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Dillow v. Berryhill

United States District Court, W.D. Kentucky, Louisville

February 26, 2018




         This 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.[1]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.

         Plaintiff 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 prejudice.[2]


         Plaintiff 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 42-45, 141-143).

         Gabrielle, 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, 54).

         Several 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, 38).

         Gabrielle 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.

         In 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 April 2014.

         Gabrielle 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 94-95).

         Gabrielle 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).

         An 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.

         By way 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).

         Gabrielle 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).

         Based 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 that

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).

         Put 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 Dillow. (Id.).

         The ALJ 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. ...

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