Hansen v. Harris

• Decision Date: 24 March 1980
• Docket Number: D,No. 324,324
• Citation: 619 F.2d 942
• Parties: Ann HANSEN, Appellee, v. Patricia Roberts HARRIS, Secretary of Health, Education and Welfare, Appellant. ocket 79-6125.
• Court: U.S. Court of Appeals — Second Circuit

Page 942

619 F.2d 942

Ann HANSEN, Appellee, v. Patricia Roberts HARRIS, Secretary of Health, Education and Welfare, Appellant.

No. 324, Docket 79-6125.

United States Court of Appeals Second Circuit.

Argued Oct. 26, 1979.

Decided March 24, 1980.

Richard Beattie, Stanley Ericsson, Dept. of HEW (Stuart E. Schiffer, Acting Asst. Atty. Gen., Washington, D. C., William B. Gray, U. S. Atty., Jerome J. Niedermeier, Asst. U. S. Atty., Rutland, Vt., Randolph W Gaines, Chief of Litigation, Baltimore, Md., of counsel), for appellant.

Ronald Lospennato, Walter M. Morris, Jr., St. Johnsbury, Vt., Vermont Legal Aid, Inc., for appellee.

Before FRIENDLY, OAKES and NEWMAN, Circuit Judges.

OAKES, Circuit Judge:

This appeal does not involve a great deal monetarily: appellee is seeking mother's insurance benefits, as provided in 42 U.S.C. § 402(g) ¹ for the year preceding June 12, 1974. Yet the case does raise a significant issue of estoppel against the Government. The Department of Health, Education and Welfare (HEW) ² appeals from a decision of the United States District Court for the District of Vermont, Albert W. Coffrin, Judge, holding for the applicant and overturning an earlier decision of the administrative law judge that had been upheld by the HEW Appeals Council.

Appellee, whose former husband died in 1967, became eligible for benefits as a divorced mother when the Social Security Amendments of 1972, Pub.L.No.92-603, 86 Stat. 1329, § 114(c), took effect on January 1, 1973. She did not, however, file the required written application, see 42 U.S.C. § 402(g)(1)(D), until May 1975. The estoppel question arises from the actions of a Social Security Field Representative who, on June 12, 1974, supplied the applicant with misinformation about her eligibility and did not encourage her to file a written application. On that date, after hearing from a fellow employee and a local attorney that she might be eligible, appellee went with her mother to the Newport, Vermont, Social Security Office. There she had a ten- to fifteen-minute interview with Dan Connelly, the Social Security Field Representative. Connelly does not recall the meeting, but his daily record for June 12, 1974 includes the last names of appellee and her two sons, followed by the notation,"P/AD," which Connelly described as an abbreviation for "post adjudication action." This means that, according to his notes, he was talking to her about a claim that had already been determined adversely. As described in appellee's testimony, however, testimony that was substantially credited by the administrative law judge, the following occurred:

A. And I went in to file a form for Mother's Benefits Divorced Mother's Benefits.

Q. All right, now, was he alone there?

A. Yes, he was.

Q. And was it in the morning, or afternoon, or when was it?

A. No excuse me but it was in the afternoon, your Honor.

Q. And how long did you spend there?

A. It couldn't have been any longer than between 10 to 15 minutes, if it was that long.

Q. And did you discuss with him anything else other than filing that application?

A. No. He asked who I was, and I told him, "Ann Riegel Hansen" and that my boys had a claim there, two Riegel boys, and I I told him that I had heard that I was illegible (sic) for Divorced Mother's Benefits, I was not

Q. That you were eligible or not?

A. That I was.

Q. All right.

A. And I was there to file a form,

Q. Uh-huh.

A. and he well, I (unintelligible)

Q. What did he tell you?

A. He asked me he said, "Were you ever married to the guy?" And I I just looked at him and

Q. What'd you tell him?

A. he repeated the question again, because I was stunned, and I said, "Well, I can cross the street and go over to the City Clerk's office and get you a marriage certificate." And he said, "Oh, no, no," he says, "that won't be necessary."

Q. All right, what else did he say?

A. And then he asked me what my marital statchus (sic) was at the time,

Q. Uh-huh.

A. "Were you divorced?" And I said, "Yes," and he said, "Well, that's it," his hands went up in the air, he said, "That's it then, that's why you're not illegible (sic)."

Q. Well, wait, did he say just, "That's it," or what else did he say, as near as you recall, after he said, "That's it," what what else did he say by way of explanation?

A. He said, "That's it, it's because you're divorced that you're not illegible (sic)."

Q. Did he say that you were not eligible?

A. He said I was not illegible (sic) to file a form for Mother's Benefits.

Q. Now, did he say the words that, "You aren't eligible?"

A. Yes, your Honor.

Q. Or did he just say, "That's it"?

A. He said, "That's it," and he said, "You're not illegible (sic) to file a form because you are divorced at the time."

Q. And did he give you any other explanation?

A. No he didn't.

When the administrative law judge asked appellee how she remembered Connelly's name, she replied, "Because he had given me a rude time." She described Connelly as being "very short, very in a hurry," and said that she was "very put out because of the questions (as to whether she had been married)." Appellee's mother testified that she had gone to the Social Security Office with her daughter and that she had stayed in the waiting room throughout the interview; she remembered that when the daughter had emerged from the office she was "very mad" and "quite upset" about Connelly's inquiry into whether she and her former husband had ever been married. Appellee and her mother left the office without taking further action and appellee made no further contact with the Social Security Administration, or with the lawyer who had suggested that she visit the Social Security Office, until May 1975, when a booklet sent by the Administration and a telephone call confirmed the fact that she was eligible. At that point, she received benefits retroactive one year to May 1974, as provided by 42 U.S.C. § 402(j), ³ but no benefits for any time prior to that date.

Relying on the Act and its regulations, the ALJ denied appellee's claim for benefits back to June 1973, finding specifically that Connelly did not refuse in the June 12, 1974 meeting to allow her to file an application and did not advise her that she had no right to do so. But the ALJ also stated:

(T)he interviewer did not ask her if she wanted to file an application. When she asked him if she should he responded by advising her she was not eligible. She testified she was not given a form by the interviewer, nor did he suggest or encourage her to file one and he didn't explain the advantages of filing an application.

The ALJ found as a matter of law that she failed to comply with the statutory and regulatory requirements for filing of a written application as prescribed in 42 U.S.C. § 402(g)(1)(D), ⁴ and (j)(1), ⁵ and 20 C.F.R. § 404.601. ⁶ He also held that the oral contact made by the claimant on June 12, 1974 could not be considered to satisfy the requirements for filing a written application, either as a matter of law or on the basis of equitable estoppel. He was upheld by the Appeals Council.

The district court reversed, concluding that appellee asked to complete an application but was denied that opportunity. In this case, the court held, the regulation requiring application in writing was "unreasonably restrictive," especially since the Social Security Claims Manual explicitly directed SSA employees to inform applicants of the advantage of filing an application and to suggest filing even in cases of doubtful eligibility. In so holding the court referred to Tuck v. Finch, 430 F.2d 1075, 1077 (4th Cir. 1970), Leimbach v. Califano, 450 F.Supp. 245, 246, (E.D.Mo.1978), and Holmes v. Weinberger, 423 F.Supp. 149, 152-54 (E.D.N.Y.1976).

Section 202(g) of the Social Security Act, 42 U.S.C. § 402(g), see note 1 supra, provides the conditions of entitlement for mother's insurance benefits. It requires in subsection (1)(D) that the claimant be someone who "has filed application." See also § 202(a)-(h), 42 U.S.C. § 402(a)-(h) (containing the same language). The filing of some sort of application is accordingly a condition precedent to entitlement to benefits under this section. E. g. Clark v. Celebrezze, 344 F.2d 479, 481 (1st Cir. 1965).

Until 1955, Social Security regulations allowed for oral applications. See Holmes v. Weinberger, supra, 423 F.Supp. at 153; Johnson v. Hobby, 131 F.Supp. 497, 499 (D.R.I.1955). Since 1955, however, the regulations implementing the "has filed application" requirement have specifically provided for applications in written form. 20 C.F.R. § 404.601(c). The regulation requiring a written application is valid on its face, particularly in light of the fact that the statute allows for delays in applying by making benefits retroactive for a year prior to the filing of the application. 42 U.S.C. § 402(j). ⁷ The purpose of this regulation is stated in Goff v. Weinberger, No. H 74-276 (D.Conn., Oct. 17, 1975), aff'd mem., 538 F.2d 309 (2d Cir.), cert. denied, 429 U.S. 896, 97 S.Ct. 258, 50 L.Ed.2d 179 (1976):

The Social Security Act, supplemented by its regulations, was intended to eliminate or at least reduce to a minimum the possibility of fraud, confusion and laxity in its administration. The vastness of the program makes it essential to adhere to the written application procedure, if there is to be an orderly and controllable system of management for approving claims and paying out insurance benefits.

See also Leimbach v. Califano, 596 F.2d 300, 304 (8th Cir. 1979), reversing the most recent of the decisions relied upon by the district court below, Leimbach v. Califano, 450 F.Supp. 245 (E.D.Mo.1978). Thus there is no doubt that the regulation requiring a written application is valid as " 'reasonably related to the purposes of the enabling legislation.' " Mourning v. Family Publications Service, 411 U.S. 356, 369, 93 S.Ct. 1652, 1661, 36 L.Ed.2d 318 (1973) (citing cases).

Here the court below,...