The opinion of the court was delivered by: RUBEN CASTILLO
Pursuant to 42 U.S.C. § 405(g), plaintiff Armando Garza ("Garza") brings this action against defendant Shirley S. Chater, Commissioner of the Social Security Administration ("Commissioner"),
seeking judicial review of the Administrative Law Judge's ("ALJ") order dismissing Garza's claim for supplemental security income.
Garza alleges that the ALJ violated Social Security Administration regulations and basic notions of fairness by prohibiting her
from presenting facts under oath that could potentially demonstrate that "good cause" existed for her untimely filing. Commissioner moves to dismiss for lack of subject matter jurisdiction pursuant to Fed. R. Civ. P. 12(b)(1). For the reasons which follow, Commissioner's motion to dismiss is granted.
The following background facts have been drawn from the Certified Administrative Record, which sets forth the procedural history in this matter. Garza filed an application for supplemental security income on May 21, 1992, which was denied initially by notice dated September 29, 1992. (R. 20-32, 33-35) Garza filed a request for reconsideration on January 21, 1993. (R. 36-38) The On reconsideration, the Administration found that the initial determination denying the application was proper and sent notice to Garza of its decision on June 2, 1993. (R. 39-40)
One hundred and forty-seven days later on October 27, 1993, Garza filed a request for a hearing before an administrative law judge. (R. 46-48) At that belated point, Garza was required to submit a statement explaining the reason for the delay in filing the hearing request. Garza, or an administrative representative, gave the following written explanation for the untimely request: "Good Cause. Claimant called 1-800# and asked for appeal forms thru mail and while waiting for forms to arrive, appeals period expired. Protective filing attached." (R. 47)
On February 11, 1994, the ALJ sent notice to plaintiff indicating that a hearing had been scheduled for March 10, 1994, to review her claim. (R. 115) At that hearing, the issue of Garza's late filing of her request for a hearing was considered, and the ALJ found that more information was needed to determine whether good cause existed; at that point, the administrative judge continued the hearing until further information could be obtained. (R. 143, 145-146, 159, 162-163) Then, on June 23, 1994, the ALJ issued a decision to dismiss the request for hearing -- or, in this case, the continuance of the hearing -- based on plaintiff's inability to establish "good cause" for filing the hearing request beyond the sixty-day statute of limitations, 20 C.F.R. §§ 416.1433(b). (R.8-12)
Plaintiff filed a timely appeal with the Appeals Council in which her attorney, Mr. Bryant, submitted a letter from the director of the Neon Street homeless shelter
to show that she filed late for "good cause." (R. 5, 140) The letter explains that during the period June 1993 to October 1993, Garza was a part of the Neon Street Center program. The letter also indicates that at some unspecified period, Garza had to be hospitalized for depression.
The Appeals Council, after reviewing the additional evidence, denied Garza's request for review stating that the letter contained no new or material information about [her] late filing of the request for hearing." (R. 3) On January 26, 1995, plaintiff filed this district court action.
Commissioner maintains that this Court is without subject matter jurisdiction over this action. Specifically, Commissioner claims that Garza has failed to exhaust her administrative remedies with respect to her claim for benefits; thus, there has been no "final decision of the Commissioner as contemplated by Section 405(g) of the Social Security Act. Def.'s Mem. at 1.
I. The District Court's Limited Power of Review
Title II of the Social Security Act (the "Act") and the regulations promulgated thereunder establish Procedures for administrative and judicial review of applications for disability benefits and supplemental security income under the Act. Regulations four and sixteen set forth the administrative procedures by which a claimant may obtain a "final decision" of the Commissioner. An individual takes the first step in the administrative process by filing a claim for benefits with the Social Security Administration. At that point, an "initial determination is rendered granting or denying the claim. 20 C.F.R. §§ 404.902, 416.1402. Claimants who receive adverse initial determinations may request reconsideration of their claim within 60 days. 20 C.F.R. §§ 404.909, 416.1409. The Commissioner may then exercise her discretion to review the merits of the claim once again and issue a "reconsidered determination." 20 C.F.R. §§ 404.907, 416.1407. If the claimant is dissatisfied with the initial and reconsidered determinations, she may request a hearing before an administrative law judge. 20 C.F.R. §§ 404.916, 416.1416 (1995). Such a request must be made in writing to the Social Security Administration within 60 days from the date or receipt of notice of the reconsidered determination -- or, show good cause for late filing. 20 C.F.R. §§ 404.911, .933, 416.1411, .1433.
Under certain circumstances, the claimant will not be granted a hearing before an administrative law judge. For example, untimely filing without good cause is grounds for dismissal. 20 C.F.R. §§ 404.957(c)(3), 416.1457(c)(3). Such dismissal is binding unless vacated by an administrative law judge or the Appeals Council. 20 C.F.R. §§ 404.959, 416.1459. If the claimant is given a hearing that results in an unfavorable decision, she may request discretionary review by the Appeals Council. 20 C.F.R. §§ 404.967, 416.1467. Finally, after exhausting her administrative remedies, the claimant may request federal judicial review. 42 U.S.C. 405(g) (1995).
Judicial review of a claim originating under Title II of the Social Security Act is provided in, and expressly limited by, Section 205(g) and (h) of the Act, 42 U.S.C. § 405(g) and (h). The remedy established within the statute is exclusive; the law has been settled for decades that where a statute creates a right and provides a special remedy, that remedy is exclusive. United States v. Babcock, 250 U.S. 328, 331, 63 L. Ed. 1011, 39 S. Ct. 464 (1919). Section 405(g) requires that the claimant receive a "final decision of the Secretary made after a hearing" to which the claimant was a party before a federal district court may acquire jurisdiction.
42 U.S.C. § 405(g). Although a decision rendered on a claim at each stage of the administrative process is final and binding on the parties, the regulations define a "final decision of the Secretary" for the purpose of § 405(g) as a decision made by the Appeals Council which either reviews or denies review of a determination made by an ALJ after an evidentiary hearing on the merits of the claim. Watters v. Harris, 656 F.2d 234, 236-237 (7th Cir. 1980). Furthermore, § 405(h) strictly limits review of the Commissioner's decision to those methods of review expressly provided within the statute.