Opinion
Civil Action No. 03-11829-RWZ.
June 18, 2004
MEMORANDUM OF DECISION
In July 1998, Plaintiff applied for disability insurance benefits under Title II and supplemental security income payments under Title XVI of the Social Security Act, effective June 1997. The first ALJ to hear his case denied the application. After a successful appeal and remand, the second ALJ found plaintiff to be entitled to benefits, but effective March 2001, not June 1997. Again plaintiff appealed. At this stage, the procedural issues presented in the case before took shape. The cassette recording of the hearing was nowhere to be found. That created a major problem for the Appeals Council as the ALJ's decision was "to a great extent, based on medical expert testimony. . . ." (Pl.'s Opp'n Attachment D). "Because the cassette recording is missing[,]" the Appeals Council found that "the record is incomplete and neither favorable or (sic) unfavorable aspects of the decision are supported by substantial evidence." Id. It therefore vacated the entire decision and remanded the case for a new hearing. Thereafter, plaintiff filed a Complaint in this Court. He seeks a stay prohibiting defendant from reopening the plaintiff's disability application until this action is over, an order that benefits be paid to plaintiff as of June 8, 1997, an award of attorney's fees, and such other relief as is just and proper. Defendant moves to dismiss on the grounds that this Court does not have jurisdiction, as there is no final decision from which an appeal lies. Plaintiff asserts that the Commissioner failed to timely appeal the favorable portion of the ALJ's decision.
Although equitable considerations favor plaintiff, the relevant statutes, regulations, and case law do not. Title 42 U.S.C. § 405(h) provides that "[n]o findings of fact or decision of the Commission of Social Security shall be reviewed by any person, tribunal, or governmental agency except as herein provided."Id. at 1093. Section 405(g) states that "[a]ny individual, after any final decision of the Commissioner of Social Security made after a hearing to which he was a party, irrespective of the amount in controversy, may obtain a review of such decision by a civil action. . . ." 42 U.S.C. § 405(g) (emphasis added). A decision becomes final when the Appeals Council either denies a party's request for review or allows it and makes a decision.See 20 C.F.R. § 416.1455(a). The requirement of a final decision by the Commissioner before allowing judicial review "assures the agency greater opportunity to apply, interpret, or revise policies, regulations, or statutes without possibly premature interference by different individual courts applying `ripeness' and `exhaustion' exceptions case by case." Shalala v. Illinois Council on Long Term Care, Inc., 120 S.Ct. 1084, 1093 (2000).
Here, plaintiff appealed the ALJ's decision, and the Appeals Council granted the request for review and remanded. Therefore, the ALJ's decision is not final and, thus, not ripe for judicial review. Plaintiff claims that he is only appealing the unfavorable portion of the ALJ's decision and that the favorable portion should stand However, once a claimant appeals any part of the ALJ's decision, the Appeals Council may review the entire decision. See Popps v. Barnhart, 2004 WL 240566 (D. Mass.) (dismissing plaintiff's Complaint alleging that her right to due process was violated when the Appeals Council vacated and remanded the ALJ's entire decision even though plaintiff only appealed the determination of the onset of her disability and the Commissioner did not appeal at all.). Furthermore, under 20 C.F.R. § 416.1476(a), "[t]he Appeals Council may limit the issues it considers if it notifies you and the other parties of the issues it will review." Here, the notice of the decision to the plaintiff, dated February 14, 2002, stated that "[i]f you file an appeal, the Council will consider all of my decision, even the parts with which you agree. . . . Requesting review places the entire record of your case before the Council. Review can make any part of my decision more or less favorable or unfavorable to you." (Pl.'s Opp'n Attachment A). Although administrative exhaustion may come at a price, namely, "individual, delay-related hardship," Shalala v. Illinois Council on Long Term Care, Inc., 120 S.Ct. 1084, 1093 (2000), defendant's motion to dismiss for lack of jurisdiction is allowed. However, given that plaintiff bears no responsibility for the loss of the tape and has already endured an altogether too long and inconsistent administrative process, the Court encourages defendant to provide expedited consideration of his claim.
Judgment may be entered dismissing the Complaint.