ROMINGER LEGAL
Fifth Circuit Court of Appeals Opinions - 5th Circuit
Need Legal Help?
LEGAL RESEARCH CENTER
LEGAL HEADLINES - CASE LAW - LEGAL FORMS
NOT FINDING WHAT YOU NEED? -CLICK HERE
This opinion or court case is from the Fifth Circuit Court or Appeals. Search our site for more cases - CLICK HERE

LEGAL RESEARCH
COURT REPORTERS
PRIVATE INVESTIGATORS
PROCESS SERVERS
DOCUMENT RETRIEVERS
EXPERT WITNESSES

 

Find a Private Investigator

Find an Expert Witness

Find a Process Server

Case Law - save on Lexis / WestLaw.

 
Web Rominger Legal

Legal News - Legal Headlines

 

United States Court of Appeals,
Fifth Circuit.
No. 91­7355.
Gloria HARDEN, Plaintiff­Appellant,
v.
UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES,
Defendant­Appellee.
Dec. 22, 1992.
Appeal from the United States District Court for the Northern District of Texas.
Before REYNALDO G. GARZA and GARWOOD, Circuit Judges, and WERLEIN,** District Judge.
REYNALDO G. GARZA, Circuit Jue:
Appellant appeals the method used by the Secretary of the Department of Health and Human
Services in calculating her Social Security Administration's ("SSA") disability benefits. Upon review
we conclude the calculation was reasonable and we therefore affirm.
FACTS
Gloria Harden injured her back on September 29, 1983 while working for Levi Strauss & Co.
in San Antonio, Texas. She applied for Social Security benefits on April 30, 1984. The appellant also
applied for and received state workers' compensation of $189 a week from October 3, 1983 through
July 8, 1984 for a total of 40 weeks. Harden settled her workers' compensation claim for a lump sum
of $20,000 on July 8, 1984. Appellant's request for disability benefits was originally denied but the
district court reversed the SSA's rejection and ordered payment of benefits.
The Social Security Administration offset the amount of Harden's disability benefits by part
of the workers' compensation lump sum settlement. 42 U.S.C. § 424a(a)(2) provides that the
combined amount of workers' compensation and disability benefits cannot exceed 80% of the
recipient's average earnings.1
*District Judge of the Southern District of Texas, sitting by designation.
1If a disability recipient is receiving state workers' compensation benefits, the Secretary must
reduce the amount of disability benefits so as not to exceed 80% of pre-injury earnings. 42

The SSA took the amount received per week by Harden, $189, and divided it into the
$20,000, giving her 105 weeks of reduction. They excluded Harden's legal fees from the reduction.
The fees, $5006.84, were allocated over 105 weeks is $47.62, therefore $141.68, ($189 minus
$47.62), was deducted from her benefits every week for a total of 105 weeks.
Harden appealed this calculation, arguing that the lump sum should have been prorated over
the remaining 361 weeks allowed by Texas law for permanent disability benefits. The Administrative
Law Judge ["ALJ"] affirmed the SSA's calculation. The Appeals Council declined to review Harden's
case, thus making the ALJ's decision the Secretary's final determination. The district court granted
the Secretary's motion for summary judgment.
ANALYSIS
The legislative intent of disability reduction is to prevent the receipt of duplicative benefits
resulting in greater than pre-injury earnings. Richardson v. Belcher, 404 U.S. 78, 82­83, 92 S.Ct.
254, 258, 30 L.Ed.2d 231 (1971). Congress instituted the offset because in a majority of states the
combined benefits surpassed pre-injury earnings. "This was thought to cause two evils: first, it
reduced a worker's incentive to return to the workplace and hence impeded rehabilitative efforts; and
second, it created fears that the duplication of benefits would lead to an erosion of state workers'
compensation programs." Freeman v. Harris, 625 F.2d 1303, 1306 (5th Cir.1980) (citing Hearings
on H.R. 6675 Before the Senate Comm. on Finance, 89th Cong., 1st Sess. 151, 252, 259, 366, 540,
U.S.C. § 424a(a) states benefits must be reduced:
by the amount by which the sum of--
(3) such total of benefits under [the provisions for disability and old-age and
survivor benefits] for such month, and
(4) such periodic benefits payable (and actually paid) for such month to such
individual under such [workers' compensation] laws or plans exceeds the higher
of--
(5) 80 percentum of his "average current earnings", or
(6) the total of such individual's disability insurance benefits under [the provision
for disability benefits] for such month and any monthly insurance benefits under
[the provision for old-age and survivor benefits] for such month based on his
wages and self-employment income, prior to reduction under this section. Id.

738­40, 892­97, 949, 990 (1965)). U.S.C. § 424a(b) states that if a benefit is paid in a lump sum
and the Secretary deems that it is a commutation of, or a substitute for, periodic payments, then he
shall prorate it to approximate the reduction prescribed by § 424a(a)(2). Statute § 424a(b) reads:
If any periodic benefit for a total or part ial disability under a law or plan described in
subsection (a)(2) of this section is payable on other than a monthly basis (excluding a benefit
payable as a lump sum except to the extent that it is a commutation of, or a substitute for,
periodic payments), the reduction under this section shall be made at such time or times and
in such amounts as the Secretary finds will approximate as nearly as practicable the reduction
prescribed by subsection (a) of this section. Id.
The Secretary interpreted the lump sum payment made pursuant to a compromise and release
settlement a "lump-sum as a commutation of or a substitute for periodic benefits...." 20 C.F.R. §
404.408(g) (1991). The Secretary's Program Operation Manual (POMS) establishes the Secretary's
method for proration of lump-sum awards. POMS provides that:
The priority for establishing weekly rates is as follows:
1. The rat e specified in the lump sum award. If the award specifies a rate based on life
expectancy list the case under code 557.
2. The periodic rate paid prior to the lump sum (if no rate is specified in the lump-sum award).
3. If WC [workers' compensation], the State's WC maximum in effect in the year of injury.
This figure can be used if no rate is specified in the award if there was no preceding periodic
benefit. It can also be used pending postadjudicative development of the rates specified in 1
or 2. above.
POMS, DI 11501.235C.
The Secretary correctly chose option 2 since the settlement failed to name a rate for option
1 to apply. The previous monthly rate of $189 selected by the Secretary was reasonable. The
Secretary has clearly fulfilled Congress's intent in limiting combined benefits to 80% of pre-injury
earnings. The statute is silent as to which rate the Secretary must employ when it has not been
specified in the compromise. This gap is left to the discretion of the agency to fill via Congresses'
express delegation of authority expressed in § 424a. The "court may not substitute its own
construction of a statutory provision for a reasonable interpretation made by the administrator of an
agency." Chevron U.S.A. v. Natural Res. Def. Council, 467 U.S. 837, 844, 104 S.Ct. 2778, 2782,
81 L.Ed.2d 694 (1984). We may only review whether the Secretary applied proper legal standards
and conducted the proceedings in accord with statutes and regulations. Carter v. Heckler, 712 F.2d

137, 140 (5th Cir.1983). This court finds that the Secretary has done both.
CONCLUSION
For the reasons given above the summary judgment is AFFIRMED.


Ask a Lawyer

 

 

FREE CASE REVIEW BY A LOCAL LAWYER!
|
|
\/

Personal Injury Law
Accidents
Dog Bite
Legal Malpractice
Medical Malpractice
Other Professional Malpractice
Libel & Slander
Product Liability
Slip & Fall
Torts
Workplace Injury
Wrongful Death
Auto Accidents
Motorcycle Accidents
Bankruptcy
Chapter 7
Chapter 11
Business/Corporate Law
Business Formation
Business Planning
Franchising
Tax Planning
Traffic/Transportation Law
Moving Violations
Routine Infractions
Lemon Law
Manufacturer Defects
Securities Law
Securities Litigation
Shareholder Disputes
Insider Trading
Foreign Investment
Wills & Estates

Wills

Trusts
Estate Planning
Family Law
Adoption
Child Abuse
Child Custody
Child Support
Divorce - Contested
Divorce - Uncontested
Juvenile Criminal Law
Premarital Agreements
Spousal Support
Labor/Employment Law
Wrongful Termination
Sexual Harassment
Age Discrimination
Workers Compensation
Real Estate/Property Law
Condemnation / Eminent Domain
Broker Litigation
Title Litigation
Landlord/Tenant
Buying/Selling/Leasing
Foreclosures
Residential Real Estate Litigation
Commercial Real Estate Litigation
Construction Litigation
Banking/Finance Law
Debtor/Creditor
Consumer Protection
Venture Capital
Constitutional Law
Discrimination
Police Misconduct
Sexual Harassment
Privacy Rights
Criminal Law
DUI / DWI / DOI
Assault & Battery
White Collar Crimes
Sex Crimes
Homocide Defense
Civil Law
Insurance Bad Faith
Civil Rights
Contracts
Estate Planning, Wills & Trusts
Litigation/Trials
Social Security
Worker's Compensation
Probate, Will & Trusts
Intellectual Property
Patents
Trademarks
Copyrights
Tax Law
IRS Disputes
Filing/Compliance
Tax Planning
Tax Power of Attorney
Health Care Law
Disability
Elder Law
Government/Specialty Law
Immigration
Education
Trade Law
Agricultural/Environmental
IRS Issues

 


Google
Search Rominger Legal


 


LEGAL HELP FORUM - Potential Client ? Post your question.
LEGAL HELP FORUM - Attorney? Answer Questions, Maybe get hired!

NOW - CASE LAW - All 50 States - Federal Courts - Try it for FREE


 


Get Legal News
Enter your Email


Preview

We now have full text legal news
drawn from all the major sources!!

ADD A SEARCH ENGINE TO YOUR PAGE!!!

TELL A FRIEND ABOUT ROMINGER LEGAL

Ask Your Legal Question Now.

Pennsylvania Lawyer Help Board

Find An Attorney

TERMS OF USE - DISCLAIMER - LINKING POLICIES

Created and Developed by
Rominger Legal
Copyright 1997 - 2010.

A Division of
ROMINGER, INC.