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King v. Berryhill

United States District Court, D. Massachusetts

June 18, 2019

JIMMY LEE KING, Plaintiff,
NANCY A. BERRYHILL, Acting Commissioner of Social Security, Defendant.


          Denise J. Casper United States District Judge.

         I. Introduction

         Plaintiff Jimmy Lee King (“King”) filed an application for supplemental security income (“SSI”) with the Social Security Administration (“SSA”) on September 14, 2012. R. 11.[1] Pursuant to the procedures set forth in the Social Security Act, 42 U.S.C. §§ 405(g), 1383(c)(3), King brought this action for judicial review of the final decision of Defendant Nancy A. Berryhill, Acting Commissioner of the SSA (“the Commissioner”), issued by an Administrative Law Judge (“ALJ”) denying King's application for SSI benefits on April 28, 2017. Before the Court are King's motion to reverse and remand the ALJ's decision, D. 11, and the Commissioner's motion to affirm that decision, D. 14. For the reasons discussed below, the Court DENIES King's motion, D. 11, and ALLOWS Commissioner's motion, D. 14.

         II. Standard of Review

         This Court may affirm, modify, or reverse a decision of the Commissioner. 42 U.S.C. § 405(g). Such review, however, is “limited to determining whether the ALJ deployed the proper legal standards and found facts upon the proper quantum of evidence.” Nguyen v. Chater, 172 F.3d 31, 35 (1st Cir. 1999) (citing Manso-Pizarro v. Sec'y of Health and Human Servs., 76 F.3d 15, 16 (1st Cir. 1996)). The ALJ's findings of fact are conclusive when supported by substantial evidence. 42 U.S.C. § 405(g). Substantial evidence exists “if a reasonable mind, reviewing the evidence in the record as a whole, could accept it as adequate to support [the Commissioner's] conclusion.” Rodriguez v. Sec'y of Health and Human Servs., 647 F.2d 218, 222 (1st Cir. 1981).

         III. Relevant Factual and Procedural Background

         King was 50 years old when he ceased working on April 30, 2012. R. 402-03; D. 13 at 19. He previously worked as a bricklayer and construction worker for the City of Boston. D. 13 at 21-22. On September 14, 2012, King filed an application for SSI benefits, alleging disability due to affective disorder, anxiety-related disorder and alcohol abuse in sustained remission. R. 11; D. 13 at 19. The SSA initially denied King's application for benefits. R. 11. King subsequently requested a hearing and an ALJ found that King was eligible for benefits. Id. He received SSI benefits thereafter. Id.; D. 15 at 2-3.

         1. SSA Denies SSI Benefits Due to Excess Resources

         On June 11, 2014, SSA issued a notice to King stating that he was owed $14, 940 in back payments for the time period between October 2012 and June 2014. R. 150. The next day, June 12, 2014, the SSA retracted the aforementioned notice and stated that King was instead owed $595 in back payments for the period from December 1, 2013 through April 30, 2014. R. 163. SSA also stated that King was ineligible for SSI benefits from October 1, 2012 to November 30, 2013 and from May 1, 2014 forward. Id. Specifically, SSA noted that King's excess resources originated from the following sources: approximately $50, 000 in “other” income in 2013, [2] R. 171-72 and worker's compensation proceeds in 2012. D. 164. On June 26, 2014, SSA sent a third notice to King stating that his resources exceeded the statutory SSI limit between November 2013 through April 2014 and, as a result, he was ineligible for SSI benefits from December 1, 2013 through April 2014. R. 175; see R. 11.

         King filed a motion for reconsideration of SSA's back pay determination on July 15, 2014. R. 199. SSA, in turn, requested that King provide receipts and other documentation concerning how he spent his excess resources, including the $50, 000 in pension payouts and worker's compensation benefits, during a conference with the SSA on September 16, 2014. R. 200-201. During this conference, King disclosed that he had also received nearly $13, 000 in tax refunds for the 2013 tax year in April of 2014. R. 201. King failed to submit the requested documentation and, as a result, SSA affirmed the denial of SSI benefits on October 8, 2014. R. 202.

         2. Proceedings Before the ALJ

         On November 18, 2014, King requested a hearing before an ALJ regarding whether his resources exceeded the statutory limit for receipt of SSI benefits. R. 205-208. At the hearing on February 27, 2017, the ALJ heard testimony from King's counsel, King and his wife, Mikkayla King, regarding their total resources during the relevant period. R. 394-433. King submitted bank records showing cash withdrawals totaling approximately $30, 000. R. 12-13. Although King contended that he used these funds to pay for food, clothing and bills, he did not proffer documents to support these assertions. R. 13, 416. King also explained that he deposited some of the money into a savings account. R. 12, 421-423. The bank records associated with the savings account, however, did not provide additional information regarding how King spent the funds and did not cover the relevant time period. R. 12-13. The ALJ agreed to hold the record open for two weeks after the hearing to allow King to submit additional information regarding his income and cash withdrawals of $30, 000, including tax returns from 2012 to 2016, savings account statements and additional checking account statements. R. 424, 432. King, however, only submitted savings account statements from 2016, R. 13, a copy of his tax refund check issued in 2014, R. 147, and a copy of a March 17, 2017 letter from his mother regarding a loan of $7, 000, D. 13 at 29-30.

         3. ALJ Findings

         On April 28, 2017, the ALJ affirmed SSA's decision denying SSI benefits because King's resources exceeded the statutory countable resources limit for SSI recipients and he did not produce sufficient evidence to rebut this conclusion. R. 12-13. In reaching this decision, the ALJ noted that King failed to account for how he spent or otherwise disbursed $30, 000 of the nearly $63, 000 in income he had received. R. 13 (explaining that “the financial records provided by the claimant fail to document the whereabouts of nearly thirty thousand dollars of funds that were withdrawn from [King's] bank account”). The ALJ further concluded King was ineligible to apply for SSI benefits for a period of thirty-six months beginning the month after the “inappropriate transfer” of resources took place. Id. In implementing this period of ineligibility, the ALJ noted that an individual “may be ineligible for receipt of SSI benefits for up to 36 months” if he or she “transfers a resource or sells it for less than it is worth.” R. 13. The ALJ determined this period of ineligibility by consulting the SSA Programs Operations Manual System (“POMS”) SI 01150.111. R. 13. POMS SI 01150.111 instructs the ALJ to “[d]etermine the total . . . value of any resources transferred by either member of the couple since the ...

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