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Tefera v. Colvin

United States District Court, D. Massachusetts

November 25, 2014

CAROLYN COLVIN, Acting Commissioner, Social Security Administration, Defendant

Page 208

Waineshet Tefera, Plaintiff, Pro se, Lynn, MA.

For Commissioner of Social Security, Defendant: Rayford A. Farquhar, LEAD ATTORNEY, United States Attorney's Office, Boston, MA.

For Social Security Administration, Interested Party: Thomas D. Ramsey, LEAD ATTORNEY, Office of the General Counsel, Social Security Administration, Boston, MA.

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Denise J. Casper, United States District Judge.

I. Introduction

Plaintiff Waineshet Tefera (" Tefera" ) was overpaid Social Security benefits at various points between April 1995 and August 2003. R. 16-17.[1] Tefera sought waiver of overpayment recovery and the Social Security Administration (" the SSA" ) denied Tefera's request. R. 20, 62, 65-66. Pursuant to the procedures set forth in the Social Security Act (" the Act" ), 42 U.S.C. § § 405(g), 1383(c)(3),

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Tefera, proceeding pro se, brings this action for judicial review of the final decision of Defendant Caroline Colvin, Acting Commissioner of the Social Security Administration (" the Commissioner" ), issued by an Administrative Law Judge (" ALJ" ) on August 19, 2011. R. 12-15. Before the Court are Tefera's motion to reverse the decision of the Commissioner, D. 15, and the Commissioner's motion to affirm, D. 18. For the reasons discussed below, Tefera's motion, D. 15, is ALLOWED, the Commissioner's motion, D. 18, is DENIED and the matter is remanded to the ALJ for further proceedings.

II. Relevant Facts

Tefera received Social Security benefits from April 1995 through August 2003.[2] R. 16-17. In December 1997, Tefera submitted a Work Activity Report[3] to the SSA, in which she reported working since October 1997 as a part-time cashier five days a week earning $6.00 an hour. R. 68-70. In April 2002, the SSA sent Tefera a letter stating that her reported earnings for 1995, 1997, 1998, 1999 and 2000 were $271.80, $1,566, $9,126.65, $7,380.50 and $20,636.93, respectively, and asking for additional work information. R. 77. Tefera subsequently completed another Work Activity Report to the SSA in August 2003 indicating that she worked as a cashier until December 1998 and then worked off and on until March 2000 when she started a position in data processing earning $10.00 an hour at a bank. R. 80-83. In June 2001, Tefera was laid off by the bank because back problems prevented her from lifting heavy boxes. R. 76, 81. According to the report, Tefera did not work again until January 2003 when she became a research assistant making $13.25 an hour at a hospital. R. 84. Tefera collected unemployment benefits for a period between June 2001 and January 2003. R. 57.

III. Procedural Background

On October 8, 2003, the SSA notified Tefera that she was overpaid $37,476.50 in disability insurance benefits at various points between January 1999 and August 2003 and had to refund the overpayment, in whole or in part, within thirty days. R. 45. Tefera filed a Request for Waiver of Overpayment Recovery at the end of October, contending that the overpayment was not her fault because she sent her paystubs to the local SSA office and " [kept] calling the 1-800 number to stop the payment[s]." R. 49-51, 56. Tefera also argued that she could not afford to repay the money because her monthly income went towards rent and her daughter's after-school program. R. 51. In March 2004, the SSA sent Tefera a second notice explaining that the overpayment occurred during periods when Tefera's benefits were suspended or terminated. R. 59. The SSA identified the suspension periods as January 1999 to July 1999, December 1999, and July 2001 to October 2001, and the termination period as November 2001 to August 2003. Id. The notice again instructed Tefera to repay all or some of the money within thirty days. Id.

On March 4, 2005, the SSA denied Tefera's waiver request but informed her that she had the right to appeal the denial by

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appearing at a conference. R. 62. Tefera did not appear at the scheduled conference or request that it be rescheduled prior to that date. R. 65. Although SSA indicated a willingness to reschedule it when the agency was contacted on her behalf after the scheduled conference, neither Tefera nor any representative on her behalf followed up on this request. D. 66. Accordingly, the SSA's affirmed its decision to deny her waiver request. D. 65, 66.

Tefera requested reconsideration of the SSA's decision on August 15, 2005. R. 24. In December 2009, the SSA informed Tefera that it had reviewed her case and recalculated the overpayment for which she was responsible as $22,337.90 and denied her request for reconsideration. R. 16-17, 20. Tefera submitted a second request for reconsideration, which was denied, for the reasons that the SSA had previously stated, in a letter dated April 6, 2010. R. 24. Tefera filed a timely request for a hearing before an ALJ pursuant to SSA regulations. R. 35-36. A hearing was held before the ALJ on August 4, 2011. R. 119. In a written decision dated August 19, 2011, the ALJ affirmed the denial of Tefera's request for a waiver of recovery of the overpayment. R. 12-15. Tefera requested a review of the ALJ's decision and the Appeals Council denied the request on May 23, 2013. R. 3. Accordingly, the ALJ's decision is the final decision of the Commissioner. Id.

IV. Discussion

A. Legal Standards

1. Waiver of Recovery of Overpayment

The Social Security Act provides that the SSA may seek recovery of amounts that were overpaid to an individual who has received more than the correct payment under Title II of the Act. 42 U.S.C. § 404(a). However, the Commissioner's regulations provide that recovery of an overpayment shall be waived if: (1) the recipient is found to be without fault in causing the overpayment, and (2) the " recovery would either defeat the purpose of [T]itle II . . . or be against equity and good conscience." 20 C.F.R. § 404.506(a). The burden is on the claimant to establish that she meets both of these requirements ...

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