Danielle Gordon v. Donna E. Shalala, Secretary of Health and Human Services, 55 F.3d 101, 2d Cir. (1995)
Danielle Gordon v. Donna E. Shalala, Secretary of Health and Human Services, 55 F.3d 101, 2d Cir. (1995)
3d 101
48 Soc.Sec.Rep.Ser. 24
The Secretary of Health and Human Services appeals from a judgment of the
United States District Court for the Eastern District of New York (Spatt, J.)
reversing the Secretary's reduction of Danielle Gordon's Supplemental Security
Income ("SSI") benefits on the ground that the Secretary applied incorrect legal
standards in computing the benefits payable. For the reasons that follow, we
reverse.
The SSI program provides benefits to aged, blind, or disabled individuals who
meet the statutory income and resource limitations. 42 U.S.C. Secs. 1382 and
1382a; 20 C.F.R. Part 416, Subpart K. A comprehensive discussion of the
complicated regulatory framework under which this program operates is
contained in Ruppert v. Bowen, 871 F.2d 1172, 1174-75 (2d Cir.1989). For
purposes of this opinion, the following summary will suffice. An SSI recipient
is paid a flat monthly benefit rate, but the benefits are reduced by the amount of
non-excludable income received by the individual. 42 U.S.C. Sec. 1382(b); 20
C.F.R. Secs. 416.1100 and 416.1104. Such income is anything that the SSI
recipient receives in cash or in kind that can be used to meet his or her needs for
food, clothing and shelter, thus obviating, in part at least, the use of SSI funds
for these purposes. 20 C.F.R. Sec. 416.1102. In-kind support and maintenance
is valued using one of two methods. 20 C.F.R. Sec. 416.1130(c). When the
recipient lives in the household of another person who provides both food and
shelter, the in-kind support and maintenance is valued at one-third of the
recipient's federal benefit rate, regardless of its actual value. 20 C.F.R. Sec.
416.1131. In other situations, the Social Security Administration ("SSA")
presumes that the in-kind income is worth a maximum value that is one-third
the recipient's federal benefit rate plus $20 (the general unallocated income
exclusion described in 20 C.F.R. Sec. 416.1124(c)(12)). 20 C.F.R. Sec.
416.1140. This presumption can be rebutted by showing that the current market
value of the in-kind support minus any payment made for it by the recipient, or
the actual amount paid by someone else for the recipient, is lower than the
presumed value. Id.
In Ruppert, this Court held that further analysis is required in calculating SSI
benefits. We said there that in order for a recipient's benefits to be reduced
because of subsidized support, he or she must receive an "actual economic
benefit" from the subsidy. In other words,
4 the proportion of income that [SSI recipients] expend on shelter is so great that "it
if
flies in the face of reality to conclude that 'unearned income' in the form of
subsidized shelter ... is 'actually available' to the recipient," see Jackson [v.
Schweiker ], 683 F.2d [1076,] 1085 [ (7th Cir.1982) ], the unearned income should
be disregarded.
5
Ruppert, 871 F.2d at 1180. Although this Court did not clearly state how this
"actual economic benefit" test should be applied, we stated that "[t]he
regulations used in the Seventh Circuit might provide a good indication of that,
though we do not necessarily require their adoption as a matter of law." Id. at
1181.
In Jackson, the Seventh Circuit had required the Secretary to modify the SSI
10
When Danielle turned eighteen in May 1986, she entered into a written
agreement with her mother under which she paid her mother $100 per month
for "rent" and an additional $100 per month for the separately designated
purchase of food. Based on this agreement, Danielle requested reconsideration
of the SSA's decision, contending that she had rental liability and lived in her
own household. The SSA denied the reconsideration request, concluding that
Danielle's living arrangements had not changed after she filed her application. It
reasoned that, because she was not paying her equal share of the household
expenses, she continued to live in the household of another. This decision was
affirmed by an administrative law judge and the Appeals Council.
11
legal, but had little success until the promulgation of the Secretary's Ruppert
Acquiescence Ruling on July 16, 1990. Thereafter, Danielle was awarded
higher monthly benefits retroactive for the period from June 1986 through
December 1990. However, she did not obtain the full amount of her benefit
request. Because Danielle's $100 rent was less than the presumed maximum
value, the Appeals Council concluded that she had an "actual economic
benefit" each month and reduced her benefits accordingly. The presumed
maximum values during the relevant period were the following:
12 to December, 1986--$132.00 per month [$112 (one-third of the monthly benefit
June
rate of $336) plus $20]
13
January
to December, 1987--$133.33 per month [$113.33 (one-third of the monthly
benefit rate of $340) plus $20]
14
January
to December, 1988--$138.00 per month [$118 (one-third of the monthly
benefit rate of $354) plus $20]
15
January
to December, 1989--$142.66 per month [$122.66 (one-third of the monthly
benefit rate of $368) plus $20]
16
January
to November, 1990--$148.66 per month [$128.66 (one-third of the monthly
benefit rate of $386) plus $20]
17
Danielle sought review of the Appeals Council's decision, claiming that the
Secretary failed to apply the Ruppert standard properly. The district court
agreed, believing that it would " 'fly in the face of reality' to conclude that the
rent subsidy ... or even the presumed maximum value ... was actually available
to the plaintiff and thus a[n] economic benefit to her." The court ordered the
Secretary to recalculate Danielle's SSI benefits and to reimburse her for the
underpayments.
19
Arguing for affirmance, Danielle contends that under the Ruppert standard, she
cannot be said to have received an actual economic benefit from the rental
subsidy. She contends that in 1986 she received monthly SSI benefits of $241
from which she paid $100--or 41%--in rent, leaving her with only $141 per
month. She argues that this constitutes such a disproportionate share of income
going towards rent that the rental subsidy should be disregarded. She also
argues that since the amount of the subsidy--the rental value of the property,
$406, less the $100 she paid--exceeded the amount of SSI benefits she
received--$241--it "flies in the face of reality" to say that the amount of the
rental subsidy was "actually available" to her. The district court agreed with
Danielle; we do not.
20
In Ruppert, this Court remanded to the district court to "determine whether the
imputed income reflected any 'actual economic benefit.' " 871 F.2d at 1180-81.
As mentioned above, we did not articulate any particular method for
determining "actual economic benefit." However, we did specifically state that
"[t]he regulations used in the Seventh Circuit [i.e., 20 C.F.R. Sec. 416.1130(b) ]
might provide a good indication." Id. at 1181. In acquiescing in Ruppert, the
Secretary decided to apply those regulations. We cannot say that the Secretary
applied an incorrect legal standard. Although we did not require adoption of
those regulations as a matter of law, we did suggest that they were reasonable.
We now hold that they are acceptable.
21
Danielle focuses on the wrong details when she argues that a disproportionate
share of her income is allocated to shelter. The 41% figure she cites is based on
her post-reduction income, but examination of Jackson, upon which Ruppert is
based, shows that the relevant percentage of income is determined using figures
"before termination [or here, reduction] of SSI" benefits. Jackson, 683 F.2d at
1085 (emphasis in original). Here, the pre-reduction figure--based on the
maximum monthly benefit rate for the period in question--is only about 30%. It
is not at all clear that 30%--or even 41%--is disproportionate, especially since
at least $141 in benefits remained after rent payments. See Jackson, 683 F.2d at
1082 (post-reduction figure of 33% considered "not ... abnormally large"); id. at
1085 n. 16 (22% pre- and 38% post-reduction considered "relatively high ... but
not ... unmanageably large"); id. at 1083 (37% pre- and 66% post-reduction
considered "not ... necessarily unreasonable" where $70 per month remained
after rent payments). By comparison, the figures in Jackson were 77% before
termination, id. at 1085, and 106% after the termination of benefits, id. at 1081.
22
In the instant case, it does not "fl[y] in the face of reality to conclude that
unearned income in the form of subsidized shelter ... is actually available to"
plaintiff. Ruppert, 871 F.2d at 1180 (internal quotations omitted). The
Secretary is not attempting to impute the full amount of the rental subsidy or
even the presumed maximum value as income. Instead, the Secretary is
imputing an amount ranging between $12 and $28.66 per month, and reducing
her benefits by that amount. In other words, she received nearly the maximum
monthly benefits. Because we believe that Danielle received an "actual
economic benefit" from paying only $100 per month for shelter worth over four
times as much, we cannot say that the Secretary's conclusion was erroneous.
23
Danielle also complains that the Secretary failed to apply the rule of Hickman
v. Bowen, 803 F.2d 1377, 1381-82 (5th Cir.1986). The Hickman rule is that
"in-kind loans" of support and maintenance are not "income" for SSI purposes
under 20 C.F.R. Sec. 416.1103(f). That section provides as follows:
24
(f) Proceeds of a loan. Money you borrow or money you receive as repayment
of a loan is not income.... Buying on credit is treated as though you were
borrowing money and what you purchase this way is not income.
25
Since an in-kind loan basically is "buying on credit," the Hickman rule is not
unreasonable. Danielle is wrong, however, when she argues that we ordered the
Secretary to follow the Hickman rule in the Second Circuit. Although the
district court adopted the rule in Ruppert v. Secretary of U.S. Dept. of Health
and Human Services, 671 F.Supp. 151, 167-68 (E.D.N.Y.1987), the issue was
not before us on appeal, see 871 F.2d at 1178. We merely stated that by not
reaching the issue,
26 do not mean to invite the Secretary to appeal a similar ruling in a later case or to
we
seek to avoid as to individual claimants the precedential effect of [the district court's]
well reasoned opinion in the Eastern District or elsewhere in the Second Circuit.
27
Id.
28
In any event, we fail to see how the Secretary acted inconsistently with the
Hickman rule. Danielle argues that the Appeals Council erroneously counted
the in-kind loan of rent she received from her landlord-mother. Her argument is
based on her claim that, despite the written lease agreement between her and
her mother, there was no in-kind rental subsidy because her mother did not
intend the unpaid portion of Danielle's share to be a gift. Rather, there allegedly
was an implied agreement that the reasonable value of her necessities would be
871 F.2d at 1178 (citations omitted). However, this does not mean that
Danielle's mother is free to assert after the fact the existence of a loan. The
issue is whether a loan existed at the time the support was given, not whether
the mother wishes to consider the support a loan now. The Appeals Council did
not find the rental subsidy to be a loan, and there is no evidence that it was
intended as such at the time. Furthermore, the implied contract claim is barred
by the existence of the parties' express agreement on the matter. Radio Today,
Inc. v. Westwood One, Inc., 684 F.Supp. 68, 71-72 (S.D.N.Y.1988) (citing New
York case law).
31
Finally, plaintiff claims that the Ruppert Acquiescence Ruling had to have been
publicly promulgated pursuant to the Administrative Procedure Act (the
"APA") in order to be effective. This argument is frivolous. The general rule on
acquiescence rulings is that although they "do not have the force and effect of
law, they constitute Social Security Administration interpretations of its own
regulations and the statute which it administers. Accordingly, Social Security
rulings are entitled to deference except when they are plainly erroneous or
inconsistent with the [Social Security] Act." Walker v. Secretary of Health &
Human Services, 943 F.2d 1257, 1259-60 (10th Cir.1991) (citations omitted).
This Court, in White v. Shalala, 7 F.3d 296 (2d Cir.1993), dealt with the issue
of whether a ruling must be promulgated under the APA. In that case, we said:
32
33
33
34
The judgment of the district court is reversed and the case is remanded with
orders to reinstate the Secretary's determination.