United States District Court, W.D. Wisconsin
OPINION AND ORDER
WILLIAM M. CONLEY District Judge.
42 U.S.C. § 405(g), pro se plaintiff Amanda
Craven seeks judicial review from a denial of her application
for supplemental security income by the Commissioner of
Social Security. Before the court is the defendant's
motion to dismiss for lack of subject matter jurisdiction.
(Dkt. #10.) Specifically, the defendant contends that a
decision dismissing an appeal as untimely is not a
“final decision” subject to judicial review under
§ 405(g). Because Seventh Circuit precedent permits
plaintiff to seek review under these circumstances, however,
defendant's motion to dismiss will be denied.
August 5, 2010, Craven filed an application for supplemental
security income benefits. In her application, Craven provided
the address for her appointed guardian, but indicated that
her living situation was unstable. She also provided a phone
number. According to Craven, an SSA agent advised that she
would be notified of the results of her application by
telephone. Plaintiff was also apparently told by
acquaintances familiar with the process that her application
would likely take more than a year to process.
Craven's application was denied initially on November 12,
2010, for her “failure to cooperate.” Apparently,
the agency had requested -- via mail -- that plaintiff
provide a signed and dated medical release form so that her
application could proceed. Because Craven neither received
nor responded to that request, her application was dismissed.
According to the Commissioner, a written notice was sent to
Craven informing her of this dismissal, but she denies ever
receiving that notice as well.
applicable regulations, Craven had 60 days to file a request
for reconsideration from this notice. Unaware of the notice,
and believing that SSA would take much longer to act, Craven
not only failed to seek reconsideration within the 60-day
deadline, she took no additional action on her
application for more than a year. In the spring of 2013, when
Craven finally called to check on her claim, she was told
that it had been denied years ago and that she would need to
file a new application. Instead, plaintiff filed a request
for review on July 8, 2013, along with a statement arguing
that she had good cause for her untimely request. On July 9,
2013, the SSA denied reconsideration, finding no good cause
for plaintiff's untimely filed request. The July 9th
notice denying reconsideration also advised that Craven could
request a hearing, which she did on September 4, 2013.
March 12, 2014, a hearing was held before an ALJ to consider
her arguments as to good cause. On April 8, 2014, however,
the ALJ issued an unfavorable decision, finding Craven's
request for reconsideration was untimely and finding
no good cause was established.
April 25, 2014, Craven filed a request for review of the
ALJ's decision with the Appeals Council. On August 9,
2015, the Appeals Council issued a “notice of intent to
dismiss plaintiff's request for hearing, ” offering
her 30 more days to send additional evidence or a
supplemental statement in support of her claim.
November 23, 2015, the Appeals Council issued a decision
stating that Craven's request for a hearing should not
have been granted because she had not shown good cause. The
Appeals Council decision also stated that its decision
“is final and not subject to further review.”
Craven filed this lawsuit on January 21, 2016, seeking review
of the decision finding that she lacked good cause for an
untimely request for reconsideration of the denial of her
2010 application for benefits. She contends that the agency
failed to provide her with notice of its decision against her
and that the ALJ failed to adequately develop the factual
record at the good cause hearing.
Commissioner moves to dismiss this action on the grounds that
this court lacks jurisdiction because no “final
decision” was ever issued within the meaning of 42
U.S.C. § 405(g). Under that section, judicial review of
decisions by the Commissioner of Social Security is limited
“to a particular type of agency action, a ‘final
decision of the [Commissioner] made after a
hearing.'” Califano v. Sanders, 430 U.S.
99, 108 (1977) (quoting § 405(g)). Moreover, §
405(g) is the exclusive source of federal court
jurisdiction for Social Security cases. 42 U.S.C. §
405(h); Jackson v. Astrue, 506 F.3d 1349, 1353 (11th
Cir. 2007). Acknowledging that the statute does not define
“final decision, ” the Commissioner points the
court to regulations in support of her argument that a
“final decision” for purposes of § 405(g)
includes only those decisions that are subject to an
administrative review process. See 20 C.F.R. §
416.1400(a). In particular, defendant points out that the
regulations classify certain determinations as “initial
determinations, ” which are, in turn, “subject to
administrative and judicial review.” See 20
C.F.R. § 416.1402. In contrast, defendant again notes,
other decisions are “not initial determinations”
under the regulations, and thus they are subject only to
internal agency review, not judicial review.
See 20 C.F.R. § 416.1403(a). Even more to the
point, among the decisions that are not initial
determinations under the regulations is “[d]enying [a]
request to extend the time period for requesting review of a
determination or a decision.” Id. §
Commissioner further points out, this is exactly the type of
decision that plaintiff now wants reviewed: she asks this
court to review the Commissioner's determination that she
did not show good cause for her untimely request for
reconsideration of the dismissal of her 2010 application for
benefits. Since the decision to dismiss is not an
“initial determination, ” the defendant argues it
could not have resulted in a “final decision”
subject to judicial review. Therefore, the Commissioner
argues, plaintiff is not entitled to judicial review, and her
claim must be dismissed for lack of subject matter
Commissioner's argument has some superficial appeal.
Certainly, the Supreme Court has acknowledged that not all
Commission decisions are subject to judicial review. See
Califano, 430 U.S. at 108 (holding that agency's
decision refusing to reopen a claim for benefits is not
subject to judicial review absent a constitutional
challenge). The Seventh Circuit also recently confirmed,
albeit in an unpublished case, that the agency may designate
some findings as not “initial determinations” and
therefore not subject to judicial review. See Alfreds v.
Colvin, 618 Fed. App'x 289, 290 (7th Cir. 2015).
Moreover, the type of decision at issue here has been