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Regarding: Michael Thomas Paul

SSN:465-59-7389
Continuing Disability review and cessation
affirmative defense: estoppel by misrepresentation

An estoppel arises when one makes a false statement. Such false statement induces
another person to believe something and that simultaneously results in that person's reasonable
and detrimental reliance on the belief. In a case involving the doctrine of estoppel by
misrepresentation, one has to analyze whether the facts constitute a misrepresentation. Such a
misrepresentation can be due to the ambiguity of language and also due to the fact that
representations can be made by conduct.

It has been alleged that a letter notifying me that I was requested to supply more
information concerning my Social Security Continuing Disability Review and I failed to supply
such information. The only request I received was for me to resubmit the last two pages on the
application which were missed when sending the packet back. October 3, 2016 I personally
delivered the requested information by driving to the Social Security office in Seguin and waited
in line to speak with a representative with whom took the information that was requested..

The Administration claims to have sent a notice of determination in December to my


home but I received no such notice.

I only learned of the adverse action when Humana sent me a letter on 2/19/17 that said my
Medicare A & B have been canceled effective 2/28/17.

I immediately telephoned Social Security to find out why my medical coverage was
ending. I was told a letter had been sent to me December 6, 2016 that said my review had shown
I was no longer disabled. When I learned my disability was canceled I stated I wanted to
immediately APPEAL the decision upon which I was told I couldnt appeal because I was passed
the 60 days to request an appeal.
I sent a request for my U.S. Representative Senator John Cornyn to intervene. The
Senator was provided a response that included a statement by Social Security that a notice was
sent to me on December 6, 2016 but no actual copy of the notice. The statement document was
identical to the document I received that did not include the original notice and the document
which was to include the reason for the denial of my entitlement was undated.
The US code does state that a determination of disability can be denied if more
information is requested and the information is not provided but this only applies to new
applicants seeking certification of initial disability determination.

For review applicants already Certified that do not provide further information when
requested the US code says that a review of the information in the case record will be used to
make the determination for continuation of disability.

Once an individual begins receiving disability benefits under the DI or SSI program,
SSA ensures only those individuals who remain disabled will continue receiving
benefits. SSA conducts CDRs on DI beneficiaries and SSI recipients to determine
whether they remain medically eligible for disability payments. Generally, the frequency of
medical CDRs depends on SSAs assessment of the likelihood of medical
improvement. 20 C.F.R. 404.1590(d) and 20 C.F.R. 416.990(d). Because I showed no
possibility for future improvement my last review was on 2009.

I was sent to a doctor provided by Social Security for my last CDR in 2009 who
determined I was and continued to be 100% totally and permanently disabled with no possibility
of further improvement only future deterioration.

I have not engaged in Substantial Gainful Activity.

Facts listed in the statement to Senator Cornyn are a misrepresentation of the truth
because it is lacking the entire medical record information already provided to Social Security
such as Thoracic disk-ectomy of multiple levels T2-T3, T3-T4, T5-T6, along with having two
Invasive shoulder operations to the left shoulder to reconstruct the shoulder girdle most recent
2013.

March, 6 2017 Michael Thomas Paul