Searching over 5,500,000 cases.

Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

Cheers v. Secretary of Health

decided: November 23, 1979.


Appeal from the United States District Court for the Northern District of Illinois, Eastern Division. No. 78-C-910 -- Joseph Sam Perry, Judge.

Before Pell, Sprecher and Bauer, Circuit Judges.

Author: Pell

In this case, we are asked to review one of those unfortunate occurrences where well-founded law imposes harsh consequences upon the individual. We are asked to review and overturn a final decision of the Secretary of Health, Education, and Welfare denying appellant disabled children's benefits for a period prior to May 1, 1975. The Secretary readily admits appellant was eligible for these benefits at the time, but refuses to grant the benefits because the appellant failed to file a written application as required by the administration's regulations.*fn1

Appellant's mother died in August, 1960. Appellant, through his father, filed at that time a written application with the local Social Security office for surviving children's benefits. This application was correctly denied because appellant was ineligible under the then-existing requirements of the Act.*fn2 Appellant does not contest this denial. On October 10, 1967, appellant sustained a severe injury which caused him to become a permanent paraplegic.

In February 1968, Congress amended the Social Security Act, eliminating the requirements appellant failed to meet in 1960,*fn3 thereby making appellant newly eligible for disabled children's benefits. On April 1, 1976, appellant filed a written application for these benefits which were granted retroactive to April 1, 1975 in accordance with 42 U.S.C. § 402(j)(1) (Supp.1978).*fn4 Appellant requested reconsideration of this award, however, contending he should have received payments for a period prior to 1975 because he had become eligible in 1968, and he or others acting for him had repeatedly inquired orally at local Social Security offices about potential benefits between 1968 and 1975. On reconsideration, however, the Administration affirmed the limited award. A hearing was then held at the appellant's request. Appellant testified that in response to his oral inquiries, he was consistently and incorrectly informed by Administration employees, again orally, that he remained ineligible, and that because of this information, he had failed to file a written application at those times. The Administration has no record of these inquiries, nor do any of its employees recall speaking on this subject with the appellant or anyone acting for him, nor could appellant pinpoint exactly when, where, or with whom these inquiries were made. The Administrative Law Judge (ALJ) held, therefore, that the appellant was not entitled to benefits prior to April 1, 1975. This decision was affirmed by the Social Security Administration Appeals Council, and thus became the final decision of the Secretary. Appellant next filed a Pro se action in the United States district court pursuant to 42 U.S.C. § 405(g), requesting review and reversal of the Secretary's determination. The Secretary moved for summary judgment contending the regulations requiring written applications were a valid exercise of her authority, and that appellant had admittedly violated these regulations. This motion was granted by the district judge and appellant now appeals from that ruling.

In our review of administrative determinations under the Social Security Act, we are constrained by the limitations contained in 42 U.S.C. § 405(g). That section provides that the findings of the Secretary as to any fact are conclusive if supported by substantial evidence. The section also states that if a claim is denied due to the claimant's failure to comply with an Administration regulation, our review shall consider only the claimant's conformity with that regulation and the regulation's validity. In addition, 42 U.S.C. § 405(a) grants the Secretary full power and authority to promulgate rules and regulations which are necessary and appropriate to carry out the provisions of the Act. It is well established, of course, that we must uphold such regulations if they are "reasonably related" to the purposes of the enabling legislation. Mourning v. Family Publications Service, Inc., 411 U.S. 356, 369, 93 S. Ct. 1652, 36 L. Ed. 2d 318 (1972); Thorpe v. Housing Authority of the City of Durham, 393 U.S. 268, 280-81, 89 S. Ct. 518, 21 L. Ed. 2d 474 (1969). Because we feel that the present regulations' aim of reducing fraud, confusion and laxity and increasing accuracy in the administration of the Social Security Act is "reasonably related" to the purposes of the Act, we find that these regulations are a valid and enforceable exercise of the Secretary's power under § 405(a).

The vast majority of prior holdings on this issue is in accord with our decision here. In Leimbach v. Califano, 596 F.2d 300 (8th Cir. 1979), for example, the court squarely faced the exact issue presently before us. In that case, the claimant's mother, the wage earner, died in January of 1967. The children, like appellant here, became eligible for surviving children's benefits with the passage of the 1968 amendments to the Social Security Act. The children's father made a written application for surviving spouse's benefits in November of 1967, but did not inquire about surviving children's benefits until he orally did so sometime in September of 1968. The father could not remember exactly when or with whom these inquiries were made, but he testified that in response to these inquiries the Administration employees erroneously told him that his children remained ineligible. The father claimed he made further oral inquiries in 1970, 1971 and 1972, always receiving the same response. In 1975, he independently learned of his children's eligibility from reading a newspaper article and made a written application which was granted retroactive only to June, 1974. The Administration affirmed the limited award throughout its procedures. The district court, however, reversed, awarding the children benefits as if a written application had been filed in 1968. On appeal, the Eighth Circuit reversed and reinstated the administrative determination. The appellate court held that the regulations were reasonably related to the need for prompt and effective administration of the Act, and thus were a valid exercise of the Secretary's powers under 405(a). See also Goff v. Weinberger, Unempl. Ins. Rep. (CCH) P 14,470 (D.Conn.1975), Aff'd, 538 F.2d 309 (2d Cir. 1976), Cert. denied, sub nom. Goff v. Mathews, 429 U.S. 896, 97 S. Ct. 258, 50 L. Ed. 2d 179.

Appellant has attempted to avoid these and a great number of other cases that have relied upon and applied these regulations, found them to set forth a substantive precondition to the awarding of benefits, and held oral applications insufficient. E.g., Johnson v. U. S., 572 F.2d 697 (9th Cir. 1978); Clark v. Celebrezze, 344 F.2d 479 (1st Cir. 1965); Bender v. Celebrezze, 332 F.2d 113 (7th Cir. 1964); Coy v. Folsom, 228 F.2d 276 (3rd Cir. 1955); Parker v. Finch, 327 F. Supp. 193 (N.D.Ga.1971); Mandelstram v. Celebrezze, Unempl. Ins. Rep. (CCH) P 14,733 (E.D.N.Y.1967); Emerson v. Celebrezze, Unempl. Ins. Rep. (CCH) P 14,237 (N.D.Ga.1965); Smaltz v. Ribicoff, Unempl. Ins. Rep. (CCH) P 14,623 (W.D.Mo.1962); Flamm v. Ribicoff, 203 F. Supp. 507 (S.D.N.Y.1961); McNally v. Flemming, 183 F. Supp. 309 (D.N.J.1960). Appellant characterizes these cases as simply evaluating the respective "applications" in light of the regulations, without evaluating the regulations themselves in light of the philanthropic intent of the Social Security Act. We believe after reviewing these cases in light of the provision of § 405(g) that reviewing courts are to address the validity of the regulations as well as the claimants' compliance with those regulations, that the appellant incorrectly characterizes these prior holdings. However, even if appellant's characterization were correct, we would still choose to follow the Eighth Circuit in Leimbach and would uphold these regulations.

The circumstances of this case demonstrate the need and value of these regulations. At the hearing, the appellant was unable to specify exactly when, where, how often or with whom he or others acting for him inquired about potential benefits between 1968 and 1975. The ALJ made commendable efforts to obtain corroboration for appellant's allegations, corresponding with numerous Administration offices appellant or his representatives may have visited. At least one office affirmatively indicated it had never communicated with the appellant or his representatives, and the other efforts were similarly unsuccessful. Though we appreciate that the appellant proceeded Pro se below,*fn5 he simply was unable to establish the exact dates of his inquiries or the dates he felt his payments should have begun. Appellant testified, for example, that an inquiry was made at one office in 1973, yet other evidence indicated that office was not even opened until 1974. Appellant later testified that the first time he visited an office was in 1975, then, after being corrected, changed his testimony to indicate the first visit to be in 1976. We do not recount this testimony to in any way intimate that appellant deliberately or even unintentionally fabricated his testimony. We fully realize and appreciate the difficulty in remembering specific dates, times, and places of occurrences up to nine years after those occurrences took place. Yet it is this very difficulty that underlines and justifies the need for regulations that require written applications. A written record is simply a practical necessity for the accurate payment of benefits.

Appellant contends that these regulations are invalid, however, and relies upon Holmes v. Weinberger, 423 F. Supp. 149 (E.D.N.Y.1976) which held that under the "exceptional circumstances" of that case, it would order benefits to be granted upon an oral application alone. Holmes involves facts somewhat similar to those before us in this case, with some important differences.

In Holmes, the plaintiff's husband died in 1967 and the plaintiff soon thereafter by telephone inquired of the local Social Security office concerning surviving children's insurance benefits for her son. The office employees advised her to not file a written application until the deceased's social security number could be established. This was, apparently, malefic advice because the Administration's regulations provided for the filing of an application even though the applicant is missing certain information, including a social security number. Nevertheless, based upon this advice, the plaintiff did not file a written application until February, 1973. She sought benefits, however, retroactive to 1967, the time when she could establish her first contact with the Administration. The ALJ granted these retroactive benefits because it found the plaintiff had sufficiently established her inquiries during 1967. The appeals council reversed, though it acknowledged that the plaintiff had orally inquired during 1967, on the grounds that the Administration's regulations provided only for written applications. The district court, on the other hand, noted that the Act required only an "application" without specifying a written application, and held that the regulation requiring a written application conflicted with the "liberal construction" to be accorded the Social Security Act. See, Rosenberg v. Richardson, 538 F.2d 487 (2d Cir. 1976). The court found, therefore, that a "literal application" of the regulations would be "inappropriate," 423 F. Supp. at 152. We believe that the Holmes decision is distinguishable from the instant litigation, but to the extent that Holmes conflicts with our present holding, we respectfully decline to follow it.

The most important distinguishing feature between these two cases, of course, is that in Holmes the ALJ specifically stated that he had "listened to and observed (the claimant's testimony) and (had) no reason to doubt that she made the inquiries alleged," 423 F. Supp. at 150. In addition, the record in Holmes contained copies of two letters mailed to the claimant by the Administration in 1967 which referred to the claimant's "inquiries" about the relevant social security account. In the present case, on the other hand, the ALJ specifically found that there was no persuasive evidence to support the appellant's claim that he had actually inquired about his benefits prior to 1976, and, in fact, stated:

In support of his allegation that he did make contact with the Social Security office prior to April 1976, claimant has offered statements from physicians and friends. These statements indicate that claimant did discuss the fact that he should file for Social Security benefits, but they do not suggest that claimant actually took any action to file an application. . . . At least one of the corroborative statements is a fabrication or at least totally lacking in credibility. Attempts were made to secure corroborative facts relating to the other statements presented by claimant and none were forthcoming.

In light of 42 U.S.C. § 405(g), which states that these findings of fact and credibility determinations are binding upon us if supported by substantial evidence, which we believe they are in the present case, we find the Holmes decision is inapposite to the present controversy. This same analysis also applies to other cases relied upon by appellant: Tuck v. Finch, 430 F.2d 1075 (4th Cir. 1970) (Administration records corroborated allegation of oral application); Crumpler v. Califano, 443 F. Supp. 342 (E.D.Va.1978) (allegation of oral ...

Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.