Deanna English v. Social Security Administration
705 F. App'x 116
| 3rd Cir. | 2017Background
- Deanna English received an SSA notice of an SSI overpayment based on work activity and requested reconsideration.
- Before reconsideration concluded, English requested an ALJ hearing; the ALJ could not find a record of the reconsideration denial and remanded for reconsideration instead of issuing a decision on the merits.
- English appealed the ALJ’s remand to the Appeals Council; the Appeals Council denied review and sent the case back to the local office for a reconsideration determination.
- English filed a federal suit seeking review of the ALJ’s decision; the Commissioner moved to dismiss for failure to exhaust administrative remedies under 42 U.S.C. § 405(g).
- English later produced a reconsideration denial dated October 21, 2013, showing reconsideration had been denied before the ALJ’s remand, but no ALJ merits decision or Appeals Council merits decision on her underlying benefits claim had been issued.
- The District Court dismissed for lack of jurisdiction; the Third Circuit affirmed, holding English had not obtained a "final decision" required for § 405(g) jurisdiction.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether federal court has jurisdiction under 42 U.S.C. § 405(g) | English argued administrative process was complete (reconsideration occurred) and court review was proper | Commissioner argued English failed to obtain a final decision because she did not complete all four administrative steps for the merits | Held: No jurisdiction; English did not obtain a final decision because no ALJ or Appeals Council decision on the merits was rendered |
| Whether exhaustion requirement may be waived | English implicitly argued procedural errors justified review | Commissioner argued exhaustion is required and not waived for non-collateral benefits claims | Held: Exhaustion is not waived; claim is not collateral and exhaustion requirement stands |
| Effect of ALJ’s mistaken belief that reconsideration denial was missing | English argued mistake should not bar judicial review where denial actually existed | Commissioner noted administrative process for merits still incomplete despite clerical error | Held: Mistake does not cure lack of final decision; plaintiff must complete the administrative hearing and Appeals Council process |
| Whether constitutional or other exceptions apply to excuse exhaustion | English did not successfully raise a constitutionally based exception | Commissioner maintained no applicable exception | Held: No exception applies; constitutional exception inapplicable here |
Key Cases Cited
- Fitzgerald v. Apfel, 148 F.3d 232 (3d Cir. 1998) (distinguishes nonwaivable requirement that claim be presented from waivable exhaustion requirement)
- Weeks v. Social Sec. Admin. Com’r, 230 F.3d 6 (1st Cir. 2000) (Appeals Council remand that vacates ALJ decision is not an appealable final decision)
- Johnson v. Shalala, 2 F.3d 918 (9th Cir. 1993) (claim is non-collateral where it is essentially for benefits)
- Beattie v. Astrue, 845 F. Supp. 2d 184 (D.D.C. 2012) (exhaustion not excused where claimant appealed ALJ remand to the Appeals Council)