Casey v. Berryhill
2017 U.S. App. LEXIS 1652
| 7th Cir. | 2017Background
- Casey received SSDI since 1979 and later entered the Witness Protection Program; he allegedly was told by Marshals Service he could keep disability benefits for life.
- In 2009 SSA notified Casey of a $333,893.90 overpayment; Casey requested a waiver in 2010 and an ALJ denied the waiver in an August 25, 2011 decision.
- Casey missed the 60-day window to seek Appeals Council review but, on March 2, 2012, his attorney asked the Council to find good cause for the late filing, grant more time to gather evidence, and treat the appeal as timely.
- On April 12, 2012 the Appeals Council wrote that it had “granted your request for more time” and invited submission of evidence; it granted further extensions in April and May 2012.
- More than a year later, on July 17, 2013 the Appeals Council dismissed the request for review, stating Casey had not provided a promised “good cause” statement and concluding there was no good cause to extend the time.
- Casey sued under 42 U.S.C. § 405(g); the district court dismissed for failure to exhaust, but the Seventh Circuit reversed and remanded, holding the Appeals Council’s retroactive denial arbitrary and ordering the agency to decide the waiver on the merits without revisiting timeliness.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the Appeals Council’s dismissal was a final, reviewable decision | April 12 letter granted good cause and extensions; dismissal is arbitrary | Dismissal is unreviewable procedural failure to exhaust; claimant didn’t show good cause in complaint | Appeals Council dismissal is reviewable under §405(g); court had jurisdiction (following Boley) |
| Whether the April 12, 2012 letter granted good cause or merely extended time to show good cause | Letter and subsequent extensions amounted to grant of good cause; Casey reasonably relied on it | Letter ambiguous; claimant should have alleged facts showing good cause | Court reads letter as granting good cause; agency cannot rescind after leading claimant to rely on it |
| Whether Casey failed to adequately show good cause (insufficient evidence; unsworn attorney letter) | Attorney’s explanation (did not receive ALJ decision, was seeking documents) sufficed and fit regulatory examples of good cause | Attorney’s unsworn letter insufficient; claimant should have supplied affidavits or more proof | Even if showing was weak, Appeals Council exercised discretion to grant good cause and cannot later fault Casey for not providing evidence it never requested |
| Appropriate remedy and scope of review | Remand to agency for merits determination on waiver without revisiting timeliness | Agency’s dismissal should be upheld or district court dismissal affirmed | Reverse district court; remand to SSA to decide waiver on merits; Appeals Council must not reopen timeliness issue |
Key Cases Cited
- Boley v. Colvin, 761 F.3d 803 (7th Cir. 2014) (Appeals Council dismissals for untimeliness can be judicially reviewed for agency mishandling)
- Bates v. Colvin, 736 F.3d 1093 (7th Cir. 2013) (standard of review for district-court judgment under §405(g))
- Scrogham v. Colvin, 765 F.3d 685 (7th Cir. 2014) (deferential review of agency factual findings; de novo review of legal conclusions)
- Jones v. Astrue, 623 F.3d 1155 (7th Cir. 2010) (review standards for Social Security decisions)
- Hickman v. Apfel, 187 F.3d 683 (7th Cir. 1999) (procedural rules governing federal review of SSA decisions)