Charlene B. v. Soc. Sec. Admin., Civil Action No. 4:20cv00014

CHARLENE B.,¹ Plaintiff, v. SOCIAL SECURITY ADMINISTRATION, Defendant.

Civil Action No. 4:20cv00014

UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF VIRGINIA Danville Division

July 12, 2021

MEMORANDUM OPINION

By: Joel C. Hoppe United States Magistrate Judge

Plaintiff Charlene B., appearing pro se, asks the Court to review the Social Security Administration's ("SSA") decision to reduce the amount of her monthly supplemental security income ("SSI") payments under Title XVI of the Social Security Act, 42 U.S.C. §§ 1381-1383f. See Compl. 1, ECF No. 2; Compl. Ex. 1, Pl.'s Position Statement ¶¶ 13, 20, ECF No. 2-1. She seeks a judgment against the SSA for $4,886.80, which reflects the total amount that Charlene alleges the SSA erroneously withheld between September 2016 and March 2018. Pl.'s Position Statement 4. The case is before me by the parties' consent under 28 U.S.C. § 636(c). ECF Nos. 6, 14.

Having reviewed the parties' filings and the applicable law, I find that the Court does not have authority to hear Charlene's case because she is not challenging "any final decision of the Commissioner of Social Security made after a hearing to which [s]he was a party," 42 U.S.C. § 405(g) (emphasis added). See Smith v. Berryhill, 139 S. Ct. 1765, 1771 (2019). Instead, she is challenging the SSA's initial determination, made in September 2016, to reduce her monthly payments by $244.33 after it found that the value of Charlene's monthly in-kind income went upby the same amount. See Pl.'s Position Statement ¶ 13 ("[R]educing my supplemental security benefits [by] $244.33 for shelter and food was wrong."); Def.'s Br. in Supp. of Mot. to Dismiss, Decl. of Janay Podraza Ex. 10, Soc. Sec. Admin., Notice of Appeals Council Action ("On September 3, 2016, you received a notice informing you that your [SSI] would be reduced by $244.33 monthly for the value of food and shelter you received in someone else's home or apartment. . . . This was the initial determination in your case.") (Sept. 19, 2019), ECF No. 21-1, at 31; 20 C.F.R. § 416.1402(a)-(b). The SSA was still considering that initial determination when Charlene filed this lawsuit in February 2020. See Podraza Decl. Ex. 11, Soc. Sec. Admin., Order of Appeals Council (vacating ALJ's order dismissing Charlene's premature request for a hearing and instructing the SSA Field Office to determine whether Charlene could show "good cause for . . . [her] untimely request for reconsideration" of the September 2016 determination and, if so, to "reopen the prior determination and issue a revised determination on the issue of reduction of benefits") (Nov. 8, 2019), ECF No. 21-1, at 37-40. Accordingly, Defendant's motion to dismiss, ECF No. 20, will be granted and the action dismissed without prejudice for lack of subject-matter jurisdiction. Fed. R. Civ. P. 12(b)(1), (h)(3).

I. Standard of Review

A Rule 12(b)(1) motion to dismiss "challenges the district court's subject matter jurisdiction, asserting, in effect, that the plaintiff lacks any 'right to be in the district court at all.'" State Constr. Corp. v. Slone Assocs., Inc., 385 F. Supp. 3d 449, 457 (D. Md. 2019) (quoting Holloway v. Pagan River Dockside Seafood, Inc., 669 F.3d 448, 452 (4th Cir. 2012)). The challenge can "proceed 'in one of two ways': (1) . . . a facial challenge, asserting that the allegations pleaded in the complaint are insufficient to establish subject matter jurisdiction; or (2) a factual challenge, asserting 'that the jurisdictional allegations of the complaint are not true.'"MedSense, LLC v. Univ. Sys. of Md., 420 F. Supp. 3d 382, 389 (D. Md. 2019) (cleaned up) (quoting Kerns v. United States, 585 F.3d 187, 192 (4th Cir. 2009)). In a facial challenge, the facts alleged in the complaint are accepted as true, and the court must deny the Rule 12(b)(1) motion if those well-pled facts are enough to invoke the district court's authority to entertain the legal claims asserted. See Kerns, 585 F.3d at 172. In a factual challenge, on the other hand, the district court "may regard the pleadings as mere evidence . . . and may consider evidence outside the pleadings," Velasco v. Gov't of Indonesia, 370 F.3d 392, 398 (4th Cir. 2014), "to decide disputed issues of fact with respect to subject matter jurisdiction," Kerns, 585 F.3d at 192. See Majors v. Astrue, No. 3:08cv5, 2008 WL 414436, at *1 & n.1 (W.D. Va. Sept. 5, 2008) (considering declaration and exhibits attached to Commissioner's Rule 12(b)(1) motion). "[T]he plaintiff bears the burden of proving the truth of such facts by a preponderance of the evidence." U.S. ex rel. Vuyyuru v. Jadhav, 555 F.3d 337, 347 (4th Cir. 2009). When a plaintiff is pro se, the court should liberally construe her filings in determining whether she carried this burden. Bond v. Soc. Sec. Admin., No. 4:13cv46, 2014 WL 2215902, at *6 (W.D. Va. May 29, 2014) (citing Erickson v. Pardus, 551 U.S. 89, 94 (2007)). The court must dismiss the action, without prejudice, if it determines at any time that it lacks subject-matter jurisdiction. Fed. R. Civ. P. 12(h)(3); see S. Walk at Broadlands Homeowner's Ass'n, Inc. v. OpenBand at Broadlands, LLC, 713 F.3d 175, 185 (4th Cir. 2013).

II. The Legal Framework

The federal SSI program exists to ensure "a minimum level of income for people who are age 65 or over, or who are blind or disabled" and whose other income and resources fall below specified amounts. 20 C.F.R. § 416.110. A person's rights to SSI "payments—how much [s]he gets and under what conditions—are clearly defined in the law." Id. § 416.110(b). "The amountof benefits paid under the program is inversely proportional to an eligible recipient's income" and generally "equals a periodically determined subsidence level of income" minus the value of the recipient's other qualifying monthly income. Kennedy v. Shalala, 992 F.2d 28, 29 (4th Cir. 1993); see 20 C.F.R. § 416.1100 ("Generally, the more income you have the less your benefit will be. If you have too much income, you are not eligible for a benefit. However, we do not count all of your income to determine your eligibility and benefit amount."). Because a person's income is "a major factor in deciding" the amount of her monthly SSI payments, 20 C.F.R. § 416.1100, the SSA must "redetermine" that amount "on a scheduled basis at periodic intervals" or when there is a change in the person's financial situation that affects her eligibility or benefit amount, id. § 416.204(b). If the person disagrees with the SSA's initial decision to reduce her monthly benefit, she can pursue three separate levels of "administrative review of the decision and if still not satisfied, [s]he may initiate court action." Id. § 416.110(b).

First, and most importantly in Charlene's case, the person must ask the agency to reconsider its initial determination by filing a written request within 60 days after receiving notice of the initial determination, or by asking for more time to file such request. See id. §§ 416.1400(a)(2), 416.1413b. Next, if the person is dissatisfied with the agency's "reconsidered determination" she must request a hearing before an Administrative Law Judge ("ALJ"), id. § 416.1430, who will issue a written decision setting out "findings of fact and the reasons for the decision," id. 416.1453(a). Finally, the person must ask the Appeals Council to review the ALJ's written decision. Id. § 416.1468. The Appeals Council's claim-ending resolution of this request for review produces "a[] final decision of the Commissioner of Social Security made after a hearing to which [the claimant] was a party," which is then subject to judicial review under 42U.S.C. § 405(g).² See Smith, 139 S. Ct. at 1772, 1774-77. If a claimant misses any of these steps, "there is no final decision and, as a result, no judicial review in most cases. In administrative-law parlance," the claimant cannot "obtain judicial review because [s]he has failed to exhaust administrative remedies." Sims v. Apfel, 530 U.S. 103, 107 (2000). Similarly, federal courts typically do not have jurisdiction to review SSI claims that are still being considered by the SSA when the claimant files suit because there is no "final decision," 42 U.S.C. § 405(g), for courts to review in those cases.³ See Turner v. Soc. Sec. Admin., No. 5:17cv58, 2017 U.S. Dist. LEXIS 88639, at *2-3 (W.D. Va. June 8, 2017) (citing Sims, 530 U.S. at 107), aff'd, 705 F. App'x 187, 187 (4th Cir. 2017).

III. Background

In March 1992, the SSA determined that Charlene's diagnosed intellectual disability entitled her to SSI benefits beginning on October 1, 1991. See Podraza Decl. Ex. 2, Soc. Sec. Admin., Disability Determination & Transmittal (Mar. 3, 1992), ECF No. 21-1, at 9; Notice of Appeals Council Action, ECF No. 21-1, at 32. As of August 2016, Charlene received $733.00 each month, which was "[t]he most SSI money the law allow[ed the SSA] to pay" at the time. See Notice of Planned Action, ECF No. 21-1, at 15. On September 3, 2016, the Portsmouth Field Office sent Charlene a "Notice of Planned Action" informing her that the SSA was lowering hermonthly SSI payment "from $733.00 to $488.67 beginning [in] October 2016 . . . . because [her] other income increased." Id. at 10. The letter explained that the "food and shelter" Charlene received "in someone else's home" counted as "income" and that the SSA considered this food and shelter to be worth $244.33 as of August 2016.⁴ Id. at 10, 15. Thus, Charlene's monthly SSI payments would also be reduced by $244.33. Id.; see generally Pl.'s Position Statement ¶¶ 13, 20. The letter explained that Charlene had the right to appeal, or request "reconsideration," if she disagreed with this initial decision. Notice of Planned Action, ECF No. 21-1, at 11-12. Charlene had 60 days, starting "5 days after the date on the letter," to file an appeal in writing. Id. at 12; see Podraza Decl. Ex. 5, Soc. Sec. Admin., Notice of Reconsideration ("[Y]ou did not submit your appeal within the 65 day time limit") (...