Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-4_13-cv-02465/USCOURTS-azd-4_13-cv-02465-0/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 (SSID)

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IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF ARIZONA 

Frances Lundberg, 

Plaintiff, 

v. 

Carolyn W. Colvin, Acting Commissioner 

of Social Security, 

Defendant.

No. CV-13-02465-TUC-RCC (BPV)

REPORT AND RECOMMENDATION

Plaintiff, Frances Lundberg, filed this action for review of the final decision of the 

Commissioner of Social Security pursuant to 42 U.S.C. § 405(g). Plaintiff raises one 

issue on appeal: whether the Administrative Law Judge (“ALJ”) erred by determining 

that Plaintiff was not entitled to retroactive wife’s insurance benefits as a divorced spouse 

from the time she reached full retirement age in April 2006 until March 2009, when the 

agency determined she was entitled to wife’s benefits. 

Pending before the court is an opening brief filed by Plaintiff (Doc. 17), the 

Commissioner’s response (Doc. 21), and Plaintiff’s reply (Doc. 22). Pursuant to the Rules 

of Practice of this Court, this matter was referred to Magistrate Judge Bernardo P. 

Velasco for a report and recommendation. (Doc. 10.) Based on the pleadings and the 

administrative record submitted to the Court, the Magistrate Judge recommends that the 

District Court, after its independent review, affirm the decision of the ALJ. 

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I. Procedural and Factual History 

Plaintiff, born on October 21, 1940, reached full retirement age (“FRA”) at age 65 

and 6 months, or on April 21, 2006. See 20 C.F.R. § 404.409 (defining FRA); 

Administrative Record (“Tr.”) 28, 94. She was married to Donald Lundberg from 

February 14, 1961, until they were divorced on June 14, 1984. Tr. 27-28. 

Plaintiff attended an appointment at her local Social Security office and filed for 

Medicare benefits only on September 20, 2005. Tr. 75, 83, 90-91, 140. Plaintiff’s 

appointment confirmation indicates the type of claim the appointment was scheduled for 

was “Retirement”. Tr. 90. At the appointment, however, Plaintiff did not file for 

retirement benefits or divorced spouse’s benefits at that time (see, e.g., Tr. 83). The notes 

from Plaintiff’s file show that Plaintiff stated that she would wait until her FRA, or April. 

2006, to apply for retirement insurance benefits (“RIB”). Tr. 73. Plaintiff admitted that at 

this appointment she did not ask any “specific question[s]” regarding her ability to file on 

her ex-husband’s record, but stated that she gave the claims representative all of her 

information and he did not mention that she had the ability to file on her ex-husband’s 

record. Tr. 140-41. 

Plaintiff began receiving Medicare benefits in October 2005 (Tr. 86-88). In an 

October 2005 notice of award letter, the agency informed Plaintiff that her Medicare 

benefit was “the only one [she] could receive from Social Security” and that she would 

have to file another application in the future to receive any other kind of benefit. Tr. 86. 

In February 2006, Plaintiff’s ex-husband, Mr. Lundberg, filed a Medicare only 

application. Tr. 36. Mr. Lundberg reached FRA in October 2006 and in November 2006, 

Mr. Lundberg filed an application for retirement benefits listing Plaintiff as a divorced 

spouse. Tr. 36, 38. These applications created what are called claim “leads”, an indication 

that Social Security should attempt to find the person listed to see if that person wants to 

file for Social Security benefits. Tr. 38. Plaintiff asserts that she never received notice, or 

a “lead letter” for benefits. Tr. 131. The agency searched an Online Retrieval System for 

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a lead letter for benefits addressed to Plaintiff in 2006 and was unable to locate any such 

lead letter. Tr. 133. 

On September 10, 2009, Plaintiff filed a Title II application for wife’s insurance 

benefits as the divorced spouse of Donald H. Lundberg. Tr. 28-29. Plaintiff testified that 

she did not learn that she could file on his record until she read a magazine article, which 

led her to file for wife’s benefits in 2009. Tr. 141, 143. Plaintiff said that she did not file 

for her own benefits when she reached FRA because she wanted to let that benefit grow 

and that she worked until age 70. Tr. 141, 143. Receiving wife’s insurance benefits 

allows Plaintiff to receive benefits while at the same time letting her benefit mature until 

she elected to draw on her own benefits. 

On September 27, 2009, the agency determined that Plaintiff was entitled to wife’s 

benefits effective March 2009, six months retroactive to her filing date of September 

2009 pursuant to 42 U.S.C. § 402(j)(1)(B). Tr. 31-33. In November 2009, Plaintiff filed a 

request for reconsideration disputing the March 2009 start date and requesting wife’s 

benefits retroactive to April 2006. Tr. 34-35. Plaintiff’s request for reconsideration was 

denied in April 2010. Tr. 37-39. 

After holding a hearing (Tr. 134-59), at which Plaintiff appeared pro se, the 

Administrative Law Judge (“ALJ”) issued his decision finding that Plaintiff was not 

entitled to wife’s insurance benefits retroactive to April 2006. Tr. 16-18. Specifically, the 

ALJ found that Plaintiff filed for Medicare benefits only in September 2005, at age 65, 

and that she did not contact the agency again until she filed for wife’s insurance benefits 

as a divorced spouse in September 2009. Tr. 17. Although Plaintiff alleged that she was 

misinformed concerning wife’s benefits in 2005, the ALJ noted that an agency supervisor 

had reviewed the record and “found no indication or likelihood that [Plaintiff] was 

misinformed”. Tr. 17. Therefore, the ALJ concluded that Plaintiff was given the earliest 

possible retroactive entitlement date of March 2009 (six months prior to her filing date of 

September 2009), and was not entitled to wife’s insurance benefits retroactive to April 

2006. Tr. 17-18. This decision became the Commissioner’s final decision when the 

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Appeals Council denied review. Tr. 5-8. Plaintiff then commenced this action for judicial 

review. (Doc. 1) 

II. Discussion 

 A. Standard of Review 

The district court reviews the Commissioner’s final decision under the substantial 

evidence standard; the decision will be disturbed only if it is not supported by substantial 

evidence or is based on legal error. See 42 U.S.C. § 405(g) (“findings of the 

Commissioner of Social Security as to any fact, if supported by substantial evidence, 

shall be conclusive”); Smolen v. Chater, 80 F.3d 1273, 1279 (9th Cir. 1996); Andrews v. 

Shalala, 53 F.3d 1035, 1039 (9th Cir. 1995). “Substantial evidence is such relevant 

evidence as a reasonable mind might accept as adequate to support a conclusion.” Webb 

v. Barnhart, 433 F.3d 683, 686 (9th Cir. 2005). “‘Substantial evidence’ means ‘more than 

a scintilla,’ but ‘less than a preponderance.’” Smolen, 80 F.3d at 1279 (quoting 

Richardson v. Perales, 402 U.S. 389, 401 (1971) and Sorenson v. Weinberger, 514 F.2d 

1112, 1119 n.10 (9th Cir. 1975)) (internal citations omitted); see also Bray v. Comm’r of 

Soc. Sec. Admin., 554 F.3d 1219, 1222 (9th Cir. 2009); Vasquez v. Astrue, 572 F.3d 586, 

591 (9th Cir. 2009). 

Where the evidence may be susceptible of more than one rational interpretation, 

the decision of the Commissioner, acting through the ALJ, must be upheld. See Reddick 

v. Chater, 157 F.3d 715, 720–21 (9th Cir. 1998); Orteza v. Shalala, 50 F.3d 748, 749 (9th

Cir. 1995) (per curiam). 

B. Analysis 

One of the prerequisites for receiving wife’s insurance benefits as a divorced 

spouse is the filing of an application for benefits; benefits cannot be paid for periods 

earlier than the retroactive limit provided for in the Social Security Act (“Act”). See 42 

U.S.C. § 402(b)(1)(A); Johnson v. United States, 572 F.2d 697 (1978)(finding that the 

explicit language of § 402 makes filing an application a substantive condition to 

receiving benefits under the Act); see also Driver v. Heckler, 779 F.2d 509 (1985). It is 

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undisputed that, but for Plaintiff’s failure to file an application, Plaintiff was entitled to 

wife’s insurance benefits on her ex-husband’s record as of April 2006, when she attained 

FRA. See (Doc. 21 at 5-6). It is also undisputed that Plaintiff did not file a claim for 

wife’s benefits until September 2009. Thus, under the retroactivity provision of the Act, 

she was entitled to benefits commencing March 2009. See 42 U.S.C. § 402(j)(1)(B). 

The only exception to this rule concerns circumstances where no application is 

filed because an applicant is misinformed by agency employees about her eligibility to 

receive benefits; in such cases the agency may backdate an application for benefits. See

42 U.S.C. § 402(j)(5); see also 20 C.F.R. § 404.633. 

In order to sustain a claim of misinformation, the claimant must demonstrate: (1) 

the information was provided by an employee acting in his or her official capacity, (2) the 

information was incorrect, misleading, or incomplete in a situation when providing 

additional information was required, (3) the information was provided orally or in 

writing, and (4) the information was provided in response to a specific request from the 

claimant about eligibility for benefits.. See 20 C.F.R. § 404.633 (c)(1)-(4). 

Under the agency’s regulations a deemed filing date based on misinformation 

must be supported by sufficient evidence. Id. at (d)(1)-(2). Such evidence may be 

“preferred” or “secondary.” Id. “Preferred evidence” is written evidence which “relates 

directly” to the applicant’s inquiry about their eligibility for benefits and which shows 

that the agency provided misinformation which caused the applicant to not file an 

application. Id. at (d)(1). This evidence includes a notice, letter, or other document issued 

by the agency or the agency’s records of a telephone call, letter, or in-person contact. Id. 

at (d)(1)(i). 

In the absence of “preferred evidence,” the agency will consider “other evidence,” 

which includes, but is not limited to, the applicant’s statements, statements from others, 

and an evaluation of the credibility and validity of the claimant’s allegations in 

conjunction with other relevant information. Id. at (d)(2)(i)-(iii). However, the agency 

may not base a finding that misinformation was given by an agency employee upon only 

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a claimant’s statements. Id. at (d)(2) (“We will not find that we gave you misinformation, 

however, based solely on your statements.”). 

The ALJ determined Plaintiff was not excused from her failure to timely file an 

application for wife's benefits because the record did not establish that Plaintiff received 

misinformation concerning these matters. Because there is substantial evidence to support 

the ALJ's determination the Agency's decision denying benefits must be affirmed. While 

the ALJ found no reason to question Plaintiff’s credibility (see generally Tr. 17-18, 152 

(“You’re a credible lady.”), and neither does this Court, Plaintiff’s statements, even if 

true, do not establish that Plaintiff was provided misinformation about her eligibility for 

wife’s insurance benefits as a divorced spouse. 

Plaintiff’s evidence does not support a finding that she was misinformed as that 

term is defined under the regulations. First, the plain language of the regulation and the 

examples provided to illustrate the term “misinformation” speak in terms of affirmatively 

providing misinformation in response to a direct inquiry about filing an application for 

benefits. See generally, 20 C.F.R. § 404.633(a). There is no evidence that Plaintiff was 

provided misinformation about her eligibility for wife’s benefits in response to a specific 

inquiry she made about such an application. 

Upon review of the record there is no evidence that the representative Plaintiff 

spoke to in September 2005 provided her with misinformation in response to any specific 

request. There is no evidence that Plaintiff expressed any intention to file for retirement 

benefits on her ex-husband’s record in 2005. Granting Plaintiff the benefit of the doubt, 

her evidence establishes she made an appointment to inquire into retirement benefits (See

Tr. 90), but that she did not directly inquire about her eligibility to receive wife’s 

insurance benefits, nor that she was misinformed about her eligibility. In fact, Plaintiff 

admitted that at this appointment she did not ask any “specific question[s]” regarding her 

ability to file on her ex-husband’s record. Tr. 140-41. The agency reviewed Plaintiff’s 

record and “found no indication or likelihood that [Plaintiff] was misinformed” Tr. 17; 

see Tr. 37. 

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As the ALJ noted at the administrative hearing, the “bottom line is going to come 

down to what the duty was of the claims rep[resentative] that was dealing with you to 

advise you of this nuance.” Tr. 146. Plaintiff’s lack of knowledge of her eligibility for 

wife’s insurance benefits is not one of the circumstances when the Agency can recognize 

an earlier application filing date. See § 404.633 (c)(1)-(4). The undersigned is unaware of 

any authority which, in the absence of a direct inquiry, establishes that the agency has a 

duty to solicit applications or actively advise members of the public as to their rights to 

file a claim for spousal retirement benefits. Moreover, a review of the record indicates 

that, in September 2005, Plaintiff decided to file only for Medicare benefits because she 

had not yet attained FRA. Tr. 37, 73. Thus, Plaintiff’s inquiry into Medicare benefits, for 

which she was eligible, did not trigger an affirmative duty for the agency representative 

to advise Plaintiff, who was nearing FRA, of her eligibility for wife’s insurance benefits. 

Such a failure to advise is not what the agency regulations contemplate by the term 

“misinformation.” See, e.g., Holcomb v. Colvin, 2014 WL 51148, at *3, fn. 4 (W.D. 

Wash. Jan. 7, 2014) (unpublished) (noting that the Commissioner’s failure to advise 

someone regarding a claim for spousal retirement benefits does not constitute the type of 

misinformation contemplated by the agency’s regulations). The agency representative’s 

failure to advise Plaintiff about her eligibility for benefits for which she was not applying 

or into which she was not inquiring, is not the same as being provided with 

misinformation and does not entitle her to an earlier deemed filed date. 

Plaintiff also asserts several other incidents where the agency has supplied her 

with misinformation regarding her retirement age and filing deadlines for appellate 

review of her case. Though unfortunate, this misinformation is also not in response to a 

direct inquiry about her spousal benefits and did not in fact misinform her about her 

eligibility for those benefits, and thus cannot serve as grounds to backdate her 

application. See 20 C.F.R. § 404.633(c)(1)-(4). 

Looking at the record as a whole, considering both evidence that supports and 

undermines the ALJ's findings, it is clear that the evidence may be susceptible of more 

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than one rational interpretation, but in that case, the decision of the Commissioner, acting 

through the ALJ, must be upheld. See Reddick v. Chater, 157 F.3d 715, 720–21 (9th Cir. 

1998); Orteza v. Shalala, 50 F.3d 748, 749 (9th Cir. 1995) (per curiam). 

IV. Recommendation 

 This Court recommends that the District Court, after its independent review of the 

record, enter an order affirming the decision of the Commissioner.

 Pursuant to 28 U.S.C. §636(b), any party may serve and file written objections 

within fourteen days after being served with a copy of this Report and Recommendation. 

A party may respond to another party's objections within fourteen days after being served 

with a copy thereof. Fed.R.Civ.P. 72(b). No reply to any response shall be filed. See id.

If objections are filed the parties should use the following case number: CV 13-2465-

TUC-RCC. 

 If objections are not timely filed, then the parties' right to de novo review by the 

District Court may be deemed waived. 

 Dated this 12th day of November, 2014. 

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