United States District Court, W.D. Michigan, Southern Division
HUGH W. BRENNEMAN, Jr., Magistrate Judge.
Plaintiff brings this action pursuant to 42 U.S.C. § 405(g), seeking judicial review of the March 26, 2012 decision of the Commissioner of the Social Security Administration (Commissioner) determining that plaintiff was overpaid benefits in the amount of $53, 297 for the period extending June 2007 through September 2011 (AR 12-16).
Plaintiff (sometimes referred to as "claimant") was born on September 24, 1967 (AR 58, 163). The administrative law judge (ALJ) summarized the jurisdictional and procedural history of this matter as follows. Plaintiff received Supplemental Security Income (SSI) payments as a child for chronic and persistent mental illness based on an application filed in May 1990 (AR 12). "The claimant became entitled to auxiliary child's benefits on the record of [his father] Arthur Haege in March 1996... At the time of the application for auxiliary benefits, the claimant's disability was noted and benefits converted after the age of 18 to Childhood Disability Benefits [CDB]" (AR 12). Plaintiff worked while he was receiving benefits, earning $285.00 in 1999, $10, 001.35 in 2000 and $3, 704.41 in 2001 (AR 12). The ALJ stated, without citation to any authority, that "[t]he record did not indicate initiation or completion of a work review with regard to entitlement to childhood disability benefits" and "based on the verified monthly amounts, the claimant was working at substantial gainful levels from February 2000 to November 2000 and in March 2001 (AR 12). It is unclear from the ALJ's statements as to whether plaintiff was receiving CDB, auxiliary child's benefits, or both during the time he worked. While the ALJ noted that "due to the performance of substantial gainful employment by Arthur Haege, the claimant's benefits terminated in 2001, " it is unclear which benefits terminated or exactly when the benefits were terminated, because the ALJ's decision did not cite any documents from the administrative record (AR 12).
The termination date of the benefits appears relevant, because the ALJ stated that Arthur Haege became entitled to Retirement Insurance Benefits in August 2001, but that plaintiff was not listed as a disabled child on Arthur Haege's application for those benefits (AR 12). The ALJ does not explain the relevance of this omission, but does state that plaintiff applied for reentitlement to benefits as a disabled adult child in March 2002 (AR 12). The claim was denied in May 2002 due to plaintiff's substantial gainful earnings after the age of 22 (AR 12-13). The ALJ noted that plaintiff remained entitled to SSI benefits, and these benefits were medically continued in February 2003 following the completion of a medical review (AR 13).
The ALJ provides no further information with respect to plaintiff's situation over the next four years. The ALJ notes that following Arthur Haege's death in March 2007, plaintiff was listed as a disabled child on the application for survivor benefits filed by Carol Haege (AR 13). Nine months later, in December 2007, plaintiff filed for benefits as a disabled adult child based on an onset date of January 1, 1987 (AR 13). Plaintiff was awarded these benefits in February 2008, with entitlement beginning in June 2007 (AR 13). The ALJ, however, does not explain why plaintiff was awarded disabled adult child benefits in February 2008, when he had been denied those benefits back in March 2002. The ALJ also stated that "[a]fter converting to a higher survivor rate in March 2007, SSI benefits were not payable as of April 2008 and subsequently terminated in March 2009" (AR 13).
The ALJ summarized the events which led to the present controversy:
In approximately August 2011, review of the claimant's earnings in 2000 and 2001 resulted in a determination which reopened and reversed the prior February 2008 award. Citing 20 CFR 404.351 and POMS DI 10115.035 and RS 00203.015 as guides, the claimant did not meet the criteria for reentitlement as his prior period of entitlement to childhood disability benefits had not terminated due to his performance of substantial gainful activity but rather, the claimant's entitlement terminated due to Arthur Haege's performance of substantial gainful activity. As such, the claimant had been incorrectly reentitled to benefits as a disabled adult child.
A notice of proposed decision was issued on August 30, 2011 providing due process. The final notice was issued on September 19, 2011. The claimant was subsequently notified of an overpayment totaling $53, 297.00 for the period June 2007 to September 2011 (Ex 2-4, 6, 9).
Further contacts with the local servicing office were viewed as informal requests for appeal of the facts or the amount of the overpayment which remained unchanged. However, the claimant was not issued notices to this effect. Thereafter, the claimant filed a written request, considered a request for hearing on October 4, 2011 (20 CFR 404.929 et seq.) (Ex 7-8).
A hearing was held before the ALJ on February 28, 2012 in West Des Moines, Iowa (AR 167-220). Plaintiff waived his right to representation at the hearing and advised the ALJ that he wanted to proceed pro se (AR 169-71). The ALJ summarized plaintiff's arguments as follows: that he was disabled prior to the age of 22; that the only period of substantial gainful activity took place in 2000; that he remains under a disability; and that he should be reentitled to childhood disability benefits on the record of Arthur Haege (AR 13).
The ALJ determined that plaintiff's claim involved two issues. The ALJ identified the first issue as:
[W]hether the claimant can be reentitled to childhood disability benefits. Under the authority of the Social Security Act, the Social Security Administration has promulgated regulations that provide for the payment of disabled child's insurance benefits if the claimant is 18 years old or older and has a disability that began before attaining age 22 (20 CFR 404.350(a)(5)).
(AR 13-14). The regulation regarding the award of child's benefits provides in pertinent part:
You are entitled to child's benefits on the earnings record of an insured person who is entitled to old-age or ...