SSR 68-58c: SECTION 205(g). -- JUDICIAL REVIEW -- APPEAL FROM ADMINISTRATION'S REFUSAL TO REOPEN PRIOR FINAL DECISION

20 CFR 404.951; 404.954; 404.957; and 404.958

SSR 68-58c

STEVENS v. GARDNER, U.S.D.C., District of Kansas, Civil No. T-4186 (9-5-67) (CCH U.I.R., Vol. 1, Fed. Par. 14,871)

: Where claimant's first application for disability insurance benefits was denied by the Secretary and subsequently, after the period for requesting judicial review as required under section 205(g) of the Act had elapsed, claimant filed a second application which the Secretary allowed, held, Secretary's decision on first application was final and not subject to judicial review since claimant did not request such review within the time required; accordingly, claimant's right to benefits may be determined solely on the basis of the second application.

TEMPLAR, District Judge:

Anna B. Stevens, claimant, first applied for disability benefits under the Social Security Act on May 26, 1960. This application was duly processed and the final decision denying plaintiff's claim was rendered on January 15, 1962. The right to review such final order by suit in the United States District Court, 422 U.S.C.A. § 405(g) was not exercised by plaintiff.

Thereafter, on January 12, 1965 plaintiff filed a second application with the Department of Health, Education and Welfare. Once again plaintiff exhausted the requisite administrative procedure and on November 15, 1966 the Secretary rendered his final decision denying plaintiff disability benefits under the Act. On December 28, 1966, plaintiff filed this action seeking judicial review, pursuant to 42 U.S.C.A. § 405(g), of the Secretary's denial of plaintiff's second application. The Secretary then filed a motion for a remand pursuant to 42 U.S.C.A. § 405(g) for the purpose of obtaining additional evidence which existed but which had not been presented to the Secretary. This Court granted the motion on February 21, 1967. Thereafter, the Secretary found that claimant was "entitled to a period of disability from February 27, 1959." The position is now taken by the Social Security Administration that the claimant's "entitlement to retroactive benefits must be based solely on the January 12, 1965 application,^[1] and as the Act prescribes that benefits can be retroactive for only one year prior to the filing of an application, the claimant is entitled to benefits from January, 1964, only." It is this position that the plaintiff challenges. Plaintiff contends that "she is entitled to retroactive benefits based on her first application." Therefore, claimant contends that she is entitled to benefits from and after August 27, 1959. * * *

1. The Secretary's decision of January 15, 1962 is final and not reviewable by this court.

Section 205(g) of the Act gives the United States District Court the power to hear Social Security disability complaints. By implication it also sets forth when an application is final and not reviewable by the Court. This section provides:

: Any individual, after any final decision of the Secretary made after a hearing to which he was a party, irrespective of the amount in controversy, may obtain a review of such decision by a civil action commenced within sixty days after the mailing to him of notice of such decision or within such further time as the Secretary may allow. (Emphasis added.)

It would therefore appear that the findings and decision of the Secretary may become final either by lapse of time or by the Court's approval of Secretary's decision. The obvious evils of allowing relitigation of a decision which has become final because of lapse of time is set forth in Hobby v. Hodges, 215 F.2d 754, 759, (10 CA 1954) as follows:

: To permit the applicant to relitigate a claim after failure to obtain a court review within the statutory time would run counter to the apparent purposes and provisions of the Act. (Citations supplied.) If the applicant in this case is permitted to have his claim relitigated, as he has sought to do, there would be no end to the controversy, and the provision in the statute which requires an action to be brought within sixty days after notice of a decision would become meaningless.

In essence, what the claimant is asking this Court to do is to reverse the January 15, 1962 decision of the Secretary and therefore enable the claimant to use the first application as a basis for determining the effective date of the disability benefits. This the Court cannot do because of the fact that the January 15, 1962 decision was final and therefore not reviewable by this Court.

The question now before this Court has been recently litigated by the Sixth Circuit in Sangster v. Gardner, 240 F.Supp. 638 (E.D. Mich. 1965), reversed 3- 22-67 374 F.2d 497 (6th Cir.). In the Sangster case the plaintiff filed an application for Social Security disability benefits which was denied at all stages of review by the Social Security Administration. As the plaintiff here, the claimant Sangster filed a second application for benefits rather than commencing an action in the Federal District Court.

After exhausting the requisite administrative procedure the claimant brought an action in the Federal District Court. The District Court determined that the claimant was entitled to benefits retroactive from the date of the first rather than the second application. In reversing the District Court the Circuit Court states:

: We do not consider that the District Judge was at liberty to enter such order. The denial of the first application was no longer subject to review, and under the second application benefits could not start earlier than December 1959.
: Decisions of the Secretary not reviewed as permitted by the statute, 42 U.S.C. 405(g), are final.

The Court in Sangster held that the effect of starting the benefits in accordance with the first application was to reverse the "Secretary's earlier decision which had become final because Sangster failed to seek District Court review of it."

This Court must therefore rule that the decision of the Secretary denying benefits sought by plaintiff under her claim filed May 26, 1960 and thereafter re-applied for must be sustained.

* * * * * * *

^[1] A decision of the Secretary which is otherwise final under section 404.951 of the Social Security Administration Regulations No. 4 (20 CFR 404.951), may be reopened, as provided in section 404.957 of the Regulations (20 CFR 404.957), within four years after the date of notice of the initial determination to the party to such determination, upon a finding of good cause as described in section 404.958 of the Regulations. In this case, claimant took no action within such 4-year period to establish good cause for reopening decision on first application. [Ed.]

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