United States District Court, W.D. Tennessee, Eastern Division
WILLIAM T. CARSLEY, Plaintiff,
COMMISSIONER OF SOCIAL SECURITY, Defendant.
GRANTING DEFENDANT'S OBJECTIONS TO REPORT AND
RECOMMENDATION, ADOPTING REPORT AND RECOMMENDATION ONLY TO
THE EXTENT IT RECOMMENDS REVERSAL OF THE COMMISSIONER'S
DETERMINATION, AND REVERSING AND REMANDING TO THE
COMMISSIONER FOR FURTHER CONSIDERATION
DANIEL BREEN UNITED STATES DISTRICT JUDGE.
complaint in this action was filed on May 1, 2012, by the
pro se Plaintiff, William T. Carsley. On February 3,
2017, the matter was referred to United States Magistrate
Judge Charmiane G. Claxton for a report and recommendation.
(Docket Entry (“D.E.”) 18.) On March 3, 2017,
Judge Claxton recommended that the final decision of the
Commissioner be reversed, the Plaintiff's waiver of
overpayment of benefits be granted, benefits withheld from
the claimant as a result of recoupment of overpayments be
reimbursed, and judgment be entered pursuant to Sentence
Three of 42 U.S.C. § 405(g) modifying the
Commissioner's decision. (D.E. 19.) On March 16, 2017,
the Commissioner filed timely objections to the magistrate
judge's report and recommendation. (D.E. 20.) As no
response to the Commissioner's objections has been filed
and the time therefor has expired, this matter is ripe for
COURT'S REVIEW OF MAGISTRATE JUDGE'S DETERMINATION
objections have been filed with respect to a report and
recommendation of the magistrate judge, the district judge
“shall make a de novo determination of those portions
of the report or specified proposed findings or
recommendations to which objection is made.” 28 U.S.C.
§ 636(b)(1); see also Fed. R. Civ. P. 72(b)(3).
He “may accept, reject, or modify, in whole or in part,
the findings or recommendations made by the magistrate
judge.” 28 U.S.C. § 636(b)(1); see also
Fed. R. Civ. P. 72(b)(3). The district judge may not
“simply concur” in the magistrate judge's
findings, but must “conduct [his] own review in order
to adopt the recommendations.” Fharmacy Records v.
Nassar, 465 F. App'x 448, 456 (6th Cir. 2012) (per
curiam) (internal quotation marks omitted). “[T]he
filing of an objection does not oblige the district court to
ignore the report and recommendation; it requires the court
to give fresh consideration to the finding objected to
insofar as the objection impugns the integrity of the
Plaintiff began receiving disability insurance benefits
(“DIB”) on March 1, 1991.On December 21, 2009, the Social
Security Administration (“SSA”) issued a notice
informing him that he was overpaid in the amount of $27, 135
for the period from March 2008 to November 2009.
(Administrative Record (“AR”) 74-77.) The
claimant sought a waiver of the overpayment and, after a
hearing before the Administrative Law Judge
(“ALJ”) on July 14, 2011, at which Carsley
represented himself, the waiver was granted. (AR 22-26.) The
ALJ concluded that, while the claimant was overpaid, he was
not at fault in causing the overpayment and recovery of the
payment defeated the purpose of Title II of the Social
Security Act, 42 U.S.C. § 401, et seq. On
November 17, 2011, the Appeals Council decided, sua
sponte, to review the determination of the ALJ and
agreed that Carsley had been overpaid, but found he was not
without fault in the overpayment and denied the waiver. The
instant appeal of the Appeals Council's determination
as here, the Appeals Council grants review of a claim, its
determination becomes the Commissioner's final decision.
See Sims v. Apfel, 530 U.S. 103, 106-07 (2000);
Snell v. Apfel, 177 F.3d 128, 132 (2d Cir. 1999);
Walker v. Sec. of Health & Human Servs., 884
F.2d 241, 244 (6th Cir. 1989). The determination of the
Commissioner must be affirmed if the correct legal standards
were used and the decision is supported by substantial
evidence. Bowman v. Comm'r of Soc. Sec.___, F.
App'x ___, 2017 WL 1065553, at *3 (6th Cir. Mar.
21, 2017). “Substantial evidence exists if a reasonable
mind might accept the relevant evidence as adequate to
support” the decision. Mueller v. Comm'r of
Soc. Sec., ___ F. App'x ___, 2017
WL 1065550, at *1 (6th Cir. Mar 21, 2017) (per curiam).
“The substantial-evidence standard presupposes that
there is a zone of choice within which the decisionmakers can
go either way, without interference by the courts.”
Blakley v. Comm'r of Soc. Sec., 581 F.3d 399,
406 (6th Cir. 2009) (quoting Mullen v. Bowen, 800
F.2d 535, 545 (6th Cir. 1986)). “Therefore, if
substantial evidence supports the [Commissioner's]
decision, th[e] [c]ourt defers to that finding even if there
is substantial evidence in the record that would have
supported an opposite conclusion.” Id.
(internal quotation marks omitted). When considering whether
substantial evidence supports the Commissioner's
decision, the district courts “do not try the case de
novo, resolve conflicts in evidence, or decide questions of
credibility.” Bass v. McMahon, 499 F.3d 506,
509 (6th Cir. 2007).
404 of the Social Security Act permits the Commissioner to
recover from persons to whom Social Security benefits have
been overpaid those monies in excess of the correct amount.
42 U.S.C. § 404(a)(1). The statute further provides,
however, that recovery may not be had from “any person
who is without fault if such . . . recovery would defeat the
purpose of [the statute] or would be against equity and good
conscience.” 42 U.S.C. § 404(b)(1); see
also 20 C.F.R. § 404.506(a).
threshold inquiry in determining whether an overpayment of
benefits should be waived is the “fault” of the
beneficiary. Watson v. Sullivan, 940 F.2d 168, 171
(6th Cir. 1991) (per curiam); Chavez v. Comm'r of
Soc. Sec., No. 1:14-cv-532, 2015 WL 1730371, at *2 (S.D.
Ohio Apr. 14, 2015), report & recommendation
adopted 2015 WL 4540138 (S.D. Ohio July 27, 2015).
“Although the [SSA] may have been at fault in making
the overpayment, that fact does not relieve the overpaid
individual . . . from whom the [SSA] seeks to recover the
overpayment from liability for repayment if such individual
is not without fault.” 20 C.F.R. § 404.507. As
explained in the regulation, fault depends “upon
whether the facts show that the incorrect payment to the
individual . . . resulted from . . . [a]n incorrect statement
made by the individual which he knew or should have known to
be incorrect”; “[f]ailure to furnish information
which he knew or should have known to be material”; or
“acceptance of a payment which he either knew or could
have been expected to know was incorrect.” Id.
Section 404(b) provides that “[i]n making for purposes
of [analyzing fault] any determination of whether any
individual is without fault, the Commissioner of Social
Security shall specifically take into account any physical,
mental, educational, or linguistic limitation such individual
may have[.]” 42 U.S.C. § 404(b)(2); see
also 20 C.F.R. § 404.507 (the Commissioner
“will consider all pertinent circumstances, including
the individual's age and intelligence, and any physical,
mental, educational, or linguistic limitations . . . the
conclusion that the claimant was not without fault does not
require a finding of bad faith; instead, an overpayment may
arise from an honest mistake. Morgan v. Finch, 423
F.2d 551, 553 (6th Cir. 1970); Quaynor v. Comm'r of
Soc. Sec., Civil Action No. 14-12258, 2015 WL 9487846,
at *4 (E.D. Mich. Dec. 9, 2015), report &
recommendation adopted 2015 WL 9478026 (E.D. Mich. Dec.
29, 2015). It is the burden of the claimant to demonstrate
that he is without fault before a benefits overpayment can be
considered waived. Watson, 940 F.2d at 171.
“The question of fault is one of fact and as such is
subject to the substantial evidence standard of
review.” Doan v. Sec. of Health & Human
Servs., No. 86-5956, 1987 WL 36143, at *1 (6th Cir. July
7, 1987) (per curiam); Hassett v. Comm'r of Soc.
Sec., No. 1:12cv419, 2013 WL 3834372, at *4 (W.D. Mich.
July 24, 2013).
decision which must be reached in a fault determination is
highly subjective, highly dependent on the interaction
between the intentions and state of mind of the claimant and
the peculiar circumstances of his situation.”
Piskorek v. Colvin, No. 13 CV 3831, 2014 WL 5152565,
at *7 (N.D. Ill. Oct. 7, 2014). The determination of fault
requires the ALJ, or the Appeals Council in this case, to
evaluate whether a reasonable person in the claimant's
own circumstances, and with whatever limitations he may have,
could believe he was entitled to continued benefits.
Harrison v. Heckler, 746 F.2d 480, 482 (9th Cir.
1984); Ducharme v. Astrue, Civil Action No.
PWG-08-2698, 2012 WL 907777, at *3 (D. Md. Mar. 15, 2012).
“[w]here an individual . . . accepts such overpayment
because of reliance on erroneous information from an official
source within the Social Security Administration . . . with
respect to the interpretation of a pertinent provision of the
Social Security Act or regulations pertaining thereto, . . .
such individual, in accepting such overpayment, will be
deemed to be without fault.” 20 C.F.R. § 404.510a.
“[W]here an individual demonstrates satisfaction of 20
C.F.R. § 404.510a, the individual has also satisfied the
‘without fault' requirement of 42 U.S.C. §
404(b).” Valley v. Comm'r of Soc. Sec.,
427 F.3d 388, 393 n.2 (6th Cir. 2005). Adjustment or recovery
is waived in the situation described in § 404.510a
“since it will be deemed such adjustment or recovery is
against equity and good conscience.” 20 C.F.R. §
404.512(a). Nonetheless, the claimant may be determined to be
at fault for accepting overpayment after receiving