649 F. App'x 705
11th Cir.2016Background
- Tomaszewski received SSI in 2004; benefits were later terminated when his household income exceeded SSI limits after his wife inherited money.
- He did not administratively challenge the termination; instead he filed a new SSI application in 2009.
- The ALJ denied the 2009 application; the district court affirmed, and Tomaszewski appealed.
- Tomaszewski argued Simpson v. Schweiker required presumptive continuation of his earlier disability finding and that res judicata barred re-litigation.
- The Commissioner argued Simpson does not apply to a new application and that res judicata is inapplicable because the new claim covers a different period and includes new evidence.
- The Eleventh Circuit affirmed, holding Simpson inapplicable and that the denial was supported by substantial evidence.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Simpson presumption of continuing disability applies | Simpson requires presumptive continuation of prior benefits; prior award should control | Simpson applies only to benefit-continuation procedures, not to a new application | Simpson does not apply; filing a new application removes the case from Simpson’s scope |
| Whether res judicata bars re-litigation of disability | Prior disability finding should preclude re-litigation | New application covers a different time period and presents new, independent evidence | Res judicata does not apply because of different time period and new evidence |
| Whether expedited reinstatement was required | Plaintiff contended he was entitled to expedited reinstatement | Commissioner noted issue not raised administratively and thus not before the court | Issue not considered because plaintiff did not exhaust administrative remedies; not properly before the court |
| Whether Commissioner’s denial is supported by substantial evidence | Plaintiff argued denial was erroneous | Commissioner maintained decision is supported by the record and substantial evidence | Court found the Commissioner’s decision supported by substantial evidence and affirmed |
Key Cases Cited
- Simpson v. Schweiker, 691 F.2d 966 (11th Cir. 1982) (establishes presumption of continuing disability in benefit-continuation contexts)
- Luckey v. Astrue, [citation="331 F. App'x 634"] (11th Cir. 2009) (res judicata ineligibility where new application covers different period and presents new evidence)
- Lewis v. Callahan, 125 F.3d 1436 (11th Cir. 1997) (substantial-evidence standard for reviewing Commissioner’s disability determinations)
- United States v. Magluta, 418 F.3d 1166 (11th Cir. 2005) (appellate courts will not consider issues raised for first time in a reply brief)