Tonelli v. Director, Office of Workers' Compensation Programs, U.S. Dept. of Labor

Citation878 F.2d 1083
Decision Date18 March 1988
Docket NumberNo. 87-1455,87-1455
PartiesCharles TONELLI, Petitioner, v. DIRECTOR, OFFICE OF WORKERS' COMPENSATION PROGRAMS, UNITED STATES DEPARTMENT OF LABOR, As Designee of William E. Brock, III, Secretary of Labor, Respondents.
CourtUnited States Courts of Appeals. United States Court of Appeals (8th Circuit)

I. John Rossi, Des Moines, Iowa, for petitioner.

Barbara J. Johnson, Sylvia T. Kaser, Patricia M. Nece, U.S. Dept. of Labor, Washington, D.C., for respondents.

Before HEANEY, ** and JOHN R. GIBSON, Circuit Judges, and HENLEY, Senior Circuit Judge.

HEANEY, Senior Circuit Judge.

Charles Tonelli seeks review of the decision of the Department of Labor's Benefits

                Review Board (BRB) denying his 1982 claim for disability benefits under the Black Lung Benefits Act, 30 U.S.C. Sec. 901 et seq.  (the Act). 1   The BRB concluded that the ALJ did not need to reconsider Tonelli's 1974 claim, as that claim had been abandoned.  It affirmed the ALJ's use of the permanent entitlement criteria under 20 C.F.R. Part 718 and the decision on the merits to deny Tonelli's 1982 claim.  On appeal, Tonelli contends that the BRB erred in finding that his 1974 claim had been abandoned and in refusing to merge his two claims.  We affirm
                
BACKGROUND

Tonelli filed an initial application for benefits under the Act on July 1, 1974. The Department of Labor denied the claim on May 1, 1975. Tonelli took no further action at that time. In 1979, the claim was automatically reviewed by the Department pursuant to the Reform Act, 30 U.S.C. Sec. 945. 2 Tonelli learned of the review on June 6, 1979. The Department informed Tonelli that the information in his file was insufficient to substantiate his claim for benefits but that he had thirty days in which to obtain further medical evidence. Tonelli did not respond, nor did he seek additional evidence. On July 10, 1979, the Department denied his claim by letter. In this letter, Tonelli was informed that he had sixty days either to submit additional evidence or to request a hearing. The letter also notified Tonelli that inaction would result in a finding that his claim was abandoned and that he had a right to request a reconsideration of the denial within one year if his condition changed or if a mistake had been made. Again, Tonelli did not respond.

On February 16, 1982, Tonelli filed a second application for benefits which was denied on January 10, 1983. The deputy commissioner held that Tonelli's 1974 application had been closed because Tonelli failed to appeal or to seek a reconsideration within the requisite time period. A hearing was then held before an ALJ on June 6, 1984. The ALJ held that, because Tonelli failed to respond to the Department's July 10, 1979 letter, his 1974 claim had been abandoned and his 1982 claim was properly evaluated under criteria in 20 C.F.R. Part 718. 3 The ALJ denied Tonelli's claim, finding that Tonelli was not totally disabled due to pneumoconiosis. The BRB affirmed the ALJ's decision in its entirety.

DISCUSSION

On appeal, Tonelli raises several issues, all of which relate to the finding that his 1974 claim had been abandoned. Tonelli argues that the ALJ and BRB erred in finding that he had abandoned his 1974 claim, that the Department of Labor failed to give him the requisite notice of abandonment, and that the ALJ and BRB erred by failing to merge his two claims. This Court's scope of review is limited to an evaluation of whether the ALJ's and the BRB's decisions are rational, supported by substantial evidence and consistent with applicable law. Old Ben Coal Co. v. Luker, 826 F.2d 688, 691-92 (7th Cir.1987); see also, Brazzelle v. Director, Office of Workers' Comp., 803 F.2d 934, 936 (8th Cir.1986) (application of substantial evidence test).

First, in his supplemental brief before this Court, Tonelli disputes the ALJ's Second, Tonelli asserts that, even if he received notice of the initial finding of ineligibility, he had not been properly notified that his claim had been denied by reason of abandonment. Tonelli bases his argument on an alleged interplay between two regulations. The pertinent regulations provide in part:

                factual finding that he received the July 10, 1979 letter from the Department notifying him that his claim had been denied.  This Court will not overturn this finding of fact if it is supported by substantial evidence on the record taken as a whole.  Brazzalle, 803 F.2d at 936.    The record shows that the letter was issued by an Office of Workers' Compensation Programs' claim examiner and sent to Tonelli's home address.  At the 1984 hearing before the ALJ, Tonelli testified that he remembered receiving a letter from the Department of Labor and that he responded to it.  He later contradicted himself by saying he could not remember ever receiving the letter.  Tonelli's wife also testified that he had been notified of the denial and had asked for a review of his claim.  Based on this testimony, we do not believe that the ALJ erred by disbelieving Tonelli's testimony.  There is substantial evidence supporting the determination that Tonelli received the letter notifying him that his claim would be abandoned by failing to respond. 4
                

Sec. 725.409 Denial of a claim by reason of abandonment.

(a) A claim may be denied at any time by the deputy commissioner by reason of abandonment where the claimant fails:

(1) To undergo a required medical examination without good cause; or,

(2) To submit evidence sufficient to make a determination of the claim; or,

(3) To pursue the claim with reasonable diligence.

(b) If the deputy commissioner determines that a denial by reason of abandonment is appropriate, he or she shall notify the claimant of the reasons for such denial and of the action which must be taken to avoid a denial by reason of abandonment. If there is no response to the notice within 30 days after such notice is sent, the claim shall be considered denied by reason of abandonment. If the claimant responds in a timely fashion, indicating a desire to pursue the claim, by requesting a hearing or indicating the intent to submit additional evidence, the deputy commissioner shall, if a hearing is requested, proceed in accordance with Sec. 725.412 or allow a reasonable time of not less than 60 days for the claimant to take the specified remedial action. If the claimant completes the action requested within the time allowed, the claim shall be developed, processed and adjudicated as specified in this part. If the claimant does not fully comply with the action requested by the deputy commissioner, the deputy commissioner shall so notify the claimant. If the claimant does not request a hearing or fully comply with the action requested by the deputy commissioner within 30 days of such notification, the claim shall be considered denied by reason of abandonment, except that a new claim may be filed at any time and new evidence submitted where the requirements of Sec. 725.310 are not met. (emphasis added).

Sec. 725.410 Initial findings by the deputy commissioner.

* * *

* * * (c) If the evidence submitted does not support an initial finding of eligibility, the deputy commissioner shall so notify the claimant in writing. This notification shall specify the reasons why the claim cannot be approved, the additional evidence necessary to establish entitlement, the right of the claimant to submit additional evidence, and the right to request a hearing. Within 60 days from the mailing of such notice, unless such period is extended by the deputy commissioner for good cause shown, the claimant may submit new evidence or request a hearing. If the claimant:

(1) Takes no action within the specified 60 day period, the claim shall be considered denied by reason of abandonment (see Sec. 725.409).

Tonelli asserts that the procedural requirements of 20 C.F.R. Sec. 725.409(b) are incorporated into Sec. 725.410(c)(1) by the parenthetical at the end of the latter provision. If so read, the deputy commissioner would be required to send a 30-day notice letter regarding abandonment after sending and receiving no response to a 60-day initial denial letter. Because Tonelli did not receive a notice of the sort prescribed in Sec. 725.409(b), he claims that the ALJ's finding of abandonment was improper.

This argument was advanced and rejected by the court in Clark v. Director, O.W.C.P., U.S. Dept. of Labor, 838 F.2d 197, 199-200 (6th Cir.1988). We agree with the Sixth Circuit that the advice to "see Sec. 725.409" was not intended to incorporate this regulation into section 725.410(c)(1). As the Department of Labor points out, section 725.410 applies to situations in which there is sufficient evidence in the record and the agency has made a factual determination. Section 725.409, however, applies to situations in which the record does not contain sufficient evidence to allow the agency to make a factual determination. Thus, the two sections cover different stages of the administrative process. In this case, the deputy commissioner found that sufficient facts existed to deny Tonelli's claim and the Department fully notified him of this denial as required by section 725.410. We believe the notice Tonelli received was sufficient. 5

Third, Tonelli argues that under 20 C.F.R. Secs. 725.309(c) and (d), his 1982 claim should have been merged automatically with his 1974 claim and subject to review under Part 727. These regulations provide in pertinent part:

(c) A claimant who filed a claim for benefits under Part B of title IV of the Act or Part C of title IV of the Act before March 1, 1978, and whose previous claim(s) are pending or have been finally denied, who files an additional claim under this part, shall have the later claim merged with any earlier claim subject to review under Part 727 of this subchapter. If an earlier claim subject to review under Part 727 of this subchapter has been denied after review, a new claim filed under this part shall also...

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