the judgment of the ALJ with its own. See id. at 82.
In order for this court to uphold the ALJ's decision, the ALJ must have articulated her analysis at some minimal level. Delgado, 782 F.2d at 83. The evidence need not compel the ALJ's conclusion; rather the evidence must simply support that conclusion. See Walker v. Bowen, 834 F.2d 635, 639-40, 642 (7th Cir. 1987).
Under the SSI guidelines, an individual does not qualify for SSI benefits if his non-excludable resources exceed $ 2,000. 42 U.S.C. §§ 1382(a)(1)(B), (2)(B); 20 C.F.R. §§ 416.1205 (1995). Unspent portions of Title II retroactive payments are included in calculating resources. 20 C.F.R. § 416.1233 (1989). However, here, the retroactive payments made in January 1989 were excluded from this calculation for nine months from the date of payment. Id. Accordingly, Plaintiff's Notice included the statement that the retroactive payment would not be counted for the nine-month grace period when determining his eligibility for benefits.
Benefits are suspended when resources exceed the $ 2,000 limit 20 C.F.R. §§ 416.1240(a), 416.1324(a)(1) (1993). Thus, because his resources exceeded the allowable limit, Plaintiff should not have received benefits after the expiration of his nine-month grace period. Nevertheless, Plaintiff accepted payment, after the grace period, from November 1989 to February 1991 (when his benefits were suspended). Plaintiff was not entitled to those benefits. Thus, the benefits constitute an overpayment.
Plaintiff did apply for a waiver of the overpayment. A two-prong test applies to answer whether waiver of overpayment should be granted. Waiver of overpayment may be granted if (1) the payee was "without fault" in connection with the overpayment and (2) recovery would (a) defeat the purpose of the Act based on the payee's financial circumstances, (b) be against equity and good conscience, or (c) impede effective administration due to the nominal dollar amount at issue. 20 C.F.R. § 416.550 (1995). Where recovery deprives an innocent payee of income required for necessary and ordinary living expenses, such recovery defeats the purpose of the Act. 20 C.F.R. § 416.553 (1994). Recovery runs contrary to equity and good conscience where an innocent payee has changed position in reliance on the overpayment. 20 C.F.R. § 416.554(a) (1994). Nominal dollar amounts are measured by the average administrative cost of the recovery process. 20 C.F.R. § 416.555 (1994).
To establish the first prong of the waiver test, the payee must meet the burden of showing initially that he was "without fault" in obtaining the overpayment. See Heins v. Shalala, 22 F.3d 157, 162-63 (7th Cir. 1994). "Fault" includes acceptance of a payment that one knew or could have been expected to know was incorrect. 20 C.F.R. § 416.552 (1994). Determination of "fault" must include consideration of a payee's individual circumstances such as age, intelligence, education, and physical or mental impairments. Id. This is a subjective test.
In the instant case, the record contains substantial evidence to support the ALJ's determination that Plaintiff did not meet his burden of showing that he was "without fault". The Notice, set forth above, states in plain language that the retroactive payment had to be "spent down" below the resource limit within the nine-month grace period. In addition, Plaintiff discussed the SSI program with an agency representative.
Moreover, Plaintiff is a high-school graduate. One having such qualification is presumed to possess the reasoning, math, and language skills acquired through formal education at the twelfth-grade level or above. 20 C.F.R. § 416.964(b) (1994). Although, as the Commissioner acknowledges, the grade-level completed may not reflect a claimant's actual skills, id., Plaintiff here admits that he has no reading or writing difficulties. In addition, Plaintiff acknowledged that he would have been able to contact the agency if he had any questions concerning his benefits.
Still, Plaintiff argues that he was "without fault" in failing to "spend down" his savings account because he did not understand "how it worked." He alleges that he did not understand the plain language of the Notice and that he was not otherwise notified of the $ 2,000 resource limit, despite meetings with agency representatives. Plaintiff contends that better efforts should have been made to assure his understanding of the rules. However, Plaintiff should not profit from his own failure to investigate his responsibilities under the benefit plan.
The court concludes that the substantial weight of the evidence supports the ALJ's finding that Plaintiff knew, or could have been expected to know, of the impropriety of the November 1989 to February 1991 payments. Thus, Plaintiff was not "without fault" in connection with the overpayment. See 20 C.F.R. § 416.552 (1994).
Where a payee is not "without fault" (and, therefore, fails to meet the first prong of the waiver analysis), the analysis is complete and waiver will not be granted. It is irrelevant that Plaintiff may have been able to satisfy the second prong. See Samuss v. Sullivan, 972 F.2d 352 (7th Cir. 1992) (payee was not "without fault" despite her misunderstanding caused by mental disability).
When excess benefits have been paid, future payments may be adjusted to recover that overpayment. 42 U.S.C. § 1382(b)(1) (1995). Accordingly, the Commissioner may continue to withhold $ 45.00 per month from Plaintiff's benefit check in order to recover the overpayment.
In sum, the ALJ's decision to deny Plaintiff's application for waiver of recovery of the overpayment was not against the substantial weight of the evidence. The Commissioner's Motion for Summary Judgment is granted. Plaintiff's Motion for Summary Judgment is denied.
IT IS SO ORDERED.
CHARLES RONALD NORGLE, SR., Judge
United States District Court