Stafford v. Saul
| Decision Date | 13 November 2019 |
| Docket Number | Case No. 18-cv-3016 |
| Parties | ARLENE STAFFORD, Plaintiff, v. ANDREW SAUL, Commissioner of Social Security, Defendant. |
| Court | U.S. District Court — Northern District of Illinois |
MEMORANDUM OPINION AND ORDER
Plaintiff Arlene Stafford ("Plaintiff") brings suit against the Commissioner of Social Security ("Commissioner") seeking review of the determination of the Social Security Administration ("SSA") that Plaintiff was overpaid divorced spouse's benefits and is not entitled to waiver of recovery of the overpayment. Currently before the Court is the Commissioner's motion for summary judgment [22]. For the reasons stated below, the Court denies the Commissioner's motion [22], vacates the Administrative Law Judge's May 3, 2017 hearing decision, and remands the case to the SSA for further proceedings consistent with this opinion. Civil case terminated.
Plaintiff was born on August 24, 1938 and is currently eighty-one years old. In 2000, Plaintiff became entitled to Social Security benefits on the earnings record of her then-husband, Harry Mitchell ("Mitchell"), to whom she had been married for more than forty years. In 2003,Plaintiff and Mitchell divorced. Plaintiff's Social Security benefits were converted to divorced spouse's benefits in December 2003.
On March 3, 2005 Plaintiff married Lawrence Stafford. Plaintiff did not report her remarriage to the SSA at that time. Just over ten years later, on March 17, 2015, Plaintiff applied for Social Security benefits on Stafford's earnings record. This is when the SSA first became aware of Plaintiff's marriage to Stafford. According to Plaintiff, she waited ten years to inform the SSA of her remarriage because she believed based on the advice of a friend who did not work for the SSA that she was required to wait ten years before claiming benefits under Stafford's earning record. Plaintiff also maintains that she was not aware that she had any obligation to promptly report her remarriage to the SSA.
The SSA opened an investigation and determined that Plaintiff was overpaid $78,636.30 in benefits from March 1, 2005 to August 2014 because, upon her marriage to Stafford, she was no longer entitled to benefits under Mitchell's account. The SSA sought repayment from Plaintiff even though, according to Plaintiff and not disputed by the Commissioner, Plaintiff would have been entitled to the same or greater benefits during that period based on Stafford's earnings record. See [27] at 13.
Following hearing, the ALJ determined that Plaintiff had been overpaid $78,636.30. See [14-1] at 22. The ALJ further determined that Plaintiff was not entitled to have recovery of the overpayment waived because she was at fault (the ALJ's reasoning is discussed in the analysis section below). Id. at 21-22. Plaintiff filed a timely request for review of the ALJ's actions by the Appeals Council. The Appeals Council denied Plaintiff's request, concluding without analysis that Plaintiff failed to provide a basis for changing the ALJ's decision. See [14-1] at 5. Plaintiff timely filed the instant appeal. See [1]. In her memorandum in support of reversing theCommissioner's decision [15], Plaintiff argues that the ALJ erred by (1) re-opening her 2004 award of benefits without a regulatory basis; and (2) finding that Plaintiff was not without fault for receiving the overpayment. Plaintiff requests that the Court reverse the ALJ's decision, finding either that there was no statutory basis for reopening the 2004 award of benefits or that Plaintiff was without fault and it would be against equity and good conscience to require repayment. In the alternative, Plaintiff requests remand for additional proceedings.
Currently before the Court is the Commissioner's motion for summary judgment [22].
Because the Appeals Council denied Plaintiff's request for review, the Court evaluates the ALJ's decision "as the final word of the Commissioner of Social Security." Moreno v. Berryhill, 882 F.3d 722, 728 (7th Cir. 2018). The Court may affirm, reverse, or modify the ALJ's decision, with or without remanding the case for further proceedings. 42 U.S.C. § 405(g); Allord v. Astrue, 631 F.3d 411, 415 (7th Cir. 2011). The Court reviews the ALJ's decision to determine if it is supported by substantial evidence, "which has been defined as 'such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.'" Ghiselli v. Colvin, 837 F.3d 771, 776 (7th Cir. 2016) (quoting Pepper v. Colvin, 712 F.3d 351, 631-32 (7th Cir. 2013)). A court reviews the entire administrative record, but does not "reweigh evidence, resolve conflicts, decide questions of credibility, or substitute [its] own judgment for that of the Commissioner." McKinzey v. Astrue, 641 F.3d 884, 889 (7th Cir. 2011) (citation and internal quotation marks omitted).
The ALJ's decision must contain sufficient analysis to allow the Court "to trace the path of the ALJ's reasoning from evidence to conclusion." Lopez v. Berryhill, 340 F. Supp. 3d 696, 700 (N.D. Ill. 2018) (citing Minnick v. Colvin, 775 F.3d 929, 938 (7th Cir. 2015); Jelinek v. Astrue,662 F.3d 805, 812 (7th Cir. 2011)). Thus, "[e]ven if the court agrees with the ultimate result" reached by the ALJ, "the case must be remanded" if the decision does not "build that logical bridge." Id.; see also Craft v. Astrue, 539 F.3d 668, 673 (7th Cir. 2008); Sarchet v. Chater, 78 F.3d 305, 307 (7th Cir. 1996); Ephrain S. v. Berryhill, 355 F. Supp. 3d 738, 743 (N.D. Ill. 2019) ().
The doctrine of harmless error "is applicable to judicial review of administrative decisions." Spiva v. Astrue, 628 F.3d 346, 353 (7th Cir. 2010). "If it is predictable with great confidence that the agency will reinstate its decision on remand because the decision is overwhelmingly supported by the record though the agency's original opinion failed to marshal that support, then remanding is a waste of time." Id.; see also McKinzey, 641 F.3d at 892 (). It is not sufficient for the Court to "find enough evidence in the record to establish that the administrative law judge might have reached the same result had she considered all the evidence and evaluated it as the government's brief does," if, "[h]ad she considered it carefully, she might well have reached a different conclusion." Spiva, 628 F.3d at 353.
A. Whether the ALJ "Reopened" Plaintiff's 2004 Award of Benefits, Such that the Four-Year Time Limitation Set Forth In 20 C.F.R. § 404.988 Would Bar SSA From Seeking Repayment Under the Facts of this Case
The first question raised by the parties' briefs is whether the ALJ had (or needed) authority under 20 C.F.R. § 404.988 to "reopen" Plaintiff's 2004 award of benefits in order to determine that Plaintiff was overpaid. The regulation provides in relevant part that "[a] determination, revised determination, decision, or revised decision may be reopened *** (b) Within four years ofthe date of the notice of the initial determination if we find good cause, as defined in § 404.989, to reopen the case; or (c) At any time if—It was obtained by fraud or similar fault[.]" 20 C.F.R. § 404.988. Plaintiff contends that this regulation applies to proceedings to collect overpayments and that remand is required because the ALJ made no finding that Plaintiff obtained her 2004 award by fraud or similar fault. See [15] at 5. In his motion for summary judgment, the Commissioner argues that (1) Plaintiff failed to exhaust this argument in the SSA and, therefore, has waived it; and (2) SSA's attempt to collect the overpayment from Plaintiff is not a "reopening" of her 2004 award and therefore 20 C.F.R. § 404.988 does not apply.
The ALJ's decision does not address the applicability of 20 C.F.R. § 404.988. In the Commissioner's view, this must be because Plaintiff "made clear" in the proceedings before the SSA "that she was not appealing the overpayment itself, or that she lacked means to repay the overpayment." [23] at 3 (citing AR 43-44, 52). The Commissioner cites to Plaintiff's counsel's September 18, 2015 letter to the ALJ and the December 15, 2015 "report of contact" between Plaintiff's counsel and the SSA in support of his exhaustion argument. However, as Plaintiff points out, she subsequently raised the "reopening" issue to the ALJ, both in her corrected issues statement for the administrative hearing, see [14-1] at 94 () whether she was overpaid, b) whether the Agency can reasonably reopen the prior determination that she was entitled to benefits on her first husband's account, and c) whether Ms. Stafford should be granted a waiver of the requirement that she repay the overpayment."), and in her pre-hearing memorandum, see [14-1] at 103 (). Plaintiff also raised the issue before the Appeals Council.See [14-1] at 109 (). Therefore, the Court is not persuaded by the Commissioner's exhaustion argument.
As Plaintiff requests, see [15] at 5, the Court will remand to the ALJ to determine in the first instance whether, and if so how, 20 C.F.R. § 404.988 applies to the SSA's collection of overpayment from Plaintiff. See Villano v. Astrue, 556 F.3d 558, 562 (7th Cir. 2009) (). Remand is appropriate given the ALJ's expertise applying its own regulations and given that remand is required to address other issues, as well, as discussed in the next section.
B. Whether the ALJ's...
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