20 CFR 404.907 et seq.

SSR 73-44c

James D. Chambers v. Social Security Administration, U.S.D.C., D.Kan., Civil Action L-2296 (11/20/72)

Where claimant for disability insurance benefits was advised on August 15, 1972, that on basis of initial determination he was not entitled to such benefits because he failed to meet statutory disability requirements, and was further advised of his right to request review within 6 months of date of notice, but who instead sought judicial review, held, initial determination is first step in a four-step administrative review system to safeguard rights of a claimant; accordingly, since claimant failed to exhaust the administrative remedies available to him, the court is without jurisdiction to proceed.

O'Connor, District Judge:

By order dated October 19, 1972, we requested that the plaintiff supplement his pleadings by stating whether he has heretofore applied for social security benefits, and if so, whether a final order denying benefits had been entered by the Secretary. The plaintiff has now filed with the Clerk of this Court, a letter from the Department of Health, Education and Welfare, which states that the plaintiff "is not entitled to disability insurance benefits because he fails to meet the disability requirement of the law." However, as stated in our prior memorandum and order, the crucial question before us is whether the plaintiff has adequately exhausted his administrative remedies pursuant to 42 U.S.C. § 301, et seq. Whether plaintiff is entitled to benefits is initially a matter for administrative action, subject only to our limited inquiry as to whether there is "substantial evidence" to support the Secretary's decision. [42 U.S.C.A. § 405(g); Branch v. Finch, 313 F.Sup. 337 (D.C.Kan. 1970); Gardner v. Bishop, 362 F.2d 917 (10th Cir. 1966).] It is fundamental that under Section 405(g), our jurisdiction is limited to reviewing final decisions of the Secretary of Health, Education and Welfare denying requested benefits.

It is apparent that plaintiff has received but an "initial determination" pursuant to 20 C.F.R. 404.907. The court concludes that it presently is without jurisdiction in this matter in that plaintiff has administrative remedies remaining available to him. From the text of the "initial determination" letter itself, it is obvious that plaintiff may request that the case be re-examined within six months of the date of the notice, dated August 15, 1972.

Furthermore, plaintiff is entitled to a hearing, pursuant to 42 U.S.C. § 421(d), 20 C.F.R. 404.917, et seq. If petitioner receives an adverse decision at the hearing, he may then appeal to the Appeals Council, pursuant to 20 C.F.R. 404.938, et seq. At any of these stages, a remand or reconsideration is possible. It is only after plaintiff has fully exhausted his remedies within the structure of the Social Security Administration, that this court would receive the aforementioned limited jurisdiction to review the record to determine whether there exists "substantial evidence" to support the Secretary's decision. Branch v. Finch, supra. From the face of the complaint itself, it is obvious that plaintiff has failed to exhaust the administrative remedies available to him, and that we are without jurisdiction to proceed in this matter until the Secretary has made a final decision.

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