The Record of Judge Sonia Sotomayor on Critical Legal Rights for Women: Other Issues That Have an Impact Women's Rights: Public Benefits

As both a district and circuit judge, Judge Sotomayor reviewed cases dealing with public benefits, including challenges to denials of Social Security Disability benefits (SSDI) and Supplemental Security Income (SSI) benefits, as well as one case involving a challenge to a discontinuation of Medicaid and Medicare benefits under § 1983.  

In one case involving Medicaid and Medicare, Cohen v. Wilson-Coker,^[1] the plaintiff brought an action under §1983, claiming that the Connecticut Department of Social Services violated his federal statutory and Equal Protection rights by including the cash surrender value of his veteran’s National Service Life Insurance (NSLI) policy, worth approximately $4,700, as a resource to deny him continued participation in Medicaid and Medicare programs.  At issue was a statute that explicitly stated that insurance policies totaling more than $1,500 shall be taken into account.[2]  The district court granted summary judgment to the Department, and plaintiff appealed.  Judge Sotomayor sat on the panel of the Second Circuit that ruled, in a summary order, that the Department was not statutorily or constitutionally obligated to exempt veterans’ life insurance policies in calculating eligibility for these benefits and affirmed the district court’s order.[3]

The bulk of the cases involving public benefits heard by Judge Sotomayor involved her review of a denial of SSDI and/or SSI benefits by an Administrative Law Judge (ALJ).  At the district court level, this review entails assessing whether the ALJ has applied the appropriate legal standards and whether the ALJ’s findings of fact are supported by substantial evidence.  ALJ decisions are given substantial deference by a reviewing district court.[4]  On the Second Circuit, Judge Sotomayor participated in appeals of such district court reviews of denials of benefits.[5]  In these cases, the appellate court conducts a plenary review of the ALJ decisions, similarly considering whether those decisions were supported by substantial evidence and whether the correct legal standards were applied.

Judge Sotomayor’s district court opinions demonstrate that she was extremely careful to apply the correct standard of review, pay careful attention to the factual record and closely track relevant statutory and regulatory provisions, as well as Circuit precedent. This appears to be true whether she affirmed or vacated the ALJ’s decision.[6] For example, in Todd v. Chater,[7] Judge Sotomayor affirmed the ALJ’s denial of SSDI and SSI benefits after undertaking a careful and thorough review of a factual record that showed that the plaintiff had worked successfully for years with her physical ailment prior to applying for disability benefits.[8] In her opinion, Judge Sotomayor noted that the plaintiff had suffered her physical disability, an atrophied leg, since birth, but had been working as a secretary for many years. Judge Sotomayor also noted that the plaintiff engaged in physical activities while caring for her child which were far more strenuous than those required at her job. Looking to the legal standard and the application of that standard in her Circuit, Judge Sotomayor found that there was substantial evidence to support the ALJ’s determination that the plaintiff retained a capacity to perform certain types of sedentary work, and thus was not disabled as a matter of law. In this case, she spent several paragraphs detailing her limited role in reviewing determinations of an ALJ.

Similarly, in Jasmin v. Callahan,[9] a case in which the ALJ had found the claimant was not disabled and thus ineligible for SSDI benefits, Judge Sotomayor vacated the determination after a careful detailing of the facts of the case and a close examination of how the factual record was developed in the administrative proceedings below.  She noted in particular that the claimant was unable to respond to pre- and post hearing testimony submitted by his chiropractor, and that the claimant (who had limited English proficiency) offered incoherent and inconsistent responses to questions regarding his allegedly debilitating back condition. In support of her determination that the claimant did not receive a full and fair hearing below, Judge Sotomayor quoted extensively from the testimony at the administrative hearing, and explained her standard of review by explaining the relationship between the statutory regime and case law and extensively discussing Second Circuit precedent.[10] 

Both Supreme Court and Second Circuit precedent provide that ALJs have an affirmative duty to develop the factual record in disability cases even when a claimant is represented by counsel.[11] Second Circuit precedent demands a particularly scrupulous inquiry into the facts when a claimant is unrepresented.[12] Judge Sotomayor applied this standard in a number of cases in which the plaintiff was pro se, had language barriers, or both.[13]

Judge Sotomayor’s appellate cases also include a number of public benefits decisions. She sat on panels that undertook plenary review of ALJ denials of SSDI and/or SSI benefits.  Judge Sotomayor also sat on panels that reviewed decisions regarding disability compensation benefits under the Longshore and Harbor Workers’ Compensation Act.  In these cases, the appellate court reviews decisions of the Benefits Review Board (BRB), which itself reviews decisions of ALJs.  Appellate review of the BRB’s legal decisions is de novo, while review of the BRB decision with regard to factual findings considers whether the BRB adhered to its statutory standard of review.  The following are examples of such cases:

¤     Horowitz v. Barnhart[14] was a summary order in which the district court affirmed the ALJ’s determination that money available to a disabled claimant via a trust can be classified as a resource for the purpose of determining eligibility for SSI benefits. The claimant had been denied SSI benefits for a three-year period because she was found to have resources in excess of $2000. The district court found the ALJ had properly considered the claimant’s resources in determining her SSI eligibility for the period in question. On appeal, plaintiff argued, inter alia, that executive orders and Supreme Court precedent precluded the Social Security Commissioner from treating trust funds as “resources” because such action would “disobey state court orders holding funds in trust for a disabled person.”[15]  Plaintiff also appeared to argue that the district court’s decision violated Equal Protection principles.[16]  After discussing the applicable statutes and regulations, Judge Sotomayor’s panel held that the district court correctly relied on Second Circuit precedent in classifying the trust as a resource, rejected the argument that counting trusts as resources would violate state court orders, and found that the appellant’s Equal Protection claim was not supported by the case she cited.

¤     In Kolher v. Astrue,[17] Judge Sotomayor authored a unanimous panel opinion reversing the ALJ’s decision to deny a bipolar plaintiff’s claim for SSDI and SSI benefits.  In vacating and remanding the ALJ’s decision, Judge Sotomayor held that the ALJ erred by not following the five-step “special technique” analysis of evaluating the severity of a mental impairment set forth in regulations.[18]  Judge Sotomayor concluded that the ALJ had not properly applied the analysis outlined in the regulations and hence had not adequately developed the evidentiary record.  Judge Sotomayor concluded that in this case the error was not harmless. 

¤     In American Stevedoring Ltd. v. Marinelli,[19] the respondent had applied for and was granted permanent total disability compensation under the Longshore and Harbor Workers' Compensation Act (LHWCA).  The employer appealed, challenging the BRB’s decision (which affirmed an initial ALJ determination) that the respondent’s duties qualified as “maritime employment” for the purposes of the LHWCA, that an employer-employee relationship existed between the respondent and the employer for the purposes of the LCHWA, and that respondent was totally and permanently disabled.[20] Judge Sotomayor wrote the unanimous panel opinion undertaking a review of the BRB’s decision, and concluded that the determination in favor of the respondent was supported by substantial evidence.

Prior to her service as a judge, Judge Sotomayor served as a member of the board of PRLDEF, which litigated in the area of government benefits, focusing primarily on the right of applicants to obtain Spanish-language written materials and oral assistance. During the years in which Judge Sotomayor served on the board, PRLDEF served as counsel or amicus curiae in a few public benefits cases involving multilingual access to government benefits, including cases involving claims of discrimination on the basis of national origin based on the lack of Spanish-language materials for individuals seeking public benefits or an absence of interpreters and translators in public benefits administrative proceedings.[21] Again, PRLDEF’s litigation activities offer only limited insight into Judge Sotomayor’s legal views, but PRLDEF staff reported to the Board that the organization was involved in cases involving public benefits.[22] As a result, it is fair to say that Judge Sotomayor willingly served on the board of an organization that supported access to Spanish-language resources for Spanish-speaking applicants for public benefits.