Robinette v. Commissioner of Social Security, 6:16-cv-01241

Plaintiff received SSD benefits from Jan 2009 after being found disabled; SSA later determined medical improvement and terminated benefits effective Dec 31, 2012.
Plaintiff (pro se) requested a hearing (Mar 29, 2013); hearing set for Oct 22, 2014. SSA sent notices: certified mail June 26, 2014 (returned unclaimed), purported July 1, 2014 and Oct 8, 2014 notices (no certified-mail evidence; no returned acknowledgments).
Plaintiff did not appear at the Oct 22, 2014 hearing; ALJ dismissed the request for hearing, reasoning claimant had been notified (ALJ relied on a USPS August 2, 2014 response that “mail is delivered to address given”).
Plaintiff appealed to the Appeals Council, which vacated and remanded for consideration of good cause; on remand the ALJ again dismissed, concluding claimant "clearly received" the July notice; Appeals Council denied review on May 24, 2016.
Plaintiff sued in district court under 42 U.S.C. § 405(g) and sought mandamus; Commissioner moved to dismiss for lack of jurisdiction or, alternatively, for summary judgment. The Magistrate Judge recommended denial of the Motion and reversal/remand.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether the district court has subject-matter jurisdiction under 42 U.S.C. § 405(g) to review the ALJ’s dismissal of the hearing request where no ALJ hearing occurred	Robinette: § 405(g) review is available because the Appeals Council denied review (final decision) and the agency waived the hearing requirement; alternatively, Robinette raises a colorable due-process claim	Commissioner: No "final decision after a hearing," so § 405(g) jurisdiction is lacking; mandamus is not warranted	Court: Jurisdiction exists — agency’s failure to provide a hearing is effectively a waiver and Appeals Council denial finalized the decision; a colorable constitutional claim further supports jurisdiction
Whether the ALJ’s dismissal (as finalized by the Appeals Council) is supported by substantial evidence (i.e., whether claimant received proper notice)	Robinette: There is no evidence he received the July notice or the reminder; USPS response does not prove mailing or receipt; good cause exists (memory issues, family death, household mail handling)	Commissioner: ALJ’s finding that notice was provided is supported by the record (USPS verification and administrative declarations)	Court: ALJ’s finding that claimant received the July notice is not supported by substantial evidence — USPS response and agency declarations do not prove the July notice was mailed or received; presumption of receipt not triggered; dismissal reversed and remanded

Mathews v. Eldridge, 424 U.S. 319 (Sup. Ct. 1976) (administrative-exhaustion/hearing requirement can be waived by the agency under certain circumstances)
Weinberger v. Salfi, 422 U.S. 749 (Sup. Ct. 1975) (Commissioner’s regulations flesh out § 405(g) ‘‘final decision’’ requirement)
Sims v. Apfel, 530 U.S. 103 (Sup. Ct. 2000) (procedural requirements for administrative review are not jurisdictional in a way that bars judicial review where a final decision exists)
Bloodsworth v. Heckler, 703 F.2d 1233 (11th Cir. 1983) (Appeals Council denial can finalize an administrative decision for § 405(g) purposes)
Winschel v. Comm’r of Soc. Sec., 631 F.3d 1176 (11th Cir. 2011) (scope of judicial review and substantial-evidence standard)
Lewis v. Callahan, 125 F.3d 1436 (11th Cir. 1997) (definition of substantial evidence)
Foote v. Chater, 67 F.3d 1553 (11th Cir. 1995) (court must consider the record as a whole and may not reweigh evidence)