JACQUELYN D. AUSTIN, Magistrate Judge.
This matter is before the Court for a Report and Recommendation pursuant to Local Rule 73.02(B)(2)(a), D.S.C., and Title 28, U.S.C. § 636(b)(1)(B).
Ricky D. Tyler ("Tyler"), Katelyn's father, applied for disability insurance benefits ("DIB") and supplemental security income ("SSI") in February 2004. [R. 126-28; see R. 80-84.] On May 24, 2006, an administrative law judge ("ALJ") issued a decision granting Tyler's claims, finding he had been disabled since October 1, 2000. [R. 19-25.] On January 5, 2007, Plaintiff applied on Katelyn's behalf for child's insurance benefits based on Tyler's Social Security record.
In an initial determination, the Social Security Administration ("the Administration") granted the application and found Katelyn was entitled to child's insurance benefits beginning January 2006 but not before. [See R. 11, 45.] Plaintiff filed a request for reconsideration, seeking a determination that Katelyn was entitled to benefits beginning February 2003. [R. 47.] After the initial determination was affirmed on reconsideration [R. 45-46], Plaintiff requested a hearing before an ALJ [R. 44]; a hearing was held on March 19, 2008 [R. 570-77]. On August 18, 2008, the ALJ denied Plaintiff's claim, finding that, pursuant to 20 C.F.R. § 404.621, Katelyn was entitled to benefits beginning January 2006 but not before. [R. 11-12.]
Plaintiff filed a request for review with the Appeals Council [R. 7, 568], but the Appeals Council denied Plaintiff's request for review [R. 3-6] such that the ALJ's decision became the Commissioner's final decision for purposes of judicial review, see 20 C.F.R. § 404.981. Plaintiff timely commenced this action for judicial review on August 25, 2010. [Doc. 1.]
Plaintiff contends the Commissioner erred in denying Katelyn benefits from October 1, 2000
The Commissioner contends the ALJ's decision is supported by substantial evidence because the ALJ's finding that Katelyn's eligibility for benefits began in January 2006, twelve months before Plaintiff applied for benefits on Katelyn's behalf, is legally correct. [Doc. 33 at 3-6.]
The Commissioner's findings of fact are conclusive if supported by substantial evidence. 42 U.S.C. § 405(g). Substantial evidence is more than a scintilla—i.e., the evidence must do more than merely create a suspicion of the existence of a fact and must include such relevant evidence as a reasonable person would accept as adequate to support the conclusion. See Richardson v. Perales, 402 U.S. 389, 401 (1971) (quoting Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229 (1938)); Laws v. Celebrezze, 368 F.2d 640, 642 (4th Cir. 1966) (citing Woolridge v. Celebrezze, 214 F.Supp. 686, 687 (S.D.W. Va. 1963)) ("Substantial evidence, it has been held, is evidence which a reasoning mind would accept as sufficient to support a particular conclusion. It consists of more than a mere scintilla of evidence but may be somewhat less than a preponderance. If there is evidence to justify a refusal to direct a verdict were the case before a jury, then there is `substantial evidence.'").
Where conflicting evidence "`allows reasonable minds to differ as to whether a claimant is disabled, the responsibility for that decision falls on the [Commissioner] (or the [Commissioner's] designate, the ALJ),'" not on the reviewing court. Craig v. Chater, 76 F.3d 585, 589 (4th Cir. 1996) (quoting Walker v. Bowen, 834 F.2d 635, 640 (7th Cir. 1987)); see also Edwards v. Sullivan, 937 F.2d 580, 584 n.3 (11th Cir. 1991) (stating that where the Commissioner's decision is supported by substantial evidence, the court will affirm, even if the reviewer would have reached a contrary result as finder of fact and even if the reviewer finds that the evidence preponderates against the Commissioner's decision). Thus, it is not within the province of a reviewing court to determine the weight of the evidence, nor is it the court's function to substitute its judgment for that of the Commissioner so long as the decision is supported by substantial evidence. Laws, 368 F.2d at 642; Snyder v. Ribicoff, 307 F.2d 518, 520 (4th Cir. 1962).
The reviewing court will reverse a Commissioner's decision on plenary review, however, if the decision applies incorrect law or fails to provide the court with sufficient reasoning to determine that the Commissioner properly applied the law. Myers v. Califano, 611 F.2d 980, 982 (4th Cir. 1980); see also Keeton v. Dep't of Health & Human Servs., 21 F.3d 1064, 1066 (11th Cir. 1994). Where the Commissioner's decision "is in clear disregard of the overwhelming weight of the evidence, Congress has empowered the courts to modify or reverse the [Commissioner's] decision `with or without remanding the cause for a rehearing.'" Vitek v. Finch, 438 F.2d 1157, 1158 (4th Cir. 1971) (quoting 42 U.S.C. § 405(g)). Remand is unnecessary where "the record does not contain substantial evidence to support a decision denying coverage under the correct legal standard and when reopening the record for more evidence would serve no purpose." Breeden v. Weinberger, 493 F.2d 1002, 1012 (4th Cir. 1974).
Under Title II of the Social Security Act ("the Act"), the child of an individual entitled to DIB may receive child's insurance benefits. 42 U.S.C. § 402(d). However, to be eligible for these benefits, the child must file an application for child's insurance benefits, id. § 402(d)(1)(A); 20 C.F.R. §§ 404.350(a)(3), 404.603, which must be on a form and in a manner prescribed by the Administration, 20 C.F.R. § 404.610. Thus, "[f]iling a written application is a `substantive condition' to receiving child's insurance benefits, even `when the applicant is a minor seeking retroactive benefits.'" Shepherd ex rel. Shepherd v. Chater, 932 F.Supp. 1314, 1317 (D. Utah 1996) (quoting Johnson v. United States, 572 F.2d 697, 698 (9th Cir. 1978)); see also Schweiker v. Hansen, 450 U.S. 785, 790 (1981) (per curiam) ("Congress expressly provided in the Act that only one who `has filed application' for benefits may receive them, and it delegated to petitioner the task of providing by regulation the requisite manner of application. A court is no more authorized to overlook the valid regulation requiring that applications be in writing than it is to overlook any other valid requirement for the receipt of benefits.").
Further,"[i]t is the date on which the application is filed, and not the date on which the claimant is ultimately determined to be eligible, that triggers his entitlement to benefits under the Act." Wright v. Califano, 603 F.2d 666, 671 (7th Cir. 1979); see 42 U.S.C. § 402(d)(1)(C)(iii). However,
Shepherd, 932 F. Supp. at 1317.
"`The filing of an application is a prerequisite to the entitlement to benefits, and benefits cannot be paid for periods earlier than the retroactive limit provided for in the Act.'" Morton v. Barnhart, No. 02-CV-4166, 2003 WL 1856530, at *4 (S.D.N.Y. Apr. 4, 2003) (quoting Driver v. Heckler, 779 F.2d 509, 511 (9th Cir. 1985)) (collecting cases supporting this proposition). Generally, a claimant who is found eligible for insurance benefits is entitled to retroactive benefits for a period of up to twelve months preceding the effective date of the application. 42 U.S.C. §§ 402(j)(1), 423(b). This statutory twelve-month limit on retroactive benefits applies to claims for child's insurance benefits. Id.
Plaintiff's arguments in this action center on the contention that it is inequitable to deny Katelyn insurance benefits because Tyler failed to identify Katelyn as his minor child in his application for disability benefits. [See Doc. 30 at 5.] While the Court understands Plaintiff's frustration, the Court is bound to apply the law, which supports the Commissioner's decision to limit Katelyn's retroactive award to twelve months of benefits.
Courts have uniformly refused to find equitable exceptions to the statutory limit on retroactive benefits because Congress clearly intended to limit retroactive awards of benefits. For example, in Yeiter ex rel. Yeiter v. Secretary of Health & Human Services, the United States Court of Appeals for the Sixth Circuit rejected an argument that the limit should not apply to a mentally incompetent claimant:
818 F.2d 8, 9 (6th Cir. 1987); see also Howard v. Barnhart, 2006 WL 305464, at *3 (S.D.N.Y. Feb. 7, 2006) ("The lower courts have . . . den[ied] benefits beyond the retroactive limit provided for in the Social Security Act, even if claimants would have been entitled to further benefits had they filed the application earlier. This result is the same, even under circumstances that might justify an equitable adjustment, such as inability to apply due to a physical disability or fault of another." (internal citations and footnote omitted)); Tusson v. Bowen, 675 F.Supp. 1032, (E.D. La. 1987) (denying the claimant retroactive benefits for the entire period he was disabled, even though he was unable to file for a period of years because of a mental disability, because the twelve-month limit on retroactive benefits applied and did not violate the claimant's rights to due process or equal protection), aff'd, 847 F.2d 284 (5th Cir. 1988); Sweeney v. Sec. of Health, Educ. & Welfare, 379 F.Supp. 1098, 1100 (E.D.N.Y. 1974) (holding "there seems no doubt that equitable considerations are irrelevant" to the application of a statutory requirement that has a clear meaning, such as the limit on retroactive benefits).
Further, in a case substantially similar to the action before the Court, the United States District Court for the Eastern District of New York upheld the Commissioner's denial of child's insurance benefits for more than one year prior to the claimant's application. Carpenter ex rel. Espada v. Barnhart, No. CV020828DRHWDW, 2003 WL 22071574 (E.D.N.Y. Aug. 29, 2003). In Carpenter, a mother filed for insurance benefits on behalf of her minor daughter in June 1997, based on the minor's father's receipt of benefits. Id. at *1. The minor was born in December 1989, and the father executed an affidavit in August 1990 swearing he was the minor's father. Id. The minor's father had applied for disability insurance benefits in November 1992; he stated on his application for disability insurance benefits that he had no children who might be entitled to benefits. Id. The father's application was granted, awarding him benefits effective December 1991. Id. In July 1996, the mother learned the father was receiving benefits, and an Administration employee encouraged the mother to file an application for benefits on her daughter's behalf, but the mother did not file an application until June 1997. Id. The application was granted, and the daughter was awarded benefits effective June 1996, twelve months prior to the filing date of her application. Id. The mother administratively appealed this decision, and finally appealed to the district court, arguing the daughter was entitled to benefits effective December 1991, when the father's benefits began. Id.
As in this case, the mother in Carpenter argued before the court that it was inequitable to deny the daughter child's insurance benefits because the father did not correctly complete his application for disability benefits. Id. at *3. In upholding the Commissioner's decision that the daughter was not entitled to retroactive benefits beyond one year prior to the date of her application, the court noted other courts had strictly interpreted the applicable statutes to conclude filing an application is a prerequisite to the entitlement to benefits and that benefits cannot be paid beyond the twelve-month limit on retroactive benefits. Id. (quoting Morton, 2003 WL 1856530, at *4). The court also noted the filing requirement was not waivable. Id. (citing Shepherd, 932 F. Supp. at 1316). Further, the court found the mother did not advance the argument that she failed to apply earlier based on misinformation from the Administration; rather, the mother argued there was no earlier application based on misinformation from the father to the Administration. Id. at *4. The court concluded
Id.
Likewise, this Court is restrained by the law to conclude Katelyn is not entitled to benefits prior to January 2006, one year prior to the application for child's insurance benefits filed on her behalf. Plaintiff filed an application for child's benefits on Katelyn's behalf on January 5, 2007. [R. 112-18.] By failing to indicate on his application he had a minor child, Tyler failed to establish a protective filing date for Katelyn's application of February 2004, the date of Tyler's application.
Wherefore, based upon the foregoing, the Court recommends the Commissioner's decision be AFFIRMED.
IT IS SO RECOMMENDED.
