and Opinion, No. 92 C 5472 (N.D. Ill. July 15, 1993). Blackman and the Secretary now move for summary judgment, pursuant to Fed. R. Civ. P. 56.
1. Summary Judgment
A movant is entitled to summary judgment when the moving papers and affidavits show there is no genuine issue of material fact and that the movant is entitled to judgment as a matter of law. Fed. R. Civ. P. 56(c); Celotex Corp. v. Catrett, 477 U.S. 317, 322, 91 L. Ed. 2d 265, 106 S. Ct. 2548 (1986); Local 103 v. Babcock & Wilcox, 1 F.3d 589, 591 (7th Cir. 1993). A genuine issue of material fact exists when "the evidence is such that a reasonable jury could return a verdict for the nonmoving party." Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248, 91 L. Ed. 2d 202, 106 S. Ct. 2505 (1986).
In considering a motion for summary judgment, the court must consider all evidence in the light most favorable to the nonmoving party. Local 103, 1 F.3d at 591; Biddle v. Martin, 992 F.2d 673, 675 (7th Cir. 1993). However, once the moving party meets its burden of production, the nonmoving party must go beyond the pleadings and set forth specific facts showing that there is a genuine issue for trial. Fed. R. Civ. P. 56(e); Anderson, 477 U.S. at 248; Hickey v. A.E. Staley Mfg., 995 F.2d 1385, 1388 (7th Cir. 1993). Where the nonmovant fails to make a sufficient showing on an essential element of the case on which it would bear the burden of proof at trial, summary judgment is proper. Celotex, 477 U.S. at 322-23.
In this case, there are no genuine issues of material fact;
summary judgment therefore is appropriate. The only contested question in this case is the legal effect of the Secretary's forwarding rule. Blackman and the Secretary move for summary judgment, both contending that they must prevail as a matter of law. Accordingly, the court must decide not whether summary judgment is appropriate, but which side should prevail.
2. The SSI Program And The Forwarding Rule
The SSI program provides basic subsistence to certain classes of needy persons. Howard v. Bowen, 823 F.2d 185, 187 (7th Cir. 1987). Under Title XVI of the Social Security Act, the Secretary must pay benefits under the SSI program to "every aged, blind, or disabled individual who is determined . . . to be eligible on the basis of his income and his resources." 42 U.S.C. §§ 1381a, 1382(a).
The Secretary has prescribed by regulation a four-step eligibility determination process for SSI benefits. See 20 C.F.R. § 416.1001, et seq. A claimant first must apply with the state Disability Determination Service ("the state DDS") for an initial determination of eligibility.
If the state DDS denies the claimant's application, she may seek reconsideration. If the claim again is denied or reconsideration is denied, the claimant is entitled to a hearing before an administrative law judge ("ALJ"). Finally, if the ALJ rejects the claim, the claimant may request review of the ALJ's decision by the appeals council.
To assist in implementing the foregoing regulations, the Secretary has established internal operating rules, set forth in the Program Operations Manual System ("the manual"). The manual provides that when a claimant files an application while she has a prior claim pending before the appeals council, the subsequent application is forwarded to the appeals council for consideration without an initial determination being made by the state DDS. See Manual § DI 20101.025(C)(1) ("the forwarding rule").
The appeals council may consider new and material evidence attached to the subsequent application relating to the period before the ALJ's decision on the first claim, but the appeals council may not consider evidence of a worsened condition or of a new, independent condition that arose after the ALJ's decision. 20 C.F.R. § 416.1470(b).
The appeals council does not rule on the subsequent application. Rather, the appeals council determines whether the subsequent claim concerns essentially the same issues as the first, and is therefore duplicative, or whether it involves issues that arose after the ALJ decision. Pl.'s Mot. Summ. Judg., Ex. 23. The appeals council considers any evidence attached to the second application that may concern the original claim, but it does not address the merits of the subsequent application. Id.7 If the appeals council determines that the subsequent application involves issues that arose after the ALJ's decision, the application is sent to the state DDS for an initial determination -- after the appeals council has ruled on the initial claim. Pl.'s Mot. Summ. Judg., Ex. 3 P 15.
When the appeals council rules that a claimant is entitled to benefits based on the original application, the claimant is awarded benefits from the date she filed the initial claim. 20 C.F.R. § 416.330 However, when the appeals council rules against the claimant on her original application, the subsequent application is sent to the state DDS for initial determination. Thus, when a claimant files a second application, and later has her first claim denied, the net effect of the Secretary's policy is to postpone ruling on SSI eligibility for as much as six months.
3. Counts I And II: The Claimant's Right To Resolution And A Timely Hearing
In Counts I and II, Blackman contends that the forwarding rule violates the Social Security Act. Blackman argues that by forwarding new SSI applications to the appeals council (which does not rule on them), the Secretary fails to meet her statutory mandate. The Social Security Act directs the Secretary:
to make findings of fact, and decisions as to the rights of any individual applying for payment under this subchapter. . . .