SSR 74-2c: SECTIONS 202(d)(1)(B) and 204(b) (42 U.S.C. 402(d)(1)(B) and 404(b)). -- CHILD'S INSURANCE BENEFITS -- OVERPAYMENT -- FAILURE BY STUDENT TO REPORT EARNINGS -- WAIVER OF RECOVERY

20 CFR 404.501; 404.507-404.512

SSR 74-2c

Severn v. Richardson, U.S.D.C., D. Idaho, Civ. No. 1-72- 81 (1/4/73) (CCH U.I.R. Fed. Par. 17,020)

After a student beneficiary's child's insurance benefits were terminated upon his attaining age 22, it was determined that the student beneficiary had been overpaid for four months due to excess earnings. On the issue of waiving recovery of the overpayment, the Secretary determined that the student beneficiary was not "without fault" and that recovery of the overpayments would not "defeat the purpose" of the Social Security Act nor be "against equity and good conscience." (42 U.S.C. 404(b)) The record showed that the student beneficiary's personally signed application for child's insurance benefits warned that benefits might not be payable if he earned in excess of the designated monthly limit and exempt amount for the taxable year, and the refund questionnaire he submitted showed that his income exceeded his expenses. Held, substantial evidence supported the Secretary's decision not to waive recovery of the overpayment.

MCNICHOLS, Chief Judge: Plaintiff brings this action pursuant to the provisions of Title II of the Social Security Act (Act) § 401 et seq., (42 U.S.C.A. § 401 et seq.), for judicial review of a final decision of the Secretary of Health, Education and Welfare requiring plaintiff to repay monies overpaid to him for surviving child's insurance benefits.

This Court has jurisdiction over the matter under 42 U.S.C.A. § 405(g) of the Act. Review is limited in scope by the following language of the Act:

. . . The findings of the Secretary as to any fact, if supported by substantial evidence, shall be conclusive. . . .

Defendant has filed a complete transcript of the hearing and the hearing examiner's decision with this court. The defendant has filed a motion for summary judgment in the matter.

The Secretary's policy with regard to overpayments under the Act is dictated by § 204(b) of the Act, (42 U.S.C.A. 404(b)), which reads:

(b) In any case in which more than the correct amount of payment has been made, there shall be no adjustment of payments to, or recovery by the United States from, any person who is without fault if such adjustment or recovery would defeat the purpose of this subchapter or would be against equity and good conscience.

The record reflects the following administrative history of the case:

On August 31, 1965 an application for child insurance benefits on behalf of the plaintiff, Charles R. Severn, was filed by his father, Charles A. Severn, and benefits were awarded. Plaintiff's mother filed an application January 14, 1966 substituting herself as payee following the death of plaintiff's father. On August 18, 1966 the plaintiff filed an application for surviving child's insurance benefits himself. Pursuant to this application the plaintiff was awarded benefits.

On August 14, 1968 the plaintiff was advised that beginning in July, 1968 he had become ineligible for the benefits as he had attained the age of twenty-two and was not disabled. Thereafter, on September 29, 1969 the plaintiff was advised that due to excess earnings in 1968 he had been overpaid for the months January through May in the amount or $549.60 and that this amount would have to be repaid since the plaintiff was not without fault. (Subsequently it was determined that the amount overpaid totaled $450.00).

Plaintiff then requested and received reconsideration of the decision asserting that he was without fault. The reconsideration resulted in notice dated September 11, 1970 informing the plaintiff that the original decision requiring repayment was correct and in accordance with the law and regulations. It was determined that the actual amount of overpayment totaled $450.00 for February through May of 1968.

Plaintiff filed a request for a hearing November 11, 1970 again alleging that he was without fault. A hearing was held February 17, 1971 at which both the plaintiff and his mother testified. Based on § 203 of the Act, (42 U.S.C.A. § 403) the hearing examiner found that there had been overpayments made in the amount of $450.00. He also found that the plaintiff was not without fault and that recovery of the overpayments would not defeat the purpose of the Act nor would it be against equity and good conscience. Based on these findings the hearing examiner held that the recovery of the overpayment could not be waived.

On March 21, 1972 the Appeal's Council affirmed the hearing examiner's decision and informed the plaintiff of the decision and of his right to institute the present action in this Court.

The function of this Court is not to reweigh the evidence but rather to determine, from the record, whether the Secretary's decision is supported by substantial evidence. Jackson v. Richardson, 465 F.2d 998 (9th Cir. 1972). If the Secretary's findings are supported by substantial evidence, this Court must grant the defendant's motion for summary judgment.

The issues decided by the hearing examiner were: (1) was the plaintiff without fault? If he was without fault, (2) would repayment defeat the purpose of the Act or would it be against equity and good conscience?

If the claimant was "not without fault", repayment would be ordered in any case. If he was without fault repayment would be required only if it would not defeat the purpose of the Act or would not be against equity and good conscience.

The record shows that the application form for surviving child's insurance benefits filed August 18, 1966 by the plaintiff contains the statement that "Some or all of the child's benefits may not be payable if the child works for more than the monthly limit in employment and has earnings in excess of the exempt amount for the taxable year." The record also reflects that it is the policy of the Social Security offices to call this earnings restriction to the attention of the applicants. There was no proof to show that this plaintiff had been so warned however. The hearing examiner held that the plaintiff should have known of this restriction if, in fact, he did not actually know of it. The record also shows in the form of a refund questionnaire received from the plaintiff that his income exceeded his expenses.

That there was an overpayment is supported by substantial evidence in the record. The examiner's finding that the plaintiff was not without fault is likewise supported by substantial evidence and will not be disturbed here. Even if I were to find the plaintiff was without fault the record contains substantial evidence that the plaintiff has the means to repay the overpayment without undue hardship. Thus the hearing examiner's decision not to waive the repayment must be sustained also on the grounds that repayment would not defeat the purpose of the Act nor would it be against equity and good conscience.

The decision of the Secretary is affirmed. Plaintiff's complaint is dismissed.

Summary judgment for the defendant is granted.


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