The opinion of the court was delivered by: Mihm, District Judge.
The Plaintiff, Robin Adams, has filed suit seeking review of
a final decision by the Secretary of the United States
Department of Health and Human Services finding that she had
received an overpayment of child's benefits to her daughter,
Melissa Hibser, in the amount of $2,223.60 and denying waiver
of that amount. The benefits had been paid pursuant to
42 U.S.C. § 402(d), 405, 416, and 1302. Judicial review is
permitted and defined by 42 U.S.C. § 405(g).
In order to qualify for a waiver of reimbursement under the
Social Security Act, a person must be "without fault" and
there must be a showing that the requirement to return the
overpayment would defeat the purpose of the Act or be against
equity and good conscience.
The burden of proof is on Plaintiff to establish the absence
of fault and the injury to the purposes of the Act or equity
or good conscience.
Judicial review of an Administrative Law Judge's (ALJ)
findings pursuant to these standards is limited to scrutiny of
the record in its entirety and a determination of whether each
essential element of the administrative findings is supported
by substantial evidence. 42 U.S.C. § 405(g); Lechelt v. Cohen,
428 F.2d 214 (7th Cir. 1970); Strickland v. Harris,
615 F.2d 1103 (5th Cir. 1980). Substantial evidence is "such relevant
evidence as a reasonable mind might accept as adequate to
support a conclusion." Richardson v. Perales, 402 U.S. 389, 91
S.Ct. 1420, 28 L.Ed.2d 842 (1971). In making this
determination, the Court must be extremely cautious to avoid
substituting its judgment for that of the ALJ, Strickland v.
Harris, supra) but may also not relieve itself of the problem
of considering and resolving complex issues by "uncritical
rubberstamping of the administrative action." Stark v.
Weinberger, 497 F.2d 1092 (7th Cir. 1974).
If there is a conflict in the evidence, the burden is upon
the claimant to prove that he or she meets the requirements of
eligibility. Johnson v. Weinberger, 525 F.2d 403, 407 (7th Cir.
1975). In addition, an Administrative Law Judge's credibility
determination regarding subjective evidence should be given
considerable weight by the court. Bibbs v. Secretary of Health,
Education & Welfare, 626 F.2d 526, 528 (7th Cir. 1980);
Zblewski v. Schweiker, 732 F.2d 75 (7th Cir. 1984); Zalewski v.
Heckler, 760 F.2d 160 (7th Cir. 1985).
Robin Adams is the mother of Melissa L. Hibser (who was ten
years old on March 7 of this year) and the divorced wife of
Roy Hibser. The Social Security Administration had determined
that Mr. Hibser was disabled and entitled to receive benefits
and, on August 1, 1978, Plaintiff signed an application
prepared by Roy Hibser for benefits for Melissa as permitted
by 42 U.S.C. § 402(d). Payments on the child's behalf began in
January, 1979 and continued until June of 1982 when they were
discontinued by the Administration.
Apparently, during that period of time, Roy Hibser had been
performing substantial, gainful work while continuing to
collect his disability benefits. The Social Security
Administration learned of his deception and, in February of
1982, advised Plaintiff that there appeared to have been an
overpayment of benefits to Melissa and that she had ten days
to present additional evidence for consideration. She was told
that she would be advised when a formal determination was
made. There was no further communication between the
Administration and Plaintiff and all payments were
discontinued effective the end of June, 1982.
On November 12, 1983, Plaintiff received a letter which
informed her that the original overpayment was $10,806.10 but
that, because she had not been notified until February 1982 of
any problem, that $8,582.50 would be excused. The Officer of
Disability Operations told her that the Administration would
not, however, relieve her of the obligation to repay the
balance of $2,223.60 for the period February 1982 through June
1982. Ms. Adams sought and was granted a meeting with claims
representatives of the Administration and, on January 4, 1984,
the revised overpayment was confirmed and waiver was denied.
She was informed of this decision by letter dated March 9,
On that same day she requested a hearing on the overpayment;
that hearing was held on July 12, 1984 before an
Administrative Law Judge. On July 30, 1984, the ALJ issued his
decision affirming the earlier denial of waiver by the
Administration. Thereafter, on October 11, 1984, Plaintiff
sought review of the matter by the Appeals Council and on
April 25, 1985, the Council upheld the ALJ's decision. That
action became the final decision of the Secretary.
The only issue before the Court in this action is whether
the final decision of the Secretary is supported by
substantial evidence in the record.
Plaintiff has no quarrel with the decision of the Social
Security Administration that there was an overpayment because
of Roy Hibser's apparent duplicity or that, as a result of his
activity, her daughter Melissa became ineligible for continued
payment of child's insurance benefits. Plaintiff only objects
to being held responsible for reimbursing the Social Security
Administration for the overpayment to Melissa.
Overpayments and underpayments of benefits are covered under
42 U.S.C. § 404 which is ...