# AR 92-1(3): AR 92-1(3): Mazza v. Secretary of Health and Human Services , 903 F.2d 953 (3d Cir. 1990) -- Order of Effectuation in Concurrent Application Cases -- (Title II/Title XVI)

> Federal · Rulings · In force

URL: https://www.frixlaw.com/law-library/statutes/SSA_SSR_AR_AR_92_1_3

## Section

- **Citation:** AR 92-1(3)
- **Heading:** AR 92-1(3): Mazza v. Secretary of Health and Human Services , 903 F.2d 953 (3d Cir. 1990) -- Order of Effectuation in Concurrent Application Cases -- (Title II/Title XVI)
- **Jurisdiction:** Federal
- **Kind:** Rulings
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Social Security Rulings / AR / Third Circuit Court / AR 92-1(3)

## Text

AR 92-1(3)

EFFECTIVE/PUBLICATION DATE: 01/10/92

ACQUIESCENCE RULING 92-1(3)

ISSUE:

Whether the Secretary's processing of concurrently filed claims for Title
II benefits and Supplemental Security Income (SSI) payments under Title
XVI which resulted in the Title II benefits being calculated first and the
potential Title XVI payments being offset was permissible under section
1127 of the Social Security Act. Section 1127 (the windfall statute)
provides that when a person is entitled to both SSI and retroactive Social
Security benefits for one or more months, either the SSI or the
retroactive Social Security benefits will be reduced by the amount of SSI
payments that would not have been paid if the retroactive Social Security
benefits had been paid in the months in which they were regularly due.

STATUTE/REGULATION/RULING CITATION:

Section 1127 of the Social Security Act (42 U.S.C. 1320a-6), 20 CFR
404.408b, 416.1100, 416.1123(d).

CIRCUIT:

Third (Delaware, New Jersey, Pennsylvania, and the Virgin Islands)

Mazza v. Secretary of Health and Human Services , 903 F.2d 953 (3d
Cir. 1990)

APPLICABILITY OF RULING:

This Ruling applies to determinations or decisions at all administrative
levels (i.e., initial, reconsideration, Administrative Law Judge hearing
and Appeals Council Review).

DESCRIPTION OF CASE:

In June 1984, Mr. Mazza filed concurrent applications for disability
insurance benefits (Title II benefits) and SSI payments. In February 1985,
Mr. Mazza began receiving a veterans pension which caused his income to
exceed the limits for SSI eligibility. Accordingly, Mr. Mazza's claim for
SSI payments covered the period between June 1984 and February 1985. In a
letter dated June 5, 1985, he was notified that he met the medical
requirements for Title II benefits. Shortly thereafter, Mr. Mazza's
eligibility for Title II benefits and SSI payments was determined
terans pension which caused his income to
exceed the limits for SSI eligibility. Accordingly, Mr. Mazza's claim for
SSI payments covered the period between June 1984 and February 1985. In a
letter dated June 5, 1985, he was notified that he met the medical
requirements for Title II benefits. Shortly thereafter, Mr. Mazza's
eligibility for Title II benefits and SSI payments was determined. The
Social Security Administration (SSA) calculated Title II benefits first
and applied an offset against potential SSI payments pursuant to the
windfall statute since SSI would not have been paid if the Title II
benefits had been paid when due. Thus, Mr. Mazza was precluded from
establishing SSI eligibility.

On July 15, 1985, SSA informed Mr. Mazza that his application for SSI was
denied because of his income, including Title II benefits for the period
beginning June 1984. SSA notified him on August 6, 1985, that he would
receive a check for Title II benefits covering the months from June 1984
to July 1985.

Mr. Mazza requested reconsideration of his SSI denial. On September 20,
1985, SSA affirmed the initial determination because of his receipt of
retroactive Title II benefits covering the period beginning June 1984. Mr.
Mazza appealed this determination. At his hearing, he pointed out that
SSA's denial of SSI payments also resulted in a denial of Medicaid
coverage for medical expenses incurred during his initial illness. The
Administrative Law Judge found that the retroactive Title II benefits
raised by Mr. Mazza's income above the SSI eligibility ceiling for the
months in question.

Because of a transcription difficulty, Mr. Mazza received a second
hearing before a different Administrative Law Judge. His SSI claim was
denied at both the Administrative Law Judge and Appeals Council levels.
Mr. Mazza appealed to the district court. The district court granted
summary judgment in favor of the Secretary.
come above the SSI eligibility ceiling for the
months in question.

Because of a transcription difficulty, Mr. Mazza received a second
hearing before a different Administrative Law Judge. His SSI claim was
denied at both the Administrative Law Judge and Appeals Council levels.
Mr. Mazza appealed to the district court. The district court granted
summary judgment in favor of the Secretary.

Mr. Mazza then appealed to the United States Court of Appeals for the
Third Circuit. He conceded that he was not entitled to duplicative
payments for the June 1984 to February 1985 period at issue. He also
disclaimed any attempt to evade the windfall statute or to collect any
additional sums. He contended that the Secretary should have first
calculated the SSI payments and then deducted them from the Title II
payments. Had this procedure been followed, he would have received the
Medicaid assistance that had been denied him.

HOLDING:

The United States Court of Appeals for the Third Circuit analyzed the
history of the windfall statute, its amendment in 1984, and the
Secretary's position in litigation concerning the 1980 statute. The court
then stated:

Because the court found that SSA's process was "not in accordance with
statutory intent," the court reversed the district court and directed the
district court to remand the case to SSA with directions that Mr. Mazza be
found eligible for SSI, thereby protecting his eligibility for
Medicaid.

STATEMENT AS TO HOW MAZZA DIFFERS FROM SSA POLICY

SSA has interpreted the 1984 amendments to the windfall statute to allow
the offset of either SSI or Title II retroactive benefits to prevent a
windfall payment. Specifically, the offset is applied to whichever benefit
is paid second. The Third Circuit found this procedure to be arbitrary and
held that in cases involving concurrent claims, SSI should be effectuated
first.

EXPLANATION OF HOW SSA WILL APPLY THIS DECISION WITHIN THE
CIRCUIT
l statute to allow
the offset of either SSI or Title II retroactive benefits to prevent a
windfall payment. Specifically, the offset is applied to whichever benefit
is paid second. The Third Circuit found this procedure to be arbitrary and
held that in cases involving concurrent claims, SSI should be effectuated
first.

EXPLANATION OF HOW SSA WILL APPLY THIS DECISION WITHIN THE
CIRCUIT

This Ruling applies only to concurrent cases involving claimants who
reside in Delaware, New Jersey, Pennsylvania, or the Virgin Islands at the
time of the determination or decision at any administrative level, i.e.,
initial, reconsideration, Administrative Law Judge hearing or Appeals
Council review. When an adjudicator has determined that an individual is
eligible for a retroactive period based on concurrent applications, the
SSI determination or decision shall be effectuated first. The individual's
Title II benefits shall be offset by the amount of SSI payments due or
paid for the retroactive period.

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- [AR 92-1(3) AR 92-1(3): Mazza v. Secretary of Health and Human Services , 903 F.2d 953 (3d Cir. 1990) -- Order of Effectuation in Concurrent Application Cases -- (Title II/Title XVI).](https://www.frixlaw.com/law-library/statutes/SSA_SSR_AR_AR_92_1_3.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/SSA_SSR_AR_AR_92_1_3. Check the current official text before relying on it. Not legal advice.