SSR 70-45c: SECTION 224. -- DISABILITY INSURANCE BENEFITS -- REDUCTION UPON RECEIPT OF LUMP-SUM PAYMENT OF WORKMEN'S COMPENSATION BENEFITS
20 CFR 404.408
SSR 70-45c
NIEVES V. SECRETARY, U.S.D.C., P.R., Civil Action No. 63-68 (5/20/69) (CCH U.I.R. Fed. Par. 15,479)
- The plaintiff, entitled to disability insurance benefits, also became entitled to weekly workmen's compensation benefits under Puerto Rican law. Therefore, his disability insurance and his family's supplemental benefits became subject to reduction under section 224 of the Social Security Act. Subsequently, the plaintiff elected to receive a lump-sum payment as a substitute for additional monthly workmen's compensation benefits. Consequently, the Administration determined that the lump-sum payment of $6,000 constituted benefits paid as a substitute for periodic workmen's compensation benefits. Therefore, further reduction of his disability insurance benefits was required by section 224 of the Act. The plaintiff, protesting such determination, contended that the acceptance of the lump-sum payment terminated the periodic nature of his workmen's compensation benefits and that no further reduction of his disability insurance benefits was required. Held, the weekly workmen's compensation benefits and the lump-sum workmen's compensation payment received by the plaintiff were in the first instance, periodic workmen's compensation benefits, and in the second instance, a substitute therefor, both of which required reduction of social security insurance benefits under section 224 of the Act.
CANCIO, District Judge This is an action under Section 205(g) of the Social Security Act, s amended, 42 U.S.C.A. 405(g), to review a final decision dated December 31, 1968 of the defendant Secretary of Health, Education, and Welfare, following remand of the case by this Court on March 22, 1968. The decision holds that the plaintiff's disability insurance benefits were subject to reduction pursuant to Section 224 of the Act, 42 U.S.C.A. 424, because of his receipt of workmen's compensation benefits in the amount of $35.00 per week. The decision further held that the lump-sum workmen's compensation payment in the total amount of $6,000.00 made to plaintiff Benedicto Nieves were benefits paid as a substitute for periodic workmen's compensation benefits of $50.00 per month beginning with the month of June 1967 and that, therefore, a reduction of the Social Security benefits of plaintiff and his family is proper under said Section 224 of the Act, on the basis of such payment commencing with the month of June 1967.
The sole question before the Court is whether the above mentioned decision of the Secretary is supported by substantial evidence. The matter has been submitted to the Court on the transcript attached to defendant's answer, as required by law, together with an exhaustive brief in support of his allegations to said answer.
The administrative proceedings in the case disclosed that plaintiff's application filed on September 8, 1965 for disability insurance benefits was allowed, but subject to reduction with respect to State workmen's compensation payments he received. Numerous requests for reconsideration ensued until finally plaintiff filed this action for review on June 26, 1968.
Section 224 of the Act provides, inter alia, that a claimant's Social Security disability insurance benefits must be reduced in accordance with the formula set out therein, if the claimant receives periodic workmen's compensation payments or a lump-sum payment as a substitute for periodic payments. Therefore, the question raised in this case is whether the amounts received by plaintiff pursuant to his workmen's compensation award were either periodic payments, or a substitute for periodic payments, so as to render his Social Security benefits subject to reduction pursuant to Section 224(b) of the Act.
The record is clear with respect to the compensation payments plaintiff actually received.
The Supreme Court of Puerto Rico has held that weekly amounts, as received by plaintiff herein under the provisions of the Workmen's Compensation Law of Puerto Rico, are considered weekly compensation. Arecibo Dock & Shipping Co. et al., v. District Court of Arecibo, 47 P.R.R. 258 (1934).
So the terms used to refer to the benefits plaintiff received do not alter the nature of the payment. Nor was the periodic nature of this compensation received by plaintiff in any way altered by the fact that he was permitted to receive the total at one time for investment rather than to be paid the total over a period of time.
As the Supreme Court of Puerto Rico held in Cordero v. Industrial Commission of P.R., 59 P.R.R. 754 (1942), the Workmen's Compensation Law recognizes the existence of a transitional period during which an injured workman receives medical treatment and a weekly compensation.
From the record it is clear that Benedicto Nieves, plaintiff herein, was entitled to and received a periodic workmen's compensation benefit under the laws of Puerto Rico which requires that his Social Security benefits be subject to reduction pursuant to Section 224 of the Social Security Act. The applicability of the law in the instant case is clear, and it is not within the province of judicial review to go into the wisdom of Congress in providing for such reduction in Social Security benefits under Section 224, supra, in order to avoid payment of excessive combined benefits.
Under the pertinent jurisprudence it is also clear that Congress has the power to exercise such discretion in the benefit program under the Social Security Act, Flemming v. Nestor, 363 U.S. 603 (1960), reh. denied 364 U.S. 854 (1960), and that therefore the Secretary of Health, Education, and Welfare properly reduced the plaintiff's Social Security benefits in the instant case.
It is therefore ORDERED that the final decision of the Secretary of Health, Education, and Welfare be and it is hereby AFFIRMED, and the complaint herein must be and hereby is DISMISSED.