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Matar v. Berryhill

United States District Court, D. Montana, Billings Division

March 18, 2019

KAREN L. MATAR, Plaintiff,
v.
NANCY A. BERRYHILL, Acting Commissioner of the Social Security Administration, Defendant.

          ORDER

          TIMOTHY J. CAVAN UNITED STATES MAGISTRATE JUDGE

         On October 30, 2017, Plaintiff Karen L. Matar (“Plaintiff”) filed a Complaint pursuant to 42 U.S.C. § 405(g) of the Social Security Act, requesting judicial review of the final administrative decision of the Commissioner of Social Security (the “Commissioner”) regarding the denial of her request that an overpayment of disability insurance benefits be waived. (Doc. 2.) On January 2, 2018, the Commissioner filed the Administrative Record (“A.R.”). (Doc. 7.)

         Presently before the Court is Plaintiff's motion for summary judgment, requesting the Court set aside the decision of the Commissioner, grant Plaintiff's request for a waiver, and recalculate the overpayment. (Doc. 12.) The motion is fully briefed and ripe for the Court's review. (Docs. 13, 14.)

         For the reasons set forth herein, and after careful consideration of the record and the applicable law, the Court finds Plaintiff's motion should be GRANTED, and the Commissioner's decision should be REVERSED.

         I. PROCEDURAL BACKGROUND

         Plaintiff began receiving disability insurance benefits (“DIB”) in July 1990. (A.R. 12.) In July 2010, the Social Security Administration (“SSA”) notified Plaintiff that she was no longer entitled to DIB payments, and that she had been overpaid. (A.R. 21.) Subsequently, the SSA sent Plaintiff a letter indicating she was overpaid in the total amount $27, 497.70.[1] (A.R. 33-37.)

         Plaintiff requested that recovery of the overpayment be waived. (A.R. 113.) The SSA denied her request initially and after a personal conference. (A.R. 44, 46, 49-51.) On April 9, 2015, Plaintiff filed a written request for a hearing. (A.R. 59.) Administrative Law Judge Michele M. Kelley (the “ALJ”) held a hearing on March 24, 2016. (A.R. 141-162.) On July 28, 2016, the ALJ issued a written decision determining that recovery of the overpayment should not be waived. (A.R. 9-16.)

         Plaintiff requested review of the ALJ's decision. (A.R. 7-8.) On August 25, 2017, the Appeals Council issued a partially favorable decision in which it reduced the amount of the overpayment to account for the fact Plaintiff's federal tax refunds had been withheld to repay the overpayment.[2] (A.R. 2.) But the Appeals Council affirmed the portion of the ALJ's decision finding that recovery of the overpayment could not be waived. (Id.) This made the ALJ's determination the Commissioner's final decision for purposes of judicial review. 20 C.F.R. § 404.981. Thereafter, Plaintiff filed the instant action.

         II. LEGAL STANDARDS

         A. Scope of Review

          The Social Security Act allows claimants to seek judicial review of the Commissioner's final agency decision. 42 U.S.C. §§ 405(g), 1383(c)(3). The scope of judicial review is limited. The Court must affirm the Commissioner's decision unless it “is not supported by substantial evidence or it is based upon legal error.” Tidwell v. Apfel, 161 F.3d 599, 601 (9th Cir. 1999). See also Bayliss v. Barnhart, 427 F.3d 1211, 1214 n.1 (9th Cir. 2005) (“We may reverse the ALJ's decision to deny benefits only if it is based upon legal error or is not supported by substantial evidence.”); Flaten v. Sec'y of Health & Human Servs., 44 F.3d 1453, 1457 (9th Cir. 1995).

         “Substantial evidence is more than a mere scintilla but less than a preponderance.” Tidwell, 161 F.3d at 601 (citing Jamerson v. Chater, 112 F.3d 1064, 1066 (9th Cir. 1997)). “Substantial evidence is relevant evidence which, considering the record as a whole, a reasonable person might accept as adequate to support a conclusion.” Flaten, 44 F.3d at 1457. In considering the record as a whole, the Court must weigh both the evidence that supports and detracts from the ALJ's conclusions. Jones v. Heckler, 760 F.2d 993, 995 (9th Cir. 1985); Day v. Weinberger, 522 F.2d 1154, 1156 (9th Cir. 1975)); Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005) (“Where evidence is susceptible to more than one rational interpretation, it is the ALJ's conclusion that must be upheld.”); Flaten, 44 F.3d at 1457 (“If the evidence can reasonably support either affirming or reversing the Secretary's conclusion, the court may not substitute its judgment for that of the Secretary.”). However, even if the Court finds that substantial evidence supports the ALJ's conclusions, the Court must set aside the decision if the ALJ failed to apply the proper legal standards in weighing the evidence and reaching a conclusion. Benitez v. Califano, 573 F.2d 653, 655 (9th Cir. 1978) (quoting Flake v. Gardner, 399 F.2d 532, 540 (9th Cir. 1968)).

         B. Applicable Law Regarding Overpayments

         When a DIB recipient receives more disability benefits than she is entitled, the Commissioner may recover the overpayment. 42 U.S.C. § 404(a)(1)(A). The Commissioner may, however, waive repayment if: (1) the DIB recipient is without fault; and either (2) recovery of the overpaid benefits would defeat the purpose of Title II of the Social Security Act; or (3) recovery of the overpaid benefits would be against equity and good conscience. 42 U.S.C. § 404(b)(1).

         The Social Security regulations define fault as: (1) an incorrect statement made by the individual that she knew or should have known to be incorrect; (2) failure to furnish information that she knew or should have known to be material; or (3) acceptance of a payment that she either knew or could have been expected to know was incorrect. 20 C.F.R. § 404.507; McCarthy v. Apfel, 221 F.3d 1119, 1126 (9th Cir. 2000). “In making these determinations of fault, the agency ‘will consider all pertinent circumstances, including [the claimant's] age, ...


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