Summary
holding that, in reviewing decisions in cessation of benefits cases, Appeals Council should consider new evidence post-dating ALJ's decision “because an SSI claimant can reestablish eligibility during the post-cessation appeals process without having to file a new application”
Summary of this case from Ferrell v. KijakaziOpinion
02 Civ. 9207 (RWS).
March 23, 2005
NORTHERN MANHATTAN IMPROVEMENT CORPORATION, New York, NY, By: KENNETH ROSENFELD, ESQ., JAMES M. BAKER, ESQ., Of Counsel, Attorneys for Plaintiff.
HONORABLE DAVID N. KELLEY, United States Attorney for the Southern District of New York, New York, NY, By: LORRAINE S. NOVINSKI, Assistant US Attorney Of Counsel, Attorneys for Defendant.
OPINION
Pursuant to Fed.R.Civ.P. 59(e) and Local Civ. R. 6.3, plaintiff Nancy Nieves ("Nieves") has moved for reconsideration of the Court's determination that the end date for determining whether Child Supplemental Social Security Income ("SSI") benefits claimant Jennifer Nieves ("Jennifer") was still disabled was the date of the initial decision to terminate benefits. See Nieves ex rel. Nieves v. Barnhart, No. 02 Civ. 9207 (RWS), 2004 WL 2569488, at *8 n. 13 (S.D.N.Y. Nov. 12, 2004) (the "Opinion"). Also pursuant to Rule 59(e) and Local Civil Rule 6.3, defendant Jo Anne B. Barnhart (the "Commissioner") has moved for reconsideration of the Court's order that Jennifer be provided with interim benefits for the period beginning March 29, 2002, the date of the erroneous Appeals Council determination, and continuing during the pendency of the remand to the Commissioner.Id. at *11.
Nieves' motion was filed on November 23, 2004. Pursuant to the Court's grant of an extension of time to file, the Commissioner's motion was filed on December 8, 2004. Both motions were marked fully submitted without oral argument on December 22, 2004. On January 12, 2005, the Honorable Loretta A. Preska, acting as the Part One Judge for this district, signed a stipulation and order staying the payment of interim benefits in this case pending the Court's resolution of these motions.
Rule 59 provides that "[a]ny motion to alter or amend a judgment shall be filed no later than 10 days after entry of the judgment." Fed.R.Civ.P. 59(e). Local Civil Rule 6.3 provides, in pertinent part, as follows:
A notice of motion for reconsideration or reargument of a court order determining a motion shall be served within ten (10) days after the entry of the court's determination of the original motion, or in the case of a court order resulting in a judgment, within ten (10) days after the entry of the judgment. There shall be served with the notice of motion a memorandum setting forth concisely the matters or controlling decisions which counsel believes the court has overlooked. . . .
Local Civ. R. 6.3 (emphasis in original).
Motions to alter or amend judgments under Rule 59(e) and for reconsideration under Local Civil Rule 6.3 are evaluated under the same standard. See Word v. Croce, No. 01 Civ. 9614 (LTS), 2004 WL 434038, at * 2 (S.D.N.Y. Mar. 9, 2004); Williams v. New York City Dep't of Corr., 219 F.R.D. 78, 83 (S.D.N.Y. 2003);Griffin Indus., Inc. v. Petrojam, Ltd., 72 F. Supp. 2d 365, 368 (S.D.N.Y. 1999). On a motion made pursuant to either rule, "`the moving party must demonstrate controlling law or factual matters put before the court on the underlying motion that the movant believes the court overlooked and that might reasonably be expected to alter the court's decision.'" Word, 2004 WL 434038, at *2 (quoting Parrish v. Sollecito, 253 F. Supp. 2d 713, 715 (S.D.N.Y. 2003)); see also Williams, 219 F.R.D. at 83. Alternatively, "`reconsideration may be granted to correct clear error, prevent manifest injustice or review the court's decision in light of the availability of new evidence.'" Word, 2004 WL 434038, at *2 (quoting Parrish, 253 F. Supp. 2d at 715).
1. Nieves' Motion Is Granted
In the Opinion, the Court noted that a dispute existed between the parties as to the relevant period of time that the Commissioner must examine in order to determine whether a claimant's disability has ended. The Opinion stated:
There is a dispute between the parties as to the relevant time period. Based on the cases cited by the parties (none of which are controlling), this dispute appears to focus on the proper interpretation of 42 U.S.C. § 423(f), which provides that when the [Social Security Administration (SSA")] terminates a claimant's benefits, it must examine "all the evidence available in the individual's case file, including new evidence concerning the individual's prior or current condition" to determine whether "the individual is now able to engage in substantial gainful activity. . . ." Plaintiff interprets this provision to mean that the Commissioner must determine whether any medical improvement occurred between January 17, 1995 and April 16, 2001 (the date of the ALJ's decision). The Commissioner argues that the relevant time period is January 17, 1995 to January 27, 1999 (the date that the benefits were terminated). The statutory provision is ambiguous, and both interpretations are plausible. However, this court is bound to follow an agency's permissible interpretation of an ambiguous statute. Chevron U.S.A., Inc. v. Natural Resources Defense Council, Inc., 467 U.S. 837, 843 (1984). Therefore, the Commissioner's interpretation must control.Nieves, 2004 WL 2569488, at *8 n. 13.
Nieves does not dispute that the Commissioner's plausible interpretation of an ambiguous statute is entitled to deference. Rather, Nieves argues that the position advanced on the Commissioner's behalf during the course of the underlying motion is at odds with the interpretation actually adopted by the Social Security Administration (the "SSA"). According to Nieves, 20 C.F.R. § 416.1476(b)(2), which provides as follows, is dispositive: "In reviewing decisions other than those based on an application for benefits, the Appeals Council will consider the evidence in the administrative law judge ["ALJ"] hearing record and any additional evidence it believes is material to an issue being considered." Furthermore, Nieves argues that the official commentary that accompanied the publication of the current version of 20 C.F.R. § 416.1476 in 1987 makes clear (1) that the phrase "other than those based on an application for benefits" refers to cessation cases and (2) that post-cessation evidence is material because an SSI claimant can reestablish eligibility during the post-cessation appeals process without having to file a new application. See Limit on Future Effect of Applications and Related Changes in Appeals Council Procedures, 52 Fed. Reg. 4001, 4003 (Feb. 9, 1987) (to be codified at 20 C.F.R. pts. 404 416) (stating that "in SSI cases not based on an application for benefits (e.g., cases involving suspension or termination of benefits), the [Appeals Council] will consider additional evidence regardless of whether it relates to the period ruled on by the ALJ or to a subsequent period.")
Nieves has requested that the Opinion be amended to state that the end date for determining disability in SSI cessation cases is the date of the Appeals Council's decision on the recipient's claim for benefits.
In her motion papers, the Commissioner admits that the position taken in the underlying motion with respect to the relevant time period was erroneous. The Commissioner explained that:
[The Commissioner's] counsel was not aware of the error in the Commissioner's position until plaintiff's counsel identified it during oral argument on February 4, 2004. The error was not brought to the Court's attention at that time because of [the government's] belief that the issue was not key to the resolution of this case. . . . The undersigned apologizes to the Court for the inconvenience resulting from her failure to acknowledge the error sooner.
Mem Supp. Def. Mot. Recons., at 2-3 n. 1. Accordingly, the government has joined Nieves' request that footnote 13 of the Opinion be amended.
2. The Opinion Is Amended
Based on the foregoing, footnote 13 of the Opinion is deleted, the first full sentence on page twenty (20) of the hardcopy version of the Opinion is deleted, and the following text is substituted in its place:
Upon remand, the ALJ will consider all material evidence that relates to the period through the date of the ALJ's decision. If Nieves subsequently requests Appeals Council review of the ALJ's decision, the Appeals Council will also consider any additional evidence submitted that relates to a subsequent period.3. The Commissioner's Motion Is Denied
The Commissioner argues that the Court lacked authority to award Jennifer interim benefits based on delay in the resolution of her claim.
As set forth in the Opinion, the Second Circuit has held that a district court has inherent power to award interim benefits to SSI claimants. See Day v. Schweiker, 685 F.2d 19, 24 (2d Cir. 1982) (per curiam), rev'd on other grounds, Heckler v. Day, 467 U.S. 104 (1984) (holding that a district court lacks authority "to prescribe mandatory deadlines with respect to the adjudication of disability claims under Title II of the [Social Security] Act" and declining to "address the propriety of that part of the [d]istrict [c]ourt's order requiring payment of interim benefits"); see also State of New York v. Sullivan, 906 F.2d 910 (2d Cir. 1990) (stating that a district court has "remedial power to award interim benefits prior to administrative readjudication of [SSI and Social Security Disability Insurance] claims").
In support of her argument that the Court lacks authority to award interim benefits during the pendency of the remand, the Commissioner points out that the Social Security Act (the "Act") does not authorize payment of such SSI benefits based on a finding that errors by the Commissioner delayed the resolution of the claim. Rather, according to the Commissioner, the Act authorizes payments of interim benefits based on delay in only one circumstance — i.e., when an ALJ has determined after a hearing that the claimant is entitled to SSI benefits based on disability and the Commissioner has not issued a final decision in the case within 110 days after the date of the ALJ's determination. See 42 U.S.C. § 1383(a)(8)(A).
This argument ignores the fact that the provision of interim benefits to an SSI claimant is an equitable remedy. See Barnett v. Califano, 580 F.2d 28, 33 n. 12 (2d Cir. 1978) (stating that interim benefits are a form of equitable relief);White v. Mathews, 559 F.2d 852, 861 (2d Cir. 1977) (same). It is well established that "[w]hile Congress has the authority to limit the equitable powers and discretion of the federal courts in order to implement important federal policy, such limitation will not be found in the absence of the clear legislative command." Huie v. Bowen, 788 F.2d 698, 704 (11th Cir. 1986) (holding that district court had inherent power to order the payment of retroactive disability benefits even though such remedy was not provided by the Act); see also Califano v. Yamasaki, 442 U.S. 682, 705 (1979) (stating that "[a]bsent the clearest command to the contrary from Congress, federal courts retain their equitable power to issue injunctions in suits over which they have jurisdiction"); Porter v. Warner Holding Co., 328 U.S. 395, 398 (1946) (stating that "[u]nless a statute in so many words, or by a necessary and inescapable inference, restricts the court's jurisdiction in equity, the full scope of that jurisdiction is to be recognized and applied").
Since the Act does not expressly divest the federal courts of their power to provide interim benefits to SSI claimants based on errors by the Commissioner, this Court retains its power to provide such equitable relief under appropriate circumstances.See City of New York v. Heckler, 742 F.2d 729, 740 (2d Cir. 1984) (holding that the Act did not preclude a court from awarding interim benefits under appropriate circumstances),aff'd on other grounds sub nom. Bowen v. City of New York, 476 U.S. 467 (1986).
The City of New York v. Heckler court stated:
We do not construe the recent amendment to [ 42 U.S.C. § 423] as indicating a congressional understanding that federal courts lacked remedial power to order the award of interim benefits in appropriate circumstances. That amendment entitles claimants who are challenging a termination decision to continue to receive benefits throughout their administrative appeals. We see no reason to think that Congress, in authorizing interim benefits during administrative appeals, believed that such benefits were not available during pursuit of judicial remedies. The more plausible interpretation is that Congress was anxious to fill a gap and ensure continuity of benefits on the understanding that, after administrative remedies were pursued, courts had adequate authority to continue interim benefits.Id. at 740.
The Commissioner also argues that the Court's award of interim benefits violates the Appropriations Clause of the United States Constitution, which provides in pertinent part that "No money shall be drawn from the Treasury, but in Consequence of Appropriation made by Law. . . ." U.S. Const. art. I § 9, cl. 7. The Commissioner argues that for the type of claim at issue here — a claim for money from the federal treasury — the "Clause provides an explicit rule of decision." Office of Personal Management v. Richmond, 496 U.S. 414, 424 (1990). That is, "[m]oney may be paid out only through an appropriation made by law; in other words, the payment of money from the Treasury must be authorized by statute." Id. (citing Reeside v. Walker, 11 How. 272, 52 U.S. 272 (1851)).
However, in Richmond, the parties agreed that the sought payment was in direct contravention of the federal statute upon which the ultimate claim to the funds rested. In contrast, the payments at issue here are authorized by statute. The Second Circuit has taken the position that 42 U.S.C. § 405(i) expressly authorizes the payment of interim benefits to SSI claimants whose benefits have been wrongfully terminated. See City of New York v. Heckler, 742 F.2d at 740. The City of New York v. Heckler court explained that "[o]nce the District Court properly invalidated the [Commissioner's] termination decisions because of the acknowledged procedural illegality, the Court was clearly entitled [pursuant to 42 U.S.C. 405 (i)] to reinstate the earlier favorable final decisions pending lawful redeterminations of each claimant's continuing eligibility." Id.
The Commissioner also argues that the payment of interim benefits is barred by the doctrine of sovereign immunity, which provides that "the United States, as sovereign, is immune from suit save as it consents to be sued . . . and the terms of its consent to be sued in any court define that court's jurisdiction to entertain the suit." Lehman v. Nakshian, 453 U.S. 156, 160 (1981) (internal quotations omitted). The Commissioner argues that consistent with this doctrine, a court may not award monetary relief against the federal government absent a congressional enactment waiving the United States' sovereign immunity. United States v. Mitchell, 463 U.S. 206, 212-13 (1983). As described above, the Second Circuit has concluded that in cases of wrongful termination of disability benefits, the SSA expressly authorizes the payment of interim benefits pending lawful redetermination of the claimant's eligibility. City of New York v. Heckler, 742 F.2d at 740. Accordingly, the Second Circuit has concluded that "[the] award of interim benefits [does not violate] the principle of sovereign immunity." Id.
Finally, the Commissioner argues that the Court should vacate its award of interim benefits in light of the possible availability of such benefits pursuant to 42 U.S.C. § 1383 (a)(7)(A) and 20 C.F.R. § 416.996(e)(4). Under the circumstances of this case, the Court's order of interim benefits is the proper remedy to avoid further delay during the redetermination of Jennifer's eligibility for SSI benefits and to undo at least some of the harm caused by the "SSA's failure to abide by the law." City of New York v. Heckler, 742 F.2d at 740.
It is so ordered.