United States District Court, D. Maryland
Commissioner, Social Security Administration;
STEPHANIE A. GALLAGHER UNITED STATES MAGISTRATE JUDGE
March 8, 2018, Plaintiff Judith R. petitioned this Court to
review the Social Security Administration's
(“SSA”) final decision to deny her request for
waiver of an overpayment. [ECF 1]. I have considered the
parties' cross-motions for summary judgment, and
Plaintiff's Reply. [ECF 18, 23, 24]. I find that no
hearing is necessary. See Loc. R. 105.6 (D. Md.
2018). This Court must uphold the decision of the Agency if
it is supported by substantial evidence and if the Agency
employed proper legal standards. See 42 U.S.C.
§§ 405(g), 1383(c)(3); Craig v. Chater, 76
F.3d 585, 589 (4th Cir. 1996). Under that standard, I will
deny Plaintiff's motion, grant the SSA's motion, and
affirm the SSA's judgment pursuant to sentence four of 42
U.S.C. § 405(g). This letter explains my rationale.
was found disabled and began receiving disability benefits as
of August 1, 1993. (Tr. 274). In 2003, Plaintiff returned to
work. (Tr. 35-38). As required, she reported the information
about her return to work to the SSA. (Tr. 310). Almost two
years later, on June 22, 2005, the SSA sent Plaintiff a
letter stating that, “it appears we will decide that
your disability ended because of substantial work February
2004 [sic] and that you are not entitled to payments for: May
2004 through July 2004, September 2004 and continuing.”
(Tr. 39). The letter also states, “[b]ased on the
information we have, your extended period of eligibility
began February 2004 and will end if substantial work is
performed after 36 months following this date.” (Tr.
41). Finally, the letter states, “[u]sually, we find
that work is substantial if gross monthly earnings average
more than the following amounts (followed by a list of
amounts for a given year).” (Tr. 41). The SSA sent
Plaintiff a near-identical letter two weeks later, on July 7,
2005. (Tr. 50-53).
September 13, 2005, Plaintiff submitted an informal waiver
request. (Tr. 229). Then, on September 20, 2005, the SSA sent
Plaintiff a letter stating that, “[w]e received your
request that we not collect the overpayment. You will receive
benefits as follows until we respond to your request . . ..
You will receive $557.00 for September 2005 in October 2005.
After that, you will receive $557.00 on or about the third of
each month.” (Tr. 69). Several years later, on November
6, 2008, the SSA sent Plaintiff another letter stating,
[w]e restarted your Social Security disability payments
during your extended period of eligibility because you were
no longer doing substantial work. However, we now have
information about your work and earnings that could affect
your payments. Based on this information, it appears we will
decide that you are not entitled to payments for: October
2005 through June 2006, October 2006 and continuing.
(Tr. 72). On December 2, 2008, the SSA sent Plaintiff a
letter stating that she owed a new overpayment of $26,
792.70. (Tr. 74). Plaintiff again requested a waiver. The
total amount of the overpayments the SSA ultimately sought to
collect was $34, 604.71. (Tr. 81-82).
request to waive recovery of the overpayment was denied. (Tr.
85-87). A hearing was held on September 12, 2012, before an
Administrative Law Judge (“ALJ”). (Tr. 300-17).
Following the hearing, the ALJ determined that a waiver was
inappropriate because Plaintiff was at fault in causing the
overpayment. (Tr. 19-21). The Appeals Council
(“AC”) issued a decision incorporating and
adopting the ALJ's opinion, and making further findings
in support of a waiver denial. (Tr. 8-10). Plaintiff appealed
the final determination of the SSA. (Tr. 390). On appeal,
this Court remanded the case “for further hearing and
consideration of [Plaintiff's] position.” (Tr.
390-93). Specifically, this Court highlighted the ALJ's
failure to assess Plaintiff's credibility. (Tr. 392). The
AC vacated the earlier decision and remanded the case to an
ALJ for further proceedings. (Tr. 431-33). A second hearing
was held on September 21, 2016. (Tr. 462-516). Following that
hearing, on March 1, 2017, the ALJ issued a partially
favorable decision, determining that Plaintiff was at fault
for $26, 692.70 of overpayment for the periods of October,
2005, through June, 2006, and October, 2006, through
December, 2008, but was not at fault for $7, 912.00 of
overpayment for the periods of May, 2004, through July, 2004,
and September, 2004 through June, 2005. (Tr. 342-47). This
time, the AC denied Plaintiff's request for review, (Tr.
318-22), so the ALJ's 2017 decision constitutes the
final, reviewable decision of the Agency.
case turns on whether the ALJ provided substantial evidence
to support the determination that Plaintiff was not entitled
to a waiver of $26, 692.70 of the overpayment. The ALJ found
that Plaintiff was without fault for the periods of May,
2004, through July, 2004, and September 2004, through June,
2005, but that she was not without fault for the periods of
October, 2005, through June, 2006, and October, 2006, through
December, 2008. (Tr. 344-46). Accordingly, the only issue
before this Court is whether Plaintiff was without fault for
those latter time periods.
overpayment is defined as “the difference between the
amount paid to the beneficiary and the amount of the payment
to which the beneficiary was actually entitled.” 20
C.F.R. § 404.504. When an overpayment occurs, SSA will
adjust any benefit payments due to an overpaid claimant, or
recover the funds by, for example, requiring the claimant to
refund the overpayment. See 42 U.S.C. §
404(a)(1)(A). No. adjustment or recovery is permitted if: (1)
the overpaid individual is without fault and; (2) recovery
would defeat the purpose of Title II of the Act, or be
“against equity and good conscience.” 42 U.S.C.
§ 404(b)(1); Garnett v. Sullivan, 905 F.2d 778,
781 (4th Cir. 1990). In determining whether an individual is
without fault, the Agency will consider all pertinent
circumstances, including any physical, mental, educational,
or linguistic limitations the individual might have.
See 42 U.S.C. § 404(b); 20 C.F.R. §
regulations provide that what constitutes fault on the part
of the overpaid individual depends upon whether the facts
show that the overpayment resulted from:
(a) An incorrect statement made by the individual which he
knew or should have known to be incorrect; or (b) Failure to
furnish information which he knew or should have known to be
material; or (c) With respect to the overpaid individual
only, acceptance of a payment which he either knew or could
have been expected to know was incorrect.
20 C.F.R. § 404.507. The overpaid individual bears the
burden of demonstrating that she is without fault, and that
repayment would be inequitable, or would defeat the purposes
of the Act. Gatewood v. Astrue, Civil No.
JKS-08-1744, 2011 WL 939027, at *2 (D. Md. Mar. 16, 2011)
(citing Valente v. Sec'y of HHS, 733 F.2d 1037,
1042 (2d Cir. 1984); Harrison v. Heckler, 746 F.2d
480, 482 (9th Cir. 1984)). Even when the Agency has some
culpability in making the overpayment, an assessment of fault
applies only to the overpaid individual. See 20
C.F.R. § 404.507. Thus, the fact that the SSA made
overpayments and confused Plaintiff with its correspondence
in this case is not dispositive as to whether ...