Nov 27, 2017

A Narrow Win For Social Security

     The First Circuit Court of Appeals has issued an opinion in Justinano v. Social Security holding that the federal court have no jurisdiction, prior to a final administrative decision, to review Social Security's termination of disability benefits due to allegedly fraudulent medical evidence. These cases arose in Puerto Rico but this is essentially the same as the situation when the first civil actions were filed in the cases of claimants who had been represented by Eric Conn. 
     Note that no one is denying that there is jurisdiction to review a final administrative determination in these cases. Presumably, by now there are final administrative determinations to review.

5 comments:

Anonymous said...

this win is bit less narrow:

https://www.leagle.com/decision/infdco20171114719

Anonymous said...

Let's see, the court ruled that administrative remedies had to be exhausted before taking this matter to court. So because SSA was making up policy on the fly when it adjudicated these cases, i.e., acting in an arbitrary and capricious manner, it was appropriate to see what and how policy would be applied at the final levels of administrative review.

I thought that one of the purposes behind judicial review was to protect us from arbitrary and capricious administrative action. Why jerk people around in proceedings where the deck has been stacked? It is not far fetched to say that due process requires 1) SSA to explain specifically why the evidence in a specific case is so inherently unreliable that it has to be thrown out and 2) offer an opportunity for rebuttal. Since the statute that triggers these reviews requires SSA to have "reason to believe", SSA should have demonstrated that its actions were reasonable in each individual case.

Anonymous said...

@3:13

I could see merit to some form of interlocutory appeal process during the course of administrative proceedings, but the Social Security Act does not establish such a method. While judicial review is meant to protect claimants and recipients from arbitrary and capricious administrative action, it is not designed to do so, preemptively.

In regard to due process demanding SSA explain why they believe evidence is fraudulent before throwing it out, it will be interesting to see how it would play out in Court once the final decision is rendered. I have a difficult time imagining a more straight-forward abuse of discretion than an ALJ refusing to consider evidence based on allegations of fraud, allegations not supported in any way in the evidence of record. I'm unfamiliar with First Circuit caselaw in regard to submitting evidence subsequent to administrative proceedings, but given the evidence was properly before the ALJ it seems like it would be difficult to argue the improperly rejected evidence should not be before the District Court.

Anonymous said...

Well, if there is a clear constitutional question involved you can go right to federal court before administrative finality. Here it looks more like administrative process - bad or good - that needs to run its course without any clear due process injury.

Anonymous said...

@3:17

I am familiar with the expedited appeals process, but I have never seen it implemented. I thought SSA had to agree a particular issue being unconstitutional? I don't see SSA agreeing to anything, particularly not when the end goal is them being sued faster.