Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-casd-3_06-cv-01217/USCOURTS-casd-3_06-cv-01217-0/pdf.json

Nature of Suit Code: 863
Nature of Suit: Social Security - DIWC/DIWW (405(g))
Cause of Action: 42:405 Review of HHS Decision (DIWW)

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UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF CALIFORNIA

NANCY ELAINE JENKINS, ) Case No. 06cv1217 J (RBB)

)

Plaintiff, )

)

v. ) ORDER GRANTING DEFENDANT’S 

) MOTION TO DISMISS

JO ANNE B. BARNHART, )

Commissioner of Social Security )

Administration, )

)

Defendant. )

____________________________________)

Before the Court is a Motion to Dismiss Plaintiff’s Complaint pursuant to Federal

Rule of Civil Procedure 12(b)(1) of Defendant, Linda S. McMahon, the acting Commissioner

of Social Security. [Doc. No. 11.] Plaintiff seeks judicial review under 42 U.S.C. § 405(g)

for the denial of her Disability Insurance Benefits (“DIB”) and Supplemental Security

Income (“SSI”) payments under Titles II and XVI of the Social Security Act. [Doc. No. 1.] 

Pursuant to Civil Local Rule 7.1(d)(1), the Court decides the matter on the papers submitted

and without oral argument. See S.D. Cal. Civ. R. 7.1(d)(1). For the reasons set forth below,

the Court GRANTS Defendant’s Motion to Dismiss for lack of subject matter jurisdiction.

 Background

On June 12, 2004, Plaintiff filed an application for Disability Insurance Benefits and for

Supplemental Security Income payments under Titles II and XVI of the Social Security Act.

(Decl. ¶ 3(a).) Plaintiff’s application was denied. (See id.) On February 11, 2005, Plaintiff filed

a request for a hearing before an administrative law judge (“ALJ”). (See id.) The ALJ went

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through a five-step evaluation for determining disability. (Ex. 1 at 2.) The ALJ found that

Plaintiff had not worked since June 17, 1993. (See id. at 2.) Additionally, the ALJ determined

that Plaintiff retained the “residual functional capacity to do light level work with occasional

climbing, stooping, kneeling, and crouching.” (Id. at 5.) The ALJ also found that Plaintiff could

perform requirements of her past work as an order clerk, and that she was not under a

“disability” as defined in the Social Security Act. (Id. at 8-9.) On December 2, 2005, Plaintiff

filed a request for review by the Commissioner’s Appeals Council which is still pending. (Decl.

¶ 3(c).) On April 6, 2006, Plaintiff received a notice of disapproved claim denying a new

application for Supplemental Security Income Benefits, and explaining Plaintiff’s rights to

request reconsideration. (Decl. ¶ 3(d).) This new application was separate from the application

that was filed on June 12, 2004. (Id.)

 Legal Standard

Federal Rule of Civil Procedure 12(b)(1) allows a party to raise a defense by motion

that the court lacks subject matter jurisdiction over the claim. “A motion to dismiss for lack

of subject matter jurisdiction may either attack the allegations of the complaint or may be

made as a speaking motion attacking the existence of subject matter jurisdiction in fact.” 

Thornhill Publ’g Co. v. Gen. Tel. & Electronics, 594 F.2d 730, 733 (9th Cir. 1979). The

Plaintiff bears the burden in a 12(b)(1) motion to prove that jurisdiction exists. Sopcak v.

Northern Mountain Helicopter Serv., 52 F.3d 817, 818 (9th Cir. 1995). “In reviewing a

motion [pursuant to this rule], the court may consider affidavits or any other evidence

properly before the court.” Sommatino v. United States, 255 F.3d 704, 710 (9th Cir. 2001). 

Discussion

A claimant may bring a case for judicial review, irrespective of the amount in

controversy, after a final decision of the Commissioner of Social Security is made. See 42 §

U.S.C. 405(g) (2006). The phrase “final decision” is not defined in § 405(g), and its

“meaning is left to the [Commissioner of Social Security] to flesh out by regulation.”

Weinberger v. Salfi, 422 U.S. 749, 766 (1975). However, a final decision has two elements:

(1) presentment of the claim to the Commissioner, and (2) complete exhaustion of

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administrative remedies. See Johnson v. Shalala, 2 F.3d 918, 921 (9th Cir. 1993).

A claimant may obtain a review of a final decision by a civil action in federal district

court commenced within sixty days after the mailing of notice of such decision or within

such further time as the Commissioner of Social Security may allow. See 42 U.S.C. § 405(g)

(2006). Before a party can bring its case for judicial review, an initial determination,

reconsideration, hearing before an ALJ, and an Appeals Council review is required. See 20

C.F.R. § 404.900(a)(1-4) (2007).

 The Appeals Council can “grant the request and either issue a decision or remand the

case to an [ALJ].” 20 C.F.R. § 404.967 (2007). The Appeals Council can deny the request

for review and allow the ALJ’s decision to stand as the “final decision” of the Commissioner. 

See 20 C.F.R. § 404.981 (2007). If the Appeals Council denies the request for review, then

the ALJ’s decision is binding unless the claimant or another party files an action in federal

district court within sixty days after the date the claimant receives notice of the Appeals

Council’s action. See 20 C.F.R. § 404.98 (2007). 

Exhaustion of administrative remedies is required before a claimant can seek judicial

review in order for an agency to function efficiently, correct its own errors, afford the parties

and the courts the benefit of its experience and expertise, and compile a record which is

adequate for judicial review. Weinberger, 422 U.S. 749, 765 (1975) (citing Parisi v.

Davidson, 405 U.S. 34 (1972)).

A. Presentment of a Claim to the Commissioner

Presentment of a claim to the Commissioner is purely jurisdictional and cannot be

waived. See Matthews v. Eldridge, 424 U.S. 319, 328 (1976). Courts have interpreted the

presentment requirement liberally. See Lopez v. Heckler, 725 F.2d 1489, 1503 (9th Cir.

1984), vacated on other grounds by Heckler v. Lopez, 469 U.S. 1082 (1984). Presentment of

a claim to the Commissioner is the first element of a final decision. See Johnson, 2 F.3d 918

at 921. In Lopez, the Court determined that presentment can be fulfilled by “some decision

by the Secretary.” Lopez, 725 F.2d at 1503 (quoting Matthews, 424 U.S. at 328 ). 

Additionally, “some courts have found that mere termination of benefits fulfills the

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presentation requirement.” Lopez, 725 F.2d at 1503 (quoting Kuehner v. Schweiker, 717

F.2d 813, 817 (3d Cir. 1983)). In Matthews, the court “concluded that the complaint was

sufficient since it alleged that they had ‘fully presented their claims for benefits to their

district Social Security Office and, upon denial, to the Regional Office for reconsideration.’ ” 

424 U.S. at 328 (quoting Weinberger, 422 U.S. 749 at 764). 

Here, Plaintiff filed an application for a Period of Disability, Disability Insurance

Benefits, and Supplemental Security Income Benefits on July 12, 2004. (Decl. ¶ 3(a).) The

application was denied, and Plaintiff filed a request for a hearing by an ALJ. On October 27,

2005, the ALJ issued an unfavorable decision. (Id. at ¶ 3(b).) On December 2, 2005,

Plaintiff filed a request for review by the Appeals Council. (Id. at ¶ 3(c).) However, the

request for review is still pending before the Appeals Council. (Id.) Plaintiff filed another

application for Supplemental Security Income Benefits, and received a notice of disapproved

claim on April 6, 2006. (Id. at ¶ 3(d).) 

Accordingly, Plaintiff has fulfilled the presentment requirement because Plaintiff has

sufficiently presented claims for benefits to the district Social Security office, and

subsequently filed for reconsideration.

B. Exhaustion of Administrative Remedies

Plaintiff has not exhausted all administrative remedies under 42 U.S.C. § 405(g)

(2006). The exhaustion requirement is waivable and is not jurisdictional. See Matthews, 424

U.S. at 328. “The waivable element is the requirement that the administrative remedies

prescribed by the Secretary be exhausted.” Id.

As described above, a claimant must exhaust a four-step process before she can obtain

judicial review in federal court. See 20 C.F.R. § 404.900 (2007). The four-step process

involves an initial determination, reconsideration, hearing before an administrative law judge,

and appeals council review. See id. Here, Plaintiff has not exhausted all administrative

remedies, because the disability claim is still pending before the Appeals Council, and

Plaintiff has not received a final decision of review by the Social Security Commissioner. 

(Decl. ¶ 3(c).)

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However, the Ninth Circuit has adopted a three-part test for determining whether a

particular case merits waiver of the exhaustion requirement. Johnson, 2 F.3d at 921. “The

claim must be (1) collateral to a substantive claim of entitlement (collaterality), (2) colorable

in its showing that denial of relief will cause irreparable harm (irreparability), and (3) one

whose resolution would not serve the purposes of exhaustion (futility).” Id. (citing Briggs,

886 F.2d at 1139). Here, Plaintiff is not entitled to a waiver of the exhaustion requirements.

A claim is collateral to a substantive claim of entitlement when “it is not essentially a

claim for benefits.” Johnson, 2 F.3d at 921 (citing Bowen v. City of New York, 476 U.S. 467

(1985)). Plaintiff’s claim is not collateral because Plaintiff is seeking benefits in district court. 

Additionally, a claim is collateral if it is not bound up with the merits so closely that a

decision of the court would interfere with agency process. See Weinberger, 422 U.S. at 765. 

In this case, Plaintiff has not exhausted all administrative remedies, therefore a decision from

the district court would directly interfere with the agency process. 

Plaintiff’s claim does not show irreparable harm. “A colorable claim of irreparable

harm is one that is not “wholly insubstantial, immaterial, or frivolous.” Johnson, 2 F.3d at

922 (quoting Briggs, 886 F.2d at 1140). In Briggs, the Ninth Circuit held that economic

hardship does constitute irreparable harm. Briggs, 886 F.2d at 1140. Here, however, Plaintiff

does not describe anything in her Complaint that would give her a colorable claim of

irreparable harm.

Lastly, resolution of Plaintiff’s claim through the administrative process would not be

futile. An agency has a duty to compile a detailed factual record, which conserves judicial

resources, and allows the agency to have an opportunity to correct its errors. Bowen, 476 U.S.

467 at 485. “However, when the agency applies a ‘systemwide policy’ that is ‘inconsistent in

critically important ways with established regulations,’ nothing is gained ‘from permitting the

compilation of a detailed factual record, or from agency expertise.’ ” Johnson, 2 F.3d 918 at

922 (quoting Bowen, 476 U.S. at 485). 

 Here, administrative exhaustion is not futile because Plaintiff is not challenging a

systemwide policy and has not asserted that the Social Security Commission has treated her

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case in a manner inconsistent with an established regulation. Accordingly, while Plaintiff has

fulfilled the presentment requirement, Plaintiff has not exhausted administrative remedies, and

Plaintiff has not met the criteria for waiving the exhaustion requirements.

Conclusion

For the reasons set forth above, the Court GRANTS Defendant’s Motion to Dismiss. 

IT IS SO ORDERED.

DATED: August 3, 2007

HON. NAPOLEON A. JONES, JR.

United States District Judge

cc: All Parties

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