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Craven v. Berryhill

United States District Court, W.D. Wisconsin

March 31, 2019

NANCY A. BERRYHILL, Acting Commissioner of Social Security, Defendant.



         Under 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. For the reasons provided below, the court concludes that the record and explanation of the ALJ adequately justify dismissal of her untimely request for review, having submitted no evidence supporting a finding of good cause to excuse her two-and-a-half-year delay in seeking benefits. As such, the court will affirm the ALJ's determination.


         In September of 2010, Craven filed an application for supplemental security income (“SSI”) benefits, with a protective filing date of August 5, 2010. In her application, Craven provided the address for her appointed guardian, but indicated that her living situation was unstable. Accordingly, she also provided a phone number. Craven expected the process to take a long time because acquaintances familiar with the process had told her that the processing of her application would likely take more than a year. Based on her conversation with an unnamed SSA agent, Craven also expected to be contacted via telephone about the results of her application.

         Unfortunately, in correspondence dated October 14, 2010, the agency requested certain documents necessary to process the claim, and on November 12, 2010, when the agency did not receive the requested forms, her application was denied in writing for failure to cooperate. This written denial included formal notice that Craven had 60 days to seek reconsideration of that decision.

         While Craven claims that she never received this denial, she concedes taking no additional action on her application until July 8, 2013, two and a half years after the agency denied her application. At that time, Craven filed her request for reconsideration of the November 12, 2010 decision, stating that she “is significantly disabled from mental health issues that have been ignored by SSA.” (Tr. 40 (dkt. #20).) She also submitted a statement arguing good cause for her untimely request. On July 9, 2013, the SSA denied reconsideration, finding there was no good cause for such a significant delay. The July 9th notice denying reconsideration also advised that Craven could request a “good cause” hearing, which she did on September 4, 2013. Along with that request, Craven's representative submitted a chronology of her mental health issues, which included a 1998 ADHD diagnosis, as well as records of a 2008 consultation related to her progress and need for medication. (Id. at 55-66.)

         On March 12, 2014, a hearing was held before ALJ William Spalo to consider evidence and argument as to good cause. The ALJ admitted sixteen exhibits, including additional records of her psychiatric care from 2007 and 2008 that referenced a Wellbutrin prescription, and a chronology of her ADHD diagnosis and treatment. (Id. at 55-56, 65-66.) Additionally, Craven appeared with a non-attorney representative, who argued that Craven was misled into believing that the claims process would take years.

         On April 8, 2014, the ALJ issued an unfavorable decision, finding (1) Craven's request for reconsideration was untimely and (2) her delay in requesting reconsideration was not excused by good cause. (Tr. 27-30 (dkt. #20).) In particular, the ALJ was unpersuaded by Craven's claim that she reasonably thought that her claim was under review from September 2010 through July 2013:

She has not argued that her mental health prevented her from understanding the claim process. She described her condition at the time as “a bit frazzled”; however, she was not hospitalized or taking any psychotropic medication at the time. In fact, she was working as an in-home babysitter for her counsel and looking for employment in a depressed job market.
I note that the claimant alleges never receiving any of the written notices from the agency in 2010; however, she testified that she was living with her cousin and babysitting at that time. It is unclear why she would not have received her mail there. If she moved, the notices should have been forwarded or returned to the Administration. There is nothing in the record to show that the Administration knew or could have known that the correspondence did not reach the claimant.
Even accepting that the claimant's statement that she did not receive forms to sign or notice of her denied claim, the claimant should have contacted the agency within a reasonable time to check the status of her claim. If the claimant had trouble reliably receiving her mail, she should have kept close contact with the Administration by telephone. Based on her testimony, she had telephone contact with the Administration in the past. She would have known how to contact them for updates.
Finally, I note that the primary foundation of the claimant's argument is that she was told by “advocates” that that claims process was very slow; therefore, waiting more than two years to follow up was not unreasonable. However, at the hearing, the claimant could not recall who these “advocates” were and did not remember ever being told that “people die waiting” for their benefits.

(Id. at 29.)

         On April 25, 2014, Craven filed a request for review of the ALJ's decision with the Appeals Council. On August 9, 2015, the Council issued its “notice of intent to dismiss plaintiff's request for hearing, ” citing to the SSA's Hearing, Appeals, and Litigation Manual (“HALLEX”) provision 1-3-4-20, which permits the Appeals Council to dismiss a request for hearing for any reason available to an Administrative Law Judge under 20 C.F.R. § 416.1457. In particular, the notice explained that dismissal appeared appropriate because the ALJ should have dismissed the request for hearing, having found that Craven's ...

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