Johnson v. Social Security Administration

Background

Robert W. Johnson, proceeding without a lawyer, sought review of the denial of his July 19, 2017 applications for Supplemental Security Income (SSI) and disability insurance benefits (DIB). The opinion also refers to a later SSI application filed on March 28, 2019, but states that Johnson was not seeking review of that application in this case.

The Social Security Administration denied Johnson’s DIB claim because he had not earned enough work credits. It denied his SSI claim because his resources exceeded the $2,000 maximum for SSI eligibility. Johnson requested reconsideration of the SSI denial, but after that request was denied, the agency had no record that he requested a hearing before an administrative law judge or review by the Appeals Council. Johnson argued that he had exhausted his remedies by appearing at a Social Security office and by filing a reconsideration request concerning his DIB claim. The agency had no record of the DIB reconsideration request.

The Commissioner moved to dismiss under Federal Rule of Civil Procedure 12(b)(1), which permits dismissal when the court lacks authority to hear the case. Johnson also moved for default judgment; the court had denied that motion on November 21, 2019, and ordered him to respond to the Commissioner’s motion. He did not file a response.

Legal standard

The Social Security Act generally permits federal-court review only after the claimant receives a final decision from the Commissioner. The administrative process ordinarily requires four steps: an initial determination, a request for reconsideration, a hearing before an administrative law judge, and review by the Appeals Council. The court explained that the Commissioner may waive the exhaustion requirement—the requirement to complete the agency appeal process—but courts excuse exhaustion only in rare circumstances.

The court considered whether Johnson’s claims were separate from the benefits dispute, whether completing the administrative process would be pointless, and whether requiring exhaustion would cause serious and immediate harm.

Court’s analysis

For the SSI claim, the court found that Johnson completed only the initial determination and reconsideration steps. He did not request an administrative-law-judge hearing or Appeals Council review. The court rejected his argument that visits to a Social Security office amounted to exhaustion, noting that those visits occurred before the reconsideration step was complete and that the agency’s notices explained how to request further review.

For the DIB claim, the court found that Johnson completed only the initial determination, or possibly the first two steps if his claimed reconsideration request had in fact been filed. Either way, he did not request an administrative-law-judge hearing or Appeals Council review. The court therefore found no final decision on either the SSI or DIB claim.

The court also found that none of the recognized grounds for excusing exhaustion applied. Johnson’s claims directly challenged the benefits determinations rather than presenting a separate claim, he had not shown that further administrative review would be pointless, and he had not shown that delay would cause serious and immediate harm.

Ruling and effect

Because Johnson had not exhausted the required administrative remedies and the requirement was not excused, the court held that it lacked subject-matter jurisdiction. It granted the Commissioner’s motion to dismiss. The opinion did not decide whether Johnson qualified for SSI or DIB benefits. The court also certified that an appeal would not be taken in good faith and denied permission to appeal without paying filing fees.