SSR 77-14c: SECTION 205(a) (42 U.S.C. 405(a)) -- APPLICATIONS -- EFFECTIVE FILING REQUIREMENT FOR ENTITLEMENT TO BENEFITS
20 CFR 404.601 and 404.613
Goff v. Weinberger, (1975-1976 transfer Binder) 1A U.I.R. 14,470 (D. Conn.
aff'd 538 F.2d 309 (2d Cir. 1976),
cert. denied 45 U.S. L.W. 3302 (Oct. 18, 1976)
- Although no formal written application was filed for benefits on behalf of the children until January 1971, the claimant alleges her attorney made telephone contact in July 1959 with the Social Security office. Claimant contends that she was dissuaded from filing an application for benefits in 1959 because of alleged false advice given in a telephone conversation by an employee of the local Social Security office to her attorney, and that because of such false advice, her attorney's oral inquiry should be considered tantamount to a written statement of intent to file an application for benefits, and further that benefits should be payable from the date of death of the wage earner. Held, only a written expression of intent to claim benefits can be accepted and considered as a valid application under the law.
CLARIE, Chief Judge:
This action was brought pursuant to § 205(g) of the Social Security Act, as amended, 42 U.S.C. § 405(g), requesting judicial review of a final decision of the Secretary of Health, Education and Welfare. The Appeals Council reversed the Administrative Law Judge's decision, which had allowed dependents' insurance benefits to the plaintiff and her children retroactive to March 31, 1959. The case comes before the Court on cross-motions for summary judgment pursuant to Rule 56, Fed. R. Civ. P. No remaining factual issues exist to be resolved and the case can now be decided as a matter of law. The legal issue presented is whether or not the record contains substantial evidence to support the Secretary's denial action of survivor's insurance benefits for any month prior to January, 1970; and whether or not any valid application was filed with the Social Security Administration prior to January, 1971. The Court finds that the Secretary's findings are supported by substantial evidence and his decision is therefore affirmed.
At the time of Clayton E. Wooley's death, he was married to the plaintiff, Nellie T. Goff. He died on March 31, 1959 from injuries suffered during the course of his employment by the State of Connecticut and was covered at the time by Workmen's Compensation. At that time the couple had three living children, a stepchild, Jane (Woolley) Turgeon, born June 1, 1949, married during May 1969; James Woolley, born February 3, 1953, and Patricia Woolley, born October 19, 1955.
The plaintiff concedes that no written application for Social Security benefits was formally filed in writing in behalf of the children until January 28, 1971. The defendant awarded payments for one year retroactively back to January, 1970, to the two minor children, James and Patricia, both of whom were under 18 years of age.
The plaintiff thereafter married her present husband, Joseph P. Goff, in 1962. She complains that she and the children should have been qualified to receive benefits commencing on March 31, 1959. Immediately after the death of her husband on March 31, 1959, she applied under Connecticut State Law § 5-144, for Workmen's Compensation and received an award for herself and said children. For that purpose she was represented by retained counsel and consulted him on the question of whether or not she and the children were entitled to receive Social Security Benefits. The attorney stated in an attached affidavit, that he had telephoned the New Britain Social Security Office sometime during July, 1959, to inquire as to the family's eligibility and was informed by a Social Security employee, that since she and the children were already receiving benefits under the State Workmen's Compensation Act, they did not qualify for Social Security insurance benefits.
She now claims that since she was dissuaded from filing in 1959, through the alleged false advice given by an employee of the agency to her attorney, the latter's oral inquiry should be considered tantamount to a written statement of intent to file an application for benefits, as required by § 404.613 of Regulation No. 4. In fact, the Administrative Law Judge here made his finding that the oral telephone inquiry made by the plaintiff's attorney, of which no record could be found, constituted a lawful statement of intent, within the meaning of the Social Security regulations and justified a finding that the claim of the mother and children was valid and effective on March 31, 1959.
Discussion of Law
Title 42 U.S.C. § 405(a) vests in the Secretary the right to make and promulgate procedural regulations to administer the Act. Under these regulations, 20 C.F.R. § 404.601(d) provides:
- ". . . an individual has not 'filed an application' for purposes of sections 202, 216(i), or 223 of the Act . . . until an application on a form prescribed in § 404.602 has been filed in accordance with the regulations in this subpart."
20 C.F.R. § 404.601(e) provides:
- "The term 'to execute an application' (or a written statement, request, or notice . . .) means the completion and signing of the application (or written statement, request, or notice) . . . ."
In furtherance of the foregoing policy, § 404.613 of these regulations provides, that if an individual files a written statement with the Social Security Administration, which indicates an intention to claim benefits and such statement bears his signature, the filing of such statement shall be considered to be the filing of an application for such benefits. Thus the administrative purpose of the Act and its supporting regulations were specifically designed to assure, that only a written expression of intent to claim Social Security benefits should be accepted and considered as a valid application under the law. This case is clearly distinguishable from the case of Tuck v. Finch, 430 F.2d 1075 (4th Cir. 1970), cited by the plaintiff, and the plaintiff concedes that no written record exists in the Social Security office to confirm that an application, written or oral, was ever filed.
The Social Security Act, supplemented by its regulations, was intended to eliminate or at least reduce to a minimum the possibility of fraud, confusion, and laxity in its administration. The vastness of the program makes it essential to adhere to the written application procedure, if there is to be an orderly and controllable system of management for approving claims and paying out insurance benefits.
The plaintiff claims that the defendant is estopped from denying relief, because the agency's own employee dissuaded her from filing a written application. Furthermore, she claims that since the Administrative Law Judge, its own agency employee, found in her favor, the Government has thereby waived any procedural non-compliance by her in failing to file the required written application.
The Government cannot be estopped in this manner from insisting upon the performance of statutory conditions precedent, by the unauthorized acts of a local Social Security office employee.
- "But even assuming that he did receive 'misinformation' in which . . . acted to her detriment, it is plaint that estoppel will not lie against the Government under these circumstances. Parties dealing with the Government are charged with knowledge of and are bound by statutes and lawfully promulgated regulations despite reliance to their pecuniary detriment upon incorrect information received from Government agents or employees. Failure to comply with the applicable statute and regulations precludes recovery against the Government 'no matter with what good reason' the claimant believed she had come within the requirements. Estoppel will not lie regardless of the financial hardship 'resulting from innocent ignorance.' Federal Crop Insurance Corp. v. Merrill, 332 U.S. 380, 68 S.Ct. 1, 92 L.Ed. 10; Walker-Hill Co. v. United States, 162 F.2d 259 (7 Cir. 1947), cert. den. 332 U.S. 771, 68 S.Ct. 85, 92 L.Ed. 356; James v. United States, 185 F.2d 115, 22 A.L.R. 2d 830 (4 Cir. 1950)." Flamm v. Ribicoff, 203 F.Supp. 507, 510 (S.C.N.Y. 1961).
Also see, McIndoe v. United States, 194 F.2d 602, 603 (9th Cir. 1952); and Taylor v. Flemming, 186 F.Supp. 280, 284 (W.D. Arkansas 1960).
While the Administrative Law Judge found that the telephone inquiry made by the plaintiff's attorney constituted a statement of intent on the part of the plaintiff to file for benefits within the meaning of § 404.613, that conclusion was in fact an interpretation of a rule of law applied to the factual circumstances as the judge found them. To press beyond and claim that his ruling, as an employee of the agency, constituted an actual waiver of the defendant's position, so as to estop it from denying benefits, would destroy the quasi-judicial character of the Administrative Law Judge. It would also unduly curb the Secretary's clear statutory right to an effective review of final rulings, pursuant to 42 U.S.C. § 405(b). This statute provides in part:
- "The Secretary is further authorized, on his own motion, to hold such hearings and conduct such investigations and other proceedings as he may deem necessary or proper for the administration of this title." (Emphasis added).
Such a construction would also unduly limit the right to a full judicial review under 42 U.S.C. § 405(g); a result never contemplated by the Congress.
The factual situation found to exist here does not conform to the essential requirements of the Social Security Regulations, 20 C.F.R. §§ 404.602 and 404.613. Failure of the plaintiff to file a timely application under the rules is not simply a non- essential procedural requirement, it is a substantial and basic requirement of the regulations.
- "In examining the regulations promulgated by the Secretary of Health, Education, and Welfare, the Court refers to pertinent provisions of 20 C.F.R. § 404.601 et seq. Under § 404.601, it is required that an individual file an application on a form prescribed by the Administration. Section 404.607(b) provides for benefits retroactive for one year from the date of filing. Section 404.608 sets out the guideline that a written statement, request, notice or application is deemed 'a filing,' but only on the date it is received by the local office. In addition, such a statement must be reduced to the prescribed form within certain periods for it to be effective." Parker v. Finch, 327 F.Supp. 193, 195 (N.D. Ga. 1971).
The defendant Secretary is charged with the duty to weigh the evidence, to resolve material complaints in the testimony and to determine the cases accordingly. Moss v. Gardner, 411 F.2d 1195 (4th Cir. 1969); Staples v. Gardner, 357 F.2d 922 (5th Cir. 1966); Stumbo v. Gardner, 365 F.2d 275 (6th Cir. 1966); Rhinehart v. Finch, 438 F.2d 920 (9th Cir. 1971). The findings of the Secretary are conclusive, if supported by substantial evidence and a proper application of the law.
The Court adopts the findings and decisions of the Appeals Council (Tr. 4-10) as affirmed by the Secretary of Health, Education, and Welfare. The Court finds that the Secretary's determinations were supported by substantial evidence, as required under § 205(g) of the Social Security Act, 42 U.S.C. § 405(g). Newman v. Celebrezze, 310 F.2d 780 (2d Cir. 1962); Dondero v. Celebrezze, 312 F.2d 677 (2d Cir. 1963).
The defendant's motion for summary judgment is granted.
 42 U.S.C. § 405(a) provides: "Rules and regulations. The Secretary shall have full power and authority to make rules and regulations and to establish procedures, not inconsistent with the provisions of this title, which are necessary or appropriate to carry out such provisions, and shall adopt reasonable and proper rules and regulations to regulate and provide for the nature and extent of the proofs and evidence and the method of taking and furnishing the same in order to establish the right to benefits hereunder."