Priscilla R. v. Kojakazi

Background

Priscilla R. began receiving Social Security disability benefits in 1996. In June 2021, the Social Security Administration notified her that her trial work period and extended period of eligibility had ended. According to the complaint, she had worked as a school crossing guard and a drug-store clerk, and the agency’s review resulted in the cessation of her benefits.

Under the regulations discussed by the court, a benefits recipient who timely requests reconsideration of a decision suspending, reducing, or terminating benefits may continue receiving payments while reconsideration is pending. Priscilla R. did not request reconsideration within the required ten-day period. Her benefits temporarily stopped in October 2021. She was later evaluated for expedited reinstatement and approved in September 2022, and her benefits were reinstated at approximately the beginning of 2023.

After hearings in February and March 2023, an administrative law judge decided that Priscilla R. had been overpaid $8,901 between January and September 2021 but waived recovery because she was not at fault and recovery would defeat the purpose of the Social Security Act. The administrative law judge described the decision as “Fully Favorable,” but did not address reinstatement because there had been no initial or reconsideration decision on that issue. Priscilla R.’s appeal to the Appeals Council was requested in October 2023 and remained pending when this case was decided.

Earlier rulings and current motion

Priscilla R. filed this action in July 2023 seeking review of the May 2023 administrative law judge decision and asserting injuries related to reinstatement. In November 2023, the court granted the defendant’s motion to dismiss under Rule 12(b)(1), which concerns the court’s subject-matter jurisdiction. The court held that Priscilla R. had not exhausted the administrative process and that there was no final decision by the Commissioner that could be reviewed under 42 U.S.C. § 405(g). The court also stated that claims characterized as part of the request for judicial review would not survive dismissal under Rule 12(b)(6), which concerns whether a complaint states a legally sufficient claim.

The court allowed Priscilla R. to seek permission to amend the complaint to plead separate claims with additional facts. It later denied her motion for leave to amend because the proposed complaint added no new facts addressing the defects identified in the earlier order. Judgment was entered for the defendant.

Three days later, Priscilla R. moved for relief from judgment under Rules 59(e) and 60. Her motion primarily concerned a claim under Section 504 of the Rehabilitation Act.

Court’s analysis

Rule 59(e) governs requests to alter or amend a judgment. The court explained that such relief generally requires newly discovered evidence, clear error, or an intervening change in controlling law. Rule 60(a) allows correction of clerical mistakes, while Rule 60(b) allows relief for specified reasons such as mistake, inadvertence, surprise, excusable neglect, or another reason that justifies relief.

The court characterized the substance of Priscilla R.’s motion as an allegation that the court had made a legal error. It agreed with the defendant that disagreement with the result did not justify relitigating the issues and concluded that Priscilla R. had not shown grounds for relief under either rule.

The court nevertheless addressed the Rehabilitation Act allegations. Section 504 prohibits excluding an otherwise qualified person with a disability from, denying that person the benefits of, or discriminating against that person under a covered federally assisted or federal executive-branch program solely because of the disability.

For a Section 504 claim based on denial of benefits, the court stated that a plaintiff must allege facts showing that she has a disability, is otherwise qualified for the benefits, was denied the benefits solely because of the disability, and was denied benefits by a covered program or activity. Priscilla R. argued that the Social Security Administration knew or should have known that her disability prevented her from responding to the ten-day notice. The court held that, even assuming her disability caused her not to respond on time, the alleged facts did not support the conclusion that she was denied benefits solely because of that disability. The court noted that schizophrenia can recur and that the agency had found she worked and reached the substantial-gainful-activity level after her extended period of eligibility ended.

The court also considered allegations that the agency failed to provide reasonable accommodations. Priscilla R.’s complaint referred to accommodations received in other cases but did not explain what those accommodations were. The court concluded that the agency could not fairly be said to have failed to provide an accommodation when the requested accommodation was not identified. It also rejected as an accommodation the request that the agency provide access to continuing disability reviews, because benefits recipients do not ordinarily have access to those agency reviews.

The court stated that Priscilla R. might be seeking support from agency field-office personnel in responding to requests for updated information during future continuing disability reviews. It said she could expressly request that assistance from the agency and might be able to pursue a Section 504 reasonable-accommodation claim if the agency refused and she alleged sufficient facts. The court emphasized that no order had held that such a claim could be considered only in the pending administrative appeal; a sufficiently pleaded claim could proceed independently.

Disposition

The court denied Priscilla R.’s motion for relief from the judgment. The opinion does not change the earlier dismissal and judgment. Judge William Alsup also vacated the hearing and decided the motion on the written submissions.