JAMES v. COMMISSIONER OF SOCIAL SECURITY

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United States Court of Appeals, Sixth Circuit.

Carlos M. JAMES, Plaintiff-appellant, v. COMMISSIONER OF SOCIAL SECURITY, Defendant-Appellee.

No. 16-6224

Decided: May 04, 2017

Before: KEITH, CLAY, and McKEAGUE, Circuit Judges.

ORDER

Carlos M. James appeals a district court judgment granting the Commissioner's motion to dismiss his complaint for lack of subject matter jurisdiction. This case has been referred to a panel of the court that, upon examination, unanimously agrees that oral argument is not needed. See Fed. R. App. P. 34(a).

As of May 2001, James had been receiving disability insurance benefits (DIB), but the social security administration (Agency) notified him that month that his disability had ended and that he was not entitled to benefits between September 1998 and March 1999. The Agency later revised this determination and notified James in January 2002 that his benefits had ended in February 1991. Represented by counsel, James filed a timely request for a hearing on this decision, but he later withdrew this request, and an administrative law judge (ALJ) issued an order of dismissal based on James's withdrawal of his request for a hearing. The ALJ's order also confirmed that the Agency's decision remained in effect.

Because James had continued receiving benefits after he was no longer eligible, the Agency determined that he had been overpaid a total of $142,690.70, and sent James a notice of this overpayment in May 2002. This notice informed James that he had sixty days to appeal the decision, but James did not appeal or request reconsideration.

In February 2004, the Agency informed James that, because he had misrepresented material facts to the Agency to support a subsequent application for DIB, he would be assessed a “penalty,” specifically non-payment of benefits for six months if he became eligible for benefits in the future. After James appealed this sanction, an ALJ eventually removed it and applied $5,820 of James's social security retirement benefits to offset the amount of overpayment that he owed. In June 2011, the Agency notified James of this decision. In July 2011, through counsel, James requested reconsideration, challenging only the overpayment that was assessed in 2002. In a pro se filing, James admitted that his request for reconsideration of the overpayment determination was untimely.

In January 2015, James filed his pro se complaint in the district court, claiming that he was entitled to benefits during periods that the Commissioner had decided he was not disabled. He also accused the Agency of committing fraud and forgery in processing his claim for benefits. The Commissioner filed a motion to dismiss for lack of subject matter jurisdiction, and the district court granted the motion. This appeal followed.

James now challenges the Agency's May 2001 decision regarding the date his DIB ended. He argues that his Sixth Amendment right of confrontation was violated when he was denied a hearing to confront social security representatives and their witnesses, and that his Fourteenth Amendment right was violated because he is innocent until proven guilty. He also accuses the ALJ of failing to consider all of the evidence and claims that the Commissioner's evidence was “fabricated.” Because James has failed to challenge the district court's determination that it lacks jurisdiction to hear his case, he has arguably abandoned the only issue before this court. See O'Hara v. Brigano, 499 F.3d 492, 498 (6th Cir. 2007). In any event, the district court did not err in holding that it lacked subject matter jurisdiction over James's action.

We review de novo a district court's dismissal for lack of subject matter jurisdiction under Federal Rule of Civil Procedure 12(b)(1). Harkness v. United States, 727 F.3d 465, 469 (6th Cir. 2013). Pursuant to 42 U.S.C. § 405(g), federal courts are authorized to review “any final decision of the Commissioner of Social Security made after a hearing to which he was a party.” Although the Social Security Act does not define “final decision,” there is not a final decision of the Commissioner until the claimant exhausts the administrative process established by the applicable regulations. Willis v. Sullivan, 931 F.2d 390, 396–97 (6th Cir. 1991).

In order to exhaust administrative remedies, a social security claimant must receive an initial determination of disability and request de novo reconsideration of that determination if dissatisfied; if still dissatisfied, a claimant seeking review before this Court must request an evidentiary hearing before an ALJ and then take an appeal to the Appeals Council. Id. at 397; see also 20 C.F.R. § 404.900(a)(1)-(5). After completing this process, the claimant may seek judicial review in federal court. Willis, 931 F.2d at 397. The Supreme Court has stated that disregarding this exhaustion requirement “would frustrate the congressional purpose, plainly evidenced in § 205(g) [of the Social Security Act], to impose a 60-day limitation upon judicial review of the Secretary's final decision on the initial claim for benefits.” Califano v. Sanders, 430 U.S. 99, 108 (1977). Here, James failed to properly fulfill the requirements for exhaustion because James did not (1) timely request reconsideration of the Agency's determinations regarding the date his benefits ended and his overpayment, (2) request an evidentiary hearing, (3) request a de novo review before an ALJ, or (4) appeal to the Appeals Council. See Willis, 931 F.2d at 397. Thus, the district court properly determined that there was no final decision over which it had jurisdiction under § 405(g).

There is an exception to the exhaustion requirement when a claimant presents a colorable constitutional claim for relief. Sanders, 430 U.S. at 108–09. However, James failed to raise his constitutional claims before the district court so these claims are waived. See Ealy v. Comm'r of Soc. Sec., 594 F.3d 504, 513 (6th Cir. 2010). Moreover, these claims are meritless. The Sixth and Fourteenth Amendment rights that James asserts apply only to criminal proceedings, and he fails to support his bare accusation that the Commissioner and the ALJ fabricated the evidence upon which they relied.

Accordingly, we AFFIRM the district court's judgment.