computation of his retirement benefits corrected. On November 6, 2012, plaintiff completed a Request For Reconsideration form which had been sent to him by the Birmingham SSA office, requesting an additional increase of his social security benefits based upon his active duty and National Guard service. On May 6, 2013, plaintiff went to the Fort Myers SSA office for a review of his Request For Reconsideration, and learned that his Social Security file had been destroyed by the SSA. The SSA provided only a "Military Service & Windfall Elimination Input" printout as its file. The SSA refused to remove the WEP deduction from the calculation of plaintiff's retirement benefits.
On May 20, 2013, plaintiff wrote the SSA National Headquarters requesting a change in his benefits to remove the WEP deduction. For the first time, plaintiff made reference to an untitled Eighth Circuit case. On June 6, 2013, the SSA National Headquarters acknowledged plaintiff's request to remove the WEP offset of his benefits based on
On June 10, 2013, plaintiff completed and returned a "Statement of Claimant or Other Person" form requesting a review of the WEP reduction of benefits, asserting that as a military reservist the WEP deduction was inapplicable to his retirement benefits pursuant to Policy #RS00605.383 (of the Commissioner's Program Operations Manual System [POMS]) and requesting that his benefits be corrected.
An August 28, 2013, letter from the SSA denied plaintiff's request to correct his benefits. The SSA stated that it had made plaintiff's benefits calculation decision prior to the Eighth Circuit decision in
On September 27, 2013, plaintiff filed a Request For Hearing by an Administrative Law Judge. Plaintiff asserted that pursuant to 42 U.S.C. § 415(a)(7)(D) he was exempt from the WEP. On January 9, 2014, the SSA granted the request for a hearing before an Administrative Law Judge.
On January 28, 2015, plaintiff was given an administrative hearing before Administrative Law Judge Maria C. Northington (ALJ), and plaintiff and his wife presented various evidence and arguments. On March 10, 2015, the ALJ issued a fully favorable decision to plaintiff. The ALJ stated that the only issue was whether plaintiff's benefits were incorrectly calculated. The ALJ found that while
Plaintiff's favorable decision did not last long. On March 30, 2015, an assistant regional commissioner opined that the ALJ's decision was "contrary to the law and regulations." (Doc. #19-1, Exh. 2.) On May 6, 2015, the Appeals Council sent plaintiff a Notice of Appeals Council Action in which it informed plaintiff it was reviewing the decision of the ALJ because it found an error of law. The Appeals Council stated that it planned to vacate the ALJ decision and dismiss the request for a hearing filed on September 30, 2013. The Appeals Council stated that it had determined that the ALJ correctly determined that
Plaintiff thereafter filed requests for appearance and memoranda of law, but on June 9, 2015, the Appeals Council denied the requests for appearance. Plaintiff filed additional information, as allowed by the Appeals Council.
On September 25, 2015 the Appeals Council entered an Order Of Appeals Council from which plaintiff seeks judicial review. The Appeals Council held that the ALJ correctly found that
After conducting a careful and complete review of the findings and recommendations, a district judge may accept, reject or modify the magistrate judge's report and recommendation. 28 U.S.C. § 636(b)(1);
The only issue that was properly before the magistrate judge, and the only issue currently before the Court, is whether subject-matter jurisdiction exists for a federal district court to review the September 25, 2015 Order of Appeals Council. (Doc. #40, p. 14.) The Commissioner's motion to dismiss raises a factual challenge to the district court's subject matter jurisdiction. (Doc. #19, pp. 6-7.)
"The district court's jurisdiction is limited by the Social Security Act, and judicial review exists only over the `final decision of the Commissioner of Social Security.'"
The Social Security Act does not define "final decision," instead leaving it to the Commissioner to give the term meaning through regulations.
The Commissioner makes a factual challenge to the subject matter jurisdiction of the Court, and therefore the Court may consider extrinsic evidence and need not weight the facts in the light most favorable to plaintiff.
"When the jurisdictional basis of a claim is intertwined with the merits [of the claim], the district court should apply a Rule 56 summary judgment standard when ruling on a motion to dismiss which asserts a factual attack on subject matter jurisdiction."
The Report and Recommendation proceeds along the following lines: Plaintiff did not demonstrate that he presented his claim for an "initial determination" by SSA, or demonstrate that the SSA made an initial determination of entitlement, or that plaintiff's claim was subject to the administrative review process set forth in 20 C.F.R. § 404.900 et seq. The Magistrate Judge found that the denial of plaintiff's request to reopen or reconsider the 2001 calculation of his retirement benefits was not an "initial determination," nor was the denial of plaintiff's request to apply the Acquiescence Ruling. Thus, while plaintiff's claim to reopen could be reviewed by the SSA, it was not subject to the administrative review process or judicial review. The magistrate judge concluded that the decision of the Appeals Council "was not a final decision made after a hearing by SSA subject to review by the Court. None of the steps to exhaust administrative remedies occurred and SSA made no final decision in this action." (Doc. #40, p. 19.)
The Report and Recommendation also recognizes that notwithstanding the lack of a final decision, a decision by the Commissioner is subject to judicial review if: (1) a colorable constitutional claim is raised; or (2) the decision is reconsidered to any extent at any administrative level. The Report and Recommendation found that neither of these two circumstances had been established. (Doc. #40, pp. 19-25.)
The SSA, and the magistrate judge, viewed plaintiff's 2012 request to re-compute benefits only as a request to re-open the 2001 determination that plaintiff was entitled to early retirement benefits and the amount of those benefits. Although the SSA should not have taken such a myopic view of plaintiff's request, even when viewed this narrowly, the SSA resolution does not deprive plaintiff of his right to judicial review.
As a request to re-open the 2001 determination, the request is governed by certain time restrictions set forth in § 404.988. Plaintiff was far beyond the 12 month limit of § 404.988(a), which allows reopening for any reason. Plaintiff was also far beyond the 4 year limit of § 404.988(b), which allows reopening for good cause. The determination, however, may be reopened "at any time" under certain circumstances, including if the determination "is fully or partially unfavorable to a party, but only to correct clerical error or an error that appears on the face of the evidence that was considered when the determination or decision was made." § 404.988(c)(8). While the Court agrees with the magistrate judge's finding that the clerical error portion of this regulation is not applicable (Doc. #40, pp. 17-18), the second prong is at least plausibly applicable to this case but went unaddressed by the SSA. Since the SSA destroyed plaintiff's file and simply had a one-sheet printout, the record does not establish "the evidence that was considered when the determination or decision was made." Therefore, on this record it cannot be determined whether this prong of § 404.988(c)(8) was satisfied, which would make the request timely. While plaintiff bears a heavy burden of establishing such facial error
Even without the (c)(8) issue, and when viewed solely as a request to reopen the 2001 determination, the record still does not establish a lack of subject matter jurisdiction. It is certainly true that "[g]enerally, courts do not have jurisdiction over the Commissioner's decision not to reopen a claim since such a refusal is not a final decision within the meaning of 42 U.S.C. § 405(g)."
"The law is well established that judicial review under § 405(g) is available when a social security claim is in fact reopened and reconsidered on the merits to any extent at any administrative level."
First, the Court does not find a persuasive legal basis for the proposition that the Appeals Council can make the ALJ action disappear by simply saying it "has no effect." "The Appeals Council may affirm, modify, or reverse the administrative law judge's hearing decision, or it may adopt, modify or reject a recommended decision." 20 C.F.R. §404.979. While this certainly includes the authority to vacate the action of an ALJ, that does not expunge the action from the record. To "vacate" an action simply means "to set aside a previous action." 20 C.F.R. § 404.901. While a vacated decision will have no legal effect, it is not expunged from the record for jurisdictional purposes.
Second, the Order of Appeals Council, independently of the ALJ's Decision,
The magistrate judge also found that the lack of a colorable constitutional claim precluded subject matter jurisdiction under this exception to the final order requirement. Plaintiff raises two putative constitutional claims, a violation of due process concerning the notice given by the SSA, and a violation of equal protection for treating him differently than others in the computation of benefits.
The Court agrees with and adopts the magistrate judge's finding that the record does not support a colorable due process violation based on the content of the notice provided by the SSA, and that equitable tolling should not be applied. (Doc. #40, pp. 20-24.)
An equally serious shortcoming in the asserted lack of subject matter jurisdiction position is that the record reflects plaintiff did present the SSA with a request for an "initial determination" with regard to re-computation of his retirement benefit amount, the SSA did make an initial determination, and plaintiff did complete the SSA administrative process. As such, a federal district court has subject matter jurisdiction to review plaintiff's challenges to the Appeals Council's decision.
A written request with acceptable evidence is all that the Commissioner requires to make a request for a recomputation of benefits. 20 C.F.R. § 404.286. Plaintiff presented his claim for recomputation of the amount of his retirement benefit by several written requests, including on November 6, 2012, May 20, 2013, and June 10, 2013. The SSA made an initial determination on August 28, 2013 when it refused to recompute the amount of plaintiff's benefits. The regulations describe an "initial determination" as "a determination we make about your entitlement or your continuing entitlement to benefits
The SSA chose to characterize plaintiff's requests as falling only under portions of § 404.903, but the requests fall just as neatly under portions of § 404.902. Plaintiff's claim clearly related to the amount of his benefits, a recomputation of his benefits, and an underpayment of his benefits. This clearly presents a claim for an initial determination under 20 C.F.R. § 404.902(a),(c), and (j). The SSA is obligated to conduct the review process "in an informal, non-adversarial manner." 20 C.F.R. § 404.901(b).
The record does not support the statement in the Report and Recommendation that "None of the steps to exhaust administrative remedies occurred and SSA made no final decision in this action." (Doc. #40, p. 19.) Plaintiff
This leaves the review on the merits of the Amended Complaint (Doc. #6), in which plaintiff seeks judicial review of the application of the WEP to the calculation of his early old age insurance benefits. The Commissioner will be required to file its answer.
Accordingly, it is now
1. The Report and Recommendation (Doc. #40) is hereby
2. Plaintiff's Objections (Doc. #43) are
3. The Commissioner's Opposed Motion to Dismiss Pursuant to Rule 12(b)(1) of the Federal Rules of Civil Procedure (Doc. #19) is
4. The Commissioner shall file an answer within
5. A Scheduling Order will issue under separate cover by the Magistrate Judge.