T.W. v. Commissioner of Social Security

Background

T.W. applied for Disability Insurance Benefits and Supplemental Security Income under Titles II and XVI of the Social Security Act, alleging disability beginning December 1, 2007. The Social Security Administration denied the applications initially and on reconsideration. At a February 7, 2018 hearing, the Administrative Law Judge questioned T.W. about whether he was still working and referred to earnings records that appeared to show substantial gainful activity, or SGA. SGA is work activity at a level that generally prevents a person from being found disabled.

The Administrative Law Judge stated that the records showed SGA earnings through the first quarter of 2017 and that T.W. had testified he was still working. The judge told T.W. that benefits could not be awarded unless there was a period of at least 12 months without earnings at the SGA level. After consulting with counsel, T.W. withdrew his request for a hearing. The Administrative Law Judge dismissed the hearing request, leaving the reconsideration determination that T.W. was not eligible for benefits in effect.

T.W. sought judicial review under 42 U.S.C. § 405(g). Before deciding the cross-motions for summary judgment, the court determined that it had subject-matter jurisdiction and denied T.W.’s motion to supplement the administrative record. The issue addressed in this order was whether the Administrative Law Judge properly dismissed T.W.’s hearing request.

Court’s Analysis

Social Security regulations allow an Administrative Law Judge to dismiss a hearing request when the claimant asks to withdraw it before the hearing decision is mailed. Agency procedures also require the record to show that the claimant understands the effects of withdrawal and that dismissal is appropriate. The court therefore examined the withdrawal in the context of the discussion that led to it, rather than looking only at the wording of the dismissal order.

The court found the record insufficient to establish that T.W. had engaged in SGA during the 12 months before the hearing. T.W. testified that he was still working for the same employer, but the Administrative Law Judge did not ask how much he was working or what wages he had received. The earnings report listing $8,629 in the first quarter of 2017 explained that the quarter represented when payments were made, not necessarily when the work occurred. The report therefore did not establish that the wages were earned during that quarter or that T.W. lacked 12 consecutive months without SGA before the February 2018 hearing.

Other records indicated that T.W. had no income in 2017 or showed no 2017 earnings. The record also showed that his wages declined in late 2016, and T.W. testified that after a 2016 bicycle accident he was frequently missing work. Thus, continuing to work for the same employer did not necessarily mean that he was earning at the prior level.

The court also observed that the record contained no evidence about facts that might rebut a presumption of SGA. Although a claimant ordinarily bears the burden of rebutting that presumption, the court said T.W. could not fairly be faulted for the absence of such evidence because the agency had not identified SGA as a basis for denying the claim before the hearing. The Administrative Law Judge therefore had a duty to develop the record fully and fairly, which the court found had not been satisfied.

Disposition

The court held that it could not conclude that the Administrative Law Judge was correct in telling T.W. that benefits could not be paid because he had engaged in SGA, and that statement prompted T.W. to agree to dismissal of his hearing request. The court GRANTED T.W.’s motion for summary judgment and DENIED the Commissioner’s cross-motion for summary judgment on this issue. It remanded the matter for further proceedings and did not reach the other issues raised in T.W.’s motion.