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Brian B. v. Saul

United States District Court, D. Maine

September 20, 2019

BRIAN B., Plaintiff
ANDREW M. SAUL, Commissioner, Social Security Administration, Defendant


          John C. Nivison, U.S. Magistrate Judge.

         On Plaintiff’s application for supplemental security income benefits under section 1614(a)(3)(A) of the Social Security Act (the Act), Defendant, the Social Security Administration Commissioner, found that Plaintiff had assets above the statutory limit of $2, 000. Defendant, therefore, denied Plaintiff’s request for disability benefits. Plaintiff filed this action to obtain judicial review of Defendant’s final administrative decision pursuant to 42 U.S.C. § 405(g).

         Following a review of the record, and after consideration of the parties’ arguments, I recommend the Court affirm the administrative decision.


         Plaintiff filed his application for SSI benefits with a protective filing date of April 14, 2016. (R. 144.) His claim was denied initially and on reconsideration. (R. 144, 135.) Plaintiff subsequently requested a hearing. (R. 134.) The Administrative Law Judge (ALJ) found that during the period under review, Plaintiff’s countable income was never below the resource limit of $2, 000. (R. 13.) The Commissioner’s final decision is the April 4, 2018, decision of the ALJ. (ALJ Decision, R. 12-14.)[1]

         The ALJ found Plaintiff to have received income in the form of workers’ compensation benefits in the amount of $268, 310[2] on September 3, 2014; that Plaintiff made withdrawals totaling $153, 610 from various bank accounts from September 8, 2014 through November 12, 2015, but Plaintiff failed to submit sufficient evidence as to how the withdrawn money was spent; that sum, therefore, was properly counted as a cash resource; that Plaintiff thus had income in excess of the resource limit of $2, 000; and that the Plaintiff was not eligible to receive SSI payments for any month following his application date. (R. 13-14.)


         A court must affirm the administrative decision provided the decision is based on the correct legal standards and is supported by substantial evidence, even if the record contains evidence capable of supporting an alternative outcome. Manso-Pizarro v. Sec’y of HHS, 76 F.3d 15, 16 (1st Cir. 1996) (per curiam); Rodriguez Pagan v. Sec’y of HHS, 819 F.2d 1, 3 (1st Cir. 1987). Substantial evidence is evidence that a reasonable mind might accept as adequate to support a finding. Richardson v. Perales, 402 U.S. 389, 401 (1971); Rodriguez v. Sec’y of HHS, 647 F.2d 218, 222 (1st Cir. 1981). “The ALJ’s findings of fact are conclusive when supported by substantial evidence, but they are not conclusive when derived by ignoring evidence, misapplying the law, or judging matters entrusted to experts.” Nguyen v. Chater, 172 F.3d 31, 35 (1st Cir. 1999).


         To be eligible for SSI benefits, a claimant must meet all the basic requirements for eligibility under the Act. A claimant must provide information to the Social Security Administration upon its request to “show [the SSA] necessary documents or other evidence to prove that [he or she] meets these requirements.” 20 C.F.R. § 416.200.

         Under the Social Security Act (the Act) and the regulations promulgated pursuant to the Act, an unmarried individual is not eligible for SSI benefits if the individual’s resources and income exceed $2, 000.00. 42 U.S.C. §§ 1382(a)(1)(A), (a)(1)(B), (a)(3)(B); 20 C.F.R. §§ 416.1205(a), (c). “Resources” is defined as “cash or other liquid assets or any real or personal property that an individual … owns and could convert to cash to be used for his or her support and maintenance.” 20 C.F.R. § 416.1201(a). Income is “anything [an individual] receive[s] in cash or in kind” that can be used to meet an individual’s “needs for food or shelter.” 20 C.F.R. § 1102. Income includes both earned and unearned income, subject to certain exceptions. 20 C.F.R. § 416.1104. Earned income includes salaries, commissions, bonuses, severance pay, and any other special payments received because of an individual’s employment. 20 C.F.R. § 416.1110(a)(1). Unearned income includes workers’ compensation benefits. 20 C.F.R. § 416.1121(a).

         Plaintiff argues the ALJ erred when she found that Plaintiff did not provide evidence to establish how he spent his workers’ compensation proceeds and thus erred when she found that Plaintiff was not eligible to receive benefits based on his resources during the period under review.

         Although Plaintiff submitted bank statements showing balances below the allowable resource limit as of April 2016, (see R. 66, 106 & 129), he could not explain the purpose of numerous transfers and withdrawals from the various accounts.[3] (See R. 183-89.) Furthermore, while Plaintiff also submitted receipts dating from August 2017, totaling $128, 500 (R. 18-21), the ALJ accurately noted that Plaintiff submitted no contemporaneous receipts; instead, the receipts had been prepared specifically for the hearing.[4] (R. 13, 18-21.) The ALJ also noted that although at the end of the hearing she requested that Plaintiff provide tax returns for 2014, 2015 and 2016, a sworn statement from the person from whom he leased his residence and to whom many of the proceeds were purportedly paid, and a copy of any written rental agreement, Plaintiff failed to do so. (R. 13; see R. 193-94.)

         Plaintiff’s failure to account adequately for his workers’ compensation proceeds is similar to the claimant’s failure to prove eligibility in the recent case of King v. Berryhill, No. 18-11426, 2019 WL 2524762 (D. Mass. June 18, 2019). In King, the claimant had received $50, 000 in pension payouts and workers’ compensation proceeds. 2019 WL 252476, at *1 & n.2. At the administrative hearing, the claimant submitted bank records showing cash withdrawals totaling approximately $30, 000. Id. at *2. The claimant testified that he had spent the funds on food, clothing and paying bills; he did not, however, offer any documentation to support his assertions. Id. The claimant also did not submit any documents following the hearing, although the ALJ held the record open for the claimant to do so. Id. The ALJ denied claimant’s request for benefits, concluding that the claimant was not eligible. In upholding the ALJ’s ...

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