Opinion ID: 591480
Heading Depth: 2
Heading Rank: 1

Heading: Reopening of the 1982 Decision

Text: 8 In this matter of first impression, we are asked to decide whether the Secretary's final decision will be deemed reopened if an ALJ, pursuant to regulations implemented under Public Law 98-460, reconsiders evidence on mental impairment presented in the first application in order to reach conclusions on the second application. The district court concluded that the ALJ did not reopen the 1982 final decision based on the ALJ's specific ruling that he was not reopening that earlier decision, even though newly applicable regulations required him to consider some evidence presented in the earlier application. 9 Passopulos alleged both physical and mental impairments in his 1986 application for benefits. The ALJ concluded that the evidence of record regarding Passopulos's physical impairments did not provide any basis for reopening the prior decision. The ALJ, however, concluded that Public Law 98-460 precluded a dismissal of Passopulos's 1986 application based on res judicata, because Passopulos's new application raised a claim that he suffered from depression. The ALJ considered Passopulos's 1986 application in light of the regulations implementing Public Law 98-460. See 20 C.F.R. § 404.1520(a) (1992); 20 C.F.R. Part 404, Subpart P, Appendix 1 (1992). In doing so, the ALJ considered two reports of possible mental impairment that Passopulos presented in his prior application. After considering the two reports and newly proffered evidence on mental impairment, the ALJ concluded that Passopulos did not suffer from a severe mental impairment through the date he last qualified for benefits. Thus, we must decide whether the ALJ reopened Passopulos's first application where newly applicable regulations precluded the ALJ from dismissing the second application based on res judicata, and where the ALJ based the ultimate denial of the second application on some evidence presented in the first application. 10 In deciding this question, we review de novo the Secretary's legal conclusion that the ALJ's actions did not constitute reopening. See Walker v. Bowen, 826 F.2d 996, 999 (11th Cir.1987) (recognizing that there is no presumption of validity that attaches to the Secretary's legal conclusions, including determinations of the proper standards to be applied in evaluating claims). 11 Generally, a final decision by the Secretary will be deemed reopened if it is reconsidered on the merits to any extent and at any administrative level Cherry v. Heckler, 760 F.2d 1186, 1189 (11th Cir.1985); Hall v. Bowen, 840 F.2d 777, 778 (11th Cir.1987). The ALJ, however, must be allowed some leeway to evaluate how newly presented evidence relates back to the prior application in order to determine whether to reopen the case pursuant to 20 C.F.R. §§ 404.988, 404.989. Hall, 840 F.2d at 778; Cherry, 760 F.2d at 1189. Specifically, this court has held that an ALJ does not reopen a prior final decision when the ALJ evaluates evidence presented in support of the original application solely to make a reasoned determination of its res judicata effect on the second application. Cherry, 760 F.2d at 1189. Alternatively, this court has suggested that the Secretary's final decision will be deemed reopened if the ALJ does not apply res judicata and bases an ultimate determination on a review of the record in the prior application. Cherry, 760 F.2d at 1189 (citing with approval Brown v. Heckler, 565 F.Supp. 72, 74 (E.D.Wis.1983)). 12 This court suggested in Cherry, 760 F.2d at 1189, that the Secretary's final decision will be deemed reopened if the ALJ does not apply res judicata and bases an ultimate determination on the record of the prior application. The court, however, was not then faced with a case where newly applicable regulations required the ALJ's decision not to apply res judicata. We now hold that an ALJ who considers evidence presented in a prior application, where newly applicable regulations require reconsideration, does not reopen a prior final decision. 13 The decision we have reached is consistent with Congress's intent. In passing the Social Security Disability Benefits Reform Act of 1984, Public Law 98-460, Congress did not intend to authorize the relitigation of claims decided prior to the enactment of the DBRA. The DBRA provides specifically that any determination that an individual was not under a disability resulting from a mental impairment, after the date of enactment of the DBRA and prior to the date of the promulgation of its implementing regulations, be redetermined as soon as feasible. DBRA, Pub.L. 98-460 § 5(c)(1), 98 Stat. at 1801-1802 (1984); see H.R.Rep. No. 98-618, 98th Cong., 2d Sess., reprinted in 1984 U.S.C.C.A.N. 3038, 3052-53. Congress enacted the DBRA on October 9, 1984, and the revised mental regulations became effective on August 28, 1985. See 20 C.F.R. § 404.1520(a) (1992); 20 C.F.R. Part 404, Subpart P, Appendix 1 (1992). Passopulos's claims fell outside of Congress's intended window of relitigation since the Secretary issued a prior final decision before the enactment of DBRA, and Passopulos filed his current application after the effective date of the revised mental regulations. 14 In addition, section 5(c)(3) of the DBRA provides that any individual with a mental impairment who is found not to be disabled pursuant to an initial disability determination made between March 1, 1981, and October 9, 1984 may be found disabled upon reconsideration. Section 5(c)(3), however, provides that the reapplication has to be filed within one year of October 9, 1984. DBRA, Pub.L. 98-460 § 5(c)(3), 98 Stat. at 1802; see H.R.Rep. No. 98-618, U.S.C.C.A.N. at 3052-53. Here, the initial disability determination on Passopulos's prior claim fell within the time frame set out in DBRA § 5(c)(3). But, Passopulos did not file his reapplication until August 25, 1986, well beyond the one-year refiling period. 15 Beyond the circumstances expressly provided in the DBRA, Congress has notexpressed a general intent that claimants be allowed to relitigate a final decision by the Secretary in a Social Security disability case. On the contrary, Congress's decision to limit judicial review to the original decision denying benefits is evidence of a policy choice obviously designed to forestall repetitive or belated litigation of stale eligibility claims. Califano v. Sanders, 430 U.S. 99, 108, 97 S.Ct. 980, 986, 51 L.Ed.2d 192 (1970) (recognizing that the opportunity to reopen final decisions is afforded by the Secretary's regulations and not by the Social Security Act itself); see 42 U.S.C. § 405(g) (1992); 20 C.F.R. §§ 404.987-404.989 (1992). This court is bound to respect Congress's policy choice to forestall litigation of stale eligibility claims. See Sanders, 30 U.S. at 108, 97 S.Ct. at 986; Bloodsworth v. Heckler, 703 F.2d 1233, 1238 (11th Cir.1983) (recognizing that the reopening of a case is an extraordinary measure, affording the opportunity of a second excursion through the decision-making process and should be allowed only for specific and substantial reasons afforded in accordance with the Secretary's regulations). Having concluded that Congress did not intend that persons in Passopulos's situation be permitted to relitigate prior applications based on the newly applicable law on mental impairments, we next examine whether the Secretary's regulations provide for a reopening in these circumstances. 16 A review of the regulations convinces us that the Secretary did not intend that the regulations on reopening permit the relitigation of a final decision merely because of a change in the applicable law. Section 404.989(b) instructs us particularly in this regard, providing: We will not find good cause to reopen your case if the only reason for reopening is a change of legal interpretation or administrative ruling upon which the determination or decision was made. 20 C.F.R. § 404.989(b) (1992). Although not specifically speaking to a change in the laws such as that created by the DBRA, section 404.989(b) does indicate that the Secretary has not promulgated regulations that become an avenue for claimants to relitigate stale disability claims, thereby respecting Congress's policy choice. 17 The significance of the Secretary's intent in promulgating the reopening regulations cannot be underemphasized in this matter. Again, the Secretary's regulations afford the opportunity to reopen a final decision in a social security disability case, not the Social Security Act. See Sanders, 430 U.S. at 108, 97 S.Ct. at 985. Therefore, if this court extends the bonus remedial opportunity beyond its intended boundaries, the court runs the risk of forcing the Secretary to repeal the reopening regulations entirely in order to avoid the burdensome intrusion on the finality of its decisions. We decline to initiate this chain of events which would ultimately result in social security claimants being denied this bonus opportunity. Accordingly, we hold that an ALJ does not reopen a final decision as a matter of law, when newly applicable regulations preclude the ALJ from dismissing a second claim based on res judicata and considers evidence presented in the prior application solely to comply with the newly applicable regulations. 18 A different result may obtain in a case where the ALJ's compliance with the new regulations results in a finding that the claimant is now disabled, forcing a complete reevaluation of all evidence presented in the prior application. In this case, the ALJ reconsidered evidence relevant underthe new regulations on mental impairment and concluded that Passopulos did not have a severe mental impairment through the date he last qualified for benefits. Thus, the ALJ was not required to evaluate the effect of an actual mental impairment on the prior decision that Passopulos is able to do a full range of light work. 19 We also note that our ruling on this matter is consistent with the effect of this court's prior decisions on reopening under 20 C.F.R. §§ 404.987-404.989. The effect of our rulings on de facto reopenings was to restrain the discretion of ALJs to disregard the regulations and declare that a reopening has not occurred when a reopening has, in fact, occurred. See Hall, 840 F.2d at 778; Cherry, 760 F.2d at 1189. Hence, our aim was to demand compliance with the Secretary's regulations on reopening. We did not seek to extend the bonus opportunity to reopen a final decision beyond the boundaries which the Secretary deems workable. Today, we merely limit the instances where de facto reopening will be recognized to the circumstances which the Secretary deems workable as particularly evidenced in section 404.989(b). 20