Immediate Awards of SSI Benefits After Agency Confession of Error:
Commentary on Hicks v. Commissioner of Social Security (6th Cir. Dec. 19, 2025)
Note: The opinion commented on here is designated “NOT RECOMMENDED FOR PUBLICATION,” meaning it is nonprecedential within the Sixth Circuit, though it may still be cited for its persuasive reasoning.
I. Introduction
This case is the latest chapter in a long-running saga involving the Social Security Administration’s (SSA) redetermination of disability benefits awarded in cases tainted by the notorious Eric Conn–ALJ David Daugherty fraud scheme. The appellant, Amy Jo Hicks, originally won Supplemental Security Income (SSI) benefits in 2008, only to have those benefits later redetermined and denied when the SSA revisited Conn-related cases under its statutory obligation to respond to suspected fraud.
After this court previously held in Hicks v. Commissioner of Social Security, 909 F.3d 786 (6th Cir. 2018) (“Hicks I”), that the SSA violated Hicks’s due process rights in its first redetermination process, the agency conducted a second redetermination and again found her not disabled. Hicks challenged that decision, raising a battery of statutory, regulatory, and constitutional arguments.
By the time her case reached the Sixth Circuit on this second appeal, however, the SSA filed an appellate brief confessing error: it conceded that the ALJ’s adverse disability finding was not supported by substantial evidence and that Hicks is entitled to SSI benefits based on her severe emphysema. The parties thus agreed on one critical point—Hicks is disabled and qualifies for benefits—but sharply disagreed on whether the court should nonetheless reach Hicks’s additional challenges (particularly statutory arguments that might help other Conn-affected claimants), or instead confine itself to the narrow ground of emphysema and immediately order an award of benefits.
The Sixth Circuit chose the latter path. It:
- Held that the ALJ’s finding that Hicks’s emphysema was “non-severe” was not supported by substantial evidence.
- Invoked its authority under sentence four of 42 U.S.C. § 405(g) to reverse and remand with an order to award benefits, rather than remanding for further administrative proceedings.
- Declined to address Hicks’s remaining statutory and procedural arguments, emphasizing judicial restraint and the duty to decide only questions necessary to the resolution of the case.
This commentary examines the factual background, the court’s holding, its reliance on key precedents, its treatment of the government’s confession of error, and the implications of this decision for Social Security law and for other victims of the Conn-Daugherty fraud scheme.
II. Factual and Procedural Background
A. Hicks’s Personal and Medical Background
The opinion recounts a stark personal history. Hicks endured severe childhood trauma: frequent and violent abuse by her mentally ill, substance-abusing father, psychiatric hospitalization during adolescence, and a suicide attempt at age 14. She left school during the ninth grade.
As an adult, she experienced further abuse from romantic partners, continued psychological trauma (nightmares, flashbacks), and longstanding substance abuse issues. Her work history is limited; a brief attempt at waiting tables failed because she “couldn’t catch on” during training.
In 2007, she suffered a car accident resulting in a fractured elbow. During that hospitalization, testing revealed severe emphysema—a finding that would later become the linchpin of her legal entitlement to SSI benefits. This emphysema diagnosis is central to the Sixth Circuit’s eventual holding.
B. Original SSI Award and the Conn–Daugherty Fraud Scheme
In 2007, Hicks applied for SSI, which under 42 U.S.C. § 1382c(a)(3)(B) provides benefits to individuals whose physical or mental impairments are so severe that, considering age, education, and work experience, they cannot engage in substantial gainful work.
In July 2008, ALJ David Daugherty awarded her benefits. But Hicks’s attorney was Eric Conn, a central figure in a widespread Social Security fraud scheme. Conn:
- Pre-filled SSA forms with fabricated or manipulated information designed to meet disability criteria.
- Had cooperative doctors sign those forms with little or no independent evaluation.
- Bribed ALJ Daugherty to take Conn’s cases and issue favorable disability decisions.
Public scrutiny mounted after a 2011 Wall Street Journal article and a Senate investigation revealed suspicious patterns in Conn’s cases and Daugherty’s rulings. By July 2014, the SSA had identified over 1,700 beneficiaries whose awards may have been tainted by Conn’s fraudulent practices. Conn began destroying records, including medical records for active clients such as Hicks.
C. SSA’s Redetermination Obligations and the First Redetermination
Under 42 U.S.C. § 405(u)(1)(A), whenever there is reason to believe that fraud or similar fault was involved in an application for benefits, the SSA must “immediately redetermine” entitlement. Despite knowing by 2014 that Hicks’s claim was Conn-related, the SSA did not notify her until 2015 that:
- Her initial award was vacated as fraud-tainted.
- She was subject to redetermination proceedings.
In March 2016, an ALJ conducted a redetermination hearing and denied Hicks’s claim, effectively concluding that she had not been disabled during the relevant period and had been erroneously paid SSI for years.
Hicks sought review in federal district court and prevailed. See Hicks v. Colvin, 214 F. Supp. 3d 627 (E.D. Ky. 2016). The Commissioner appealed, and the Sixth Circuit affirmed in Hicks I, holding that her due process rights were violated by:
- The SSA’s refusal to allow her to rebut the Office of Inspector General’s (OIG) blanket assertion that certain medical reports associated with Conn were fraudulent or unreliable.
- The agency’s failure to give her a meaningful opportunity to contest the OIG’s evidence and to have her own evidence fairly considered.
Hicks I thus established important procedural protections for Conn-affected claimants in the redetermination process.
D. The Second Redetermination, Overpayment Waiver, and New SSI Award
Following Hicks I, the SSA held a second redetermination hearing in May 2023. Once again, the ALJ concluded that Hicks was not disabled during the relevant period. This determination implied that she had no legal entitlement to the SSI benefits she had been receiving since 2008.
The SSA, however, chose not to claw back any allegedly overpaid benefits and formally waived the overpayment, representing that it would not reopen that waiver. That waiver did not, however, concede that she had in fact been disabled; it merely forgave repayment.
Hicks appealed the second redetermination decision to the district court, seeking a judicial determination that she was entitled to disability benefits. The district court affirmed the ALJ’s denial under sentence four of § 405(g).
While that appeal was pending, Hicks filed a new SSI application in August 2023. The SSA granted this new application, and she began receiving SSI benefits from September 2023 forward. Coupled with the overpayment waiver through July 2023, the result was that:
- Hicks had been paid (and would not have to repay) benefits through July 2023.
- She was receiving benefits prospectively from September 2023 onward.
- The only month for which she had not been paid SSI was August 2023, worth a little over $600.
Nonetheless, Hicks continued to seek a formal determination that she was disabled (and entitled to SSI) during the disputed period, including August 2023.
E. Appeal to the Sixth Circuit and the SSA’s Confession of Error
After the district court affirmed the ALJ, Hicks appealed to the Sixth Circuit. In her opening brief, she raised the following principal arguments:
- The ALJ’s decision was not supported by substantial evidence because he failed to properly evaluate record evidence of her emphysema, borderline intellectual functioning, and mental-health impairments.
- The ALJ applied the wrong legal standard when assessing her intellectual limitations.
- The SSA violated her due process rights by:
- Refusing to apply a rebuttable presumption that current disability establishes prior disability, and
- Refusing to appoint a medical expert.
- The failure to apply this rebuttable presumption also violated the Social Security Act and the Administrative Procedure Act.
- The ALJ was unconstitutionally insulated by double “for-cause” removal protections (a structural separation-of-powers challenge).
The SSA did not contest any of these arguments point by point. Instead, it:
- Confessed error as to the ALJ’s evaluation of Hicks’s emphysema, conceding that the ALJ’s non-disability finding was not supported by substantial evidence.
- Agreed that Hicks is entitled to SSI benefits based on her emphysema alone.
- Requested that the Sixth Circuit enter judgment under sentence four of § 405(g) awarding her the unpaid benefits, without reaching the other issues.
Previously, the SSA had moved for entry of judgment in Hicks’s favor and asked to hold briefing in abeyance; Hicks opposed that motion. The court denied the request to pause briefing, allowing a full merits presentation. Ultimately, however, the confession of error in the Commissioner’s brief reshaped the case.
Hicks conceded that the court need not reach her constitutional arguments, but she strongly urged the panel to resolve her statutory and procedural challenges in order to set guiding precedent for other Conn-related claimants. She argued that deciding only on emphysema would allow the SSA to persist in allegedly unlawful redetermination practices affecting others.
III. Summary of the Sixth Circuit’s Decision
The Sixth Circuit, per Judge John K. Bush, reversed the district court and remanded with instructions to award Hicks SSI benefits for the “relevant time period,” rendering the SSA’s earlier motion for entry of judgment moot. The key points are:
- Substantial Evidence Failure: The panel held that the ALJ’s finding that Hicks’s emphysema was “non-severe” lacked substantial evidence. The ALJ mischaracterized medical records that clearly diagnosed “severe emphysema” and documented classic symptoms (shortness of breath, wheezing, coughing).
- Immediate Award of Benefits: Invoking § 405(g) and precedents such as Faucher and Wiser, the court determined that all essential factual issues had been resolved and that the record and the SSA’s concession established Hicks’s disability. Under those circumstances, remand for further administrative proceedings would “serve no meaningful purpose,” so the court ordered an immediate award of benefits rather than another remand.
- Refusal to Address Remaining Issues: Because Hicks’s entitlement to benefits on the emphysema ground was dispositive, the court declined to reach her other statutory and procedural arguments. Citing a line of cases emphasizing judicial restraint and the prohibition on advisory opinions, the panel concluded that it should resolve only the issues necessary to the disposition of the case.
- Confession of Error vs. Mootness: The court clarified that the SSA’s confession of error did not moot the case. Instead, it provided a merits basis for the court’s judgment. By contrast, mootness doctrine (e.g., voluntary cessation) deprives courts of jurisdiction—something that did not occur here.
Accordingly, the court granted Hicks full relief as to her SSI entitlement while deliberately leaving broader questions about SSA redetermination procedures and statutory presumptions unanswered.
IV. Detailed Legal Analysis
A. The “Substantial Evidence” Standard and the ALJ’s Error
The court reaffirmed the familiar Social Security standard: an ALJ’s factual findings must be supported by “substantial evidence,” defined as “such relevant evidence as a reasonable mind might accept as adequate to support a conclusion,” quoting Ealy v. Commissioner of Social Security, 594 F.3d 504, 512 (6th Cir. 2010), which in turn quoted Lindsley v. Commissioner of Social Security, 560 F.3d 601, 604 (6th Cir. 2009).
Applying this standard, the court identified a straightforward, but critical, factual error:
- The ALJ labeled Hicks’s emphysema as “non-severe,” suggesting only minimal impact on her ability to work.
- However, the September 2007 medical records—the very records the ALJ purported to rely on—diagnosed her with “severe emphysema.”
- Those records also documented symptoms—including wheezing, coughing, and shortness of breath—that the ALJ incorrectly stated were absent.
The court concluded that the ALJ’s characterization of the medical evidence was not merely a permissible inference drawing but a misreading of the record. In Social Security cases, courts defer heavily to ALJ factfinding when the evidence is genuinely susceptible to multiple reasonable interpretations. But where the ALJ’s description directly contradicts the documentary evidence, substantial evidence support is lacking.
The Commissioner’s concession that the ALJ erred and that Hicks is disabled based on her emphysema reinforced this conclusion and eliminated any genuine dispute over the underlying medical facts.
B. When May a Court Order an Immediate Award of Benefits?
Under sentence four of 42 U.S.C. § 405(g), a reviewing court has authority to:
“enter, upon the pleadings and transcript of the record, a judgment affirming, modifying, or reversing the decision of the Commissioner of Social Security, with or without remanding the cause for a rehearing.”
In the “mine-run” of cases, as the court noted citing Kalmbach v. Commissioner of Social Security, 409 F. App’x 852, 865 (6th Cir. 2011), the usual remedy when an ALJ’s nondisability finding is not supported by substantial evidence is a remand for further proceedings, not an immediate award of benefits.
But there is a well-recognized exception, captured in Faucher v. Secretary of Health & Human Services, 17 F.3d 171, 176 (6th Cir. 1994), and relied on here:
“An award of benefits is proper if all essential factual issues have been resolved and the record adequately establishes a plaintiff’s entitlement to benefits.”
The court also cited Wiser v. Commissioner of Social Security, 627 F. App’x 523, 526 (6th Cir. 2015), which reaffirmed that a sentence-four remand can result in an immediate benefits award in appropriate cases. And the court invoked Smith v. Berryhill, 587 U.S. 471, 488 n.21 (2019), which recognized that remand can “be foregone in rarer cases…where remand would serve no meaningful purpose.”
Applying these principles, the panel emphasized:
- All essential factual issues were resolved: The Commissioner openly agreed that the existing record established severe emphysema and disability.
- No further factfinding was needed: There was no suggestion that additional evidence or proceedings were necessary to determine Hicks’s medical condition or functional limitations.
- Remand would serve “no meaningful purpose”: Because both parties agreed Hicks is entitled to benefits, another administrative hearing would simply consume resources without changing the outcome.
Thus, under the Faucher framework, the court deemed an immediate award of benefits the appropriate remedy.
C. The Role and Weight of an Agency’s Confession of Error
The Sixth Circuit acknowledged that it was not formally bound by the SSA’s confession of error, citing Orloff v. Willoughby, 345 U.S. 83, 87 (1953), which warns that courts should not simply rubber-stamp the government’s concessions without independent judicial review.
However, the court also cited Sibron v. New York, 392 U.S. 40, 58 (1968), which instructs that a governmental confession of error should be given “great weight.” Here, that confession had several important consequences:
- It confirmed that, in the Commissioner’s own view, Hicks met the legal standard for disability based on emphysema.
- It eliminated any live factual dispute about whether the medical evidence supported disability.
- It made clear that on remand the agency would be obligated to find Hicks disabled, rendering further proceedings redundant.
The court’s reliance on the confession remained anchored in the record. The medical documentation itself supported the Commissioner’s revised position and contradicted the ALJ’s findings. Thus, the confession functioned as both a persuasive concession and a practical admission that all essential factual issues had been decided in Hicks’s favor.
D. Refusal to Reach Hicks’s Other Claims: Judicial Restraint and Anti-Dictum Principles
Once the court determined that Hicks was entitled to SSI benefits because of her emphysema, the remaining issues—mental health claims, intellectual functioning, rebuttable presumptions, appointment of medical experts, and structural constitutional challenges—no longer affected the outcome.
The court therefore adhered to a familiar principle of judicial restraint: decide only what is necessary to resolve the case at hand. It cited:
- Whitehouse v. Illinois Central Railroad Co., 349 U.S. 366, 373 (1955): courts must “confine [themselves] to deciding only what is necessary to the disposition of the immediate case.”
- Wright v. Spaulding, 939 F.3d 695, 700–01 (6th Cir. 2019): if an answer to a legal question cannot affect the parties before the court, that question is not properly part of the case.
- United States v. Burris, 912 F.3d 386, 410 (6th Cir. 2019) (Kethledge, J., concurring): “dictum is usually a bad idea (the same criticism goes for alternative holdings).”
Given the SSA’s concession that emphysema alone rendered Hicks disabled, the panel characterized the other issues as “non-essential.” Addressing them would produce either dicta or alternative holdings that:
- Would not be binding on future panels (especially in a nonprecedential opinion).
- Could risk unintended doctrinal consequences without the necessity that usually disciplines judicial decision-making.
- Would not affect Hicks’s entitlement to benefits, the only direct stake in this litigation.
Hicks had expressly urged the court to decide certain statutory issues to benefit other Conn claimants. The panel rejected that invitation, noting that Hicks is not a class representative and does not legally represent anyone else’s interests. Thus, her case was not an appropriate vehicle for broad systemic pronouncements that go beyond her own concrete dispute.
E. Distinguishing Class Actions and the Voluntary Cessation Doctrine
1. Why This Is Not Like a Class Action
Hicks relied on class action decisions to argue that resolving her case on narrow grounds would leave systemic legal questions unresolved and allow the SSA to continue allegedly improper practices. The court responded that class actions differ in a crucial respect:
- In a class action, representative plaintiffs legally represent the interests of unnamed class members. See Senter v. General Motors Corp., 532 F.2d 511, 525 (6th Cir. 1976).
- Class members are typically bound by the judgment unless they opt out, as discussed in In re American Medical Systems, Inc., 75 F.3d 1069, 1083 (6th Cir. 1996).
- In such a setting, resolving systemic questions can be necessary to afford relief to the entire class and is part of the actual case or controversy.
By contrast, Hicks was litigating solely on her own behalf. Other SSI claimants, including those affected by the Conn fraud, would neither be represented by her nor bound by the outcome. Under Hansberry v. Lee, 311 U.S. 32, 40 (1940), due process concerns preclude binding absent parties who have not been adequately represented.
As a result, the panel concluded that it could not treat Hicks’s individual appeal as a de facto class action or policy lawsuit. Since its resolution of the emphysema issue fully disposed of her personal claim, additional rulings would go beyond the actual case or controversy.
2. Why This Is Not a Voluntary Cessation/Mootness Problem
Hicks also analogized the Commissioner’s confession of error to the “voluntary cessation” scenario in mootness doctrine, citing Friends of the Earth, Inc. v. Laidlaw Environmental Services (TOC) Inc., 528 U.S. 167, 190 (2000). There, the Supreme Court held that a defendant cannot generally moot a case simply by voluntarily stopping the challenged conduct during litigation because the defendant might resume it.
The Sixth Circuit rejected this analogy as “inapposite” for two reasons:
- Confession of error does not moot the case. When a case is moot, “the controversy no longer exists, and we are deprived of jurisdiction,” as summarized by the court referencing Patton v. Fitzhugh, 131 F.4th 383, 392 (6th Cir. 2025). By contrast, when the government confesses error, the controversy remains live: the court must still enter a binding judgment resolving the parties’ rights and obligations. See also Sibron, 392 U.S. at 58 (even after a confession, courts retain “the duty” to render judgment).
- No attempt to evade review. Voluntary cessation doctrine addresses attempts to evade judicial review by temporarily suspending challenged behavior. Here, the SSA did not withdraw the redetermination process or disclaim its policies; instead, it accepted that Hicks is entitled to benefits on the record as it stands. The controversy over Hicks’s entitlement remained, and the court resolved it on the merits (albeit on narrow grounds).
Thus, the confession of error served as a basis for decision, not an attempt to strip the court of jurisdiction.
F. The Conn Fraud Context and Issues Left Unresolved
This decision arises against the backdrop of the Eric Conn–Daugherty fraud scandal and the SSA’s statutory obligation under § 405(u) to redetermine benefits where fraud is suspected. In Hicks I, the Sixth Circuit addressed the due process rights of Conn-related claimants and held that the SSA must:
- Allow claimants a meaningful opportunity to rebut OIG assertions that their medical evidence is tainted by fraud or similar fault.
- Fairly consider claimant-submitted evidence in redetermination proceedings rather than mechanically discarding entire categories of evidence.
In the present decision, however, the panel explicitly declined to revisit or expand upon those issues. It did not:
- Address whether a rebuttable presumption of continuing disability (from current to prior periods) is required by the Social Security Act or APA.
- Clarify the agency’s obligations regarding appointment of medical experts in redetermination cases.
- Resolve the separation-of-powers challenge concerning alleged “double for-cause removal” protection for the ALJ.
Those questions remain open for other Conn claimants and future panels—an outcome that is both a product of judicial restraint and a source of continued uncertainty for similarly situated beneficiaries.
V. Precedents Cited and Their Influence
A. Social Security–Specific Decisions
-
Hicks v. Commissioner of Social Security, 909 F.3d 786 (6th Cir. 2018) (“Hicks I”)
The earlier appeal involving the same claimant. The court held that the SSA violated Hicks’s due process rights by not allowing her to rebut the OIG’s fraud allegations and by failing to consider her evidence fairly in the Conn-related redetermination. Hicks I is notable here chiefly as background; the present decision does not alter or expand that precedent, but it shows the prolonged and troubled procedural history of Conn-related cases. -
Ealy v. Commissioner of Social Security, 594 F.3d 504 (6th Cir. 2010); Lindsley v. Commissioner of Social Security, 560 F.3d 601 (6th Cir. 2009)
These cases supply the formulation of the “substantial evidence” standard: evidence that a reasonable mind might accept as adequate to support a conclusion. The court uses them to frame its central determination that the ALJ’s characterization of Hicks’s emphysema is unsupportable. -
Kalmbach v. Commissioner of Social Security, 409 F. App’x 852 (6th Cir. 2011)
Cited for the “mine-run” rule: when an ALJ’s nondisability finding is not supported by substantial evidence, the usual remedy is remand for further proceedings rather than an immediate award of benefits. -
Faucher v. Secretary of Health & Human Services, 17 F.3d 171 (6th Cir. 1994)
The leading case on when a court may order an immediate award of benefits under § 405(g). It provides the key test: an immediate award is appropriate if all essential factual issues have been resolved and the record adequately establishes the claimant’s entitlement. The Sixth Circuit directly applies this standard to justify ordering benefits rather than remanding. -
Wiser v. Commissioner of Social Security, 627 F. App’x 523 (6th Cir. 2015)
Confirms that sentence-four remands can be used to order immediate awards of benefits in appropriate circumstances, reinforcing Faucher. -
Smith v. Berryhill, 587 U.S. 471 (2019)
Primarily a jurisdictional case about judicial review of SSA Appeals Council dismissals, but the panel quotes footnote 21, which recognizes that in rare cases remand can be skipped where it would “serve no meaningful purpose.” The court uses this phrase to bolster its conclusion that further proceedings would be wasteful here.
B. Confessions of Error and Scope of Decision
-
Orloff v. Willoughby, 345 U.S. 83 (1953)
Stands for the principle that a government confession of error does not automatically control the court’s judgment. Courts retain independent responsibility to evaluate the legal and factual basis for relief. -
Sibron v. New York, 392 U.S. 40 (1968)
Emphasizes that courts must still decide cases even when the government confesses error, but that such confessions should be given “great weight.” The Sixth Circuit invokes Sibron to justify its reliance on the SSA’s concession that Hicks is disabled. -
Whitehouse v. Illinois Central Railroad Co., 349 U.S. 366 (1955)
The court quotes Whitehouse for the core principle of judicial restraint: courts should decide only those issues necessary to resolve the immediate case. -
Wright v. Spaulding, 939 F.3d 695 (6th Cir. 2019)
Used to underscore that questions whose answers cannot affect the parties are not part of the proper case or controversy. This supports the refusal to address Hicks’s additional statutory and procedural challenges once disability is conceded. -
United States v. Burris, 912 F.3d 386 (6th Cir. 2019) (Kethledge, J., concurring)
Cited for its criticism of dicta and alternative holdings, reinforcing the panel’s decision to avoid unnecessary legal pronouncements.
C. Class Actions, Mootness, and Voluntary Cessation
-
Senter v. General Motors Corp., 532 F.2d 511 (6th Cir. 1976)
Explains that class representatives speak for the interests of unnamed class members. Used to contrast Hicks’s individual claim with the broader Conn claimant population that she does not legally represent. -
In re American Medical Systems, Inc., 75 F.3d 1069 (6th Cir. 1996)
Discusses the binding effect of class action judgments on absent class members, supporting the court’s distinction between individual and class litigation. -
Hansberry v. Lee, 311 U.S. 32 (1940)
A foundational case on due process and class representation, cited to emphasize that absent parties cannot be bound when they have not been adequately represented—another reason not to treat Hicks’s case as a proxy for all Conn-related claimants. -
Friends of the Earth, Inc. v. Laidlaw Environmental Services (TOC) Inc., 528 U.S. 167 (2000)
Central to voluntary-cessation mootness doctrine, standing for the rule that defendants generally cannot moot a case by voluntarily stopping the challenged conduct mid-litigation. Hicks invoked this case; the panel distinguished it as inapplicable because the government’s confession of error did not deprive the court of jurisdiction. -
Patton v. Fitzhugh, 131 F.4th 383 (6th Cir. 2025)
Referenced for the proposition that when a case is moot, the controversy no longer exists and the court lacks jurisdiction. The panel contrasts mootness with the present situation, where a live controversy persisted despite the confession of error.
VI. Simplifying Key Legal Concepts
A. “Substantial Evidence”
In Social Security cases, the “substantial evidence” standard is deferential to the agency but not toothless. It asks:
- Is there enough relevant evidence that a reasonable person could accept the ALJ’s conclusion?
This does not mean the court reweighs evidence or substitutes its judgment for the ALJ’s. But when the ALJ misreads the record or ignores key evidence—such as calling “severe emphysema” non-severe—the decision cannot be said to rest on substantial evidence.
B. Sentence Four of 42 U.S.C. § 405(g)
Section 405(g) governs judicial review of Social Security decisions. Sentence four allows a district (or appellate) court to:
- Affirm (agree with) the SSA’s decision,
- Modify it, or
- Reverse it—with or without sending the case back for another hearing.
Thus, the court has discretion either to:
- Remand for further proceedings (most common), or
- Order an immediate award of benefits if the record already clearly shows the claimant is disabled and no further factfinding is needed.
C. Redetermination and Fraud under 42 U.S.C. § 405(u)
When the SSA has reason to believe that “fraud or similar fault” tainted a benefits award, § 405(u) requires it to “immediately redetermine” entitlement. In practice, this can mean:
- Re-opening old cases where the original evidence is suspicious (as with Conn’s mass-produced reports).
- Discarding evidence tied to fraud and reevaluating the claim based on remaining or new evidence.
However, due process (as explained in Hicks I) requires that claimants be allowed to rebut the fraud allegations and to present their own evidence.
D. SSI Disability Standard
To qualify for SSI, a claimant must show:
- A physical or mental impairment (or combination) of sufficient severity
- That, considering age, education, and work experience, prevents any substantial gainful activity.
The analysis involves multiple steps, including determining:
- Whether the claimant has “severe” impairments.
- Whether those impairments meet or equal a “listing” (a set of conditions presumptively disabling under SSA regulations).
- Whether the claimant can do past work or any other work in the national economy.
In Hicks’s case, the court found that her emphysema was severe and, combined with the SSA’s concession, sufficient to support disability without needing to litigate every other impairment.
E. Overpayment Waiver
If the SSA determines that a person received more in benefits than they were legally entitled to (an “overpayment”), it can seek repayment. However, the SSA can also waive recovery if:
- Requiring repayment would be against equity and good conscience, or
- The claimant was not at fault and repayment would impose hardship.
A waiver does not necessarily mean that the person was actually entitled to the payments; it simply means the SSA won’t pursue repayment. Hicks sought more: a judicial determination that she was in fact disabled during the disputed period.
F. For-Cause Removal Protection
Hicks raised a structural constitutional claim that the ALJ was protected by “double for-cause removal” restrictions—legal structures that might unduly insulate an official from presidential control, potentially violating separation of powers. The opinion notes this argument but does not address it, because deciding the case on emphysema grounds made it unnecessary. Thus, the court leaves that constitutional question untouched.
G. Mootness vs. Confession of Error; Voluntary Cessation
Mootness arises when there is no longer a live dispute the court can resolve (for example, if all relief sought is already granted and no ongoing collateral consequences remain). Under the “voluntary cessation” doctrine, a defendant cannot generally moot a case just by stopping the challenged conduct midway through litigation; courts worry the defendant could resume the conduct after the case is dismissed.
Here:
- The SSA’s confession of error did not make the case moot because the court still had to enter a legally binding decision about Hicks’s entitlement.
- The panel distinguished voluntary cessation because the SSA was not simply suspending some behavior; it was conceding legal error on the merits in Hicks’s individual case.
H. Dictum vs. Holding
A holding is the part of a decision that is necessary to resolve the case and is binding precedent (in precedential opinions). Dictum is commentary that goes beyond what is required to decide the case; it may be persuasive but is not binding.
The court’s refusal to address Hicks’s additional arguments is tied to a concern that any such discussion would constitute dictum, especially in a nonprecedential opinion. The panel explicitly warns against generating unnecessary dicta or alternative holdings.
VII. Impact and Practical Implications
A. For Social Security Claimants and Practitioners
- Pathway to Direct Awards: The opinion reinforces that when the Commissioner concedes a lack of substantial evidence and disability is undisputed, courts can and will order immediate awards of benefits rather than remanding.
- Strategic Use of Agency Concessions: Claimants’ counsel should recognize that an agency confession of error can substantially change the remedial landscape. Once entitlement is conceded, courts are less likely to entertain broader legal challenges that no longer affect the individual claimant’s outcome.
- Limits of Individual Cases for Systemic Reform: The decision underscores that individual appeals—absent a certified class—are a poor vehicle for securing systemic reforms that primarily benefit others.
B. For the SSA and ALJs
- Careful Record Review: The decision sharply criticizes the ALJ’s mischaracterization of medical evidence (treating documented “severe emphysema” as “non-severe”). It signals that such misreadings will not be insulated by deferential review.
- Incentive to Confess Error: The case suggests that the SSA can mitigate further litigation costs and judicial criticism by confessing error when the record clearly supports disability. Such confessions may prompt courts to order immediate awards, ending protracted disputes.
C. For Conn-Related Claimants
While the decision delivers full relief to Hicks, its impact on other Conn-related claimants is limited:
- The opinion is nonprecedential and explicitly refrains from addressing system-wide procedural or statutory questions surrounding SSA redeterminations.
- Key issues—such as presumptions of continuing disability, the use of OIG fraud determinations, and the need for medical experts—remain largely unresolved at the appellate level.
Put simply, the decision illustrates that individual Conn claimants may win their own cases (especially where the SSA concedes factual error) without necessarily forcing broader changes to SSA procedures.
D. For Judicial Doctrine
- Reaffirmation of Judicial Restraint: The court’s refusal to address nonessential questions, even at a claimant’s request, fortifies doctrines that limit federal courts to concrete cases and controversies and discourage advisory opinions.
- Clarification of Confession-of-Error Practice: The opinion solidifies that a government confession of error neither moots a case nor strips the court of its responsibility to render judgment; rather, it is a factor in deciding both the merits and the appropriate remedy.
VIII. Conclusion
The Sixth Circuit’s unpublished decision in Hicks v. Commissioner of Social Security provides an instructive example of how courts should respond when the SSA confesses error and agrees that a claimant is disabled on the existing record. The panel:
- Found that the ALJ’s treatment of Hicks’s emphysema as “non-severe” was flatly inconsistent with the medical evidence and thus unsupported by substantial evidence.
- Applied Faucher and related precedents to order an immediate award of benefits under sentence four of § 405(g), concluding that further proceedings would serve no meaningful purpose.
- Declined to address additional statutory, procedural, and constitutional challenges that had become unnecessary to the outcome, reinforcing the principle that courts should decide only those issues needed to resolve the case at hand.
Although labeled “not recommended for publication,” the decision is likely to be cited for its careful application of the substantial evidence standard, its treatment of agency confessions of error, and its clear articulation of when an immediate award of benefits is appropriate. At the same time, it underscores the limits of individual litigation as a tool for achieving systemic change in Social Security administration, particularly in the complex and still-evolving context of Conn-related redeterminations.
Comments