AR 99-4(11): Bloodsworth v. Heckler , 703 F.2d 1233 (11th Cir. 1983) — Judicial Review of an Appeals Council Dismissal of a Request for Review of an Administrative Law Judge Decision—Titles II and XVI of the Social Security Act.

AR 99-4(11)

EFFECTIVE/PUBLICATION DATE: 10/26/1999

Acquiescence Ruling 99-4 (11)

Issue:

Whether a dismissal by the Appeals Council of a request for review of an

ALJ decision is a "final decision" which is judicially reviewable.

Statute/Regulation/Ruling Citation:

Sections 205(g) and (h) and 1631(c)(3) of the Social Security Act (42

U.S.C. sections 405(g) and (h) and 1383(c)(3)); 20 CFR 404.955, 404.967,

404.968, 404.971, 404.972, 404.981, 404.982, 416.1455, 416.1467, 416.1468,

416.1471, 416.1472, 416.1481, 416.1482 and 422.210.

Circuit:

Eleventh (Alabama, Florida, Georgia)

Bloodsworth v. Heckler , 703 F.2d 1233 (11th Cir. 1983)

Applicability of Ruling:

This Ruling applies only to the Appeals Council dismissals of requests for

review of ALJ decisions.

Description of Case:

In 1979, Mr. Jack Bloodsworth, the claimant in this case, filed

applications for a period of disability, disability insurance benefits,

and supplemental security income payments. The applications were denied

initially, on reconsideration, and by an ALJ after a hearing. The claimant

missed the 60-day time limit for filing his request for review of the

ALJ's decision to the Appeals Council because it was filed approximately

two weeks after the deadline. Therefore, the Appeals Council dismissed the

request for review on the basis of untimeliness without good cause.

The claimant then filed a complaint in Federal district court, alleging

that denial of the extension of time to file was not supported by

substantial evidence. The district court rejected the Social Security

Administration's (SSA) argument that it lacked jurisdiction, reviewed the

Appeals Council's denial of an extension of time, and remanded the case

for consideration of the merits of the

claim. [1] On remand, the Appeals

Council restated its position that the claimant's request for review was

untimely filed, but considered the claim on the merits as ordered, and

denied the claimant's request for review

s (SSA) argument that it lacked jurisdiction, reviewed the

Appeals Council's denial of an extension of time, and remanded the case

for consideration of the merits of the

claim. [1] On remand, the Appeals

Council restated its position that the claimant's request for review was

untimely filed, but considered the claim on the merits as ordered, and

denied the claimant's request for review. The district court affirmed the

decision and the claimant appealed. On appeal, SSA again argued that the

district court lacked

jurisdiction. [2]

Holding:

The Eleventh Circuit held that an Appeals Council dismissal of a request

for review of an ALJ decision for reasons of untimeliness is a "final

decision of the Secretary made after a hearing" within the meaning of

section 205(g) of the Social Security

Act [3] and, therefore, subject

to judicial review.

Regarding the right to judicial review, the Eleventh Circuit stated that

neither the statute nor the regulations make any distinction between

Appeals Council dismissals and "determinations on the merits." The court

found that both actions are equally final and that both trigger a right to

review by the district court. The court interpreted 20 CFR 404.972 and

404.981 [4] to provide that "an

Appeals Council review determination, on whatever grounds, is perceived as

the appropriately 'final decision' from which to take an appeal to the

district court under section 405(g)."

Statement as to How Bloodsworth Differs From SSA's

Interpretation of the Regulations

The Eleventh Circuit held that an Appeals Council dismissal of a request

for review of an ALJ decision is a "final decision of the Secretary made

after a hearing" (now a "final decision of the Commissioner of Social

Security") within the meaning of section 205(g) of the Social Security Act

and, therefore, subject to judicial

review. [5]

ers From SSA's

Interpretation of the Regulations

The Eleventh Circuit held that an Appeals Council dismissal of a request

for review of an ALJ decision is a "final decision of the Secretary made

after a hearing" (now a "final decision of the Commissioner of Social

Security") within the meaning of section 205(g) of the Social Security Act

and, therefore, subject to judicial

review. [5]

Contrary to the holding of the court in Bloodsworth , SSA

policy is that the regulations make a clear distinction in regard to

rights of judicial review between dismissals and determinations on the

merits by the Appeals Council. The Appeals Council may take three types of

action following an ALJ decision: (1) it may grant a request for review;

(2) it may deny a request for review; or (3) it may dismiss a request for

review. The dismissal of a request for review of an ALJ decision is

binding and not subject to further review. 20 CFR 404.972, 416.1472. See

also 20 CFR 404.955, 416.1455, 422.210. The Appeals Council will dismiss a

request for review if it is untimely filed and the time for filing has not

been extended. [6] The Appeals

Council may also dismiss a request for review for other prescribed

reasons. 20 CFR 404.971, 416.1471.

SSA's position, based on the above-cited regulations, is that an Appeals

Council dismissal is not a "final decision of the Commissioner of Social

Security made after a hearing." Therefore, such a dismissal is not

judicially reviewable under section 205(g) of the Social Security Act (42

U.S.C. 405(g)).

Explanation of How SSA Will Apply The Bloodsworth Decision Within the Circuit

This Ruling applies only to cases involving claimants who reside in

Alabama, Florida, or Georgia at the time of the Appeals Council dismissal

of the request for review.

Notices sent by the Appeals Council which dismiss requests for review of

ALJ decisions will advise claimants in these states of their right to

request judicial review.

ill Apply The Bloodsworth Decision Within the Circuit

This Ruling applies only to cases involving claimants who reside in

Alabama, Florida, or Georgia at the time of the Appeals Council dismissal

of the request for review.

Notices sent by the Appeals Council which dismiss requests for review of

ALJ decisions will advise claimants in these states of their right to

request judicial review.

[1] Under the Social Security

Independence and Program Improvements Act of 1994, Pub.L.No. 103-296,

effective March 31, 1995, Social Security Administration (SSA) became an

independent Agency in the Executive Branch of the United States Government

and was provided ultimate responsibility for administering the Social

Security and Supplemental Security Income programs under titles II and XVI

of the Act. Prior to March 31, 1995, the Secretary of Health and Human

Services had such responsibility.

[2] The Government argued that

the district court lacked subject matter jurisdiction under sections

205(g) and (h) of the Social Security Act (42 U.S.C. section 405(g) and

(h)) because the plaintiff failed to meet the "final decision" and "made

after a hearing" requirements of these sections. The Government contended

that: (1) dismissal of a request for review on the basis of untimeliness

without "good cause" is not a "final decision" for it does not constitute

a determination on the merits; and (2) it is not "made after a hearing"

because no hearing is granted solely and specifically on the request for

review itself.

d "made

after a hearing" requirements of these sections. The Government contended

that: (1) dismissal of a request for review on the basis of untimeliness

without "good cause" is not a "final decision" for it does not constitute

a determination on the merits; and (2) it is not "made after a hearing"

because no hearing is granted solely and specifically on the request for

review itself.

[3] Section 205(g) of the Social

Security Act (42 U.S.C. section 405(g)) currently provides in pertinent

part that "[a]ny individual, after any final decision of the Commissioner

of Social Security made after a hearing to which he was a party, . . . may

obtain a review of such decision by a civil action commenced within sixty

days after the mailing to him of notice of such decision or within such

further time as the Commissioner of Social Security may allow." At the

time of the decision in Bloodsworth , however, the statute

referred to a "final decision of the Secretary."

[4] 20 CFR 404.981 and 416.1481

state, in pertinent part, that "[t]he Appeals Council's decision, or the

decision of the administrative law judge if the request for review is

denied, is binding unless you or another party file an action in Federal

district court, or the decision is revised."

[5] As the Supreme Court has

noted, the term "final decision" is not defined in the Social Security

Act, but the Act gives authority to the agency to prescribe its meaning by

regulation. Weinberger v. Salfi, 422 U.S. 749, 766 (1975).

[6] The Appeals Council, upon

good cause shown, may extend the time for filing a request for review of

an ALJ decision. 20 CFR 404.968(b), 416.1468(b).