Krishnan, Narayanan v. Barnhart, Jo Anne B.Krishnan, Narayanan v. Barnhart, Jo Anne B.
Opinion for the Court filed by Circuit Judge ROGERS.
Thе underlying issue in this case is whether a non-U.S. citizen applying for disability benefits under the Social Security Act has satisfied an exception to the general rule that alien beneficiaries cannot receive benefits if they have resided outside the United States for six consecutive calendar months,
I.
The qualification for benefits at issue revolves around the claimant’s assertion
Importantly, only earnings that are “cоvered” under social security count toward the calculation of a worker’s QCs.
See
Additional provisions of the Social Security Act apply to non-U.S. citizens attempting tо receive disability insurance benefits. As pertinent here,
An individual who is certified as disabled by the SSA, pursuant to
II.
Narayanan Rrishnan appeals on behalf of his brother and next friend, Narayanan Deviprasad,
1
the district court’s аffirmance of SSA’s denial of disability benefits to the claimant on the basis of his failure to meet an exception to the general rule that alien beneficiaries cannot receive benefits if they have resided outside the United States for six consecutive calendar months.
A.
The claimant is a citizen of India who came to the United States on August 26, 1981 to pursue a masters degree at Worcester Polytechnic Institute (“Polytechnic”). From September 1981 through May 1983, when he graduated, the сlaimant worked as a teaching assistant at Polytechnic. Following graduation, he worked in the United States as a computer software engineer. In May 1986, the claimant was diagnosed with paranoid schizophrenia. Over the next five years, he traveled to India periodically for psychiatric treatment and evaluation, but he suffered relapses each time he returned to the United States. Since April 25, 1991, the claimant has been living in India continuously, where he remains in the care of his brother.
The claimant filed an application for social security disability insurance benefits on May 22, 1993, on thе basis of disability stemming from schizophrenia. SSA’s psychiatrist agreed that the claimant suffers from paranoid schizophrenia, and determined that his disability began April 2, 1991. By a memorandum of February 7, 1994, SSA advised the American Consulate in Bombay of its disability determination, and requested that the claimant’s physician in India and his brother complete the forms necessary to process the benefits
On October 11, 1994, the SSA informed the claimant that his disability claim had been awarded, effective February 1992, but that payments to him had been suspended, pursuant to
The brother of the claimant filed suit on August 28, 1998. The district court appointed counsel for the brother, and the parties filed cross-motions for summary judgment. The brother argued that because the claimant had more than forty QCs, he qualified under an exception to the generаl bar against paying benefits to alien beneficiaries. SSA countered that the claimant had not accrued forty QCs, and submitted, as evidence, computerized extracts of his work history that had not been included in the administrative record, purporting to show that the claimant had accrued only thirty QCs. At a hearing, the brother argued that he was entitled to a judgment on the then-existing administrative record, while SSA argued that the case should be remanded for “good cause” so that it could supplement the record with the certified extracts of the claimant’s work history. The brother responded that there wаs no good cause for SSA’s failure to include the earnings history in the original administrative record. On September 17, 1999, over the brother’s objection, the district court ruled that “the new evidence counsels in favor of additional agency proceedings,” and because there was “good cause shown,” remanded the case
“pursuant to sentence six
of Section 205(g) of the Social Security Act,
On remand, an ALJ held a hearing on March 27, 2000, at which the brother, who was represented by counsel, submitted documents, including pay stubs from the claimant’s work at Polytechnic, purporting to show that the claimant had earned forty-two QCs. SSA submitted the computerized employment extracts it had first brought to the district court, and argued that because social security taxes were not withheld from money paid to the claimant for his work at Polytechnic, he had earned less than forty QCs. By decision of April
The district court affirmed SSA’s remand decision.
Krishnan v. Massanari,
B.
On appeal, the brother renews his contention that the cláimant qualified for benefits under an exception to the nonpayment provision for alien beneficiaries because the claimant had еarned more than forty QCs, and contends that the district court’s remand under sentence six was unlawful and that he is entitled to benefits based on the original administrative record.
The brother and SSA are in agreement on appeal that the district court erred when it remanded his case under sentence six of
Nor can we sanitize the district court’s error, as SSA contends, by holding that the district court
could have
entered a sentence-four remand. The district court made no substantive ruling on the correctness of SSA’s decision, which is a necessary prerequisite to a sentence-four remand,
Melkonyan,
SSA’s reliance on
Richmond v. Chater,
In light of the Supreme Court’s instruction that there are “sharp distinction[s]” between sentence-four and sentence-six remands,
Shalala,
Accordingly, we hold that the district court erred in remanding the case to SSA рursuant to sentence six and that there is no alternative ground on which to conclude that the district court’s remand was proper.
C.
The question remains what consequences should follow. Although the parties appear to agree on appeal that SSA erred by failing-to ensure from the beginning that there was a complete administrative record containing the claimant’s computerized earnings record, and that SSA also erred by failing to provide any significant explanation for its denial of benefits prior to the remand, SSA maintains that the brother is entitled to no relief because thеre is no evidence that he could refute SSA’s reasons for denying the claimant’s claim. The brother contends first, that because the district court’s decision to deny benefits was based on information gathered during an unlawful remand, this court should reverse the district court and compel SSA to provide benefits because, in his view, the evidence in the original administrative record demonstrates the claimant’s entitlement to benefits. Alternatively, he contends second, that because the SSA’s failure to follow its regulations prejudiced the claimant, the court should provide equitable relief.
To. conсlude that the brother is entitled to relief under his first contention, the court must be able to find that there was substantial evidence in the original administrative record that the claimant qualified for an exception to the non-payment provision.
Smith v. Bowen,
The brother relies solely on the handwritten chart submitted to SSA by the claimant for the proposition that SSA had uncontested evidence that the claimant had earned more than the forty QCs necessary to bypass the non-payment provision.
Once the period of time the claimant worked at Polytechnic is removed from consideration, the remaining periods of employment noted on the chart are from September 1983 through April 1991. A person can earn, at most, four QCs per calendar year.
As to the brother’s second contention, he seeks an equitable award of benefits bаsed on SSA errors throughout the administrative process that prejudiced the claimant. Specifically, the brother points to SSA’s failure during three separate administrative appeals to advise the claimant that his chart was insufficient evidence of his earnings; counsel him on how to obtain a statement of his earnings from SSA; request additional information from him; produce evidence that showed he was ineligible for benefits; or state that the denial of his claim was based on the determination that he had not accrued forty QCs. The SSA concedes its errors, but contends that they were harmless beсause the brother has never disputed that the claimant was a student at Polytechnic when he worked there and on remand did not present evidence to prove that the claimant had earned forty QCs.
SSA’s regulations provide that the only conclusive evidence of a claimant’s earnings is a statement of earnings provided by SSA.
The claimant submitted a handwritten chart of his earnings to demonstrate that he had accrued more than forty QCs. Although insufficient evidence of his earnings,
see
The glaring nature of SSA’s regulatory violations is underscored by decisions of the Supreme Court as well as the circuit courts of appeal instructing that in cases involving disability benefits SSA has an affirmative duty to develop a complete administrative record, including “arguments both for and against granting benefits.”
Sims v. Apfel,
The claimant here is the
Poulin
ease
writ large:
Not only was he not represented by legal counsel at any level of SSA review, he is not a native English speaker, lives in a far distant country, lacks the financial resources to return to this country, and suffers from a serious, progressive mental illness. Under the circumstances, SSA’s failure to develop a comprehensive administrative record is inexcusable.
Pou-lin,
We will never know whether, with SSA assistance as required by its regulations and court decisions, the claimant could have provided additional information to cure the deficiencies in his chart or otherwise acted to demonstrate that he qualified for benefits. Had SSA made the typе of thorough eligibility inquiry early in the process, consistent with its regulatory duty, this matter could have been resolved promptly. At this point, ten years after he filed his application for benefits, the claimant’s mental condition has deteriorated to the point where he cannot assist counsel in pursuing his claim. As the record stands, the brother cannot rest his entitlement to benefits on behalf of the claimant on the illusory grounds that if SSA had fulfilled its responsibilities, the claimant might have presented evidence of other employment or might have chosen to remain in the United States longer so as to qualify for benefits based on ten years of residency rather than forty QCs. The brother did not proffer any additional employment evidence on remand, and even now, assisted by counsel, he has not done so. His family’s repeated statements to SSA that for medical reasons the claimant “had no way of surviving” in the United States, that they lacked sufficient financial resources for the brother to travel back to the United States with the claimant, and that the claimant had no plans to return to the United States, dispel the notion that he might have returned to the United States. Thus, the void in the record to support the claimant’s prima facie entitlement remains.
Absent a prima facie case of the claimant’s eligibility to receive disability benefits, the authorities on which the brother relies to obtain equitable relief are inappo-site. For example, in
Allen, 881
F.2d 37, the Third Circuit chose to award benefits to the claimant rather than remand where SSA’s decision was unsupported by substantial evidence on the record.
Id.
at 43-44. The claimant in
Allen
had “established a prima faci[e] case of entitlement, the record was fully developed, and there [was] no good cause for [SSA’s] failure to adduce all the relevant evidence in the priоr proceeding.”
Id.
at 44. Here, the original administrative record betrays the fact that the claimant had not accrued forty QCs or established ten years of residency. The brother’s reliance on
Allen
and its progeny is therefore misguided.
See, e.g., Distasio v. Shalala,
Accordingly, in light of a pre-remand administrative record that fails to show that the claimant is entitled to disability benefits and no compelling reason to bеlieve that he or his brother can produce evidence to prove otherwise, we affirm the judgment affirming SSA’s denial of benefits, notwithstanding the unlawful remand under sentence six of
Notes
. Throughout the administrative and judicial proceedings, Deviprasad and Rrishnan Na-rayanan have been referred to as Narayanan Deviprasad and Narayanan Rrishnan, respectively, inverting their given first names and surname. In this opinion we will refer to them as claimant and brother, respectively.
. The court expresses its appreciation for the able assistance provided by counsel appointed by this court.