Michael F. v. O'Malley

Background

Steven Michael F. was found disabled and became entitled to disability insurance benefits in November 2017. The Social Security Administration awarded benefits for his children on his account, with Giovanna F. serving as the children’s representative payee. In August 2020, the Administration notified Steven Michael F. and the representative payee that benefits had been overpaid.

Steven Michael F. requested reconsideration, and later requested a hearing before an administrative law judge. On March 21, 2023, the administrative law judge decided that the overpayments could not be waived and held Steven Michael F. liable for the amounts owed for himself and his children. The decision required him to request review by the Appeals Council within 60 days after receiving notice.

Steven Michael F. sent his request for Appeals Council review on June 30, 2023—36 days after the deadline. He asserted that flare-ups of back pain, over-the-counter medication use, depression, fatigue, difficulty concentrating, and embarrassment about seeking legal assistance caused the delay. On January 3, 2024, the Appeals Council dismissed his request, finding that he had not shown good cause for filing late. Steven Michael F. then timely sought judicial review under 42 U.S.C. § 405(g).

Court’s review

The court explained that when the Appeals Council dismisses a request as untimely after an administrative law judge has held a hearing on the merits, the dismissal is a final decision that can be reviewed in federal court. The court’s review was limited to whether the Appeals Council properly addressed the late filing and whether its factual conclusions were supported by substantial evidence. The court reviewed the Appeals Council’s decision for abuse of discretion, meaning whether the agency applied the proper standard and reached a decision it was permitted to reach based on the evidence.

Under the applicable regulation, the Social Security Administration considers circumstances that prevented a timely request, whether the agency misled the claimant, whether the claimant misunderstood the filing requirements, and whether physical, mental, educational, or language limitations prevented timely filing. Examples may include serious illness that prevented contact with the agency or unusual or unavoidable circumstances.

Ruling

The court held that the Appeals Council did not abuse its discretion in finding that Steven Michael F. had not shown good cause. The court noted that he had received proper notice of the deadline and explained that he did not show why his back pain and depression prevented him from asking a lawyer, family member, or friend to help him file on time. The court also noted that he had worked with a lawyer before and was working with a lawyer in the federal case.

The court further held that Steven Michael F.’s disability, without more specific evidence or explanation, was not enough to establish good cause. The Commissioner’s motion for judgment on the pleadings was GRANTED; Steven Michael F.’s cross-motion for judgment on the pleadings was DENIED; and his petition for review was DISMISSED. The court also stated that the matter was dismissed, directed the clerk to terminate the pending motions, and ordered the case closed.