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Leblanc v. Commissioner of Social Security

United States District Court, E.D. Michigan, Southern Division

February 25, 2018

SUSAN E. LEBLANC Plaintiff,
v.
COMMISSIONER OF SOCIAL SECURITY, Defendant.

          Matthew F. Leitman United States District Judge

          REPORT AND RECOMMENDATION CROSS-MOTIONS FOR SUMMARY JUDGMENT (Dkt. 10, 11)

          Stephanie Dawkins Davis United States Magistrate Judge

         I. PROCEDURAL HISTORY

         A. Proceedings in this Court

         On February 2, 2017, plaintiff filed the instant suit seeking judicial review of the Commissioner's unfavorable decision disallowing benefits. (Dkt. 1). This case was referred to the undersigned for all pretrial purposes by District Judge Matthew F. Leitman. (Dkt. 2). This matter is before the Court on cross-motions for summary judgment. (Dkt. 10, 11). Plaintiff was awarded benefits based on a March 2014 application, which entitled plaintiff to benefits beginning from twelve months before her application, meaning from March 2013 forward. The only controverted issue in this matter is plaintiff's contention that she is entitled to benefits beginning in April 2012, based on an application submitted in April 2013.

         B. Administrative Proceedings

         On April 18, 2013, plaintiff appointed attorney Bryan Sunisloe as her representative. (Tr. 62-64). Four days later, she filed an online application for period of disability and disability insurance benefits (DIB). (Tr. 10-11). On May 3, 2013, the Social Security Administration notified plaintiff that her application was incomplete because she failed to submit an Adult Disability Report (Form SSA-3368). (Tr. 13). She was advised, via letter from the Social Security Administration, that she must provide the missing information by May 18, 2013, or her claim would be denied. Id. According to plaintiff, it is undisputed that the Agency did not send plaintiff's representative a copy of the letter containing the above instructions. (Dkt. 10, p. 2; Tr. 13-14). Plaintiff states in her moving papers that her counsel delivered the Adult Disability Report to the Roseville district office on May 17, 2013. (Dkt. 10, p. 3). On May 20, 2013, the Social Security Administration issued a Notice of Disapproved Claim, explaining that plaintiff's DIB claim was denied because she had not submitted the mandatory Adult Disability Report. (Tr. 12, 14). The notice advised plaintiff that she could appeal the decision by submitting a Request for Reconsideration within 60 days. Id. It also stated:

You have the right to file a new application at any time, but filing a new application is not the same as appealing this decision. You might lose benefits if you file a new application instead of filing an appeal. Therefore, if you disagree with this decision you should ask for an appeal within 60 days.

(Tr. 14). The same day the notice was issued, Mr. Sunisloe purportedly filed a Request for Reconsideration, stating that the denial was “contrary to the medical records.” (Tr. 9, 190). Mr. Sunisloe also claims that he personally delivered the Adult Disability Report to the Roseville district office on May 17, 2013 (Pl. Br. 3), although that is not mentioned in the May 20, 2013 Request for Reconsideration. (Tr. 9, 190). According to the Commissioner, there is no record that the Social Security Administration received either the May 17, 2013 Adult Disability Report or the May 20, 2013 Request for Reconsideration.[1] Thus, the Commissioner maintains that the May 20, 2013 Notice of Disapproved Claim stands as the Commissioner's final decision on the April 2013 application, and there has been no further administrative action on that claim.

         On March 5, 2014, plaintiff filed a new DIB application. (Tr. 24, 115-21). She reportedly did so “on advice of counsel, ” who was tired of waiting for a response to the Request for Reconsideration. (Pl. Br. 5). In her new application, plaintiff represented that “NO PREVIOUS APPLICATION HAS BEEN FILED WITH THE SOCIAL SECURITY ADMINISTRATION BY OR FOR ME.” (Tr. 115). The Commissioner's rules prohibit claimants from having “two claims for the same type of benefits pending at the same time.” Social Security Ruling (SSR) 11-1p, 2011 WL 3962767, at *2 (July 28, 2011); see also Program Operations Manual System (POMS) § 51501.001 (directing agency employees not to accept a new disability application when the claimant has a prior claim for the same type of benefits pending at any level of administrative review). According to the Commissioner, if the field office that accepted plaintiff's March 2014 application had discovered a pending Request for Reconsideration on the April 2013 application, then it would have stopped processing the new application and notified her that she must choose between “continu[ing] the pending appeal or withdraw[ing] the pending appeal and continu[ing] the new application.” POMS § DI 51501.010.A. The Commissioner says that did not happen here because the agency had no record of a pending appeal.

         On October 26, 2015, an administrative law judge (ALJ) issued a fully favorable decision after a hearing on plaintiff's March 2014 application. (Tr. 16-24, 25-50). At the hearing, the ALJ asked Mr. Sunisloe if there were any procedural issues for her to resolve and he replied that there were none. (Tr. 29). Plaintiff was awarded disability benefits retroactive to March 2013, in accordance with 20 C.F.R. § 404.621(a). On November 23, 2015, she requested reconsideration of the ALJ's decision, complaining that she “was only paid from March 2013.” (Tr. 189). On February 18, 2016, she re-filed her reconsideration request as a Request for Review of Hearing Decision/Order, arguing that her benefits should have been calculated based on the April 2013 application. (Tr. 6). The ALJ's decision became final on January 10, 2017, when the Appeals Council denied review. See 20 C.F.R. 404.981.

         For the reasons set forth below, the undersigned RECOMMENDS that plaintiff's motion for summary judgment be DENIED, that defendant's motion for summary judgment be GRANTED, and this matter be DISMISSED for lack of subject matter jurisdiction.

         II. THE PARTIES' ARGUMENTS

         As plaintiff explains in her brief, the sole issue in this appeal relates to whether the SSA should be held responsible for paying benefits based on the application for disability benefits filed on April 3, 2013, as opposed to the subsequent application filed on March 5, 2014. Plaintiff maintains that her attorney submitted the requisite information to process the application. According to plaintiff, the local office in Roseville, Michigan failed, omitted and neglected to process the application; accordingly, she was without any recourse other than to file a new application on or about March 5, 2014 seeking disability benefits. The ALJ found claimant to be disabled under ...


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