LESTER v. COMMISSIONER OF SOCIAL SECURITY

Filing 25

ORDER affirming decision of Commissioner. Ordered by US MAGISTRATE JUDGE THOMAS Q LANGSTAFF on 9/11/2020. (TQL)

IN THE UNITED STATES DISTRICT COURT
FOR THE MIDDLE DISTRICT OF GEORGIA
ALBANY DIVISION
S.L.,

:
:
Plaintiff,
:
:
VS.
:
:
Commissioner of Social Security,
:
:
Defendant.
:
______________________________________ :

1:19-CV-55 (TQL)

ORDER
Plaintiff filed this Social Security appeal on April 12, 2019, challenging the
Commissioner’s finding that he was liable for an overpayment. (Doc. 1). Both parties consented
to the United States Magistrate Judge conducting any and all proceedings herein, including but not
limited to, ordering the entry of judgment. (Doc. 4; Clerk’s entry on April 22, 2019). The parties
may appeal from the judgment, as permitted by law, directly to the Eleventh Circuit Court of
Appeals. 28 U.S.C. § 636(c)(3). Jurisdiction arises under 42 U.S.C. § 405(g). All administrative
remedies have been exhausted.
Legal Standard
In reviewing the final decision of the Commissioner, this Court must evaluate whether
substantial evidence supports the Commissioner’s decision and whether the Commissioner applied
the correct legal standards to the evidence. Wilson v. Barnhart, 284 F.3d 1219, 1221 (11th Cir.
2002). The Commissioner’s factual findings are deemed conclusive if supported by substantial
evidence, which is defined as more than a mere scintilla, such that a reasonable person would
accept the evidence as adequate to support the conclusion at issue. Dyer v. Barnhart, 395 F.3d
1206, 1210 (11th Cir. 2005); Cornelius v. Sullivan, 936 F.2d 1143, 1145 (11th Cir. 1991).

“Even if we find that the evidence preponderates against the [Commissioner’s] decision,
we must affirm if the decision is supported by substantial evidence.” Bloodsworth v. Heckler, 703
F.2d 1233, 1239 (11th Cir. 1983). “In contrast, the [Commissioner’s] conclusions of law are not
presumed valid . . . . The [Commissioner’s] failure to apply the correct law or to provide the
reviewing court with sufficient reasoning for determining that the proper legal analysis has been
conducted mandates reversal.” Cornelius, 936 F.2d at 1145-46.
Statement of Facts and Evidence
Willie B. Lester, Jr. was entitled to disability insurance benefits beginning in March 1984.
(Tr. 95). Plaintiff was appointed representative payee for Mr. Lester in October 2001. (Tr. 95). In
April 2009, Mr. Lester’s benefits were ceased due to his substantial and gainful work activity. (Tr.
37, 95). However, these benefits should have been suspended starting in May 2008, which caused
an overpayment. (Tr. 37). Mr. Lester stopped working in June 2011, and his benefits were
reinstated. (Tr. 95). Money was withheld from Mr. Lester’s checks each month to repay the
overpayment. (Tr. 65). Mr. Lester died in January 2014. (Tr. 133). At the time of his death, Mr.
Lester’s total overpayment was $27,681.30. (Tr. 67).
As the representative payee for Mr. Lester, Plaintiff is jointly liable for the overpayment.
(Tr. 99). Plaintiff requested a waiver of overpayment, but the request was denied. (Tr. 87-94, 10102). Plaintiff requested a hearing before an administrative law judge (“ALJ”). (Tr. 103). At the
hearing, Plaintiff testified that he was without fault for the overpayment because he did not apply
to be Plaintiff’s representative payee and was not aware that he was considered to be the
representative payee until 2009 or 2010. (Tr. 186-87). In a decision dated April 27, 2018, the ALJ
found Plaintiff was at fault and held Plaintiff liable for the overpayment. (Tr. 17-20). This decision

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became the final decision of the Commissioner upon the Appeals Council denying review. (Tr. 79).
DISCUSSION
Plaintiff challenges the ALJ’s decision because he never agreed to be the representative
payee for Mr. Lester. (Doc. 23, pp. 1-2). Generally, the Commissioner is required to recover
overpayments. See 42 U.S.C. § 404(a)(1)(A). While the Administration may have been at fault in
making the overpayment, that fact does not relieve the individual from liability for an
overpayment. 20 C.F.R. § 404.507. However, an individual can request that the overpayment be
waived. 20 C.F.R. § 404.506(b). The following two-prong test is used to determine if a waiver of
overpayment is appropriate: “(1) whether the overpaid individual was without fault in connection
with the overpayment; and (2) if so, whether recovery would either defeat the purposes of Title II
of the Act or be against equity and good conscience.” Graverson v. Comm’r of Soc. Sec., 2019 WL
1552737, at *3 (M.D. Fla. Apr. 10, 2019). “The burden is upon the claimant to establish the
negative prerequisite (‘without fault’), before the Secretary considers the second tier of the waiver
statute.” Viehman v. Schweiker, 679 F.2d 223, 227 (11th Cir. 1982).
In determining whether an individual was without fault, the Commissioner “will consider
all pertinent circumstances, including the individual’s age and intelligence, and any physical,
mental, educational, or linguistic limitations (including any lack of facility with the English
language) the individual has.” 20 C.F.R. § 404.507. An individual may be found not to be without
fault if the overpayment was the result of:
(a) An incorrect statement made by the individual which he knew or should have
known to be incorrect; or
(b) Failure to furnish information which he knew or should have known to be
material; or
(c) with respect to the overpaid individual only, acceptance of a payment which he
either knew or could have been expected to know was incorrect.
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Id. The overpaid individual includes the representative payee. Zilahy v. Astrue, 2012 WL 4207381,
at *11 (M.D. Fla. Sept. 19, 2012) (applying 20 C.F.R. § 404.507(c) to a representative payee).
In determining that Plaintiff was at fault for the overpayment, the ALJ noted that the
preponderance of the evidence showed that Plaintiff was the representative payee for Mr. Lester
since at least 2001. (Tr. 19). The ALJ relied upon the numerous Social Security Administration
notices addressed to Plaintiff for Mr. Lester without objection or question, an unsigned document
from October 11, 2001 where Plaintiff requested appointment as representative payee for Mr.
Lester, and numerous Representative Payee Reports signed by Plaintiff. (Tr. 19). The ALJ found
there was no evidence in the record that Plaintiff was unable to understand or read the forms which
identified him as the representative payee. (Tr. 19). Plaintiff testified that he was unaware of his
representative payee status because Mr. Lester was psychotic, threatening, and controlled the mail
in the house. (Tr. 19). The ALJ did not find this testimony to be credible as Mr. Lester’s work
history indicated that he was able to control his behavior. (Tr. 19). The ALJ also noted that Plaintiff
lived and worked with Mr. Lester, which demonstrated that he was involved in Mr. Lester’s life
and was aware of Mr. Lester’s work activities. (Tr. 19).
A review of the ALJ’s fault determination shows it is supported by substantial evidence.
See Austin v. Shalala, 994 F.2d 1170, 1174 (5th Cir. 1993) (concluding that an ALJ could find a
plaintiff at fault for an overpayment when the plaintiff signed, without reading, a form containing
incorrect information); Demir v. Colvin, 2015 WL 3396551, at *3 (N.D. Ill. May 26, 2015) (finding
an ALJ’s decision that the representative payee was at fault for an overpayment was supported by
substantial evidence when the representative payee was aware of the beneficiary’s work, but failed
to report the work); Stockton v. Sullivan, 1991 WL 426452, at *4 (N.D. Ala. July 23, 1991) (finding
an ALJ’s determination of fault was supported by substantial evidence when the ALJ properly
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discredited the plaintiff’s testimony as inconsistent with the record). As the ALJ’s decision
regarding Plaintiff’s fault is supported by substantial evidence, the Court need not address the
second prong of the waiver analysis. See Viehman, 679 F.2d at 227.
CONCLUSION
As the Commissioner’s decision that Plaintiff was not without fault in causing the
overpayment is supported by substantial evidence, the Commissioner’s decision is AFFIRMED
pursuant to Sentence Four of § 405(g).
SO ORDERED, this 11th day of September, 2020.
s/THOMAS Q. LANGSTAFF
UNITED STATES MAGISTRATE JUDGE

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