20 CFR 404.435(a)(3), 404.905, 404.988, and 404.989
The general issue is whether the claimant's OAIB was subject to work deductions in 1978 due to his excess earnings. The specific issue is whether the doctrine of administrative finality prohibits the claimant from being considered 72 years old in January 1978 based on new evidence presented in May 1979 where the claimant was awarded benefits based on an application filed and a determination made in 1972.
The claimant filed an application for OAIB on February 23, 1972, alleging that he was born on January 5, 1907. A date of birth of January 5, 1907, was established based on evidence submitted by the claimant, and benefits were awarded to him effective January 1972.
Following the timely submission of an annual report of earnings for 1978, SSA determined that some of the benefits paid to the claimant for that year were subject to work deductions. The claimant requested a reconsideration of that determination on June 11, 1979. He stated that he had new evidence which showed that he was born on January 5, 1906. Therefore, he contended that the benefits paid to him for 1978 were not subject to work deductions because he had attained age 72 in January of that year.
On the basis of the new evidence, SSA determined that the claimant was born on January 5, 1906. It was further determined, however, that the initial determination of the claimant's date of birth made in 1972 could not be reopened under the rules of administrative finality and that the claimant's benefits could be corrected to reflect the new date of birth effective May 1979, the month the new evidence had been received, but not retroactively. As a result, the claimant was advised that the work deductions imposed for 1978 would not be affected by the finding that he was born on January 5, 1906. The claimant requested a hearing on November 7, 1979.
The administrative law judge (ALJ) found that the rules of administrative finality barred the claimant from using the new evidence to recompute the benefit rate for the period January 1972 through April 1979, but did not bar the reopening of the determination that the claimant's benefits were subject to work deductions for 1978 based on excess earnings. The ALJ reasoned that new and material evidence had been submitted within four years of the initial determination that the claimant was subject to work deductions for 1978; and that the new evidence established good cause for reopening the work deduction determination. Consequently, the ALJ determined that the claimant was not subject to work deductions for 1978 because he had attained age 72 in January of that year.
Under the authority of section 205(a) of the Social Security Act, the Secretary has established by regulation that determinations and decisions of the Secretary shall become final and binding upon all parties after the lapse of a specified period of time, and may thereafter be reopened and revised only under limited circumstances.
Section 404.435(a)(3) of Regulations No. 4 provides, in part, that ". . . no matter how much a beneficiary earns in a given taxable year, no deduction on account of excess earnings will be made in the benefits payable for any month in which he or she was age 72 or over. . . ."
Section 404.905 of Regulations No. 4 provides that "(a)n initial determination is binding unless you request a reconsideration or a hearing, as appropriate, within the stated time period, or we revise the initial determination."
Section 404.988 of Regulations No. 4 provides that "(a) determination, revised determination, decision, or revised decision may be reopened --
Section 404.989(a) of Regulations No. 4 provides ". . . that there is good cause to reopen a determination . . . if --
The Appeals Council did not concur with the ALJ's finding that the 1978 deductions determination was separate and distinct from the 1972 date of birth determination. In determining that deductions were applicable against the benefits of the claimant for 1978, SSA only considered two factors, the amount of the claimant's excess earnings and the months in which he had either earned more than the monthly limit in employment or rendered substantial services in self-employment. The claimant's date of birth was not a factor to be decided because that determination had been made when he became entitled to OAIB. The initial determination of the claimant's date of birth was made more than four years before the determination of work deductions; therefore, it could not be reopened under the rules of administrative finality. Consequently, the only factors in the 1978 work deductions determination that were subject to correction were the amount of the claimant's excess earnings and the months to which those earnings should be charged. Accordingly, the Appeals Council found that the date of birth initially established for the claimant, January 5, 1907, was applicable for purposes of imposing work deductions for 1978.
While the 1972 determination of the claimant's date of birth may not be reopened for purposes of imposing work deductions for 1978, the Appeals Council agreed that the evidence of record now supports a finding that the claimant was born on January 5, 1906, and adopted SSA's determination that the claimant's benefit rate should be recomputed based on the corrected date of birth effective May 1979, the month the new evidence of age was received by SSA. See Social Security Ruling 66-30, C.B. 1966-1970, page 358.
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