United States District Court, W.D. Missouri, Western Division
ALLAN W. DALTON, Plaintiff,
NANCY BERRYHILL, ACTING COMMISSIONER OF THE SOCIAL SECURITY ADMININSTRATION, Defendant.
T. Maughmer United States Magistrate Judge
Dalton (“Dalton”) was previously awarded benefits
by the Social Security Administration (“SSA”) in
2000 and thereafter received benefit payments. However, in
2013, Dalton entered a plea agreement in a criminal case,
United States v. Dalton, Case No. 13-00311-CR-W-FJG
(W.D. Mo.), agreeing to plead guilty to Theft of Government
Money and therein admitting that he was engaged in
substantial gainful employment from June 2004 to June 2011
(and, thus, was not eligible to receive Social Security
benefits). On May 8, 2014, the Court accepted Dalton's
plead and adjudged him guilty.
weeks later, on May 28, 2014, Dalton filed a new application
with SSA for disability insurance benefits under Title II of
the Social Security Act, 42 U.S.C. §§ 401, et
seq. In his new application, Dalton alleged a disability
onset date of April 1, 2010. Dalton's eligibility for
Title II expired on June 30, 2010. As a consequence, to
obtain an award of Title II benefits, Dalton had to establish
that he was “disabled” (i.e, , incapable
of substantial gainful employment) during a very narrow
“eligibility window” -- between the date he
alleged his disability began (April 1, 2010) and the date his
eligibility for Title II benefits expired (June 30, 2010).
This entire time period was covered by Dalton's admission
that he was substantially gainfully employed between 2004 to
June 2011. On July 13, 2015, an administrative law
judge with SSA (“the ALJ”) dismissed
Dalton's claim for Title II benefits under the doctrine
of res judicata. The ALJ reasoned:
The record reflects that [Dalton's] date last insured had
already passed by June 2011 when he no longer admitted to
working at substantial gainful employment levels. Since
[Dalton's] actual date last insured was well before the
period covered by the claimant's plea agreement, the
matter of whether [Dalton] would be entitled to a period of
disability and disability insurance benefits has already been
Dalton now appeals to this Court the ALJ's dismissal of
his claim for Title II benefits.
an agency of the federal government, is immune from suit
unless it waives its sovereign immunity and consents to be
sued. To that end, Congress may prescribe the procedures and
conditions under which judicial review of administrative
orders may be obtained. Tacoma v. Taxpayers of
Tacoma, 357 U.S. 320, 336, 78 S.Ct. 1209, 1218 (1958).
With respect to judicial review of Social Security
administrative decisions, the exclusive
jurisdictional basis for such judicial review is provided for
and limited by 42 U.S.C. § 405(g), (h).
Any individual, after any final decision of the
Commissioner of Social Security made after a hearing to which
he was a party, irrespective of the amount in controversy,
may obtain a review of such decision by a civil action
commenced within sixty days after the mailing to him of
notice of such decision or within such further time as the
Commissioner of Social Security may allow. . . . No
findings of fact or decision of the Commissioner of Social
Security shall be reviewed by any person, tribunal, or
governmental agency except as herein provided.
42 U.S.C.A. § 405(g), (h) (emphasis added).
regard to the requirement of a “final decision, ”
federal courts have concluded that a dismissal based on
res judicata is not subject to judicial
review under Section 405. See, e.g., Califano v.
Sanders, 430 U.S. 99, 103, 97 S.Ct. 980, 983 (1977);
Rumsey v. Barnhart, 50 Fed.Appx. 789, 790 (8th Cir.
2002); Douglas v. Barnhart, 35 Fed.Appx. 295 (8th
Cir. 2002) (“42 U.S.C. § 405(g) does not allow
judicial review of decisions to dismiss claims based on
res judicata.”). The Eighth Circuit has
recognized only two exceptions to the non-reviewability of
res judicata dismissals - (1) when SSA reopens an
earlier determination as a matter of administrative
discretion, or (2) when an aggrieved party presents a
colorable constitutional claim. Id. Dalton does not
advance either argument.
Dalton argues that the elements for res judicata are
not present. Assuming without deciding that such an argument
is even a proper consideration for this Court, Dalton is
wrong. Application of administrative res judicata,
for purposes of Social Security, requires:
(1) a previous determination or decision was made about the
Social Security claimant's rights on the same facts and
on the same issue or issues as are presented in the pending
application for benefits, and
(2) the previous determination or decision has become final
by either administrative or judicial action.
20 C.F.R. § 404.957(c)(1).
argues that the “previous determination” in this
instance was not made by SSA and, as a result, there can be
no res judicata. Indeed, the typical application of
administrative res judicata involves a prior denial
of benefits by SSA followed by a claimant's request that
the prior denial be reopened as part of a new benefits
application. That did not occur in this case. Instead, the
“previous determination” relied upon by SSA was
Dalton's own admission contained in his plea agreement in
a case wherein ...