Maher v. Mathews

• Decision Date: 30 September 1975
• Docket Number: Civ. A. No. 75-147.
• Citation: 402 F. Supp. 1165
• Parties: Russell MAHER, Plaintiff, v. Forrest David MATHEWS, Secretary, Department of Health, Education and Welfare, Individually and in his official capacity, Defendant.
• Court: U.S. District Court — District of Delaware

402 F. Supp. 1165

Russell MAHER, Plaintiff, v. Forrest David MATHEWS, Secretary, Department of Health, Education and Welfare, Individually and in his official capacity, Defendant.

Civ. A. No. 75-147.

United States District Court, D. Delaware.

September 30, 1975.

COPYRIGHT MATERIAL OMITTED

Peter M. Siegel and Aida Waserstein of Community Legal Aid Society, Inc., Wilmington, Del., for plaintiff.

W. Laird Stabler, Jr., U. S. Atty., Wilmington, Del. and Dorothy Fait, Attorney of the General Counsel's Office of the Department of Health, Education & Welfare, Washington, D. C., of counsel, for defendant.

OPINION

LATCHUM, Chief Judge.

This case is now before the Court for possible disposition under three separate motions: (1) plaintiff's motion for summary judgment pursuant to Rule 56, F.R.Civ.P.;¹ (2) defendant's motion to dismiss pursuant to Rule 12(b)(1), F.R.Civ.P.;² and (3) defendant's motion for summary judgment.³ These motions were filed following a decision issued on June 12, 1975 in which the Court declined to grant preliminary relief to the plaintiff and in which it tentatively certified this action as a class action.⁴ Having heard oral argument and considered the briefs submitted in in connection therewith, the Court is now ready to rule on the above matters.

Plaintiff seeks a declaratory judgment⁵ declaring unconstitutional the defendant's termination, without advance notice and a pretermination hearing, of the monthly benefits plaintiff had been receiving as a "rollback" enrolled in the Supplemental Security Income program ("SSI," codified in Title 16 of the Social Security Act). SSI is a recently established completely federally funded and administered social welfare scheme that is designed to provide subsistence income⁶ for certain categories of individuals. It supersedes all federal grant in aid programs for aid to the permanently and totally disabled ("APTD," former Title 14 of the Social Security Act) which had been both administered and funded in part by the states.⁷ Congress adopted enabling legislation for SSI on October 30, 1972, but in order to ensure SSI's orderly implementation, postponed its effective date until January 1, 1974, decided to continue APTD grants in aid during the interim period, and explicitly provided that any person enrolled in an APTD program in December 1973 would automatically be eligible for SSI benefits.⁸ Subsequently, in mid-autumn of 1973, having been alerted to and having become alarmed by the reported attempts of certain states to pad their APTD programs with clearly ineligible persons,⁹ Congress on the eve of the inauguration of the SSI program amended the "grandfather" provision in the SSI enabling legislation so as to provide that only those persons who had received APTD benefits before July 1973 would be grandfathered into the SSI program. Those persons who had received APTD benefits on or after July 1, 1973 were stripped of such automatic eligibility.¹⁰ It is this classification of APTD beneficiaries, termed "rollbacks," whose rights to procedural due process are at issue in this case.

Russell Maher is a "rollback." Sometime prior to July 1, 1973 he was found eligible for Delaware APTD benefits pursuant to 31 Del.C. § 504 as a permamently and totally disabled individual.¹¹ From and after July 1, 1973 until early December 1973 he received a monthly Delaware APTD check on or about the first of each month. During this period plaintiff apparently had no occasion to consult with the Social Security Administration (SSA) regarding possible SSI benefits and in all probability he was unaware of the impending implementation of the SSI program.

On or about December 21, 1973 plaintiff received in the mail a form letter-notice from the SSA.¹² The front side of the letter-notice was headed in bold face brown print "Supplemental Security Income Payment Decision." Somewhat below this also in brown print there appeared the statement "This is a notice that you are eligible . . . to receive the Supplemental Security Income payment shown above. . . ." Immediately above the statement, but in black "computer printout" type, the letter-notice indicated that beginning in January 1974 plaintiff would receive $135 per month which amount included $5 from the State of Delaware. Immediately below the statement there appeared two paragraphs that were also printed in black "computer printout" type. These paragraphs read as follows:

"The amount of your check is based on all the information we have. If we get new information later, the amount of your check may change."

"You do not need to file an application to get supplemental security income. A gold-colored U. S. government check for the amount shown above will come to you automatically about the first day of each month. This check will take the place of the checks you now get from your state or local public assistance office."

At the bottom of the front page there appeared in bold face brown print this message: "Important: See other side for an explanation of your appeal rights and other information." On the back page of the letter-notice were several paragraphs in brown print which informed the reader that if he disagreed with "this determination" he could request reconsideration through "his social security office" no later than January 31, 1974 and that "the right to receive supplemental security income carries with it certain responsibilities" explained in a booklet that purportedly was enclosed with the letter-notice.

Plaintiff did receive a SSI check in the amount of $135 on or about January 1, 1974. Subsequently, on or about January 29, 1974 he received a second letter-notice from the SSA with virtually the same brown print portions as the previous communication.¹³ It now informed the plaintiff, in black "computer printout" type, that:

"Recently the Congress passed and the President signed legislation increasing the monthly amounts due persons receiving supplemental security income payments. Your new monthly amount $140 is shown above. You will begin receiving this amount in February. The check you receive in February will be higher than the amount shown above since it includes the increase payment due for January."

On or about February 1, 1974 plaintiff received a SSI check in the amount of $145, which included the $5 retroactive payment for the month of January. The next month, and continuing through June 1974, the SSA provided plaintiff with appropriate and timely monthly SSI benefit checks. However, plaintiff did not receive a SSI check for July 1974. In lieu thereof the SSA sent him a form letter that was dated June 10, 1974.¹⁴ The letter opened with these unexpected statements:

"After a careful review of your case, we have found that you are not eligible to receive supplemental security income payments under the provisions of Title XVI of the Social Security Act."

"Under the law, because you had received a disability payment for December 1973 from a State or local public assistance agency, we have been able to send you supplemental security income payments (in a gold-colored check), but only until a decision about your eligibility could be made."

The letter informed plaintiff that "the law" had established one of two requirements that he must meet in order to be eligible for any further SSI benefits. These were explained as either (1) that plaintiff had received a check for at least one month before July 1973 from a State or local public assistance office paid under an APTD program, or (2) that he was now "disabled as defined under the Federal law." The letter went on to state that the SSA had already "carefully reviewed the evidence" in his case and had found that he did not meet either of these requirements so that the SSA could not pay him SSI benefits in the future. At the bottom of the letter there appeared the standard postscript: "Important: see other side for an explanation of your appeal rights and other information."

Plaintiff began his appeal to the SSA as directed by filling out and submitting a standardized SSA form entitled "Request for Reconsideration" on July 8, 1974.¹⁵ Under the appeal process SSI benefits are not paid a "rollback" while an appeal is pending and unresolved in his favor.¹⁶ If the SSA reverses its ineligibility determination, payment of monthly SSI benefits is thereafter resumed and a "rollback" is reimbursed in full retroactively for all SSI benefits withheld from the date of termination. On October 4, 1974 the SSA informed plaintiff that it had affirmed its initial determination, following a "thorough reexamination" of his case.¹⁷ Sometime after October 10, 1974 plaintiff took the next step in the appeal process by filling out and submitting a form entitled "Request for Hearing."¹⁸ The SSA has not yet conducted a hearing with respect to his claim, so that he is still ineligible for SSI benefits.¹⁹

The aforementioned series of communiques from the SSA to the plaintiff are explainable only in light of certain actions taken by the Congress and the SSA after January 1, 1974. To begin with, P.L. 93-233, the legislation creating the "rollback" category, did not indicate how the SSA should treat a "rollback" prior to the SSA's determination of his eligibility for SSI benefits under the federal requirements. And while SSA might have been aware throughout late 1973 of Congress' mounting concern about numerous last minute spurious additions to APTD rolls designated for "grandfathering" into the SSI program as of January 1, 1974, the SSA was not equipped to make a speedy and accurate division of APTD recipients into "rollback" and non-"rollback" categories. In large part this paralysis stemmed from the fact that the SSA had decided to phase in the administrative infrastructure and data base of the SSI program by adopting in toto state welfare agency records and case files concerning APTD recipients, records which had not been indexed or catalogued so as to identify readily whether a...