Court Opinion

ID: 2963990
Source: CourtListenerOpinion
Date Created: 2015-09-21 21:18:40.697273+00
Date Added: 2024-06-11T11:42:48.067102
License: Public Domain

USCA1 Opinion

	

          March 29, 1996
                                [NOT FOR PUBLICATION]

                            UNITED STATES COURT OF APPEALS
                                FOR THE FIRST CIRCUIT
                                 ____________________

        No. 95-1743

                                     JANET NIEMI,

                                Plaintiff, Appellant,

                                          v.

              DONNA E. SHALALA, SECRETARY OF HEALTH AND HUMAN SERVICES,

                                 Defendant, Appellee.

                                 ____________________

                     APPEAL FROM THE UNITED STATES DISTRICT COURT

                          FOR THE DISTRICT OF MASSACHUSETTS

                     [Hon. Morris E. Lasker, U.S. District Judge]

                                 ____________________

                                        Before

                                Torruella, Chief Judge,
                                           ___________
                          Boudin and Stahl, Circuit Judges.
                                            ______________

                                 ____________________

            Camilla B. Duffy on brief for appellant.
            ________________
            Donald K. Stern, United States Attorney, Arthur J. Fried,  General
            _______________                          _______________
        Counsel, Randolph W. Gaines,  Acting Principal Deputy General Counsel,
                 __________________
        A. George Lowe, Acting Associate General Counsel, Litigation Division,
        ______________
        and Richard  Fox,  Attorney, Office  of  the General  Counsel,  Social
            ____________
        Security Administration, on brief for appellee.

                                 ____________________

                                 ____________________

                 Per  Curiam.    Claimant  Janet  Niemi  appeals  from  a
                 ___________

            district   court   judgment  dismissing,   on  jurisdictional

            grounds,  her   challenge  to   the  denial  of   her  second

            application for disability benefits.  We affirm.

                                          I.

                 Claimant's attempts to  obtain disability benefits  have

            ensued  long after  her insured  status expired  on June  30,

            1980.    She  filed  her  first  application,  without  legal

            representation, on December 4, 1991, claiming an inability to

            work  since May 1, 1976  because of multiple  sclerosis.  Her

            claim  was  denied at  the  initial  level of  administrative

            review by notice dated  January 13, 1992.  No  further review

            was  sought, with  the result  that the  agency determination

            became final.  See 20 C.F.R.    404.905, 404.987(a).
                           ___

                 With the assistance of  counsel, claimant filed a second

            application on November 27, 1992,  along with a smattering of

            new  evidence.  The cited medical  impairment and the claimed

            onset date were the same as those alleged earlier.  After her

            claim was  denied initially and  on reconsideration, claimant

            sought a  hearing before  an administrative law  judge (ALJ).

            In  a decision  dated January  28, 1994,  the ALJ  denied the

            hearing  request on two  grounds.  First,  he determined that

            the claim was barred on res judicata grounds, inasmuch as the

            earlier application  had involved the same  facts and issues.

            See  id.     404.957(c)(1).    Alternatively, construing  the
            ___  ___

            second application as a request to reopen the  earlier claim,

            the  ALJ concluded that no new and material evidence had been

            submitted so as to provide good cause for reopening.  See id.
                                                                  ___ ___

               404.988(b), 404.989(a)(1).  

                 Claimant   sought  review   by   the  Appeals   Council,

            supplementing  her request  with  recently  acquired  medical

            evidence.   The  Appeals Council  found that  "the additional

            reports contain  no objective findings for  the period before

            1982,  and  no  clinical  support  to  demonstrate  a  severe

            impairment  existing  continuously since  at  least  June 30,

            1980."   Agreeing  with  the  ALJ  that  no  good  cause  for

            reopening  had  been  presented,  it  therefore  declined the

            request for review.

                 Claimant  subsequently  filed   the  instant  action  in

            district court, premising jurisdiction on 42 U.S.C.   405(g).

            In  response  to  the  Secretary's  motion  to  dismiss,  the

            district  court  issued a  detailed decision  explaining that

            subject  matter jurisdiction was  ordinarily lacking  in this

            context.  Applying Califano v.  Sanders, 430 U.S. 99,  107-09
                               ________     _______

            (1977), and Matos v.  Secretary of HEW, 581 F.2d  282, 284-87
                        _____     ________________

            (1st Cir. 1978), the court observed that judicial review of a

            denial reached  without  a hearing  was  unavailable--whether

            such  denial  was based  on  administrative  res judicata  or

            involved  a decision not to  reopen.  Accord,  e.g., Colon v.
                                                  ______   ____  _____

            Secretary of HHS, 877  F.2d 148, 152-53 (1st Cir.  1989) (per
            ________________

            curiam); Torres v. Secretary of HHS, 845 F.2d 1136, 1138 (1st
                     ______    ________________

            Cir.  1988) (per  curiam) (citing  cases); see  also  Rios v.
                                                       _________  ____

                                         -3-

            Secretary  of HEW, 614 F.2d  25, 26 (1st  Cir. 1980) (finding
            _________________

            jurisdiction lacking to review denial on res judicata grounds

            and refusal to reopen, even where hearing had been held).  As

            the district court noted, an exception to this jurisdictional

            bar   exists  in   "rare   instances"   where   a   colorable

            constitutional claim  has been presented.   Sanders, 430 U.S.
                                                        _______

            at 109; accord, e.g., Colon, 877 F.2d at 152.  Yet claimant's
                    ______  ____  _____

            only  allegation to this  effect was  that invocation  of res

            judicata violated  due process where the first claim had been

            dismissed without a hearing--a contention the court  properly

            deemed meritless.   See, e.g., Rogerson v. Secretary  of HHS,
                                ___  ____  ________    _________________

            872 F.2d 24,  29 (3d Cir. 1989); see also  Matos, 581 F.2d at
                                             ________  _____

            285-86. 

                 Nonetheless, with a reference  to Shrader v. Harris, 631
                                                   _______    ______

            F.2d 297 (4th Cir. 1980), the court went on to observe that a

            separate  constitutional claim might  be stated were claimant

            able to  demonstrate that, because of  mental incapacity, she

            had been unable to understand or pursue the appeal procedures

            in connection with her  first, pro se application.   Although

            no  such argument  had been  advanced,  the court  sua sponte
                                                               __________

            afforded claimant sixty  days within which to  attempt such a

            showing.     In  response,   claimant  advanced  a   trio  of

            contentions.    First,  she  argued  that  a  combination  of

            symptoms--fatigue, depression and  a sense of powerlessness--

            had in fact prevented  her from pursuing her rights  in 1992.

                                         -4-

            Principal  support  for  this  contention  came  from  an  MS

            counselor who had provided claimant with group therapy at the

            time.  Second, claimant insisted that the January 1992 denial

            notice had been  ambiguously worded, particularly  by failing

            to  clarify the necessity of  filing an appeal  as opposed to

            reapplying for  benefits.  Finally, claimant  complained that

            many of her  medical records had been (and  to a large extent

            remained)   unavailable--a   problem   exacerbated   by   the

            Secretary's  failure to  assist her  in obtaining them.   The

            district court, unpersuaded  that these contentions  amounted

            to  a colorable  due process violation,  thereafter summarily

            allowed the motion to dismiss.  This appeal ensued.  

                                         II.

                 Claimant  now  acknowledges   that  the   jurisdictional

            question hinges on  whether a colorable constitutional  claim

            has been presented.  She argues that the factors just cited--

            her emotional difficulties; the ambiguously worded notice  of

            denial; and  the incomplete medical record--set  forth such a

            claim,  at  least in  combination  if not  individually.   We

            disagree. 

                 The Shrader case involved an extreme set of facts: e.g.,
                     _______                                        ____

            psychiatric and other medical reports  describing claimant (a

            Vietnam War shell-shock victim)  as living a "vegetative like

            existence,"  as becoming  "schizoid"  and "paranoid,"  and as

            "regress[ing] to a psychotic level."  631 F.2d at 299.  While

                                         -5-

            such dire circumstances are  not invariably a prerequisite to

            invoking the  Shrader exception, the depression  and sense of
                          _______

            powerlessness cited by claimant here are, quite obviously, of

            a lower order of magnitude.  As well, they are uncorroborated

            by any  medical evidence.   The  only relevant  submission in

            this  regard comes from a  lay person counselor;  there is no

            indication  that  claimant  has  ever  received  professional

            treatment for her emotional maladies.  It  is also noteworthy

            that, in her response  to the Secretary's motion to  dismiss,

            claimant  attributed  her  failure  to appeal  solely  to  an

            inability to obtain supporting  evidence for the period prior

            to  1980 (when her insured status  expired).  As a result, we

            agree  that  claimant  has  failed to  "present  prima  facie

            evidence  of incompetency," id. at  302, that can  be said to
                                        ___

            have  prevented  her  from  comprehending   or  invoking  the

            administrative appeal process.

                 Claimant's challenge to the wording of the denial notice

            likewise proves unavailing.   To be sure, a number  of courts

            have determined that  an earlier  version of  the notice  was

            sufficiently misleading as to be  constitutionally defective.

            See,  e.g., Day v. Shalala,  23 F.3d 1052,  1064-66 (6th Cir.
            ___   ____  ___    _______

            1994); Gonzalez v. Sullivan, 914 F.2d 1197, 1202-03 (9th Cir.
                   ________    ________

            1990).   The offending  passage involved  in those  cases had

            advised  claimants that "[i]f you do not request a hearing of

            your  case within the prescribed  time period, you still have

                                         -6-

            the right to  file another  application at any  time."   See,
                                                                     ___

            e.g., id. at 1203.  The notice received by claimant, however,
            ____  ___

            did not  contain such language;  instead, it contained  a new

            passage,  added by  the  Secretary  in  1990, which  read  as

            follows:

                 You have the right to file a new application at any
                 time,  but filing a new application is not the same
                 as  appealing  this  decision.     You  might  lose
                 benefits if  you file a new  application instead of
                 filing  an appeal.   Therefore,  if you  think this
                 decision  is wrong,  you should  ask for  an appeal
                 within 60 days.

            Claimant's  insistence  that  such  revised  language  proves

            equally  defective falls short.   See, e.g., Day,  23 F.3d at
                                              ___  ____  ___

            1065   (suggesting  that   the  1990   revision   "cured  the

            deficiencies"  found  in  the  earlier  version);  Rooney  v.
                                                               ______

            Shalala, 879 F.  Supp. 252, 255 (E.D.N.Y.  1995) (noting that
            _______

            the revision "explicitly set forth  the critical information,

            missing from the earlier  form, concerning the adverse effect

            of failing to appeal").

                 As  to  claimant's final  contention,  even  were we  to

            assume that an obligation to help  develop the medical record

            might arise at the  initial review stage, it is  not apparent

            that the  Secretary failed to make  "reasonable effort[s]" to

            do   so.     20  C.F.R.      404.1512(d).     The  Disability

            Determination Rationale accompanying the denial of claimant's

            first  application  stated  that  the  agency  "contacted any

            available  source"  of   information.    Moreover,   we  have

                                         -7-

            indicated   that,   while  the   Secretary   "must   make  an

            investigation  that  is  not  wholly  inadequate   under  the

            circumstances," Miranda  v. Secretary  of HEW, 514  F.2d 996,
                            _______     _________________

            998 (1st Cir. 1975),  she need not "go to  inordinate lengths

            to develop a claimant's case," Thompson v. Califano, 556 F.2d
                                           ________    ________

            616, 618 (1st Cir. 1977); accord, e.g., Currier  v. Secretary
                                      ______  ____  _______     _________

            of HEW,  612  F.2d  594, 598  (1st  Cir.  1980)  (Secretary's
            ______

            obligation requires attempt  "without undue  effort" to  fill

            evidentiary  gaps by, inter  alia, ordering "easily obtained"
                                  ___________

            medical reports).  The record of claimant's medical treatment

            prior  to June 1980 proves  to have been  anything but easily

            obtainable; even with the assistance of counsel, claimant was

            unable  to procure most of such evidence prior to her request

            for  Appeals Council  review  in connection  with her  second

            application. 

                 Accordingly,  as no  colorable constitutional  claim has

            been presented, we agree with the district court that subject

            matter  jurisdiction  was  lacking.1     See,  e.g.,  Doe  v.
                                               1     ___   ____   ___

                                
            ____________________

               1   Claimant separately contends that  the Appeals Council
               1
            reappraised her new  evidence in a manner that  constituted a
            de  facto  reopening,  subject  to  judicial  review.    This
            argument was not advanced below and so is not properly before
            us.  See,  e.g., Evangelista  v. Secretary of  HHS, 826  F.2d
                 ___   ____  ___________     _________________
            136, 144  (1st Cir. 1987).   We find it without  merit in any
            event.  See, e.g., Hall v. Chater, 52 F.3d 518, 521 (4th Cir.
                    ___  ____  ____    ______
            1995) (rejecting similar argument  on ground that  "Secretary
            must  be afforded some leeway in making a decision whether to
            reopen"); Torres, 845 F.2d at 1139 (noting that  Secretary is
                      ______
            "entitled to make a threshold inquiry and review the evidence
            presented ... in order to resolve the reopening issue").

                                         -8-

            Secretary of HHS, 744 F.2d 3, 5 (1st Cir.  1984) (per curiam)
            ________________

            (affirming dismissal on jurisdictional grounds  after finding

            "no tenable  constitutional claim").   Whether claimant might

            yet  be  able  to  persuade  the  Secretary  to  reopen   her

            application,  based on  new and  material  evidence uncovered

            since the date of the Appeals Council  ruling, is a matter we

            need not address.2
                             2

                 Affirmed.
                 _________

                                
            ____________________

               2    Indeed,  such a  request  might  be  bolstered by  an
               2
            apparent error  in the Secretary's  ruling here.   Under  the
            applicable  regulations,  a  final  agency  decision  may  be
            reopened:   (1)   within   twelve  months   of   the  initial
            determination "for any reason," (2) within four years thereof
            for  "good  cause"  (defined  to include  "new  and  material
            evidence"), and  (3) "at  any  time" for  the purpose,  inter
                                                                    _____
            alia,  of  "correct[ing] clerical  error  or  any error  that
            ____
            appears  on the face of the evidence that was considered when
            the  determination or decision was  made."  See  20 C.F.R.   
                                                        ___
            404.988, 404.989.
                 In the instant case, the ALJ rejected claimant's hearing
            request  on the ground that  no "good cause"  had been shown,
            and  the Appeals  Council thereafter  declined review  on the
            same  basis.   Yet  claimant's second  application was  filed
            within  twelve months  of  the  January  13, 1992  notice  of
            denial.   Construed as a request for reopening, therefore, it
            arguably should  have been  addressed under the  "any reason"
            standard rather than the  "good cause" standard.   We express
            no  view  as to  the  effect of  any  possible error  in this
            regard,  however, inasmuch  as  claimant has  not raised  the
            issue either below or on appeal.

                                         -9-