SSR 84-22c: SECTION 205(b) (42 U.S.C. 405(b)) DISABILITY -- INVALIDITY OF JUDICIALLY IMPOSED DEADLINES IN THE ADMINISTRATIVE APPEALS PROCESS
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Text
20 CFR 404.907-404.921 and 404.929-404.961
SSR 84-22c
Heckler v. Day et al., _____ U.S. _____, 104 S.Ct. 2249 (1984)
POWELL, Supreme Court Justice:
The question presented is the validity of an injunction issued on behalf
of a statewide class that requires the Secretary of Health and Human
Services to adjudicate all future disputed disability claims under Title
II of the Social Security Act, 42 U.S.C. 401 et. seq. , according to
judicially established deadlines and to pay interim benefits in all cases
of noncompliance with those deadlines.
I
Title II of the Social Security Act [Act] was passed in 1935. 49 Stat.
622, as amended, 42 U.S.C. 401 et. seq . (1976) ed. and Supp. V).
Among other things, it provides for the payment of disability insurance
benefits to those whose disability prevents them from pursuing gainful
employment. 42 U.S.C. 423. [1] Disability benefits also are payable under the Supplemental Security
Income [SSI] program established by Title XVI of the Act, 76 Stat. 197, as amended , 42 U.S.C. 1381 (1976 ed. and Supp. V). The disability
programs administered under Titles II and XVI "are of a size and extent
difficult to comprehend." Richardson v. Perales , 402 U.S. 389, 399
(1971). Approximately two million disability claims were filed under these
two titles in fiscal year
1983. [2] Over 320,000 of these
claims must be heard by some 800 administrative law judges each
year. [3] To facilitate the
orderly and sympathetic administration of the disability program of Title
II, the Secretary and Congress have established an unusually protective
four-step process for the review and adjudication of disputed claims.
First, a state agency determines whether the claimant has a disability and
the date the disability began or
ceased. [4] 42 U.S.C. 421(a); 20
CFR 404.1503 (1983). Second, if the claimant is dissatisfied with that
determination, he may request reconsideration of the determination
ave established an unusually protective
four-step process for the review and adjudication of disputed claims.
First, a state agency determines whether the claimant has a disability and
the date the disability began or
ceased. [4] 42 U.S.C. 421(a); 20
CFR 404.1503 (1983). Second, if the claimant is dissatisfied with that
determination, he may request reconsideration of the determination. This
involves a de novo reconsideration of the disability claim by the state
agency, and in some cases a full evidentiary hearing. Id. ,
404.907-404.921. Additional evidence may be submitted at this stage,
either on the request of the claimant or by order of the agency. Third, if
the claimant receives an adverse reconsideration determination, he is
entitled by statute to an evidentiary hearing and to a de novo review by
an Administrative Law Judge [ALJ]. 42 U.S.C. 405(b) (Supp. V); 20 CFR
404.929-404.961 (1983). Finally, if the claimant is dissatisfied with the
decision of the ALJ, he may take an appeal to the Appeals Council of the
Department of Health and Human Services
[HHS]. [5] Id. ,
404.967-404.983. These four steps exhaust the claimant's administrative
remedies. Thereafter, he may seek judicial review in federal district
court. 42 U.S.C. 405(g).
In this class action, the named plaintiffs sought declaratory and
injunctive relief from delays encountered in steps two and three above.
The action was initiated by Leon Day in November 1978 after his disability
benefits were terminated and he suffered substantial delays in obtaining a
reconsideration determination and in securing a hearing before an
ALJ. [6] After suffering similar
delays, Amedie Maurais intervened in the
action. [7] On June 14, 1979, the
District Court certified a statewide class consisting of:
ove.
The action was initiated by Leon Day in November 1978 after his disability
benefits were terminated and he suffered substantial delays in obtaining a
reconsideration determination and in securing a hearing before an
ALJ. [6] After suffering similar
delays, Amedie Maurais intervened in the
action. [7] On June 14, 1979, the
District Court certified a statewide class consisting of:
Plaintiffs argued before the District Court that the delays they had
experienced violated their statutory right under 42 U.S.C. 405(b) (Supp.
V) to a hearing within a reasonable
time. [8] Both parties submitted
the case to the District Court on motions for summary judgment. On the
basis of the undisputed evidence, the District Court held that, as to all
claimants for Title II disability benefits in Vermont, delays of more than
90 days from a request for hearing before an ALJ to the hearing itself
were unreasonable. [9] It granted
partial summary judgment to the plaintiff class on that issue in December
1978.
After the submission of additional evidence, the District Court
considered motions for summary judgment concerning the reasonableness of
delays in the reconsideration process. The additional evidence also was
undisputed. It consisted of factual summaries of 77 randomly selected
disability cases submitted by the Secretary. The District Court noted that
the "summaries support the positions of both parties. They show the
reconsideration process is often time consuming and complex. They also
show that the process is replete with unexplained delay; other requests
are processed with commendable dispatch." App. to Pet. for Cert. 25a. In
27 of the 77 cases, reconsideration determinations took longer than 90
days. In each of these 27, the District Court concluded that the delays
were caused by agency inefficiencies and were not justified by the
"necessary steps in the reconsideration process." App. to Pet. for Cert.
28a
lained delay; other requests
are processed with commendable dispatch." App. to Pet. for Cert. 25a. In
27 of the 77 cases, reconsideration determinations took longer than 90
days. In each of these 27, the District Court concluded that the delays
were caused by agency inefficiencies and were not justified by the
"necessary steps in the reconsideration process." App. to Pet. for Cert.
28a. On the basis of this survey, the District Court concluded that, as a
rule, delays of more than 90 days in making reconsideration determinations
were unreasonable and violated the claimant's statutory
rights. [10] In August 1981,
the District Court granted summary judgment for respondents on the
reconsideration aspect of the case.
In November 1981, the District Court issued an injunction in favor of the
statewide class that "ordered and directed [the Secretary] to conclude
reconsideration processing and issue reconsideration determinations within
90 days of requests for reconsideration made by
claimants." [11] The injunction
also required ALJs to provide hearings within 90 days after the request is
made by claimants. [12] Finally, it ordered payment of interim benefits to any claimant who did
not receive a reconsideration determination or hearing within 180 days of
the request for reconsideration or who did not receive a hearing within 90
days of the hearing
request. [13] The Court of
Appeals for the Second Circuit affirmed the District Court's determination
that the challenged delays violated the statute and upheld the District
Court's remedial order. Day v. Sckweiker , 685 F.2d 19 (CA2 1982).
We granted certiorari to consider whether it is appropriate for a federal
court, without statutory authorization, to prescribe deadlines for agency
adjudication of Title II disability claims and to order payment of interim
benefits in the event of noncompliance. _____ U.S. _____
lated the statute and upheld the District
Court's remedial order. Day v. Sckweiker , 685 F.2d 19 (CA2 1982).
We granted certiorari to consider whether it is appropriate for a federal
court, without statutory authorization, to prescribe deadlines for agency
adjudication of Title II disability claims and to order payment of interim
benefits in the event of noncompliance. _____ U.S. _____
(1983). [14] We conclude that
the legislative history makes clear that Congress, fully aware of the
serious delays in resolution of disability claims, has declined to impose
deadlines on the administrative process. Accordingly, we reverse the
judgment below.
II
The Secretary does not challenge here the determination that 405(b)
requires administrative hearings to be held within a reasonable time. Nor
does she challenge the District Court's determination that the delays
encountered in the cases of plaintiffs Day and Maurais violated that
requirement. [15] She argues
only that a statewide injunction that imposes judicially prescribed
deadlines on HHS for all future disability determinations is contrary to
congressional intent and constitutes an abuse of the court's equitable
power. She argues in the alternative that even if the injunction is
appropriate, the order requiring payment of interim benefits in cases of
noncompliance is not. The Secretary looks primarily to legislative history
to support both arguments.
A
deadlines on HHS for all future disability determinations is contrary to
congressional intent and constitutes an abuse of the court's equitable
power. She argues in the alternative that even if the injunction is
appropriate, the order requiring payment of interim benefits in cases of
noncompliance is not. The Secretary looks primarily to legislative history
to support both arguments.
A
The Secretary correctly points out that Congress repeatedly has been made
aware of the long delays associated with resolution of disputed disability
claims and repeatedly has considered and expressly rejected suggestions
that mandatory deadlines be imposed to cure that
problem. [16] She argues that
Congress expressly has balanced the need for timely disability
determinations against the need to ensure quality decisions in the face of
heavy and escalating workloads and limited agency resources. In striking
that balance, the Secretary argues, the relevant legislative history also
shows that Congress to date has determined that mandatory deadlines for
agency adjudication of disputed disability claims are inconsistent with
achievement of the Act's primary objectives, and that the District Court's
statewide injunction flatly contradicts that legislative determination. We
find this argument persuasive.
Congressional concern over timely resolution of disputed disability
claims under Title II began at least as early as
1975. [17] It has inspired
almost annual congressional debate since that
time. [18] The consistency with
which Congress has expressed concern over this issue is matched by its
consistent refusal to impose on the Secretary mandatory deadlines for
resolution of disputed disability claims.
ern over timely resolution of disputed disability
claims under Title II began at least as early as
1975. [17] It has inspired
almost annual congressional debate since that
time. [18] The consistency with
which Congress has expressed concern over this issue is matched by its
consistent refusal to impose on the Secretary mandatory deadlines for
resolution of disputed disability claims.
In 1975, the House Social Security Subcommittee held hearings on the
delays encountered in resolving disputed Social Security
claims, [19] and sixty members
of the House sponsored a bill imposing statutory deadlines for each step
in the administrative review of disputed SSA
claims. [20] Expressions of
concern were voiced in both the Senate and the House over the "huge
backlog of some 103,000 cases awaiting hearing" before an ALJ. S. Rep. No.
94-550, p. 3 (1975); accord H. R. Rep. No. 94-679, pp. 1-2
(1975). [21] Despite this
concern, the Staff of the House Subcommittee advised against statutory
deadlines because of the potential "adverse effect on the quality and
uniformity of disability adjudication which is already somewhat suspect."
Staff of the Subcomm. on Social Security of the House Comm. on Ways &
Means, 94th Cong., 1st Sess., Appeals Process: Areas of Possible
Administrative or Legislative Action 1-2 (Comm. Print 1975)
[hereinafter 1975 Staff
Report]. [22] Congress agreed
and refused to impose statutory deadlines on the Secretary.
and
uniformity of disability adjudication which is already somewhat suspect."
Staff of the Subcomm. on Social Security of the House Comm. on Ways &
Means, 94th Cong., 1st Sess., Appeals Process: Areas of Possible
Administrative or Legislative Action 1-2 (Comm. Print 1975)
[hereinafter 1975 Staff
Report]. [22] Congress agreed
and refused to impose statutory deadlines on the Secretary.
Bills proposing statutory deadlines have been proposed almost annually
since 1975, [23] and
congressional concern over the delay problem has remained high. For
example, in 1980 Congress directed the Secretary to submit a report
recommending the establishment of appropriate and realistic deadlines for
resolution of disputed SSA claims. It ordered the Secretary in doing so to
consider "both the need for expeditious processing of claims for benefits
and the need to assure that all such claims will be thoroughly considered
and accurately determined." Pub. L. 96-265, 94 Stat. 458, note following
42 U.S.C. 401 (Supp. V). The Senate Report explained that "Congress could
then evaluate the recommendations for consistency with the elements it
wishes to emphasize and, if needed, take further action next year." S.
Rep. No. 96-408, p. 59
(1979). [24] The Secretary
submitted a report in October 1980, suggesting deadlines of 150 days for
reconsideration determinations and 165 days from hearing to post-hearing
decision, both subject to certain exceptions. Report of the Department of
Health & Human Services 1 (October 21, 1980). The Secretary, however,
cautioned Congress that budget and staff limitations and burgeoning
workloads "mitigate against the Department meeting its proposed time
limitation objectives in every instance." Id. , at 2. Since
receiving the Secretary's report, Congress has refused to impose mandatory
deadlines on the Secretary, or to direct her to promulgate them
herself.
(October 21, 1980). The Secretary, however,
cautioned Congress that budget and staff limitations and burgeoning
workloads "mitigate against the Department meeting its proposed time
limitation objectives in every instance." Id. , at 2. Since
receiving the Secretary's report, Congress has refused to impose mandatory
deadlines on the Secretary, or to direct her to promulgate them
herself.
Certainly in Congress the concern that mandatory deadlines would
jeopardize the quality and uniformity of agency decisions has prevailed
over considerations of timeliness. In its most recent comment on the
subject, the House Committee on Ways and Means expressly disapproved
mandatory hearing deadlines and indicated disagreement with recent
judicial decisions imposing such time restrictions. Criticizing the
decision in Blankenship v. Secretary of HEW , No. C75-0185L(A) (W.D.
Ky. May 6, 1976), which had imposed judicially prescribed hearing
deadlines on the Secretary and ordered the payment of interim benefits in
the event of
noncompliance, [25] the
Committee reported:
Finally, the Secretary points out that judicially imposed deadlines may
vary from case to case and from state to state, requiring HHS to shuffle
its staff nationwide. Not only would this tend seriously to disrupt agency
administration, but wide variations in judicially imposed deadlines also
would prevent realization of Congress' oft-repeated goal of uniform
administration of the Act. See, e.g. , S. Rep. No. 96-408, pp. 52-56
dicially imposed deadlines may
vary from case to case and from state to state, requiring HHS to shuffle
its staff nationwide. Not only would this tend seriously to disrupt agency
administration, but wide variations in judicially imposed deadlines also
would prevent realization of Congress' oft-repeated goal of uniform
administration of the Act. See, e.g. , S. Rep. No. 96-408, pp. 52-56
(1979) (emphasizing concern over "state-to-state" variations and
expressing hope that current legislation would "both improve the quality
of determinations and ensure that claimants throughout the Nation will be
judged under the same uniform standards and procedures ") (emphasis
added.). [27]
B
Legislation enacted by Congress in 1980 and 1982 is fully consistent with
the repeated rejection of proposals for mandatory deadlines and with
efforts by Congress to ensure quality and uniformity in agency
adjudication. In 1980, Congress amended 405(b) to require that every
initial determination of ineligibility contain an easily understandable
discussion of the evidence and the reasons for the determination. Pub. L.
96-265, 94 Stat. 457, 42 U.S.C. 405(b) (Supp. V). At the same time,
Congress added 421(h) to require a tri-annual assessment of the continuing
eligibility of recipients of disability benefits. Pub. L. 96-265, 94 Stat.
460, 42 U.S.C. 421(h) (Supp. V). Congress also included in the 1980
amendments a requirement that the Secretary review at least 65% of all
determinations of eligibility made by state agencies in any fiscal year
after 1982. Pub. L. 96-265, 94 Stat. 456, 42 U.S.C. 421(c)(2), (3) (Supp.
V). [28] Before 1972, the
Secretary had reviewed the majority of state determinations as a matter of
course. A growing workload required the Secretary to abandon this practice
for a sample review only 5% of the state agency determinations. H.R. Rep.
No. 96-100, p. 10 (1979)
de by state agencies in any fiscal year
after 1982. Pub. L. 96-265, 94 Stat. 456, 42 U.S.C. 421(c)(2), (3) (Supp.
V). [28] Before 1972, the
Secretary had reviewed the majority of state determinations as a matter of
course. A growing workload required the Secretary to abandon this practice
for a sample review only 5% of the state agency determinations. H.R. Rep.
No. 96-100, p. 10 (1979). The 1980 amendment, requiring review of a
substantially higher percentage of state agency disability determinations,
presumably will have an effect on the timely resolution of disputed
disability claims. [29]
Finally, in 1982 Congress provided that effective January 1, 1984, an
initial determination that previously granted disability benefits should
be terminated entitles the claimant not only to a de novo review on
reconsideration, but to a full evidentiary hearing as well. Pub. L.
97-455, 96 Stat. 2499, 42 U.S.C. 405(b)(2). All of these changes will
impose additional duties on the Secretary and her heavily burdened staff.
In light of Congress' continuing concern that mandatory deadlines would
subordinate quality to timeliness, and its recent efforts to ensure the
quality of agency determinations, it hardly could have contemplated that
courts should have authority to impose the very deadlines it repeatedly
has rejected. [30]
C
Persuasive evidence of the intention of Congress also is found in the
distinction it has made between the resolution of SSI claims for old-age
and survivor benefits and SSI claims for disability benefits. Section
405(b), governing eligibility determinations under Title II, and
1383(c)(1), governing eligibility determinations under Title XVI, are
virtually identical. In the event of adverse determinations, both require
the Secretary to provide claimants with "reasonable notice and opportunity
for a hearing." In the case of disputed SSI claims
enefits and SSI claims for disability benefits. Section
405(b), governing eligibility determinations under Title II, and
1383(c)(1), governing eligibility determinations under Title XVI, are
virtually identical. In the event of adverse determinations, both require
the Secretary to provide claimants with "reasonable notice and opportunity
for a hearing." In the case of disputed SSI claims. This provision makes
two things clear: (i) Congress will establish hearing deadlines when it
deems them appropriate; and, (ii) Congress has determined that it is
inappropriate to subject disputed disability claims to mandatory
deadlines. [31]
III
The Secretary also contends that quite apart from the congressional
rejection of the mandatory deadlines discussed above, the District Court's
order unduly intruded upon the discretion with which Congress has granted
the Secretary to adopt rules and procedures for the adjudication of
claims. See Heckler v. Campbell , 103 S.Ct. 1952, 1957, (1983); Schweiker v. Gray Panthers , 453 U.S. 34, 43-44 (1981); Batterton
v. Francis , 432 U.S. 413, 425 (1977). We need not reach this broader
contention, however, because of repeated congressional rejection of the
imposition of mandatory deadlines on agency adjudication of disputed
disability claims. [32] In
light of the unmistakable intention of Congress, it would be an
unwarranted judicial intrusion into this pervasively regulated area for
federal courts to issue injunctions imposing deadlines with respect to
future disability claims. [33] Accordingly, we vacate the judgment of the Court of Appeals, and remand
the case for further proceedings consistent with this
opinion. [34]
It is so ordered .
Justice Powell was joined in this opinion by Chief Justice Burger and
Justices White, Rehnquist, and O'Connor. Justice Marshall filed a
dissenting opinion, in which Justices Brennan, Blackmun, and Stevens
joined.
[1] Section 423(d) defines
"disability" as:
gment of the Court of Appeals, and remand
the case for further proceedings consistent with this
opinion. [34]
It is so ordered .
Justice Powell was joined in this opinion by Chief Justice Burger and
Justices White, Rehnquist, and O'Connor. Justice Marshall filed a
dissenting opinion, in which Justices Brennan, Blackmun, and Stevens
joined.
[1] Section 423(d) defines
"disability" as:
"(A) inability to engage in any substantial gainful activity by reason of
any medically determinable physical or mental impairment which can be
expected to result in death or which has lasted or can be expected to last
for a continuous period of not less than 12 months."
Any disability benefits payable under 423 are paid out of the Federal
Disability Insurance Trust Fund, which is funded by payroll taxes. 42
U.S.C. 401(b) (Supp. V).
[2] Social Security
Administration Annual 1983 Report to Congress 43-44 (1983).
[3] Office of Hearings &
Appeals, Key Workload Indicators 1, 16 (May 1983) [hereinafter Key Workload Indicators ]. In May 1983, the average number of cases
pending per administrative law judge stood at a record 221. Id. , at
1.
[4] The state agency acts under
the authority and control of the Secretary. See 42 U.S.C. 421(a).
[5] New material evidence may be
submitted to the Appeals Council. The Council then reviews all the
evidence and will reverse the ALJ's determination only if it finds that
the determination is "contrary to the weight of the evidence currently in
the record." 20 CFR 404.970(b) (1983).
[6] Day was forced to wait 167
days for a reconsideration determination. He received a hearing before the
ALJ 173 days after his hearing request. App. to Pet. for Cert. 13a-14a.
[7] Maurais waited 215 days for
a reconsideration determination after his disability benefits were
terminated. He was given a hearing before an ALJ 65 days after his hearing
request. App. to Pet. for Cert. 14a.
[6] Day was forced to wait 167
days for a reconsideration determination. He received a hearing before the
ALJ 173 days after his hearing request. App. to Pet. for Cert. 13a-14a.
[7] Maurais waited 215 days for
a reconsideration determination after his disability benefits were
terminated. He was given a hearing before an ALJ 65 days after his hearing
request. App. to Pet. for Cert. 14a.
[8] That section provides that
after any unfavorable determination of disability, the claimant, on
request, shall be entitled to "reasonable notice and opportunity for a
hearing with respect to such decision."
[9] The evidence submitted by
the government showed that 57% of the hearings requested in Vermont after
January 1978 were scheduled within 90 days, with a range of delays varying
between two and nine months. App. to Pet. for Cert. 15a. The District
Court rejected the Secretary's claim that the delays were necessary to
ensure quality decisions and to protect the limited resources of the
Social Security program. It held that "[w]hile the SSA has made admirable
strides in reducing the average length of delay experienced by claimants a
few years ago, we [believe] . . . that the SSA is not warranted in forcing
claimants to endure such lengthy delays without benefits, while it puts
its administrative appeals process in order." App. to Pet. for Cert.
17a-18a.
[10] There is no express
statutory requirement that reconsideration determinations be conducted
within a reasonable time. The District Court reasoned, however, that
because the reconsideration determination was an "administrative
prerequisite" to an administrative hearing, "[u]nreasonable delays in the
reconsideration procedures trench on the statutory duty to provide a
hearing within a reasonable time." App. to Pet. for Cert. 27a. That
reasoning is not challenged here.
[11] The order exempted
reconsideration determinations from the 90-day deadline in the following
circumstances:
App. to Pet. for Cert. 33a.
e
prerequisite" to an administrative hearing, "[u]nreasonable delays in the
reconsideration procedures trench on the statutory duty to provide a
hearing within a reasonable time." App. to Pet. for Cert. 27a. That
reasoning is not challenged here.
[11] The order exempted
reconsideration determinations from the 90-day deadline in the following
circumstances:
App. to Pet. for Cert. 33a.
[12] The order exempted
hearing requests from the 90-day deadline in the following
circumstances:
App. to Pet. for Cert. 34a.
[13] Because the District
Court held that the challenged delays violated 405(b) of the Act, it did
not reach plaintiffs' claims that the delays violated the Administrative
Procedure Act or their due process rights under the Fourteenth
Amendment.
[14] We note at the outset
that the District Court had jurisdiction to consider respondents'
statutory claim under 42 U.S.C. 405(g). There are two prerequisites to
405(g) jurisdiction. Mathews v. Eldridge , 424 U.S. 319, 328 (1976); Weinberger v. Salfi , 422 U.S. 749, 763-767 (1975). The non-waivable
jurisdictional requirement that a claim for benefits shall have been
presented to the Secretary has been met here. The jurisdictional
requirement that administrative remedies be exhausted is waivable. In the
present case, the Secretary has not challenged the sufficiency of
respondents' efforts to exhaust administrative remedies. We interpret this
to be a waiver by the Secretary of the exhaustion requirement under
405(g). See Salfi , 422 U.S., at 767.
[15] Nor do we understand the
Secretary to dispute the District Court's determination that the 27 sample
cases it studied evidenced statutory violations of the reasonableness
requirement.
the sufficiency of
respondents' efforts to exhaust administrative remedies. We interpret this
to be a waiver by the Secretary of the exhaustion requirement under
405(g). See Salfi , 422 U.S., at 767.
[15] Nor do we understand the
Secretary to dispute the District Court's determination that the 27 sample
cases it studied evidenced statutory violations of the reasonableness
requirement.
[16] The delays are not a
recent development. In fiscal year 1973, the median time between hearing
request and post-hearing disposition was 174 days. The mean processing
time reached a high in fiscal year 1976 at 288 days. At the time this
action was filed in district court (November 1978), the mean processing
time was 151 days. Key Workload Indicators 1. As the District Court
observed, "the [Secretary] has made admirable strides in reducing the
average length of delay experienced by claimants a few years ago." See n.
9, supra .
[17] See Delays in Social
Security Appeals: Hearings Before the Subcomm. on Social Security of the
House Comm. on Ways & Means, 94th Cong., 1st Sess. (1975) [hereinafter
1975 Hearings].
[18] See, e.g. ,
Disability Insurance Program: Public Hearings Before the Subcomm. on the
Social Security of the House Comm. on Ways & Means, 94th Cong., 2d
Sess., 341-343 (1976); Administrative Law Judges, HEW Executive Level
Positions, and Salary Adjustment for Director of Office of Management
& budget: Hearings Before the Subcomm. on Employee Ethics and
Utilization of the House Comm. on Post Office & Civil Service, 95th
Cong., 1st Sess. 10-11, 16-17 (1977); Disability Insurance Program --
1978: Hearings Before the Subcomm. on the Social Security of the House
Comm. on Ways & Means, 95th Cong., 2d Sess. 15-17, 97-99 (1978).
[19] See 1975 Hearings.
ector of Office of Management
& budget: Hearings Before the Subcomm. on Employee Ethics and
Utilization of the House Comm. on Post Office & Civil Service, 95th
Cong., 1st Sess. 10-11, 16-17 (1977); Disability Insurance Program --
1978: Hearings Before the Subcomm. on the Social Security of the House
Comm. on Ways & Means, 95th Cong., 2d Sess. 15-17, 97-99 (1978).
[19] See 1975 Hearings.
[20] H.R. 5276, 94th Cong.,
1st Sess. (1975). That bill proposed the following deadlines: 90 days for
an initial determination of eligibility; 90 days for a reconsideration
determination; 120 days from hearing request to post-hearing decision; and
120 days for a decision by the Appeals Council.
[21] By the end of fiscal year
1975, there was a backlog of 111,169 cases, and a mean processing time of
262 days from hearing request to post-hearing decision. Key Workload
Indicators 1.
[22] The concern was expressed
throughout the House hearings that mandatory deadlines would worsen the
situation of an already overburdened staff, thereby jeopardizing the
quality of agency decisions. See, e.g. , 1975 Hearings 8 ("Equally
important as speed of processing of cases, is the question of the quality
of adjudication"); id. , at 17 ("Heavier work loads and efforts to
increase individual ALJ production place more strain on quality of
adjudication").
[23]
See H.R. 12466, 94th Cong., 2d Sess. (1976); H.R. 5151, 95th Cong., 1st
Sess. (1977): H.R. 12672, 95th Cong., 2d Sess. (1978); H.R. 747, 96th
Cong., 1st Sess. (1979); H.R. 4775, 97th Cong., 1st Sess. (1981).
e question of the quality
of adjudication"); id. , at 17 ("Heavier work loads and efforts to
increase individual ALJ production place more strain on quality of
adjudication").
[23]
See H.R. 12466, 94th Cong., 2d Sess. (1976); H.R. 5151, 95th Cong., 1st
Sess. (1977): H.R. 12672, 95th Cong., 2d Sess. (1978); H.R. 747, 96th
Cong., 1st Sess. (1979); H.R. 4775, 97th Cong., 1st Sess. (1981).
[24] In requesting
recommendations from the Secretary, Congress faced opposition from those
who continued to press for statutory deadlines. See Disability Insurance
Legislation: Hearings Before the Subcomm. on Social Security of the House
Comm. on Ways & Means, 96th Cong., 1st Sess., 114 (1979) (Statement of
Dennis M. Sweeney & Laura W.S. Macklin on Behalf of the Administrative
Law Center, etc.) ("[T]he problem of delays in the Social Security hearing
system has been before Congress repeatedly and for a number of years. . .
. At this point, HEW is well aware of the problems in this area. . . .
[W]e respectfully submit that this is not the time to further study the
delay problem. A provision in this bill suggesting a study from HEW . . .
can only be read as an invitation to further delay cleaning up the hearing
process and getting rid of the unreasonable and unnecessary delays").
[25] The District Court's
original unpublished memorandum opinion required the Secretary to comply
with a hearing request within 90 days. The Court of Appeals for the Sixth
Circuit reversed that order and remanded for the Secretary to issue
regulations promulgating mandatory deadlines. Blankenship v. Secretary
of HEW , 587 F.2d 329 (CA6 1978). On remand, the Secretary attempted to
promulgate such regulations, but concluded that unpredictable caseloads
made deadlines impossible. The Secretary then petitioned the District
Court for relief from the requirement that she promulgate deadlines. The
District Court refused and ordered the Secretary to promulgate the
regulations. Blankenship v
cretary
of HEW , 587 F.2d 329 (CA6 1978). On remand, the Secretary attempted to
promulgate such regulations, but concluded that unpredictable caseloads
made deadlines impossible. The Secretary then petitioned the District
Court for relief from the requirement that she promulgate deadlines. The
District Court refused and ordered the Secretary to promulgate the
regulations. Blankenship v. Secretary of Health & Human
Services , 532 F. Supp. 739 (WD Ky. 1982). The Sixth Circuit affirmed
on appeal. Blankenship v. Schweiker , Nos. 82-5130, 82-5204
(December 1, 1983). JUSTICE O'CONNOR has stayed the District Court's order
requiring the Secretary to promulgate regulations pending our decision in
this case. Heckler v. Blankenship , _____ U.S. _____ (1984).
[26] This clear expression of
congressional disapproval refutes the dissent's suggestion that Congress
implicitly has endorsed judicially mandated deadlines by failing to
repudiate those judicial decisions that have imposed them. See post , at 7. There is simply no basis for the dissent's proposition
that this passage "when read in context, supports only the inference that
Congress chose not to 'assert its power to give the district court's more
specific direction.'" Post , at 8, n. 9 (quoting White v.
Mathews , 559 F.2d 852, 861 (CA2 1977), cert. denied, 435 U.S. 908
(1978)).
[27] The dissent's suggestion
that Congress meant to prohibit only nationwide and not statewide deadlines is unpersuasive. The legislative history
suggests no distinction between the two. Moreover, injunctive orders
imposing varying deadlines from state to state would defeat the express
congressional goal of uniformity. See S. Rep. No. 96-408, 52-56 (1979).
[28] The 1980 amendments also
authorized the Secretary to review determinations of ineligibility on her
own motion. 42 U.S.C. 421(c)(1).
s unpersuasive. The legislative history
suggests no distinction between the two. Moreover, injunctive orders
imposing varying deadlines from state to state would defeat the express
congressional goal of uniformity. See S. Rep. No. 96-408, 52-56 (1979).
[28] The 1980 amendments also
authorized the Secretary to review determinations of ineligibility on her
own motion. 42 U.S.C. 421(c)(1).
[29] The legislative history
of this amendment suggests that Congress was concerned that undue emphasis
on expediting resolution of disputed claims had resulted in a marked loss
of quality and uniformity in agency decisions. See, e.g. , S. Rep.
No. 96-408, pp. 52-56 (1979).
[30] The suggestion made by
the dissent that this legislative history "has little relevance to the
task before us," post , at 6, is mistaken. The legislative history
set forth in this opinion demonstrates far more than simple congressional
inaction in the face of acknowledged delays; it explicitly shows that
Congress has rejected repeated demands for mandatory deadlines. We rarely
see as clear an expression of congressional intent.
[31] As early as 1967,
Congress recognized the difference between old-age and disability
claims:
"The process of making disability determinations is significantly
different from the retirement and survivors insurance claims process. In
the disability process[,] State vocational rehabilitation agencies are
involved importantly in the making of the decision[,] and in the
borderline cases[,] lengthy and extensive development of facts of a
medical nature is often required." S. Rep. No. 744, 90th Cong., 1st Sess.
107 (1967).
inations is significantly
different from the retirement and survivors insurance claims process. In
the disability process[,] State vocational rehabilitation agencies are
involved importantly in the making of the decision[,] and in the
borderline cases[,] lengthy and extensive development of facts of a
medical nature is often required." S. Rep. No. 744, 90th Cong., 1st Sess.
107 (1967).
[32] In view of Congress's
unequivocal determination that mandatory deadlines are inappropriate, the
repeated references in the dissenting opinion to the "reasonableness" of
the injunctive order at issue here are simply irrelevant. See post ,
at 3, n. 1, 13-14, 15-16. The dissent states that the injunction at issue
is "narrowly crafted," and assumes that the Secretary would have no
difficulty complying with it. Even if this assumption were correct, it
hardly suggests that this Court should disregard the considered
determination of Congress that mandatory deadlines are inappropriate.
[33] We make clear that
nothing in this opinion precludes the proper use of injunctive relief to
remedy individual violations of 405(b). Our decision in this case
is limited to the question whether, in view of the unequivocally clear
intent of Congress to the contrary, it is nevertheless appropriate for a
federal court to prescribe mandatory deadlines with respect to the
adjudication of disability claims under Title II of the Act. We understand
that the courts below were moved by long delays that well may have caused
serious deprivations. But this does not justify imposing absolute periods
of limitations applicable to all claims -- limitations that Congress
repeatedly has declined to enact.
[34] The District Court's
order requiring the payment of interim benefits was conditioned on
noncompliance with the injunction. Because we have held that the
injunction is invalid, we need not address the propriety of that part of
the District Court's order requiring payment of interim benefits.
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