Jay Artz v. Jo Anne B. Barnhart, Commissioners of the Social Security Administration

This appeal requires us to interpret and apply a provision
of the Social Security Act, 42 U.S.C. § 402(x)(1)(A)(ii), that
provides that disability insurance benefits and certain other
benefits are not to be paid to a person who "is confined by
court order in an institution at public expense in
connection with . . . a verdict or finding that the individual
is not guilty of [a criminal] offense by reason of insanity."
Relying on this provision, the Commissioner suspended Jay
Artz's claim for disability benefits for a 14-month period
during which he was involuntarily confined in psychiatric
institutions at public expense.

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A. Before 1994, a provision of the Social Security Act,
42 U.S.C. § 402(x)(1) (amended 1994) provided that benefits
were not to be paid to felons while incarcerated unless they
were actively and satisfactorily participating in an approved
rehabilitation program and were expected to be able to
engage in substantial gainful activity upon release and
within a reasonable time. In 1994, Congress broadened this
prohibition to apply to several other categories of persons
who are institutionalized at public expense following
criminal proceedings. 42 U.S.C. § 402(x)(1)(A). Specifically,
as amended in 1994 and as it now stands, the statute
applies to any person who

(i) is confined in a jail, prison, or other penal
institution or correctional facility pursuant to his
conviction of a criminal offense,

(ii) is confined by court order in an institution at public
expense in connection with -

(I) a verdict or finding that the individual is guilty but
insane, with respect to a criminal offense,

(II) a verdict or finding that the individual is not guilty
of such an offense by reason of insanity,

(III) a finding that such individual is incompetent to
stand trial under an allegation of such an offense, or

(IV) a similar verdict or finding with respect to such
an offense based on similar factors (such as a mental
disease, a mental defect, or mental incompetence), or

(iii) immediately upon completion of confinement as
described in clause (i) pursuant to conviction of a
criminal offense an element of which is sexual activity,
is confined by court order in an institution at public
expense pursuant to a finding that the individual is a
sexually dangerous person or a sexual predator or a
similar finding.

The House Committee Report provided the following
explanation for including persons found not guilty by
reason of insanity within this prohibition:

Social Security is intended to replace earnings and
provide basic income for food, clothing and shelter to workers who retire or become disabled. Individuals who
have been committed to an institution pursuant to
committing a crime are already relying on public funds
to cover the costs of their basic living expenses. It is
particularly inequitable that, in some instances,
criminally insane individuals so institutionalized
receive higher benefits than their victims or their
victims' survivors . . . .

In making these changes, the Committee is seeking to
establish greater consistency in the policy that
Congress enacted in 1980 banning Social Security
benefit payments to incarcerated felons. That limitation
recognizes that prisoners receive full support from
public resources in the form of food, clothing, lodging,
and basic health care. In the Committee's view, the
same situation exists in the case of criminally insane
individuals who are confined to institutions at public
expense.

H.R. Rep. No. 103-491 (1994), 1994 U.S.C.C.A.N. 3266,
3268, 3273.

B. In State v. Krol, 344 A.2d 289 (N.J. 1975), the New
Jersey Supreme Court endorsed the broad principle that
the standard for the involuntary commitment of persons
found NGRI should be substantially the same as that
applied to others who are civilly committed. Id. at 297-99.
The Court then prescribed procedures to implement this
principle. Under Krol, when a defendant is found NGRI, the
criminal court may order that the defendant "be confined in
a suitable mental institution for a period of 60 days for
observation and examination." Id. at 300. The Krol Court
continued:

Within this period, the State may move for indefinite
commitment on the ground that defendant is mentally
ill and, if permitted to remain at large in the general
population without some restraints, is likely to pose a
danger to himself or to society. If, following a hearing,
the court finds that the State has shown by a
preponderance of the evidence that defendant is
mentally ill and is likely to pose such a danger, it
should order suitable restraints placed upon defendant's liberty so as to protect the public and
provide defendant with appropriate treatment.

Id. (footnotes omitted). The Court added that orders
requiring institutionalization or lesser restraints may be
modified upon proper proof by a preponderance of the
evidence by the party seeking modification. Id. at 303-04.
"Once, however, [a] commitment order is unconditionally
terminated the defendant must be treated thereafter like
any other person for purposes of involuntary commitment."
Id.

In State v. Fields, 390 A.2d 574 (N.J. 1978), the state
supreme court imposed additional requirements. The Fields
Court held that persons who are civilly committed after a
verdict of NGRI are entitled to periodic review of the
continued validity of the restraints on their liberty and that
the state must bear the same burden of proof at these
proceedings as it bore when the person was first
committed. Id. at 580. The Krol and Fields procedures are
now codified by statute and court rule. See N.J.S.A. 2C:4-8;
N.J. Court Rules 3:19-2 and 4:74-7.

Under the New Jersey procedures, NGRI acquittees are
generally treated the same as others when civil commitment
is initially sought and when a periodic review proceeding is
held, but there are some differences. "[W]hat is required is
not absolute equality, but ‘substantial equality.' " In the
Matter of the Commitment of Edward S., 570 A.2d 917, 922
(N.J. 1990). "Indeed, the cases note that there are
differences." Id. at 923 (emphasis in original). Perhaps most
importantly, the burden of proof differs. In most civil
commitment proceedings, it must be shown by clear and
convincing evidence that "mental illness causes the person
to be dangerous to self or dangerous to others or property."
N.J. Court Rule 4:74-7(f)(1). In the case of a person who
has been found NGRI, however, "during the maximum
period of imprisonment that could have been imposed, as
an ordinary term of imprisonment, for any charge on which
the defendant has been acquitted by reason of insanity," a
preponderance of the evidence burden applies. N.J.S.A. 2C:
4-8. See also Krol, 344 A.2d at 300 & n.9. Furthermore,
"the fact that [an NGRI acquittee] has actually engaged in
dangerous conduct otherwise criminal should weigh heavily in [a] court's assessment of the need for the continued
imposition of restraints upon his liberty." Fields, 390A.2d
at 587. In addition the prosecutor has a statutory right to
appear in any proceeding regarding the commitment or
discharge of an acquittee following an NGRI verdict and in
any subsequent periodic review. N.J.S.A. 2C:4-8b(3). And
when an NGRI murder acquittee seeks release into the
community, the proceeding must generally be open to the
public. In the Matter of Commitment of Edward S., supra.

C. Artz has a long history of mental illness. See Artz,
214 F. Supp.2d at 461. In 1981, Artz was arrested for the
murder of his mother, but he was found NGRI, and his case
was then handled in accordance with the procedures
summarized above. He was confined by the criminal court
for 60 days for observation and evaluation. After that
evaluation, it was determined that he was a danger to
himself or others. He was therefore involuntarily committed
to the Ancora Psychiatric Hospital, and his status was
reviewed as required by Fields. In June of 1989, following
such a review, a New Jersey Superior Court Judge ordered
that Artz be released from the Ancora facility on certain
conditions, including the following: that he refrain from
drinking alcohol and using illegal controlled substances;
that he take prescribed psychoactive medications; that he
attend regular counseling sessions; and that he remain
available for monitoring and evaluation. App. at 144-46.

As a result of this continued monitoring and evaluation,
Artz was readmitted to the Ancora facility from July 7 to
20, 1993, and from February 23 to March 30, 1994. Id. at
149. On July 22, 1994, he was committed to another
psychiatric hospital after a judicial determination that he
posed a danger to himself and others because he was no
longer taking his medication. On March 14, 1995, Artz was
transferred to the Ancora facility. He was conditionally
released on April 10, 1996.

In January 1982, while confined in the Ancora facility,
Artz applied to the Social Security Administration ("SSA")
for disability benefits. Id. at 47-50. His claim was initially
denied, but he filed a request for reconsideration. Id. at 51-
57. This too was denied. Id. at 58-59. Artz then requested
a hearing before an ALJ. Id. at 51-53. In January of 1983, the ALJ issued a favorable decision and order. The ALJ
found that Artz suffered from "a severe impairment, and
[was] unable to perform his prior work activity, or any other
relevant work-related activity in the local and national
economy." Id. at 135. The ALJ decided that Artz was
entitled to disability benefits and to a period of disability
commencing on December 31, 1980. Id. at 136. Because of
Artz's mental condition and his confinement in Ancora
Psychiatric Hospital, the ALJ recommended that a
representative payee be appointed. Id.

In March 1995, Artz was informed by the SSA that his
benefits were being suspended while he was confined in an
institution at public expense. Id. at 138-39. Artz filed a
request for reconsideration, but the SSA denied the request
citing the previously noted amendment to 42 U.S.C.
§ 402(x) that had taken effect on February 1, 1995. App. at
142-43. Artz requested a hearing and, in March 1998, he
appeared before an ALJ. Id. at 29-46. In June 1999, the
ALJ decided that, pursuant to the amendment to 42 U.S.C.
§ 402(x), Artz's benefits had been properly suspended by
the Commissioner because Artz's involuntarily confinement
between February 1, 1995, and April 10, 1996, was "in
connection with" his 1981 NGRI verdict. App. at 19-20. The
Appeals Council of the SSA denied Artz's request for review
of the ALJ's decision. Id. at 4-5. Artz sought review in the
United States District Court for the District of New Jersey,
but the District Court affirmed the decision denying Artz's
claim. Artz, 214 F. Supp.2d at 468. The District Court
based its decision on the language of Section 202(x) and
also noted the congressional intent to avoid double
payment of public funds in the form of benefits to
individuals who are institutionalized at the public expense
following a verdict of NGRI. Artz then took the present
appeal.

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