Harper by Harper v. Bowen
| Decision Date | 07 April 1987 |
| Docket Number | No. 85-4896,85-4896 |
| Citation | 813 F.2d 737 |
| Parties | , Unempl.Ins.Rep. CCH 17,324 Michelle D. HARPER, a minor, by her mother and next friend, Easter HARPER, Plaintiff-Appellant, v. Otis R. BOWEN, M.D., Secretary of Health and Human Services, Defendant-Appellee. |
| Court | U.S. Court of Appeals — Fifth Circuit |
L. Paul Kossman, Kossman & Kossman, Cleveland, Miss., for plaintiff-appellant.
Gabriel E. DePass, Baltimore, Md., Robert Q. Whitwell, Thomas W. Dawson, Asst. U.S. Attys., Oxford, Miss., for defendant-appellee.
Appeal from the United States District Court for the Northern District of Mississippi.
Before THORNBERRY, DAVIS and HILL, Circuit Judges.
In this appeal Michelle Harper (Harper) challenges the district court's dismissal for lack of subject matter jurisdiction of her claim for disability benefits under the Social Security Act. The district court dismissed the case because Harper had failed to timely exhaust the available remedies under the Social Security Act and the applicable regulations. Because Harper did not obtain a final decision from the Social Security Administration that would allow judicial review, we affirm the district court's dismissal of her complaint.
Harper was born with the lower part of her right leg missing (a tibial hemimelia). Because of this disability, in April 1980 she was found to be eligible for Supplemental Security Income (SSI). On May 23, 1983, Harper underwent a Continuing Disability Interview at which it was determined that her disability would cease in August 1983. A notice of such planned action was sent to her mother, Easter Harper (Mrs. Harper), and subsequently on August 17 she filed a request for a hearing to contest the ruling. On March 13, 1984, following the hearing, an administrative law judge (ALJ) found that Harper's disability had ceased in August 1983 because of her ability to walk satisfactorily with a prosthesis and to engage in activities appropriate for children of her age with her disability.
On April 6, 1984, Mrs. Harper went to the Cleveland, Mississippi, office of the Social Security Administration (SSA) to file a request for a review of the ALJ's decision by the Appeals Council. The events occurring at the office are disputed. Mrs. Harper claims that she was not permitted to file the request because the office would only allow the request to be filed by her legal representative. The SSA claims representative alleges that Mrs. Harper came to the office on April 16 and asked for an appeal form but would not sign any statement requesting assistance.
The Department of Health and Human Services announced on April 13 a moratorium on continuing or restoring benefits in continuing disability review investigation cases where a final decision had not yet been made. A paralegal from the North Mississippi Rural Legal Services assisting Harper believed that the moratorium applied to her case, and therefore they did not file an appeal of the ALJ's decision.
On June 18, 1984, after discovering that the moratorium did not apply to her case, Harper appealed the ALJ's decision to the Appeals Council. On June 25 she was notified that her request for review of the ALJ's decision was not within the required 60-day period and was therefore untimely but was given an opportunity in which to present evidence showing "good cause" for the late filing. Harper's legal representative argued that good cause existed for three reasons: (1) because of Mrs. Harper's initial attempt to file an appeal on April 6, 1984, and the claims representative's refusal to allow her to do so at that time, (2) the claims representative not telling them that Harper's case was not covered by the moratorium until after the appeal time expired, and (3) that Harper's case should have been protected by the moratorium. On December 7 the Appeals Council ruled that Harper had not shown good cause for filing an untimely appeal of the ALJ's decision.
On February 22, 1985, after receiving leave to proceed in forma pauperis, Harper filed an action seeking judicial review of the denial of her request for an extension of time. A magistrate recommended dismissal for lack of jurisdiction based on the failure to timely exhaust the available remedies of the SSA. Harper objected to the recommendation. The district court, however, adopted it and dismissed the case.
The basic question involved in this appeal is whether the district court has subject matter jurisdiction to consider Harper's appeal. Jurisdiction for judicial review of an Appeals Council decision is provided for by Title II of the Social Security Act, section 205(g):
Any individual, after any final decision of the Secretary made after a hearing to which he was a party, irrespective of the amount in controversy, may obtain a review of such decision by a civil action commenced within sixty days after the mailing to him of notice of such decision or within such further time as the Secretary may allow.
42 U.S.C. Sec. 405(g) (emphasis added). Judicial review is limited by section 205(h) to the procedures set forth in the Act. 42 U.S.C. Sec. 405(h). Thus, whether there is jurisdiction depends on whether the actions of the SSA amount to a final decision after a hearing by the Secretary of Health and Human Services (the Secretary) under section 205(g).
The Secretary has established a regulatory system for administrative review, leading up to a final decision that may then be appealed to the district court. The process is begun when an individual files a claim with the SSA for benefits. This claim is either granted or denied, creating an initial determination. See 20 C.F.R. Secs. 416.1404 to 416.1405. Next, the claimant must file a request for and receive a reconsideration. See generally 20 C.F.R. Secs. 416.1407 to 416.1422. The Secretary reviews the claim again, and then issues a reconsidered determination. 20 C.F.R. Sec. 416.1420. After obtaining the initial and reconsidered determinations, a dissatisfied claimant may file for an evidentiary hearing before an ALJ. See generally 20 C.F.R. Secs. 416.1429 to 416.1468. If the claimant objects to the subsequent decision, he or she may appeal the ALJ's determination to the Appeals Council. See generally 20 C.F.R. Secs. 416.1467 to 416.1483. The decision rendered at the initial, reconsideration, and ALJ stage is binding on the claimant unless further administrative review with the Appeals Council is sought within 60 days. These four steps exhaust the claimant's administrative remedies.
Following this exhaustion of the administrative remedies with a final decision being rendered by the Appeals Council, judicial review may be sought in the district court. 20 C.F.R. Secs. 416.1400 and 416.1481. See also Califano v. Sanders, 430 U.S. 99, 108, 97 S.Ct. 980, 986, 51 L.Ed. 192, 201 (1977) (). Although a decision rendered on a claim at each stage of the proceedings is final and binding on the parties unless they proceed to the next step in the process, the regulatory scheme provides that a "final decision" allowing judicial appeal is rendered by the Secretary for the purposes of section 205(g) of the Social Security Act when the Appeals Council either reviews or denies review of the ALJ's decision. See 20 C.F.R. Secs. 416.1405, 416.1421, 416.1455, 416.1481. After such a "final decision," the claimant has 60 days in which to file for judicial review of the decision or else it is binding. 20 C.F.R. Sec. 416.1481.
Thus, the regulations provide for district court review only when the Appeals Council has reviewed or denied a request for review. However, if the Appeals Council dismisses the request for it to review for untimeliness, such "dismissal ... is binding and not subject to further review." 20 C.F.R. Sec. 416.1472. The Appeals Council does have the discretion, however, to grant an extension of time to seek review; extension will be granted if the claimant can show good cause for missing the deadline for review. 20 C.F.R. Sec. 416.1468(b). The regulations provide that the denial of a request for an extension is not subject to judicial review. See 20 C.F.R. Sec. 416.1403(a)(8).
In this case, Harper did not submit a request for review to the Appeals Council within 60 days of the ALJ's decision. Although the Appeals Council dismissed the request for review because it was untimely, it did give Harper an opportunity to show good cause for the late filing. After examining her response, however, the Appeals Council held that good cause did not exist and dismissed the appeal. The Secretary argues, therefore, that since there was only a dismissal and not a review or a denial of review, Harper never obtained a final decision that is subject to review by the district court pursuant to section 205(g).
Harper argues that the dismissal of her case by the district court should be reversed based on Langford v. Flemming, 276 F.2d 215 (5th Cir.1960), and the Eleventh Circuit's application of Langford in Bloodsworth v. Heckler, 703 F.2d 1233 (11th Cir.1983). The Secretary responds that the Supreme Court's decision in Califano v. Sanders, 430 U.S. 99, 97 S.Ct. 980, 51 L.Ed.2d 192 (1977), has implicitly overruled Langford. 1
To resolve this issue, we first examine the relevant cases. In Langford after an ALJ denied Langford's claim, she filed an appeal with the Appeals Council, although it was late. The Appeals Council dismissed her appeal as untimely. Langford subsequently appealed her claim to the district court, which dismissed it for lack of jurisdiction. This court reversed, holding that the Appeals Council's decision not to grant an extension of time in which to appeal the ALJ decision was a final decision of the Secretary and was appealable under section 205(g). Langford, 276 F.2d at 218. The basis for...
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