Rodysill v. Colvin
| Decision Date | 01 April 2013 |
| Docket Number | 4:12CV3110 |
| Parties | MICK THOMAS RODYSILL, Plaintiff, v. CAROLYN W. COLVIN, Acting Commissioner of Social Security, Defendant. |
| Court | U.S. District Court — District of Nebraska |
This is an action for judicial review of the Social Security Administration (SSA) Commissioner's final decision refusing to allow waiver of recovery for an overpayment of disability benefits for Mick Thomas Rodysill (Rodysill), despite a finding Rodysill was not at fault. Rodysill argues the Commissioner erred by taking Rodysill's spouse's income, their purchase of a home, and a projected income increase into consideration. Rodysill filed a brief (Filing No. 17) in support of the appeal. The Commissioner filed the administrative record (AR.) (Filing No. 15) and a brief (Filing No. 22) in response. Rodysill filed a brief (Filing No. 23) in reply. Section 405(g) provides for judicial review of a "final decision" made by the Commissioner in a proceeding, such as this, brought under Title II of the Social Security Act (the Act), 42 U.S.C. §§ 401 et seq.1
BACKGROUND
On February 5, 1996, at age twenty, Rodysill filed an application for disability benefits based on his inability to work due to diagnosed bipolar disorder (AR. 24). The SSA awarded Rodysill benefits effective January 1, 1996 (AR. 25). The benefits were payable to Rodysill's mother, Marlene Rodysill, who was the representative payee (AR. 262). Although Rodysill did not reside with his mother for the entire period, Rodysill and his mother worked together to report Rodysill's work activity by providing pay stubs to the SSA on a bi-monthly basis (AR. 395-397, 437-446, 544-545). Rodysill has a Bachelor's Degree in art education and works at Lincoln Public Schools as a para-educator (AR. 537, 539). Rodysill stated he was working twenty-five hours each weekduring the 2009-2010 school year, but thought he might work thirty hours each week during the 2010-2011 school year (AR. 540). Rodysill was married in 2007 to Jennifer, who teaches French at a middle school (AR. 246, 538).
On December 2, 2006, the SSA sent Rodysill a notice outlining information forming the basis of a proposed decision concluding Rodysill's disability had ended because he had engaged in substantial work since April 2003 (AR. 147-150). On April 22, 2007, the SSA sent Rodysill a Notice of Disability Cessation, stating that since July 2003 he did not qualify for benefits and he had been overpaid in the amount of $27,039.00 (AR. 163). Rodysill admits he engaged in substantial work activity starting in June 2004 and continuing through April 2007. See Filing No. 17 - Brief p. 2; AR. 190. On March 29, 2009, the SSA sent a Notice of Overpayment, changing Rodysill's end date for benefits to June 2004 and noting the overpayment was $21,929.00 (AR. 190).
On April 23, 2009, Rodysill filed a Request for Waiver of Overpayment Recovery or Change in Repayment Rate with the SSA (AR. 193). In support of the request, Rodysill stated he lived with his wife (AR. 196). Additionally, Rodysill listed two savings accounts, two cars, and a checking account as assets totaling $2,810.88 (AR. 196). Rodysill listed his and his wife's monthly household income from employment as $3,815.39, with Rodysill's income comprising $809.72 (AR. 197). Rodysill listed monthly household expenses as $2,844.20, including a $849.09 mortgage payment for an $88,500 home Rodysill and his wife purchased with a $500.00 down payment on September 15, 2009 (AR. 13, 358, 189-199).
On September 30, 2009, the SSA informed Rodysill it could not approve the request for waiver based on the facts contained in the request (AR. 227). The September 30, 2009, letter scheduled a meeting for Rodysill with an SSA employee to review the file and allow document supplementation prior to a final decision (AR. 227). On October 31, 2009, the SSA determined Rodysill was not eligible for waiver because he should have known he was ineligible for benefits he received while engaging in substantial gainful activity (AR. 229-230). Thus the SSA found Rodysill was at fault for the overpayment (AR. 229). Based on Rodysill's household income and expenses, theSSA proposed he make monthly payments of $300.00 until the SSA recovered the entire overpayment amount (AR. 230).2
On November 17, 2009, Rodysill requested review of the October 31, 2009, determination (AR. 233). In support of the review, Rodysill submitted an April 7, 2010, financial statement listing his household income as $3,540.00, with Rodysill's income comprising $640.00, and household expenses as $3,063.09 (AR. 247-249). The expense amount included $264.00 a month for weekly colonic treatments and supplements (AR. 249). An administrative law judge (ALJ) held a hearing on July 14, 2010 (AR. 526-553). Rodysill failed to provide information that the colonics were medically necessary or prescribed, so the amount was excluded as an ordinary and necessary living expense (AR. 22, 533-534).
On August 25, 2010, the ALJ determined Rodysill was liable for the overpayment, which would not be waived under the circumstances (AR. 23). Although the ALJ found Rodysill was not at fault for causing the overpayment, she determined recovery of the overpayment would not defeat the purpose of Title II of the Act or be against equity and good conscience (AR. 21-22). The Appeals Council denied Rodysill's request for review on April 5, 2012 (AR. 7). Rodysill now seeks judicial review of the ALJ's determination as it represents the Commissioner's final decision.
Rodysill does not dispute the amount of the overpayment. Instead, Rodysill argues recovery of the overpayment in his case defeats the purpose of Title II of the Act or is against equity and good conscience. See Filing No. 17 - Brief p. 1. Rodysill contends the ALJ erred by considering (1) Rodysill may receive a raise in pay after the date of the hearing; (2) Rodysill's wife's income; and (3) Rodysill's purchase of a home. The Commissioner counters the ALJ properly concluded waiver of recovery was inappropriate based on Rodysill's self-reported household income and expenses resulting in an excess sufficient to cover a modest monthly repayment installment. See Filing No. 22 - Response p. 1.
STANDARD OF REVIEW
"Federal courts have jurisdiction over social security claims under 42 U.S.C. § 405(g), which permits judicial review of a final decision of the social security commissioner." Sipp v. Astrue, 641 F.3d 975, 979 (8th Cir. 2011). A district court is to affirm the Commissioner's findings if supported by "substantial evidence on the record as a whole." Sipp, 641 F.3d at 781. "Substantial evidence is defined as less than a preponderance but is enough that a reasonable mind would find it adequate to support the conclusion." Young v. Astrue, 702 F.3d 489, 491 (8th Cir. 2013) (internal quotations and citations omitted); see also Minor v. Astrue, 574 F.3d 625, 627 (8th Cir. 2009) (). "If substantial evidence supports the decision, then [the court] may not reverse, even if inconsistent conclusions may be drawn from the evidence, and even if [the court] may have reached a different outcome." McNamara v. Astrue, 590 F.3d 607, 610 (8th Cir. 2010). The individual seeking waiver of overpayment recovery has the burden of proving he is entitled to waiver. Sipp, 641 F.3d at 781.
DISCUSSION
When an incorrect amount of payment has been made under the disability insurance program, the Act requires the Commissioner to make the proper adjustment or recovery. 42 U.S.C. § 404(a)(1); 20 C.F.R. § 404.501. If the Commissioner made an overpayment, the Act directs the Commissioner to reduce future payments or obtain a refund from either the person who received the benefits or any other person whose wages or income were the basis of the payments to the overpaid person. 42 U.S.C. § 404(a)(1)(A). Even so, the Act prohibits "adjustment of payments to, or recovery by the United States from, any person who is without fault if such adjustment or recovery would defeat the purposes of [the Act] or would be against equity and good conscience." Id. § 404(b); see 20 C.F.R. § 404.506(a). An individual may request waiver of recovery by showing a prohibition applies. See 20 C.F.R. § 404.506(c). In determining whether waiver is allowed under the Act, an ALJ relies on the Program Operations Manual System (POMS). POMS are the SSA's internal proceduralguidelines and "are entitled to respect as publicly available operating instructions for processing Social Security claims." Taylor v. Barnhart, 399 F.3d 891, 897 (8th Cir. 2005) (citation omitted). "While these internal rules do not have legal force and do not bind the Commissioner, courts should consider them in their findings." Hartfield v. Barnhart, 384 F.3d 986, 988 (8th Cir. 2004).
The ALJ determined Rodysill was without fault for the overpayment when considering his mental impairments and sincere attempts to comply with the SSA's rules and procedures requiring him to report his work activity to prevent an overpayment of benefits (AR. 21). The ALJ noted "[Rodysill] and his mother provided letters with attached pay stubs to report his work activity, but a work review was not completed until later and the claimant continued to receive his Title II disability benefit payments, which resulted in the overpayment" (AR. 21). The ALJ found Marlene Rodysill's testimony credible about responding to all SSA correspondence, despite conflicting and confusing notices, because her testimony was consistent with the evidence (AR. 21). The ALJ also noted Marlene Rodysill testified Rodysill "purchased a home and incurred other expenses with full knowledge that the overpayment appeal was pending" (AR. 21). Because the ALJ determined Rodysill was without fault, he is eligible for waiver of repayment if adjustment or recovery would defeat the...
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