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8 Soc - Sec.rep - Ser. 170, Unempl - Ins.rep. CCH 15,764 Jose M. Elchediak v. Margaret Heckler, Secretary of Health and Human Services, 750 F.2d 892, 11th Cir. (1985)
8 Soc - Sec.rep - Ser. 170, Unempl - Ins.rep. CCH 15,764 Jose M. Elchediak v. Margaret Heckler, Secretary of Health and Human Services, 750 F.2d 892, 11th Cir. (1985)
2d 892
Non-Argument Calendar.
United States Court of Appeals,
Eleventh Circuit.
Jan. 15, 1985.
Adolfo J. Vila, Miami, Fla., for plaintiff-appellant.
Marie T. Ransley, Asst. Regional Atty., Dept. of Health & Human
Services, Atlanta, Ga., for defendant-appellee.
Appeal from the United States District Court for the Southern District of
Florida.
Before VANCE, HENDERSON and CLARK, Circuit Judges.
PER CURIAM:
Plaintiff Jose Elchediak appeals the district court's granting of the Secretary's
motion to dismiss for lack of jurisdiction under 42 U.S.C. 405(g). Since we find
that plaintiff's contention that his mental illness precluded him from litigating
his claim for disability benefits because it prevented him from proceeding in a
timely fashion from one administrative level to the next raises a colorable
constitutional claim, we reverse and remand for further findings at the
administrative hearing level.
behalf asserting that he was disabled and had been unable to work since March
1975 due to his paranoid schizophrenia.1 The Social Security Administration
(Administration) denied the application on December 28, 1978. This decision
became final when neither Mr. Elchediak nor his mother pursued the
application any further. Mr. Elchediak later filed a second application for
disability benefits based on his own earnings record.2 Again, he asserted that he
had been disabled and unable to work since March 1975 due to his paranoid
schizophrenia. The Administration denied this second application finding that
Mr. Elchediak's alleged disability was not severe enough to entitle him to
benefits. Mr. Elchediak again failed to pursue his application any further.
3
On July 24, 1981, Mr. Elchediak filed a third application for disability benefits,
again alleging that he had been disabled since March 1975 due to his paranoid
schizophrenia.3 Once again the Administration denied his application finding
that Mr. Elchediak's condition had already been found not disabling as of
December 31, 1975, which was the last day he met the earnings requirement.
The notice of denial also informed him that his application did not entitle him
to any other type of benefits. This decision was affirmed on reconsideration.
With the assistance of counsel, Mr. Elchediak requested a hearing before an
administrative law judge (ALJ). At that hearing, claimant's counsel requested
that his original application be reopened. After considering all the available
evidence, the ALJ found that Mr. Elchediak had failed to present any new and
material evidence which would require reopening his original application and
thus concluded that Mr. Elchediak's current application was barred by the
doctrine of res judicata as set out in 20 C.F.R. 404.957(c)(1).
When the appeals council declined to review the ALJ's decision, plaintiff filed
this suit. The Secretary immediately moved to dismiss asserting that the district
court lacked jurisdiction under 42 U.S.C. 405(g) because the Secretary's refusal
to reopen a prior application is not a "final decision" within the meaning of the
statute. See Califano v. Sanders, 430 U.S. 99, 107-09, 97 S.Ct. 980, 985-86, 51
L.Ed.2d 192 (1977). A magistrate, relying on Califano v. Sanders, denied the
Secretary's motion because he found that the plaintiff had raised a colorable
constitutional due process claim. Later, in his report and recommendations, the
magistrate concluded that the manifest weight of the evidence compelled a
finding of disability in favor of Mr. Elchediak. In reaching this conclusion, he
determined that a remand to the Secretary was pointless since all the relevant
evidence was presently before the court and recommended that the court
reverse the Secretary's previous decision and award benefits in Mr. Elchediak's
favor retroactively from October 1977.
clearly erroneous and concluded that the magistrate erred in not granting the
Secretary's motion to dismiss. The court then granted the Secretary's motion to
dismiss holding that the Secretary's refusal to reopen a previous application is
not a final order from which relief can be sought in federal court and that the
plaintiff had failed to raise a colorable constitutional claim.
6
After Califano v. Sanders, it is clear that the federal courts are without
jurisdiction to review the Secretary's refusal to reopen a prior application absent
some constitutional challenge. 430 U.S. at 107-09, 97 S.Ct. at 985-86. The sole
issue before this court therefore is whether Mr. Elchediak's assertion that his
mental illness precluded him from effectively litigating his claim for benefits
because it prevented him from proceeding in a timely fashion from one
administrative level to the next raises a colorable constitutional claim.
While we have not addressed this precise issue, we have recognized that in
appropriate cases mental illness may destroy the res judicata effect of a prior
administrative determination. Green v. Weinberger, 500 F.2d 203, 205 (5th
Cir.1974).4 In this case, Mr. Elchediak specifically asserts that he is entitled to
benefits because his mental illness--paranoid schizophrenia--renders him
disabled. All the available medical evidence confirms that he suffers from this
type mental illness. Further, the evidence shows that his mental illness is
severe enough to have required hospitalization on several occasions. For
instance, the record shows that Mr. Elchediak's condition required an eighteen
day hospitalization just two months prior to his receiving notice that his initial
application had been denied.
Other courts addressing this issue in cases with similar factual settings have
held that a claimant suffering from mental illness raises a colorable
constitutional claim when he asserts that his mental illness precluded him from
litigating his claim because it prevented him from proceeding from one
administrative level to another in a timely fashion. See Penner v. Schweiker,
701 F.2d 256, 260-61 (3rd Cir.1983); Parker v. Califano, 644 F.2d 1199, 120103 (6th Cir.1981); Brittingham v. Schweiker, 558 F.Supp. 60, 61
(E.D.Pa.1983); Kapp v. Schweiker, 556 F.Supp. 16, 20-21 (N.D.Cal.1981). We
choose to follow this approach and find the sixth circuit's analysis in Parker to
be particularly helpful. After noting that the alleged due process deficiency was
not the content of the notices mailed and received, but rather, the claimant's
ability to understand and act on that notice, the court stated:
Parker v. Califano, 644 F.2d at 1203. Because we conclude that Mr. Elchediak
has raised a colorable constitutional claim, we remand to the district court with
instructions that it direct the Secretary to make a determination, after
considering such evidence as the parties may submit, whether Mr. Elchediak's
mental illness prevented him from understanding and pursuing his
administrative remedies following the denial of his first application for
benefits.5 In reaching this decision we do not intimate that every claimant who
alleges that a mental problem or disorder prevented him from understanding
and pursuing his administrative remedies will have raised a constitutional issue,
however, we find that the plaintiff here raises a colorable constitutional claim
since he has shown: (1) he suffers from a medically-documented mental illness
which serves as the basis for his disability claim; (2) on his first application he
was without the assistance of counsel or other suitable representation; and (3)
that he cannot assert a new claim for benefits because he now lacks insured
status.
11
Mr. Elchediak was twenty-three years old when this first application for
benefits was filed. He had an established earnings record of his own, however,
his insured status with respect to his earnings record had expired on December
31, 1975. Plaintiff was eligible to apply for child's benefits based on any
disability he suffered prior to his twenty-second birthday which was on April
24, 1977
We cannot determine from the record before us the date on which this second
application was filed or the date on which the application was rejected. We do
know, however, that in rendering its decision the Administration considered
evidence through January 4, 1980
This third application was based on Mr. Elchediak's own earnings record
We realize that Green was decided prior to Califano v. Sanders, however, there
is nothing in Sanders which undermines the principle stated in Green. See
Parker v. Califano, 644 F.2d 1199, 1203 (6th Cir.1981)
That Mr. Elchediak's mother rather than Mr. Elchediak himself filed the first
application for benefits on his behalf is not in and of itself dispositive of his