Opinion ID: 6337374
Heading Depth: 4
Heading Rank: 3

Heading: With respect to the overpaid individual

Text: only, acceptance of a payment which he either knew or could have been expected to know was incorrect. 20 C.F.R. § 404.507. The evidence cited by the ALJ does not support a finding of fault based on any of those criteria. 8 Miskey argues that the agency violated his right to due process by failing to provide adequate notice that it would reduce his spousal benefits and recoup the overpayment. Because Miskey has not explained what redress he seeks for any inadequate notice, let alone explained what he would have done differently if he had received better notice, we cannot grant any relief on this claim. See Greenwood v. FAA, 28 F.3d 971, 977 (9th Cir. 1994) (“We will not manufacture arguments for an appellant, and a bare assertion does not preserve a claim.”). 16 MISKEY V. KIJAKAZI First, the ALJ found that Miskey “misrepresented to the agency that his PERS pension and Las Vegas Water District pensions stemmed from the same entity.” But the ALJ’s citations for that proposition consist of a letter from December 2015, regarding Miskey’s Nevada PERS pension, and Miskey’s March 2016 request for a hearing about the overpayment. Those documents cannot support the proposition that Miskey made a misrepresentation that caused the overpayment, because they are dated after August 2015, by which time the agency had already concluded that there had been an overpayment and decided to re-apply the GPO to Miskey’s benefits. Second, the ALJ wrote that “[n]otes from the agency indicate that the pension amount was changed because [Miskey] provided misleading information indicating that his work with the water district . . . was [for] the same employer as [his work for] the Nevada State Department of Transportation.” There is indeed a note from an SSA employee to that effect in Miskey’s file, which says that “the offset was erroneously removed based on the misinformation provided.” But the source of that misinformation, according to the note, was the request for reconsideration that SSA received from Miskey on December 20, 2013. In that request Miskey never falsely said (1) that his Nevada DOT employment was with the same employer as his Water District employment, or (2) that his Nevada DOT employment was covered by Social Security. To the contrary, he explicitly told SSA that he had been an “employee of the State of Nevada and paid into the NVPERS system” for fifteen years, and that “in or about March 1994 . . . [he] went to work for the Las Vegas Valley Water District.” He also wrote that the Water District “is a local governmental unit governed by Clark County, Nevada.” It was not reasonable to conclude from that MISKEY V. KIJAKAZI 17 document that Miskey intentionally misled SSA into believing that his work for the State of Nevada and for the Las Vegas Valley Water District (“a local governmental unit”) were for the same employer or were covered by the same pension plan. Although Miskey did not explicitly state in his request for reconsideration that his compensation for his Nevada DOT employment had been exempt from Social Security taxes, he wrote that he left his employment with the Nevada DOT in 1994. He also said that he has worked in covered employment “since 1994.” The implication of those statements is that his employment before 1994—at the Nevada DOT—was not covered. Third, the ALJ said that Miskey failed “to provide the correct information to the agency, upon his receipt of express notification of the underlying reason for” SSA’s decision to remove the GPO in February 2014. The ALJ also wrote that “[t]he record lucidly illustrates that when the claimant’s benefits were erroneously increased to $1,067 . . . it was because the agency had been provided Water District pay stubs, suggesting that his pension was a covered one” (emphasis removed). But the record is far from lucid on this point. In a notice dated February 8, 2014, the agency explained in a single paragraph why the GPO had initially been applied to Miskey’s spousal benefits and subsequently removed. The notice said: We received your request to reconsider your government pension offset. Upon review, we found that you made a mistake when you filled out the application. You answered “yes” to the question “QUALIFY FOR US FED/STATE/LOCAL GOVT PENSION BASED ON ANY WORK YOU 18 MISKEY V. KIJAKAZI PERFORMED WHICH WAS NOT COVERED UNDER SS (Y/N): Y”. This paragraph does not provide substantial evidence for the proposition that Miskey “[f]ail[ed] to furnish information which he knew or should have known to be material.” 20 C.F.R. § 404.507. The implication from the ALJ’s reasoning is that Miskey should have corrected SSA’s apparent misapprehension that Miskey had never received a government pension based on noncovered employment. But Miskey had already told the government that he was receiving such a pension—which is why, in 2013, the GPO had been applied to his benefits to begin with. And Miskey apparently was under the impression that the only thing that mattered to determine whether the GPO applied to his spousal benefits was that he had sixty months of covered employment at the end of his government career. The quoted paragraph from SSA’s notice is not sufficiently clear to explain to someone in Miskey’s position that he would receive benefits to which he was not entitled if he did not inform the agency about his pension from his employment with Nevada DOT—information that he had already provided to SSA with his initial application. Indeed, the record suggests that Miskey had a good faith—though mistaken—belief that the GPO did not apply to his spousal benefits in light of his covered employment with the Water District. Because the ALJ has pointed to no evidence that “a reasonable mind might accept as adequate” to support the conclusion that Miskey was at fault for the overpayment, we hold that the ALJ’s finding that Miskey was at fault is unsupported by substantial evidence. Orn v. Astrue, 495 F.3d 625, 630 (9th Cir. 2007) (quoting Burch v. Barnhart, 400 F.3d 676, 679 (9th Cir. 2005)). MISKEY V. KIJAKAZI 19 When a reviewing court “reverses an administrative agency determination, ‘the proper course, except in rare circumstances, is to remand to the agency for additional investigation or explanation.’” Moisa v. Barnhart, 367 F.3d 882, 886 (9th Cir. 2004) (quoting INS v. Ventura, 537 U.S. 12, 16 (2002) (per curiam)). A district court’s decision to remand for further proceedings, instead of for an immediate award of benefits, is reviewed for abuse of discretion. Harman, 211 F.3d at 1173. The district court did not abuse its discretion by applying the default rule and remanding Miskey’s case to the agency for further proceedings, instead of for immediate payment of benefits. On remand, the agency may consider whether any evidence in the record beyond that relied on by the ALJ supports the proposition that Miskey was at fault for the overpayment. And, if Miskey is determined not to have been at fault, the agency must decide in the first instance whether recoupment of Miskey’s repayment “would defeat the purpose of [Title II] or would be against equity and good conscience.” 42 U.S.C. § 404(b)(1). A remand for further proceedings is indeed “required to allow [the] agency to consider in the first instance an issue that it had not previously addressed.” Benecke v. Barnhart, 379 F.3d 587, 595 (9th Cir. 2004) (emphasis added). SSA has never made a determination whether recoupment of Miskey’s overpayment would frustrate the purpose of Title II or be against equity and good conscience—a determination that is necessary for Miskey to prevail on his claim.