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            Title Fitzgerald v. Apfel

 

            Date 1998

            By Alito

            Subject Misc

                

 Contents

 

 

Page 1





LEXSEE 148 F 3D 232


KATHLEEN FITZGERALD, Appellant v. KENNETH S. APFEL * Commissioner of

Social Security



* Kenneth S. Apfel was sworn in as Commissioner of Social Security on September

29, 1997. Pursuant to Rule 43(c)(1) of the Federal Rules of Appellate Procedure, Kenneth S. Apfel is substituted for John J. Callahan as the defendant in this suit.


No. 97-1605


UNITED STATES COURT OF APPEALS FOR THE THIRD CIRCUIT



148 F.3d 232; 1998 U.S. App. LEXIS 11908; Unemployment Ins. Rep. (CCH) P16,048B


March 13, 1998, Argued

June 8, 1998, Filed


PRIOR   HISTORY:             **1        ON   APPEAL   FROM THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA. (D.C. Civ. No. 97-cv--2508).


DISPOSITION: Judgment of the district court affirmed.


CASE SUMMARY:



PROCEDURAL POSTURE: Appellant claimant chal- lenged the order of the United States District Court for the  Eastern  District  of  Pennsylvania,  which  dismissed her complaint against appellee Commissioner of Social Security for supplemental social security income and dis- ability insurance benefits, and held that interim benefits were not authorized by statute, and determined that her due process claim failed on the merits.


OVERVIEW:  Appellant  claimant  applied  for  supple- mental  social  security  income  and  disability  insurance benefits. At a hearing on reconsideration, the administra- tive law judge found that she was not disabled. The matter was pending before the Appeals Council. Thereupon, ap- pellant filed an action in the district court for these social security  disability  benefits.  She  then  filed  a  motion  for interim benefits. The district court denied the motion for interim benefits, dismissed her claim for social security disability benefits, and found that appellant's due process claim was without merit. On appeal, the court affirmed. The court found that the district court lacked jurisdiction to consider appellant's claim for interim benefits because she did not present a demand for such benefits to appellee Commissioner of Social Security and her claim was not collateral to a claim for final benefits. The claim for final


benefits was linked to her claim for interim benefits be- cause the commissioner had not yet issued a final decision. Further, the district court lacked jurisdiction over appel- lant's due process claim because she had not requested other equitable remedies in her complaint.


OUTCOME: The court affirmed the denial of appellant claimant's  motion  for  interim  social  security  disability benefits because the district court lacked jurisdiction to consider the motion. The claim for final disability benefits was linked to appellant's claim for interim benefits and no order had as yet been issued by appellee Commissioner of Social Security.


LexisNexis(R) Headnotes


Workers'  Compensation  &  SSDI  >  Social  Security

Disability Insurance > Judicial Review > Jurisdiction

HN1  See 42 U.S.C.S. § 405(g).


Workers'  Compensation  &  SSDI  >  Social  Security Disability  Insurance  >  Judicial  Review  >  Exhaustion of Remedies

HN2  Ordinarily, judicial review is barred absent a final decision by the Commissioner of Social Security. A final decision is central to the requisite grant of subject mat- ter jurisdiction. The final decision requirement consists of two elements, only one of which is purely "jurisdictional" in the sense that it cannot be waived by the secretary in a  particular  case.  The  waivable  element  is  the  require- ment that the administrative remedies prescribed by the secretary be exhausted. The nonwaivable element is the requirement that a claim for benefits shall have been pre- sented to the secretary.


Workers'  Compensation  &  SSDI  >  Social  Security


148 F.3d 232, *; 1998 U.S. App. LEXIS 11908, **1; Unemployment Ins. Rep. (CCH) P16,048B

Page 2


Disability  Insurance  >  Judicial  Review  >  Exhaustion of Remedies

Civil  Procedure  >  Appeals  >  Appellate  Jurisdiction  > Collateral Order Doctrine

HN3  A claim is collateral if it is not essentially a claim for Social Security benefits.


Workers'  Compensation  &  SSDI  >  Social  Security Disability  Insurance  >  Judicial  Review  >  Exhaustion of Remedies

HN4   Absent  a  finding  that  the  claimant  was  actually disabled, delay alone is an insufficient basis on which to remand for Social Security disability benefits.


COUNSEL:   Robert   Savoy,   (Argued),   Trevose,   PA, Counsel for Appellant.


Michael  R.  Stiles,  U.S.  Attorney,  Eastern  District  of Pennsylvania Joan K. Garner, Ass't U.S. Attorney, Deputy Chief, Civil Division, Arthur J. Fried, General Counsel, Charlotte  Hardnett,  Principal  Deputy  General  Counsel, John M. Sacchetti, Acting Associate General Counsel, M. Ashley Harder, (Argued), Office of the General Counsel Social  Security  Administration,  Baltimore,  Maryland, Counsel for Appellee.


JUDGES: Before:  Stapleton, and Alito, Circuit Judges, and O'Kelley, Senior District Judge. **



** The Honorable William O'Kelley, United States Senior District Judge for the Northern District of Georgia, sitting by designation.


OPINIONBY: ALITO


OPINION:   *233   OPINION OF THE COURT


ALITO, Circuit Judge:


Appellant Kathleen Fitzgerald appeals from the dis- missal  of  her  complaint  against  Kenneth  S.  Apfel,  the Commissioner  of  Social  Security,  by  the  district  court. The district court held that: it lacked subject matter juris- diction over her claim for **2   benefits; interim benefits were not authorized by statute; and Fitzgerald's due pro- cess  claim  failed  on  the  merits.  On  appeal,  Fitzgerald argues that the district court erred in concluding that in- terim  benefits  are  unavailable  and  that  her  due  process claim failed to state a claim upon which relief could be granted. Because we find that the district court did not have jurisdiction over Fitzgerald's claim for interim ben- efits, we will affirm the dismissal of her complaint. n1


n1 Although Fitzgerald did not raise the issue on appeal, we note that the district court correctly


determined that it lacked jurisdiction over her claim for  disability  benefits  for  the  same  reasons  as  it lacked jurisdiction over her claim for interim ben- efits, as will be discussed infra.



I.


Kathleen Fitzgerald applied for supplemental social security income and disability insurance benefits on July

16, 1993, and August 31, 1993, respectively. Fitzgerald's claims  were  denied  initially  and  on  reconsideration. Fitzgerald filed a timely **3    request for a hearing on October 24, 1994.


A hearing was held before an administrative law judge

("ALJ") on July 18, 1995. The ALJ issued a decision on March 18, 1996, finding that Fitzgerald was not disabled. On  March  20,  1996,  Fitzgerald  requested  review  from the Appeals Council. In her letter to the Appeals Council, counsel requested that "this claim be treated as one involv- ing CRITICAL NEED and that the matter raised below be considered as expeditiously as possible." (App. at 8). Counsel did not elaborate on this request.


On November 29, 1996, Fitzgerald's counsel sent an- other letter to the Appeals Council, stating that "my client Kathleen Fitzgerald is in desperate financial need. I re- quested  review  on  her  behalf  more  than  eight  months ago.  I  have  heard  nothing  from  you  about  the  matter."

(App. at 10). Having not heard from the Appeals Council, Fitzgerald began the present action on April 16, 1997. n2


n2 On June 27, 1997, the Appeals Council re- manded Fitzgerald's application to the ALJ for fur- ther proceedings. A hearing was held on November

14, 1997. Fitzgerald's application was again denied on February 2, 1998. Counsel requested review by the Appeals Council on February 4, 1998. That re- quest is still pending.


**4


*234   In her complaint, Fitzgerald alleged that she was disabled and entitled to disability insurance benefits and  supplemental  security  income.  She  further  alleged that she was in dire financial straits due to the extensive delay in deciding her application. Fitzgerald claimed that the failure of the Appeals Council to rule on her request for more than a year, despite the fact that she had informed them  that  she  was  destitute,  constituted  a  constructive denial of her claim. She further alleged that the unrea- sonable delay violated her Due Process rights under the Fifth Amendment and the Social Security Act. Fitzgerald requested  as  relief:   that  the  district  court  find  that  she was entitled to the benefits sought; interim benefits dur-


148 F.3d 232, *234; 1998 U.S. App. LEXIS 11908, **4; Unemployment Ins. Rep. (CCH) P16,048B

Page 3


ing the pendency of any further proceedings; and "such other relief as the court finds just and proper." (App. at

7). Fitzgerald filed a motion requesting interim benefits on May 2, 1997.


On July 24,  1997,  the district court issued an order denying the motion for interim benefits. See Fitzgerald v. Callahan,  1997 U.S. Dist. LEXIS 11278, No. Civ. A.

97-2508, 1997 WL 438483 (E.D. Pa. July 24, 1997). The district court held that interim benefits were not provided for by statute and that **5   it lacked the equitable power to grant them. The court also dismissed Fitzgerald's claim for benefits for lack of subject matter jurisdiction, since she failed to exhaust her administrative remedies. Finally, the court found that Fitzgerald's due process claim failed to state a claim upon which relief could be granted. This appeal followed.


II.


On  appeal,  Fitzgerald  argues  that  the  district  court erred in determining that interim benefits were not avail- able and that her due process claim failed as a matter of law. She apparently concedes that the district court lacked jurisdiction over her claim of entitlement to final benefits. Because we find that the district court lacked jurisdiction to consider the availability of interim benefits, we need not decide whether such benefits are precluded by statute. Jurisdiction over Social Security benefits cases is pro- vided by HN1  42 U.S.C. § 405(g), which provides, in relevant part:  "any individual, after any final decision of the Secretary made after a hearing to which he was a party

. . . may obtain a review of such decision by a civil action

. . . ." HN2  Ordinarily, judicial review is barred absent a "final decision" by the Commissioner of **6   Social Security.  Mathews v. Eldridge, 424 U.S. 319, 328, 47 L. Ed. 2d 18, 96 S. Ct. 893 (1976).


A final decision is "central to the requisite grant of subject matter jurisdiction." Id. The Supreme Court has stated that the "final decision" requirement



consists of two elements, only one of which is purely "jurisdictional" in the sense that it can- not be waived by the Secretary in a particular case.  The  waivable  element  is  the  require- ment  that  the  administrative  remedies  pre- scribed by the Secretary be exhausted. The nonwaivable element is the requirement that a claim for benefits shall have been presented to the Secretary.



Id.


If  a  plaintiff  's  claim  is  collateral  to  her  claim  for


benefits, exhaustion may be waived under certain circum- stances. See Bowen v. City of New York,  476 U.S. 467,

483,  90 L. Ed. 2d 462,  106 S. Ct. 2022 (1986). HN3

"A claim is collateral if it is not essentially a claim for benefits." Johnson v. Shalala, 2 F.3d 918, 921 (9th Cir.

1993) (citing Bowen, supra).


The district court lacked jurisdiction over Fitzgerald's claim  for  interim  benefits  both  because  she  failed  to present a demand for such benefits to the Commissioner

**7   and because her claim is not collateral to a claim for benefits. As to the former point,  there is no indica- tion in the record that Fitzgerald ever requested interim benefits from the Social Security Administration pending the outcome of the proceedings. Although she presented a general claim of disability, she did not address her claim of entitlement to interim benefits due to the excessive delay to the Commissioner. The failure to raise such a   *235  claim  violates  the  nonwaivable  jurisdictional  aspect  of exhaustion and is fatal to her claim.


Furthermore, the district court lacked jurisdiction over Fitzgerald's  claim  for  interim  benefits  because  such  a demand is not collateral to her claim for final benefits. Whether  predicated  on  §  405(g)  or  on  the  due  process clause, it is beyond cavil that interim benefits are linked to disability benefits. First, they are two forms of the same entitlement. More importantly,  Fitzgerald's claim to in- terim benefits is linked to her entitlement to final benefits. Indeed,  Fitzgerald  repeatedly  emphasized  in  her  briefs and at argument that she was entitled to such benefits not just because of the extensive delay, but also because of her indigency and the **8   merits of her case. Cf.  Bush v. Shalala, 94 F.3d 40, 46 (2d Cir. 1996) (" HN4  absent a finding that the claimant was actually disabled, delay alone is an insufficient basis on which to remand for ben- efits;" discussing Kelly v. Railroad Ret. Bd., 625 F.2d 486,

491 (3d Cir. 1980)). Since we are unable to separate the merits of her claim for interim benefits from her claim for final disability benefits,  the district court lacked ju- risdiction to hear her claim for interim benefits absent a final decision by the Commissioner. Her motion was thus properly denied. n3 Because we have determined that the federal  courts  lack  jurisdiction  to  consider  Fitzgerald's interim benefits claim, we need not decide whether such benefits are available under the Social Security statutory regime.


n3 We note that in those cases where the court discussed  the  availability  and  appropriateness  of interim benefits in initial determination cases, the court had jurisdiction under § 405(g) because, un- like the instant appeal, the Commissioner had ren- dered a final decision. See, e.g.  Doughty v. Bowen,

839 F.2d 644 (10th Cir. 1988); Taylor v. Heckler,


148 F.3d 232, *235; 1998 U.S. App. LEXIS 11908, **8; Unemployment Ins. Rep. (CCH) P16,048B

Page 4












**9


769 F.2d 201 (4th Cir. 1985); Saltares v. Bowen, 711

F. Supp. 162 (S.D.N.Y. 1989); Davenport v. Bowen,

709 F. Supp. 634 (E.D. Pa. 1989); Mason-Page v. Bowen, 655 F. Supp. 255 (D.N.J. 1987); Weiser v. Secretary, HHS, 645 F. Supp. 602 (S.D.N.Y. 1986); Dandeneau v. Heckler,  607 F. Supp. 583 (D. Me.

1985).


by  the  Appeals  Council  had  been  pending  for  thirteen months at the time she filed the instant action, the Appeals Council subsequently ordered a remand to the ALJ. The ALJ  rendered  an  unfavorable  decision  on  February  4,

1998, and Fitzgerald's request for review is currently be- fore  the  Appeals  Council.  Under  this  factual  scenario, individualized injunctive **10   relief is unwarranted.


III.


The district court may well have had jurisdiction over Fitzgerald's due process claim to the extent that she sought some other form of relief. In her complaint,  Fitzgerald added a general request for "such other relief as the court finds just and proper" to her demands for final and in- terim benefits. We do not understand her to be asking for other equitable remedies such as injunctive relief man- dating that the SSA promptly decide her application. No such request appeared in either her complaint or her ap- pellate  briefs.  Counsel  did  indicate  at  argument  that  to the extent the Court denied Fitzgerald the relief that she sought,  she  would  welcome  some  other  form  of  equi- table relief. Nevertheless, even if such a claim had been properly raised to the Court, it would be inappropriate in the present case. Although Fitzgerald's request for review

We  have  considered  Fitzgerald's  arguments  and  we conclude that the district court lacked jurisdiction to con- sider her request for interim benefits. Because Fitzgerald's application is currently proceeding in a relatively timely manner before the Social Security Administration, other forms of injunctive relief are inappropriate. The judgment of the district court is therefore affirmed. n4


n4 Because we have limited our discussion to the jurisdictional aspects of this action, nothing in this  opinion  should  be  construed  as  expressing  a view as to the merits of Fitzgerald's disability claim, or as to the availability of interim benefits in an ap- propriate case when the district court properly has jurisdiction.



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