United States District Court, W.D. Kentucky, Louisville
GABRIELLE S. DILLOW PLAINTIFF
NANCY A . BERRYHILL, ACTING COMMISSIONER SOCIAL SECURITY ADMINISTRATION DEFENDANT
WHALIN, MAGISTRATE JUDGE.
matter comes before the Magistrate Judge to consider the
motion for summary judgment of the Plaintiff, Gabrielle
Dillow in this social security action. Dillow requests that
the Court reverse the decision of the Commissioner of the
Social Security Administration (Commissioner) that requires
her to repay an overpayment of benefits she previously
received.On December 10, 2014 Administrative Law
Judge (ALJ) Mary Lassy issued a hearing decision which
determined that a “holding out” relationship
existed between Gabrielle and her male roommate, Andrew
Dillow, from December 2010 through April 2014 so that the
income of Andrew was properly deemed to be that of Gabrielle
for the purpose of determining her financial eligibility for
Supplemental Security Income (SSI) benefits. Because
Gabrielle's monthly income, when equated with that of
Andrew, exceeded the amount allowed for SSI beneficiaries
during this period, the Commissioner found that Gabrielle was
liable for the repayment of a $28, 542 in SSI benefits
overpaid her during the relevant 2010-2014 time frame.
Dillow now challenges the final decision of the Commissioner.
She argues first that the 2014 hearing decision of ALJ Lassy,
which was adopted by the Commissioner, applies the incorrect
legal standard to determine whether Gabrielle and Andrew
Dillow were holding themselves out as husband and wife.
Second, Plaintiff argues in the alternative that, even if the
ALJ did apply the correct legal standard, the hearing
decision nevertheless is not supported by substantial
evidence. The Commissioner has filed a Fact and Law Summary
(FLS) in which she argues that ample evidence confirms that
Gabrielle Dillow and Andrew Dillow held themselves out to be
husband and wife under the applicable federal regulations
found in 20 C.F.R. §§ 416.1801 through 416.1835.
(DN 15, FLS). Upon consideration, we are forced to agree and
therefore the decision of the Commissioner shall be affirmed
and the complaint shall be dismissed with
was born in 1964 with the legal name, Darnell Suzette
Spradlin. She began to receive SSI benefits in February 1991
(TR 29) as the result of severe PTSD caused by being
repeatedly raped and impregnated as a child by her biological
father. (TR 98). In March 1996, Plaintiff legally changed her
name first to “Darnell Suzette Dillow” and later
to “Gabrielle Suzette Dillow” taking the surname
of her roommate Andrew Dillow. (TR 26-27). In December 2012,
the Social Security Administration (SSA) discovered that
Gabrielle and Andrew Dillow were the joint owners of a
checking and savings account with money in excess of the
amount for Gabrielle to be eligible for SSI benefits. (TR
when questioned by the SSA, reported she had no idea that she
and Andrew were the joint owners of Andrew's bank account
adding that Andrew was her boyfriend. (TR 45). Andrew Dillow
in a letter to the SSA dated December 8, 2012 agreed that
Gabrielle had been his “on and off girlfriend for many
years.” Andrew explained that he had added Gabrielle to
his bank account several years earlier so that she could put
gas in his car when she ran errands for him. Andrew denied
that Gabrielle wrote checks on the account, adding that she
only used his credit card when they were together. When the
couple learned of the impact of the joint bank account on her
eligibility for SSI benefits, they removed her name from all
of Andrew's bank accounts so that Andrew was the sole
owner of the affected checking account. Consequently, the
SSA, which at that point had initially determined that
Gabrielle had been overpaid by $8, 328 in SSI benefits,
waived recovery of the $8, 328 overpayment after it
determined that Gabrielle was not at fault. (TR 45, 46-51,
years then passed. Later, in March 2014, the SSA discovered
that not only had Gabriel shared a joint bank account with
Andrew, but she had changed her last name to Dillow in 1996.
(TR 26-27, 58-68). The SSA also learned that Gabrielle and
Andrew jointly-owned a home and an automobile. (TR 133, 139).
Further, Andrew for the past several years had claimed
Gabrielle as his dependent on his federal income tax returns.
(TR 29, 33, 38). Gabrielle confirmed at the time that she
jointly owned a home in Irvington, Kentucky with Andrew and
that they had lived together in the home since April 2009.
(TR 133). Gabrielle also confirmed that she, along with
Andrew, jointly owned a 2012 Honda CRZ worth $12, 625. (TR
139). Finally, Gabrielle informed the SSA representatives
that she had legally changed her surname in 1996 to Dillow
because, if she had married Andrew, she would have lost her
SSI and Medicaid benefits. (TR 74). Tax records confirmed
that Andrew claimed “Darnell S. Dillow” as a
dependent tax exemption on his federal tax returns in
2010-2012 during which time he reported his total income to
be $36, 610, $59, 688 and $58, 273, respectively. (TR 29, 33,
and Andrew both completed an SSA marital relationship
questionnaire on March 31, 2014. (TR 69-70, 72-74). In their
responses they indicated that they introduced each other to
friends and family members as “girlfriend, ”
“boyfriend, ” or “fiancé.” (TR
69-70). Gabrielle denied that she and Andrew had a
“holding out” relationship by which they held
themselves out to be husband and wife. (TR 58-62) The SSA,
however, determined that the above-described evidence
contradicted Gabrielle's denial. (TR 73-79). Accordingly,
the SSA made a determination that in December 2012 Gabrielle
and Andrew had been holding themselves out to be in a spousal
relationship for the past two years so that Andrew's
income would be deemed to Gabrielle. (Id.). The
result was that the SSA determined that Gabrielle had been
financially ineligible for SSI benefits due to the fact that
her income as deemed since December 2010 had exceeded the
maximum amount allowed for SSI recipients.
April 2014, the SSA notified Gabrielle that her SSI benefits
would be ending effective May 2014 for the reasons explained
above. (TR 80-86) Also, the SSA advised Gabrielle that it
planned to reopen its prior December 2012 determination to
make a corrected determination that the holding out
relationship had existed since December 2010. (Id.)
The SSA notified Gabrielle at that time that she had been
overpaid $28, 542 in SSI benefits from December 2010 through
filed a request for reconsideration of these determinations
regarding the alleged overpayment and the cessation of her
SSI benefits. (TR 90-92). She additionally requested that her
SSI benefits continue to be paid pending the outcome of her
appeal. After the SSA reconsidered the evidence, it affirmed
its prior determination that Gabrielle and Andrew were
holding themselves out as husband and wife so that
Andrew's income would be deemed to be hers for the
purpose of calculating her eligibility for SSI benefits. (TR
then filed a request for a hearing by an administrative law
judge. (TR 101). By letter of May 7, 2014, the date of her
hearing request, Gabrielle explained that she and Andrew were
not romantically involved as Andrew was gay and she had no
interest in sexual relations due to her lengthy history of
childhood sexual abuse by her father and a former husband.
(TR 98). Andrew in separate letters of the same date
similarly advised that he was a homosexual and had merely
used his cohabitation with Gabrielle as a form of
“shield” to prevent the disclosure of his true
sexual orientation to his family members and coworkers. (TR
99). Andrew added that their arrangement also prevented
Gabrielle's abusive father and her other family members
from interfering with her. (Id.) Andrew explained
that he and Gabrielle did not sleep together. Finally, he
protested as being “mean and cruel” the efforts
of the SSA to recover the alleged overpayment of SSI benefits
and strongly denied that he considered himself to be, or that
he held himself out to be, married to Gabrielle. (TR 100).
administrative hearing was held on August 6, 2014. (TR
158-194). Gabrielle testified that she previously co-owned
the banking account with Andrew and that her monthly SSI
payments were directly deposited and used by Andrew to pay
the $600 monthly mortgage on their home. (TR 173). Gabrielle
testified that she had removed her name from the joint
account, and that the couple had sold their jointly owned
home in Irvington, in an effort to address the concerns of
the SSA. She also had attempted to remove her name from the
automobile loan, but the lending bank had refused her request
to do so.
of explanation, Gabrielle testified that she and Andrew had
jointly purchased the Irvington home and the Honda automobile
because her credit rating enabled them to obtain the
necessary loans, while Andrew had the current income to
satisfy the loan payments, if not the credit rating to obtain
the loans themselves. (TR 170, 172-73, 174-75).
further testified that she changed her last name to Dillow in
1996 because she did not want to keep the last name of her
ex-husband nor that of her biological father, both of whom
had sexually abused her. (TR 159, 168-170). Consequently, she
chose the name of her best friend and roommate Andrew Dillow
to help her hide from her former abusers. (Id.).
Gabrielle denied that she and Andrew had ever introduced one
another to anyone as husband and wife, rather she referred to
Andrew as either her friend or her boyfriend. (TR 176-77).
According to Gabrielle, she and Andrew had never had a sexual
relationship and, in fact, Andrew had an out-of-town
boyfriend that he occasionally visited. (TR 177-79).
on the above findings contained in the hearing decision (TR
15-25), ALJ Lassy ultimately found that Gabrielle and Andrew
indeed were in a “holding out” marital
relationship from December 2010 through April 2014. (TR 24).
While the ALJ was “not unsympathetic to the
non-financial reasons that Gabrielle and Andrew [had] . . .
chosen to live together, ” ALJ Lassy nevertheless found
the financial details of this relationship, specifically the
joint-ownership of a home, automobile, and bank account
during the period of overpayment, demonstrate the very
essence of why the income of one individual in a marital or
‘holding out' relationship is deemed as income of
the other individual when the SSA determines an
individual's financial eligibility for SSI benefits.
(DN 9, Administrative Record (TR) 23).
differently, ALJ Lassy explained that “basically, the
income of both individuals, in this case, Gabrielle's SSI
benefits and Andrew's earnings, are being used in
combination for the benefit of Gabrielle and Andrew as a
‘couple.'” (Id.). The ALJ continued
to find that the fact that the couple had removed
Gabrielle's name from the bank account and the mortgage
did not change the fact that they had been living together
and presenting themselves as a couple to the community since
at least 1996 when Gabrielle had legally changed her name to
found it significant in that respect that Gabrielle in her
communications with SSA representatives in early 2014
admitted that she would have legally married Andrew in 1996,
but that such a marriage would have caused her to lose her
SSI and Medicaid benefits, which is why she chose to legally
change her surname to Andrew's surname. (Id.).
Citing 20 CFR 416.1806, ALJ Lassy specifically found that:
1. A holding out relationship did exist between the claimant,
Gabrielle Dillow, and her male friend and roommate, Andrew
Dillow, during the period of December 2010 through April
2014. (20 CFR 416.1806).
2. The income of Andrew Dillow is deemed to the claimant,
Gabrielle Dillow, for the purposes of determining financial
eligibility of Title XVI Supplemental Security Income.
Therefore, the claimant's monthly income exceeded the
amount allowed for SSI beneficiaries during the period of
December 2010 through April 2014.
3. The claimant was overpaid benefits in the amount of $28,
542.00 during the period December 2010 through April 2014.
(20 CFR 416.537(a)).
4. The claimant is liable for repayment of $28, 542during the
period December 2010 through April 2014. Gabrielle sought
review of the hearing decision by the Appeals Council. ...