Janice K. v. Kijakazi
| Decision Date | 29 September 2022 |
| Docket Number | 1:21-cv-02330-JMS-MPB |
| Parties | Janice K.,[1]Plaintiff, v. Kilolo Kijakazi, Acting Commissioner of the Social Security Administration, . |
| Court | U.S. District Court — Southern District of Indiana |
Janice K.,[1]Plaintiff,
v.
Kilolo Kijakazi, Acting Commissioner of the Social Security Administration, .
No. 1:21-cv-02330-JMS-MPB
United States District Court, S.D. Indiana, Indianapolis Division
September 29, 2022
ENTRY REVIEWING THE COMMISSIONER'S DECISION
Hon. Jane Magnus-Stinson, Judge United States District Court
Plaintiff Janice K. applied for supplemental security income ("SSI") from the Social Security Administration ("SSA") in December 2014. [Filing No. 10-2 at 58-59.] In March 2017, the SSA determined that Janice K. met the medical requirements to receive SSI. [Filing No. 102 at 64.] Nevertheless, on May 2, 2017, the SSA determined that Janice K. was ineligible for SSI benefits because she did not meet the non-medical eligibility requirements. [Filing No. 10-2 at 64.] Specifically, the SSA determined that Janice K. and her partner were in a "holding out" marriage and had resources in excess of the $3,000.00 limit. [Filing No. 10-2 at 64-70.] On July 6, 2017, the SSA affirmed its ineligibility determination upon reconsideration. [Filing No. 10-2 at 74-76.] On January 8, 2019, a hearing was held before Administrative Law Judge Kevin Walker ("the ALJ"). [Filing No. 10-2 at 22-57.] The ALJ issued a decision on May 28, 2019, concluding that Janice K. is not entitled to benefits because she and her partner, Juan C., are in a "holding out" marriage and possess resources in excess of the $3,000.00 limit. [Filing No. 10-2 at 17-20.]
The ALJ further ordered that Janice K. is liable for overpayment in the amount of $20,518.00. [Filing No. 10-2 at 20.] The Appeals Council denied review, [Filing No. 10-2 at 13], and Janice K. timely filed this civil action asking the Court to review the denial of benefits pursuant to 42 U.S.C. §§ 405(g) and 1383(c), [Filing No. 1]. The Commissioner has filed a "Motion to Affirm in Part and Reverse in Part Pursuant to Sentence Four of 42 U.S.C § 405(g); Alternative Motion for Modification" ("the Motion"). [Filing No. 16.]
I.
Standard of Review
When an applicant for social security benefits appeals an adverse decision, this Court's role is limited to ensuring that the ALJ applied the correct legal standards and that substantial evidence exists for the ALJ's decision. Stephens v. Berryhill, 888 F.3d 323, 327 (7th Cir. 2018). "[S]ubstantial evidence" is such relevant "evidence that 'a reasonable mind might accept as adequate to support a conclusion.'" Zoch v. Saul, 981 F.3d 597, 601 (7th Cir. 2020) (quoting Biestek, 139 S.Ct. at 1154). "Although this Court reviews the record as a whole, it cannot substitute its own judgment for that of the SSA by reevaluating the facts, or reweighing the evidence to decide whether a claimant is in fact disabled." Stephens, 888 F.3d at 327. Reviewing courts also "do not decide questions of credibility, deferring instead to the ALJ's conclusions unless 'patently wrong.'" Zoch, 981 F.3d at 601 (quoting Summers v. Berryhill, 864 F.3d 523, 528 (7th Cir. 2017)). The Court does, however, "determine whether the ALJ built an 'accurate and logical bridge' between the evidence and the conclusion." Peeters v. Saul, 975 F.3d 639, 641 (7th Cir. 2020) (quoting Beardsley v. Colvin, 758 F.3d 834, 837 (7th Cir. 2014)).
If the ALJ committed no legal error and substantial evidence exists to support the ALJ's decision, the Court must affirm the denial of benefits. Stephens, 888 F.3d at 327. When an ALJ's decision does not apply the correct legal standard, a remand for further proceedings is
usually the appropriate remedy. Karr v. Saul, 989 F.3d 508, 513 (7th Cir. 2021). Typically, a remand is also appropriate when the decision is not supported by substantial evidence. Briscoeex rel. Taylor v. Barnhart, 425 F.3d 345, 355 (7th Cir. 2005). "An award of benefits is appropriate only where all factual issues have been resolved and the 'record can yield but one supportable conclusion.'" Id. (quoting Campbell v. Shalala, 988 F.2d 741, 744 (7th Cir. 1993)).
II.
Background
Janice K.'s initial application for SSI states: "I never was married." [Filing No. 10-2 at 58.] In March 2017, the SSA determined that Janice K. met the medical requirements to receive SSI. [Filing No. 10-2 at 64.] However, before the benefits were issued, an SSA representative conducting a "preeffectuation review contact" ("PERC")[2] called Janice K. [See Filing No. 10-2 at 54; Filing No. 10-2 at 78-79.] After speaking with Janice K., the representative determined that Janice K. was in a "holding out" marriage, writing:
I reviewed some of the medical evidence in the file prior to the PERC and found that [claimant] often told medical examiners that she lived with her husband. During the PERC she told me that she lives with her boyfriend and has for at least 10 years. I asked how they introduce each other and she said as husband and wife because it's just easier. They have a joint bank account. About 6 years ago she said they established a "domestic partnership" so that she could be covered on his Eli Lilly health insurance. She acknowledged that she has a common law relationship with Juan [C.], but was not aware as to how this would affect her SSI eligibility. I have determined that they are holding out based on their statements. In particular based on the fact that they consider themselves a domestic partnership
[Filing No. 10-2 at 79.]
In May 2017, the SSA notified Janice K. that although she met the medical requirements to receive SSI, her claim was being denied because she did not meet the non-medical eligibility requirements. [Filing No. 10-2 at 64.] Specifically, the SSA determined that Janice K. and Juan C. jointly owned a 2009 Pontiac Automobile worth $3,350.00 and had two checking accounts, each with a balance of $100.00. [Filing No. 10-2 at 70.] These assets totaled $3,550.00, which is $550.00 over the applicable resource limit. [Filing No. 10-2 at 70.]
Upon reconsideration, the SSA affirmed its conclusion that Janice K. was ineligible for SSI benefits, writing: "You alleged on the appeal form that you are 'not married.' This is true, but for SSI[,] a couple is considered married if they hold themselves out as a married couple to the community in which they live." [Filing No. 10-2 at 74.]
Janice K. requested a hearing before the ALJ, which was held on January 28, 2019. [Filing No. 10-2 at 22-57.] At the hearing, Janice K. testified that she and Juan C. had been in a relationship for 12 years. [Filing No. 10-2 at 30.] She stated that they chose not to get married because they had each been married twice before, "it didn't work out for either one" of them, and they decided not to "do it again." [Filing No. 10-2 at 30.]
Janice K. testified that she lives with Juan C. in a home that he owns. [Filing No. 10-2 at 29.] He refuses to put her name on the deed and will not give her rights of survivorship. [Filing No. 10-2 at 37.] Juan C. pays for housing costs and utilities, while Janice K. buys her own food using food stamps. [Filing No. 10-2 at 29-30.] Juan C. also pays for the gas and registration for Janice K.'s vehicle and gives her cash to cover other expenses. [Filing No. 10-2 at 31-32.]
Janice K. testified that she and Juan C. have powers of attorney for each other, and she is a beneficiary of his life insurance, along with his mother and sister. [Filing No. 10-2 at 37.] Janice K. explained that she wanted Juan C. to have a power of attorney so that, in the event of
her death, he can make her funeral arrangements and sell her property to cover the costs. [Filing No. 10-2 at 38.]
Janice K. testified that she receives health insurance through Eli Lilly ("Lilly"), where Juan C. is employed. [Filing No. 10-2 at 30.] Janice K. is covered as Juan C.'s "domestic partner." [Filing No. 10-2 at 42-43.] Lilly defines a "domestic partner" as "a qualified adult who lives with a Lilly employee or retiree but who is not legally married to the employee or retiree," and provides that "[p]artners may be the same sex or the opposite sex." [Filing No. 10-2 at 148.] Lilly has several requirements for establishing a domestic partnership, including among other things that the employee and the domestic partner "are financially interdependent" and that "[n]either the employee nor the domestic partner is currently married." [Filing No. 10-2 at 148.]
Regarding the medical records that purportedly identify Juan C. as Janice K.'s husband,[3]the following exchange occurred between the ALJ and Janice K.:
[ALJ:] Okay. Now, obviously, your doctors, at least for a while, thought you were husband and wife. And I, and I know that doctors get in their mind, certain things and it get[s] in the file one time and that's, carries through for the rest of eternity. You know, we see that all the time.
[Janice K.:] I don't understand. Dr. Patel's my psychiatrist.
[ALJ:] Uh-huh.
[Janice K.:] He doesn't even see Juan. He's never even met Juan, so, where he got the impression that we're husband and wife -- 'cause when I go in to see him, he'll, he'll say something about, so how's your boyfriend doing or -
[ALJ:] Mm-hmm.
[Janice K.:] -- how's Juan doing? He's never even done that, so why he listed us that way, I don't know. Dr. Rogers is the family physician that Juan referred me to and he knows that Juan and I live together, so maybe there was some confusion there.
[ALJ:] Okay.
[Janice K.:] Although, generally, when I go to see him, it's about my illness, it has nothing to do with Juan.
[Filing No. 10-2 at 32-33.]
When asked by her attorney if she sometimes introduces Juan C. as her husband "just 'cause it saves time," Janice K. responded:
Never. I've never introduced him as my husband. I have introduced, I introduced him as my boyfriend. People ask me why don't you get married and I tell them the same thing I told you. We've both done that before and we're not about to do...
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