Sinatra v. Heckler

Decision Date01 July 1983
Docket NumberNo. CV 80-2940.,CV 80-2940.
PartiesSalvatore SINATRA, Plaintiff, v. Margaret M. HECKLER, Secretary of Health and Human Services, Defendant.
CourtU.S. District Court — Eastern District of New York

COPYRIGHT MATERIAL OMITTED

Roy & Mondello by Philip J. Mondello, Dobbs Ferry, for plaintiff.

Raymond J. Dearie, U.S. Atty. by Igou M. Allbray, Asst. U.S. Atty., Brooklyn, N.Y., for defendant.

MEMORANDUM AND ORDER

WEINSTEIN, Chief Judge.

Plaintiff seeks to compel the Bureau of Hearings and Appeals of the Social Security Administration to grant him an administrative hearing after denial of disability benefits. Having denied a hearing on the ground that the request for one was not timely, defendant now contends that this court lacks jurisdiction because there is no final administrative order after a hearing. For the reasons stated below, the court exercises jurisdiction and remands with directions to conduct a hearing on the timeliness issue.

I. FACTS

Plaintiff's struggle for disability benefits has been going on for many years. In 1971 he sustained serious, multiple injuries in an automobile accident. In April 1976, after initial denials and a series of modifications, he was granted a closed period of disability running from December 1971 through August 1975. A request for a hearing on closure of the disability period was initially dismissed because of untimeliness. Plaintiff persisted. In September 1979 he requested a re-opening of the dismissal of his action for continued benefits, offering to present new evidence. The request was referred to the state disability agency for consideration of whether additional evidence might warrant a change in the determination that plaintiff's disability ceased in 1975.

By letter dated December 21, 1979, plaintiff was informed that his request for reconsideration had been reviewed by the state agency and the prior determination had been upheld. The letter stated that plaintiff could request a hearing before an administrative law judge "not later than 60 days from the date you receive this notice." (Emphasis added.)

December 21, 1979 was the Friday just before the year-end holiday period. The following Monday, December 24th, was Christmas Eve and Tuesday, December 25th, was Christmas Day. The balance of that week, Wednesday, Thursday and Friday, December 26th through December 28th, comprised the only full working days between Christmas and New Year's. Monday of the following week, December 31, 1979, was New Year's Eve. Tuesday was New Year's Day.

The court takes judicial notice that a substantial number of federal employees take vacations at this time of year and that there is a general slowing down of office operations during this period. Fed.R.Evid. 201. The court also takes judicial notice that the mails are heavily burdened during and in the aftermath of the holiday season and that delivery is sometimes slowed.

Notices of denial of benefits upon reconsideration are mailed from the Bureau of Disability Determinations in Baltimore, Maryland. The Postal Service applies a two-day delivery standard from Baltimore to claimant's postal district 117 in Suffolk County. But the Post Office's Origin-Destination Information System reported that for the period December 29, 1979 through January 25, 1980, on-time delivery to district 117 from two-day delivery areas was down to 49%, the worst on Long Island. For the same origin-destination combination there was 76% on-time delivery from December 1, 1979 through December 28, 1979. The Post Office ordinarily aims for 91% on-time delivery from two-day delivery areas. FY '83 Goals (Internal Post Office Memorandum).

Even at ordinary times of the year the mailing of government notices is often delayed. For example, a letter from the Office of Hearings and Appeals sent to plaintiff's counsel in this case, plaintiff's exhibit no. 1, was dated October 14, 1982, postmarked October 19th, and received October 22nd. Compare Wilson v. Watt, 703 F.2d 395, 397 (9th Cir.1983) (Bureau of Indian Affairs letters dated March 5, 1982, terminating assistance as of April 1st, not received until after March 15th).

When plaintiff received the December 21st notice is in dispute. Plaintiff claims he received the notice on January 15, 1980. Relying on a presumption, the government contends that the letter must have been delivered on or before December 26th.

A request for a hearing was not filed until March 3, 1980, 73 days after the December 21st notice is dated. Had the letter been received on or after January 3, 1980, the request would have been timely. By decision of June 2, 1980, the hearing request was dismissed as untimely. Given the administrative presumption that a notice is received by a claimant five days after it is dated, the time to request a hearing expired on February 25th. (The sixtieth day from presumed day of receipt was February 24, 1980. Since that day was a Sunday, the request period was extended by one day pursuant to 20 C.F.R. § 404.3(c). See 42 U.S.C. § 416(j).)

By order dated May 24, 1981, this court remanded the case to the Appeals Council for findings on the timeliness of plaintiff's hearing request. A hearing was held before an administrative law judge in July, 1982, at which time apparently the only evidence taken on the timeliness issue was plaintiff's testimony. A transcript of the hearing is not available. The original tape has been misplaced and a back-up tape is not accessible.

The administrative law judge, in a decision dated August 11, 1982, declared that he did not find plaintiff's arguments credible and recommended that plaintiff's hearing request be dismissed as untimely. The Appeals Council concurred by letter of December 16, 1982. A second appeal to this court followed.

II. LAW
A. Jurisdiction

Section 205(g) of the Social Security Act, 42 U.S.C. § 405(g), governing appeals to a district court from adverse determinations by the Secretary, affords district court review of "a final decision ... made after a hearing." The government contends that the statute refers only to a decision of the Secretary on the merits of a disability claim, not one denying a claimant benefits on the basis of a procedural default. Citing Califano v. Sanders, 430 U.S. 99, 97 S.Ct. 980, 51 L.Ed.2d 192 (1977), which held that section 205(g) foreclosed judicial review of a petition to reopen consideration of a claim denied by the Secretary, the government maintains that the only cognizable petition for review not involving the merits of a disability claim is one raising a constitutional challenge. See Mathews v. Eldridge, 424 U.S. 319, 96 S.Ct. 893, 47 L.Ed.2d 18 (1976); Weinberger v. Salfi, 422 U.S. 749, 95 S.Ct. 2457, 45 L.Ed.2d 522 (1975).

The Second Circuit has apparently taken the position that absent an administrative decision on the merits, district court jurisdiction cannot ordinarily be founded on section 205(g). Dietsch v. Schweiker, 700 F.2d 865 (2d Cir.1983), citing Sheehan v. Secretary of Health, Education, and Welfare, 593 F.2d 323 (8th Cir.1979); Maloney v. Harris, 526 F.Supp. 621 (E.D.N.Y.1980), aff'd mem., 657 F.2d 264 (2d Cir.1981). But see Bloodsworth v. Heckler, 703 F.2d 1233, 1239 (11th Cir.1983) ("The Secretary's argument that an Appeals Council denial of a request to review for reason of untimeliness is neither `final' because it is not a determination on the merits, nor `made after a hearing' because the request itself is not heard, makes linguistic but not legal sense."). To the extent that the proceedings in this case should be characterized as a re-opening of a disability claim rather than its initial consideration, see Letter of Harriet A. Simon, Member, Appeals Council (October 10, 1979), this court would not have jurisdiction to hear an appeal from the Secretary's determination on the merits. Latona v. Schweiker, 707 F.2d 79 (2d Cir.1983).

An action for mandamus is available, however. 28 U.S.C. § 1361. The thrust of such a suit is to compel the Secretary to take action on a request alleged to have been timely filed. The elements of the proceeding are that 1) plaintiff's challenge be a procedural one; 2) with a purportedly timely request, he seek to compel the Secretary to perform a duty; 3) he have no other avenue for relief; and 4) his procedural dispute be unrelated to the merits of his claim for benefits. Dietsch v. Schweiker, 700 F.2d 865, 868 (2d Cir.1983).

In Dietsch, plaintiff had requested a review by the Appeals Council of an adverse determination on a claim for disability benefits. The request was postmarked on the 61st day after presumed receipt of the decision of the administrative law judge, and the Appeals Council dismissed the request as untimely. See 20 C.F.R. 404.968 (1982). The plaintiff claimed that he had mailed the request on day 60 and that mailing constituted filing for the purpose of the regulations. The Second Circuit recognized jurisdiction under the mandamus statute, agreed with the plaintiff's interpretation of the regulations, and remanded for a factual finding on whether the request was mailed within the prescribed period. See also the companion case of Monferrato v. Schweiker, 700 F.2d 869 (2d Cir.1983).

While the case at bar involves a request for a hearing rather than review by the Appeals Council, its posture is similar to that of Dietsch. That a hearing on a reopened claim is provided for by regulation, 20 C.F.R. §§ 404.929, .930(a)(4), .994 (1982), rather than by statute is of no moment. The Secretary is bound by her own regulations. Plaintiff does not ask the court to address the merits of his disability claim but merely to correct an alleged procedural error that forecloses administrative consideration of the claim. Accordingly, the court has jurisdiction.

B. Filing Requirements

While the proceedings in this case appear to be in the nature of a re-opening of a prior determination, the regulations governing a request for a hearing under these circumstances track...

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