Krishnan v. Barnhart

• Decision Date: 16 May 2003
• Docket Number: No. 01-5307.,01-5307.
• Parties: Narayanan KRISHNAN, for Narayanan Deviprasad, Appellant, v. Jo Anne B. BARNHART, Commissioner, Social Security Administration, Appellee.
• Court: U.S. Court of Appeals — District of Columbia Circuit

328 F.3d 685

Narayanan KRISHNAN, for Narayanan Deviprasad, Appellant, v. Jo Anne B. BARNHART, Commissioner, Social Security Administration, Appellee.

No. 01-5307.

United States Court of Appeals, District of Columbia Circuit.

Argued March 11, 2003.

Decided May 16, 2003.

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Appeal from the United States District Court for the District of Columbia (No. 98cv2059).

Paul Schiff Berman, appointed by the court, argued the cause and filed the briefs for appellant.

Fred E. Haynes, Assistant U.S. Attorney, argued the cause for appellee. With him on the brief were Roscoe C. Howard, Jr., U.S. Attorney, R. Craig Lawrence, Mark E. Nagle, Kenneth Leonard Wainstein, Doris D. Coles-Huff and Paul Mussenden, Assistant U.S. Attorneys, and Daniel Balsam, Attorney, Social Security Administration.

Before: RANDOLPH and ROGERS, Circuit Judges, and WILLIAMS, Senior Circuit Judge.

Opinion for the Court filed by Circuit Judge ROGERS.

ROGERS, Circuit Judge:

The underlying issue in this case is whether a non-U.S. citizen applying for disability benefits under the Social Security Act has satisfied an exception to the general rule that alien beneficiaries cannot receive benefits if they have resided outside the United States for six consecutive calendar months, 42 U.S.C. §§ 402(t)(1)(A); 402(t)(4)(A-B) (2000). As the case comes to this court on appeal from a judgment affirming the denial of benefits following a remand to the Social Security Administration ("SSA"), it involves an unauthorized remand by the district court to an agency that failed to fulfill its regulatory responsibilities to assist the applicant. Notwithstanding these procedural errors, because the claimant has failed to make a prima facie showing that he was entitled to receive benefits, we affirm the judgment affirming the agency's denial of benefits.

I.

The qualification for benefits at issue revolves around the claimant's assertion that he had worked the requisite time in qualified employment to come within an exception to the general ban on alien beneficiaries receiving benefits. Title II of the Social Security Act, 42 U.S.C. § 401 et seq., provides monthly insurance benefits to "qualified" individuals who the SSA determines are unable to work because of a disability. See also id. at § 423. Whether a person "qualifies" for benefits depends largely on whether he has acquired the requisite number of "quarters of coverage," or "QCs." See id. at § 413; 20 C.F.R. § 404.101(a) (2002). For calendar years since 1978, the number of QCs that a worker earns is based on a comparison of his total "covered" earnings to the amount designated in SSA's regulations as sufficient to qualify for one QC during that year. 42 U.S.C. § 413; 20 C.F.R. §§ 404.140(c), 404.143(a); see also 20 C.F.R. Pt. 404, Subpt. B, App. Thus, a worker earns one QC if his total covered earnings equal the amount designated in the regulations as sufficient to qualify for one QC during that year, and a worker receives two QCs by earning twice the amount specified in the regulations for a single QC. 20 C.F.R. § 404.143(a). A worker cannot earn more than four QCs in any given year, id., but because the system is based on total annual earnings, an individual need not work the entire year to earn four QCs. For instance, a person could work for one quarter of the calendar year and earn four QCs if his covered earnings during that period were four times the amount required by regulation for one QC. Similarly, a person could earn two QCs if his covered earnings were twice the amount required for one QC whether he worked for three days or half of the year or for the full calendar year.

Importantly, only earnings that are "covered" under social security count toward the calculation of a worker's QCs. See id. at §§ 404.1001, 404.1012. Work performed within the United States is generally covered, subject to a few exceptions. Id. at § 404.1004. The earnings of students who work as employees of the school they are attending, for example, are not "covered" under social security. Id. at § 404.1028. Likewise, on-campus work performed by foreign students attending school in the United States is excluded from employment that is covered for purposes of calculating QCs. Id. at § 404.1036.

Additional provisions of the Social Security Act apply to non-U.S. citizens attempting to receive disability insurance benefits. As pertinent here, § 402(t) of the Act provides that alien beneficiaries cannot receive benefits for any month that occurs after they have been outside the United States for six consecutive calendar months. 42 U.S.C. § 402(t)(1)(A); see also 20 C.F.R. § 404.460(a). This so-called "non-payment provision" has two relevant exceptions: An alien beneficiary who has accrued at least forty QCs, or who has resided in the United States for a period totaling at least ten years, is eligible for benefits regardless of his absence from the United States. 42 U.S.C. § 402(t)(4)(A-B); see also 20 C.F.R. § 404.460(b)(2)(I). These two exceptions to the nonpayment provision do not apply, however, if the beneficiary is a citizen of a foreign country that has a social insurance or pension program of general application, 42 U.S.C. § 402(t)(2), or if the beneficiary resides in a foreign country to which the mailing of U.S. government benefits is prohibited, 42 U.S.C. § 402(t)(10).

An individual who is certified as disabled by the SSA, pursuant to 42 U.S.C. § 421, must file an application to receive benefits. 20 C.F.R. § 404.603. As part of the application, the claimant must provide the SSA with evidence of eligibility. Id. at § 404.704. By definition, evidence is "any record, document, or signed statement that helps to show whether [the claimant is] eligible for benefits." Id. at § 404.702. With regard to proof of a claimant's earnings, however, the only conclusive evidence is an official statement of earnings provided by the SSA, 20 C.F.R. § 404.803, which maintains an earnings record for each person whose employment is covered under the social security program. 42 U.S.C. § 405(c)(2)(A). (If there is an error in the earnings record, it may be corrected pursuant to 20 C.F.R. § 404.822.) A claimant, or his legal representative, can obtain, on request, a copy of the claimant's official SSA earnings statement from the agency free of charge. See 42 U.S.C. §§ 405(c)(2)(a), 1320b-13(a)(3)(A-C); 20 C.F.R. §§ 404.810(a), 422.125(b).

II.

Narayanan Krishnan appeals on behalf of his brother and next friend, Narayanan Deviprasad,¹ the district court's affirmance of SSA's denial of disability benefits to the claimant on the basis of his failure to meet an exception to the general rule that alien beneficiaries cannot receive benefits if they have resided outside the United States for six consecutive calendar months. 42 U.S.C. §§ 402(t)(1)(A); 402(t)(4)(A-B). The brother also appeals the denial of his motion to vacate its earlier remand allowing SSA to supplement the administrative record on which it based its eligibility decision. Through appointed counsel,² the brother urges the court not only to reverse the judgment of the district court, but also to provide equitable relief in the form of disability benefits to the claimant. We hold that the district court erred in remanding the case to SSA, and that SSA violated its regulations. These errors, however, are insufficient to overcome the fact that the original administrative record demonstrates the claimant's ineligibility for benefits; hence, the cases on which his brother relies for equitable relief are inapposite.

A.

The claimant is a citizen of India who came to the United States on August 26, 1981 to pursue a masters degree at Worcester Polytechnic Institute ("Polytechnic"). From September 1981 through May 1983, when he graduated, the claimant worked as a teaching assistant at Polytechnic. Following graduation, he worked in the United States as a computer software engineer. In May 1986, the claimant was diagnosed with paranoid schizophrenia. Over the next five years, he traveled to India periodically for psychiatric treatment and evaluation, but he suffered relapses each time he returned to the United States. Since April 25, 1991, the claimant has been living in India continuously, where he remains in the care of his brother.

The claimant filed an application for social security disability insurance benefits on May 22, 1993, on the basis of disability stemming from schizophrenia. SSA's psychiatrist agreed that the claimant suffers from paranoid schizophrenia, and determined that his disability began April 2, 1991. By a memorandum of February 7, 1994, SSA advised the American Consulate in Bombay of its disability determination, and requested that the claimant's physician in India and his brother complete the forms necessary to process the benefits claim. The American Consulate responded on April 14, 1994, by submitting paperwork to the SSA that showed that the claimant's condition is permanent and deteriorating; that he is a resident of India; and that he had been living outside the United States since April 25, 1991, had no plans to return to the United States, and had authorized his brother to serve as his payee.

On October 11, 1994, the SSA informed the claimant that his disability claim had been awarded, effective February 1992, but that payments to him had been suspended, pursuant to 42 U.S.C. § 402(t)(4), because he had been residing outside the United States for more than six months. The claimant requested reconsideration of the SSA's decision, asserting that he had earned forty-two QCs. To support his claim, the claimant attached to his request a handwritten chart with his place of work and earnings by year. In a series of administrative appeals, SSA rejected the claim, failing on three separate occasions to respond directly to the claimant's assertion of forty-two QCs. First, by letter dated February 21, 1995, the Director of SSA's Office of Disability...