Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-ca10-89-06309/USCOURTS-ca10-89-06309-0/pdf.json

Parties Involved:
Leonard F. Gilmore
Appellant
Louis W. Sullivan
Appellee

Document Text:

' 

FILED 

UNITED STATES COURT OF APPEALS United States Court of Appeals 

Tenth Cirreit 

FOR THE TENTH CIRCUIT JAN 3 0 1991 

LEONARD F. GILMORE, 

Plaintiff-Appellant, 

v. 

LOUIS W. SULLIVAN, M.D., Secretary of 

Health and Human Services, 

Defendant-Appellee. 

.ROBERT L. HOECKER 

~ Clerk 

) 

) 

) No. 89-6309 

) (D.C. No. 87-2076-R) 

) (W.D. Okla.) 

) 

) 

) 

ORDER AND JUDGMENT* 

Before MOORE, BARRETT, Circuit Judges, and SPARR,** District 

Judge. 

**Honorable Daniel 

District Court for 

designation. 

B. Sparr, District Judge, ,' united States 

the District of Colorado, sitting by 

After examining the briefs and appellate record, this panel 

has determined unanimously that oral argument would not materially 

assist the determination of this appeal. See Fed. R. App. P. 

34(a); 10th Cir. R. 34.1.9. 

submitted without oral argument. 

* 

The case is therefore ordered 

This order and judgment has no precedential value and shall 

not be cited, or used by any court within the Tenth Circuit, 

except for purposes of establishing the doctrines of the law of 

the case, res judicata, or collateral estoppel. 10th Cir. R. 

36.3. 

Appellate Case: 89-6309 Document: 010110083625 Date Filed: 01/30/1991 Page: 1 
'\ 

Plaintiff appeals from an order of the district court 

affirming the Secretary's decision that plaintiff was disabled as 

of January 3, 1981, and awarding benefits from January, 1984. 

Plaintiff filed a written application for benefits in 

January, 1985. That application was denied. On reconsideration, 

the administrative law judge (ALJ) determined that plaintiff was 

disabled as of 1981 and awarded benefits retroactive to January, 

1984, twelve months prior to the date of plaintiff's application. 

See 42 U.S.C. § 402(j)(l). 1 

Plaintiff requested a rehearing claiming that he had 

previously applied for benefits in early 1981. Plaintiff alleged 

that he was told at that time that he was not eligible for 

benefits because he did not meet the earnings requirement. 

Plaintiff also submitted affidavits from various family members to 

support his position. 

The Secretary found no record of any application for benefits 

in his files prior to the 1985 application. Therefore, the ALJ 

denied plaintiff's request because no evidence supported 

plaintiff's allegation that he had filed a written application in 

1981. The Appeals Council denied plaintiff's request for review, 

and the ALJ's decision became the Secretary's final decision. 

"Our review of social security administration cases is 

usually quite limited. 'The Secretary's decision must be 

1 Section 402(j)(l) provides that an individual who would have 

been entitled to benefits, had he filed an application for 

benefits earlier, "shall be entitled to such benefit for such 

month if he files application therefor prior to. the end of 

the twelfth month immediately succeeding such month .•.. " 

2 

Appellate Case: 89-6309 Document: 010110083625 Date Filed: 01/30/1991 Page: 2 
sustained if supported by substantial evidence. The reviewing 

court does not weigh the evidence and may not substitute its 

discretion for that of the agency.'" Sorenson v. Bowen, 888 F.2d 

706, 710-11 (10th Cir. 1989)(quoting Cagle v. Califano, 638 F.2d 

219, 220 (10th Cir. 198l)(citations omitted)). Substantial 

evidence is "'such relevant evidence as a reasonable mind might 

accept as adequate to support a conclusion.'" Richardson v. 

Perales, 402 U.S. 389, 401 (1971)(quoting Consolidated Edison Co. 

v. NLRB, 305 U.S. 197, 229 (1938)). 

Plaintiff argues that the Secretary erred in determining the 

date from which benefits would be paid. He argues that family 

members have sworn in affidavits they knew he went to apply for 

benefits and that he can identify the individuals he talked to 

when he filed his application. These statements do not meet the 

requirements set forth in the regulations. 

A claimant "must file an application to become entitled to 

benefits." 20 C.F.R. § 404.603. Under § 402(j)(l), plaintiff 

could only be awarded benefits prior to January, 1984, if he had 

actually filed an earlier application. An application "refers 

only to an application on a form described in§ 404.611." 20 

C.F.R. § 404.602. 

To be 

application 

conditions: 

considered a claim 

must generally meet 

for benefits, an 

all of the following 

(a) It must be on an application form as described 

in § 4 0 4 . 611. 

(b) It must be completed and filed with SSA 

(c) It must be signed by the claimant •..• 

3 

Appellate Case: 89-6309 Document: 010110083625 Date Filed: 01/30/1991 Page: 3 
(d) The claimant ... must be alive at the time 

it is filed. 

20 C.F.R. § 404.610. The Secretary found no application in his 

files, neither did plaintiff produce such an application. Oral 

representations that such a form was filed are insufficient. We 

further note that in his 1985 application, plaintiff stated that 

he had not filed any prior applications for benefits. 

Construing plaintiff's complaint liberally, Haines v. Kerner, 

404 U.S. 519 (1972), plaintiff may be attempting to argue that the 

Secretary is estopped from denying him benefits. "Estoppel is an 

equitable doctrine invoked to avoid injustice in particular 

cases." Heckler v. Community Health Servs. of Crawford County, 

Inc., 467 U.S. 51, 59 (1984). In order to claim estoppel, 

plaintiff must have relied on the government's conduct "'in such a 

manner as to change his position for the worse,' and that reliance 

must have been reasonable in that the party claiming the estoppel 

did not know nor should it have known that its adversary's conduct 

was misleading." Id., quoting Wilbur Nat'l Bank v. United States, 

294 U.S. 120, 124-25 (1935)(footnotes omitted). 

Here, at best, plaintiff relied on the government's 

representation that he was not qualified for benefits in 1981 

because he did not meet the earnings requirements. Even assuming 

such a representation was made, this is not proof that plaintiff 

filed a written application. 

4 

Appellate Case: 89-6309 Document: 010110083625 Date Filed: 01/30/1991 Page: 4 
The judgment of the United States District Court for the 

Western District of Oklahoma is AFFIRMED. 

ENTERED FOR THE COURT 

PER CURIAM 

5 

Appellate Case: 89-6309 Document: 010110083625 Date Filed: 01/30/1991 Page: 5