Anthony G. v. Commissioner of Social Security

Background

Anthony G. sought judicial review under 42 U.S.C. §§ 405(g) and 1383(c)(3) of the Social Security Administration’s decision concerning his disability insurance benefits. The agency determined that his disability ended because he began performing substantial gainful activity in July 2015, terminated his benefits in October 2015, and overpaid him $37,759.60 for benefits paid from October 2015 through February 2017.

Anthony moved for judgment on the pleadings, asking the court to reverse the agency’s decision. He argued that his work was subsidized or performed under special conditions, that the Commissioner had not shown he performed substantial gainful activity, and that a prior administrative decision barred the agency from reaching a different conclusion. He also argued that repayment should be waived because he was not at fault and recovery would defeat the purposes of the Social Security Act or be against fairness and good conscience.

Court’s analysis

The court explained that its review was limited to whether the administrative law judge applied the correct legal standards and whether the decision was supported by substantial evidence. Because Anthony’s earnings exceeded the regulatory threshold for presumed substantial gainful activity, the burden shifted to him to rebut that presumption.

The court held that substantial evidence supported the finding that Anthony’s work was not subsidized and was not performed under special conditions. The record included his earnings above the applicable thresholds, treatment records describing his work, and an October 2016 work report in which he stated that he did not receive special assistance, additional breaks, lighter duties, or other special conditions. The court acknowledged Anthony’s testimony that he worked slowly, needed assistance, and was often dismissed quickly, but concluded that the administrative law judge reasonably relied on contrary evidence in the record.

The court rejected Anthony’s issue-preclusion argument. The earlier administrative decision concerned whether he had performed substantial gainful activity in connection with his disability status as of September 2002. The decision under review concerned his work beginning in July 2015. The court found that the two proceedings involved different periods and different facts, including different evidence about workplace assistance and accommodations.

The court did not decide whether repayment should be waived. The Appeals Council had vacated the administrative law judge’s waiver findings because Anthony had not filed a waiver request. The court explained that the applicable regulations require a person to request a waiver and provide supporting information before the agency makes that determination. Anthony identified no evidence that he had submitted such a request and appeared to concede that point.

Disposition

The court denied Anthony’s motion for judgment on the pleadings. It stayed the case to allow Anthony to submit a waiver request under the Social Security Administration’s rules. If Anthony filed a letter by August 12, 2025, stating that he had submitted the request, the court said it would enter judgment remanding the case to the Commissioner under sentence four of 42 U.S.C. § 405(g) for consideration of the waiver request. If he did not file that letter, the court said it would enter judgment based on the denial of his motion.