In order to establish initial and continued entitlement to
disability benefits under the Social Security Act (Act), a worker
must demonstrate that,
inter alia, he is unable "to engage
in any substantial gainful activity by reason of any medically
determinable physical or mental impairment. . . ." The worker bears
the continuing burden of showing, by means of "medically acceptable
. . . techniques" that his impairment is of such severity that he
cannot perform his previous work or any other kind of gainful work.
A state agency makes the continuing assessment of the worker's
eligibility for benefits, obtaining information from the worker and
his sources of medical treatment. The agency may arrange for an
independent medical examination to resolve conflicting information.
If the agency's tentative assessment of the beneficiary's condition
differs from his own, the beneficiary is informed that his benefits
may be terminated, is provided a summary of the evidence, and
afforded an opportunity to review the agency's evidence. The state
agency then makes a final determination, which is reviewed by the
Social Security Administration (SSA). If the SSA accepts the agency
determination, it gives written notification to the beneficiary of
the reasons for the decision and of his right to
de novo
state agency reconsideration. Upon acceptance by the SSA, benefits
are terminated effective two months after the month in which
recovery is found to have occurred. If, after reconsideration by
the state agency and SSA review, the decision remains adverse to
the recipient, he is notified of his right to an evidentiary
hearing before an SSA administrative law judge. If an adverse
decision results, the recipient may request discretionary review by
the SSA Appeals Council, and finally may obtain judicial review. If
it is determined after benefits are terminated that the claimant's
disability extended beyond the date of cessation initially
established, he is entitled to retroactive payments. Retroactive
adjustments are also made for overpayments. A few years after
respondent was first awarded disability benefits, he received and
completed a questionnaire
Page 424 U. S. 320
from the monitoring state agency. After considering the
information contained therein and obtaining reports from his doctor
and an independent medical consultant, the agency wrote respondent
that it had tentatively determined that his disability had ceased
in May, 1972, and advised him that he might request a reasonable
time to furnish additional information. In a reply letter,
respondent disputed one characterization of his medical condition
and indicated that the agency had enough evidence to establish his
disability. The agency then made its final determination
reaffirming its tentative decision. This determination was accepted
by the SSA, which notified respondent in July that his benefits
would end after that month and that he had a right to state agency
reconsideration within six months. Instead of requesting such
reconsideration, respondent brought this action challenging the
constitutionality of the procedures for terminating disability
benefits and seeking reinstatement of benefits pending a hearing.
The District Court, relying in part on
Goldberg v. Kelly,
397 U. S. 254,
held that the termination procedures violated procedural due
process and concluded that prior to termination of benefits
respondent was entitled to an evidentiary hearing of the type
provided welfare beneficiaries under Title IV of the Act. The Court
of Appeals affirmed. Petitioner contends,
inter alia, that
the District Court is barred from considering respondent's action
by
Weinberger v. Salfi, 422 U. S. 749,
which held that district courts are precluded from exercising
jurisdiction over an action seeking a review of a decision of the
Secretary of Health, Education, and Welfare regarding benefits
under the Act except as provided in 42 U.S.C. § 405(g), which
grants jurisdiction only to review a "final" decision of the
Secretary made after a hearing to which he was a party.
Held:
1. The District Court had jurisdiction over respondent's
constitutional claim, since the denial of his request for benefits
was a final decision with respect to that claim for purposes of §
405(g) jurisdiction. Pp.
424 U. S.
326-332.
(a) The § 405(g) finality requirement consists of the waivable
requirement that the administrative remedies prescribed by the
Secretary be exhausted and the nonwaivable requirement that a claim
for benefits shall have been presented to the Secretary.
Respondent's answers to the questionnaire and his letter to the
state agency specifically presented the claim that his benefits
should not be terminated because he was still disabled, and thus
satisfied the nonwaivable requirement. Pp.
424 U. S.
328-330.
Page 424 U. S. 321
(b) Although respondent concededly did not exhaust the
Secretary's internal review procedures, and ordinarily only the
Secretary has the power to waive exhaustion, this is a case where
the claimant's interest in having a particular issue promptly
resolved is so great that deference to the Secretary's judgment is
inappropriate. The facts that respondent's constitutional challenge
was collateral to his substantive claim of entitlement, and that
(contrary to the situation in
Salfi) he colorably claimed
that an erroneous termination would damage him in a way not
compensable through retroactive payments warrant the conclusion
that the denial of his claim to continued benefits was a
sufficiently "final decision" with respect to his constitutional
claim to satisfy the statutory exhaustion requirement. Pp.
424 U. S.
330-332.
2. An evidentiary hearing is not required prior to the
termination of Social Security disability payments, and the
administrative procedures prescribed under the Act fully comport
with due process. Pp.
424 U. S.
332-349.
(a) "[D]ue process is flexible and calls for such procedural
protections as the particular situation demands,"
Morrissey v.
Brewer, 408 U. S. 471,
408 U. S. 481.
Resolution of the issue here involving the constitutional
sufficiency of administrative procedures prior to the initial
termination of benefits and pending review, requires consideration
of three factors: (1) the private interest that will be affected by
the official action; (2) the risk of an erroneous deprivation of
such interest through the procedures used, and probable value, if
any, of additional procedural safeguards; and (3) the Government's
interest, including the fiscal and administrative burdens that the
additional or substitute procedures would entail. Pp.
424 U. S.
332-335.
(b) The private interest that will be adversely affected by an
erroneous termination of benefits is likely to be less in the case
of a disabled worker than in the case of a welfare recipient, like
the claimants in
Goldberg, supra. Eligibility for
disability payments is not based on financial need, and, although
hardship may be imposed upon the erroneously terminated disability
recipient, his need is likely less than the welfare recipient. In
view of other forms of government assistance available to the
terminated disability recipient, there is less reason than in
Goldberg to depart from the ordinary principle that
something less than an evidentiary hearing is sufficient prior to
adverse administrative action. Pp.
424 U. S.
339-343.
(c) The medical assessment of the worker's condition
implicates
Page 424 U. S. 322
a more sharply focused and easily documented decision than the
typical determination of welfare entitlement. The decision whether
to discontinue disability benefits will normally turn upon
"routine, standard, and unbiased medical repots by physician
specialists,"
Richardson v. Perales, 402 U.
S. 389,
402 U. S. 40. In
a disability situation, the potential value of an evidentiary
hearing is thus substantially less than in the welfare context. Pp.
424 U. S.
343-345.
(d) Written submissions provide the disability recipient with an
effective means of communicating his case to the decisionmaker. The
detailed questionnaire identifies with particularity the
information relevant to the entitlement decision. Information
critical to the decision is derived directly from medical sources.
Finally, prior to termination of benefits, the disability recipient
or his representative is afforded full access to the information
relied on by the state agency, is provided the reasons underlying
its tentative assessment, and is given an opportunity to submit
additional arguments and evidence. Pp.
424 U. S.
345-346.
(e) Requiring an evidentiary hearing upon demand in all cases
prior to the termination of disability benefits would entail fiscal
and administrative burdens out of proportion to any countervailing
benefits. The judicial model of an evidentiary hearing is neither a
required, nor even the most effective, method of decisionmaking in
all circumstances, and here, where the prescribed procedures not
only provide the claimant with an effective process for asserting
his claim prior to any administrative action, but also assure a
right to an evidentiary hearing, as well as subsequent judicial
review before the denial of his claim becomes final, there is no
deprivation of procedural due process. Pp.
424 U. S.
347-349.
493 F.2d 1230, reversed.
POWELL, J., delivered the opinion of the Court, in which BURGER,
C.J., and STEWART, WHITE, BLACKMUN, and REHNQUIST, JJ., joined.
BRENNAN, J., filed a dissenting opinion, in which MARSHALL, J.,
joined,
post, p.
424 U. S. 349.
STEVENS, J., took no part in the consideration or decision of the
case.
Page 424 U. S. 323
MR. JUSTICE POWELL delivered the opinion of the Court.
The issue in this case is whether the Due Process Clause of the
Fifth Amendment requires that, prior to the termination of Social
Security disability benefit payments, the recipient be afforded an
opportunity for an evidentiary hearing.
I
Cash benefits are provided to workers during periods in which
they are completely disabled under the disability insurance
benefits program created by the 1956 amendments to Title II of the
Social Security Act. 70 Stat. 815, 42 U.S.C. § 423. [
Footnote 1] Respondent Eldridge was first
awarded benefits in June, 1968. In March, 1972, he received a
questionnaire from the state agency charged with monitoring his
medical condition. Eldridge completed
Page 424 U. S. 324
the questionnaire, indicating that his condition had not
improved and identifying the medical sources, including physicians,
from whom he had received treatment recently. The state agency then
obtained reports from his physician and a psychiatric consultant.
After considering these reports and other information in his file,
the agency informed Eldridge by letter that it had made a tentative
determination that his disability had ceased in May, 1972. The
letter included a statement of reasons for the proposed termination
of benefits, and advised Eldridge that he might request reasonable
time in which to obtain and submit additional information
pertaining to his condition.
In his written response, Eldridge disputed one characterization
of his medical condition and indicated that the agency already had
enough evidence to establish his disability. [
Footnote 2] The state agency then made its final
determination that he had ceased to be disabled in May, 1972. This
determination was accepted by the Social Security Administration
(SSA), which notified Eldridge in July that his benefits would
terminate after that month. The notification also advised him of
his right to seek reconsideration by the state agency of this
initial determination within six months.
Instead of requesting reconsideration, Eldridge commenced this
action challenging the constitutional validity
Page 424 U. S. 325
of the administrative procedures established by the Secretary of
Health, Education, and Welfare for assessing whether there exists a
continuing disability. He sought an immediate reinstatement of
benefits pending a hearing on the issue of his disability.
[
Footnote 3]
361 F.
Supp. 520 (WD Va.1973). The Secretary moved to dismiss on the
grounds that Eldridge's benefits had been terminated in accordance
with valid administrative regulations and procedures and that he
had failed to exhaust available remedies. In support of his
contention that due process requires a pre-termination hearing,
Eldridge relied exclusively upon this Court's decision in
Goldberg v. Kelly, 397 U. S. 254
(1970), which established a right to an "evidentiary hearing" prior
to termination of welfare benefits. [
Footnote 4] The Secretary contended that
Goldberg
was not controlling, since eligibility for disability benefits,
unlike eligibility for welfare benefits, is not based on financial
need, and since issues of credibility and veracity do not play a
significant role in the disability entitlement decision, which
turns primarily on medical evidence.
The District Court concluded that the administrative procedures
pursuant to which the Secretary had terminated Eldridge's benefits
abridged his right to procedural
Page 424 U. S. 326
due process. The court viewed the interest of the disability
recipient in uninterrupted benefits as indistinguishable from that
of the welfare recipient in
Goldberg. It further noted
that decisions subsequent to
Goldberg demonstrated that
the due process requirement of pre-termination hearings is not
limited to situations involving the deprivation of vital
necessities.
See Fuentes v. Shevin, 407 U. S.
67,
407 U. S. 88-89
(1972);
Bell v. Burson, 402 U. S. 535,
402 U. S. 539
(1971). Reasoning that disability determinations may involve
subjective judgments based on conflicting medical and nonmedical
evidence, the District Court held that, prior to termination of
benefits, Eldridge had to be afforded an evidentiary hearing of the
type required for welfare beneficiaries under Title IV of the
Social Security Act.
361 F.
Supp. at 528. [
Footnote 5]
Relying entirely upon the District Court's opinion, the Court of
Appeals for the Fourth Circuit affirmed the injunction barring
termination of Eldridge's benefits prior to an evidentiary hearing.
493 F.2d 1230 (1974). [
Footnote
6] We reverse.
II
At the outset, we are confronted by a question as to whether the
District Court had jurisdiction over this suit. The Secretary
contends that our decision last Term in
Weinberger v.
Salfi, 422 U. S. 749
(1975), bars the District Court from considering Eldridge's action.
Salfi was an action challenging the Social Security
Act's
Page 424 U. S. 327
"duration of relationship" eligibility requirements for
surviving wives and stepchildren of deceased wage earners. We there
held that 42 U.S.C. § 405(h) [
Footnote 7] precludes federal question jurisdiction in an
action challenging denial of claimed benefits. The only avenue for
judicial review is 42 U.S.C. § 405(g), which requires exhaustion of
the administrative remedies provided under the Act as a
jurisdictional prerequisite.
Section 405(g) in part provides:
"Any individual, after any final decision of the Secretary made
after a hearing to which he was a party, irrespective of the amount
in controversy, 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
Secretary may allow. [
Footnote
8] "
Page 424 U. S. 328
On its face, § 405(g) thus bars judicial review of any denial of
a claim of disability benefits until after a "final decision" by
the Secretary after a "hearing." It is uncontested that Eldridge
could have obtained full administrative review of the termination
of his benefits, yet failed even to seek reconsideration of the
initial determination. Since the Secretary has not "waived" the
finality requirement as he had in
Salfi, supra at
422 U. S. 767,
he concludes that Eldridge cannot properly invoke § 405(g) as a
basis for jurisdiction. We disagree.
Salfi identified several conditions which must be
satisfied in order to obtain judicial review under § 405(g). Of
these, the requirement that there be a final decision by the
Secretary after a hearing was regarded as "central to the requisite
grant of subject matter jurisdiction . . ." 422 U.S. at
422 U. S. 764.
[
Footnote 9] Implicit in
Salfi, however, is the principle that this condition
consists of two elements, only one of which is purely
"jurisdictional" in the sense that it cannot be "waived" by the
Secretary in a particular case. The waivable element is the
requirement that the administrative remedies prescribed by the
Secretary be exhausted. The nonwaivable element is the requirement
that a claim for benefits shall have been presented to the
Secretary. Absent such a claim, there can be no "decision" of any
type. And some decision by the Secretary is clearly required by the
statute.
Page 424 U. S. 329
That this second requirement is an essential and distinct
precondition for § 405(g) jurisdiction is evident from the
different conclusions that we reached in
Salfi with
respect to the named appellees and the unnamed members of the
class. As to the latter, the complaint was found to be
jurisdictionally deficient, since it "contain[ed] no allegations
that they have even filed an application with the Secretary. . . ."
422 U.S. at
422 U. S. 764.
With respect to the named appellees, however, we concluded that the
complaint was sufficient, since it alleged that they had "fully
presented their claims for benefits
to their district Social
Security Office and, upon denial, to the Regional Office for
reconsideration.'" Id. at 422 U. S.
764-765. Eldridge has fulfilled this crucial
prerequisite. Through his answers to the state agency
questionnaire, and his letter in response to the tentative
determination that his disability had ceased, he specifically
presented the claim that his benefits should not be terminated
because he was still disabled. This claim was denied by the state
agency, and its decision was accepted by the SSA.
The fact that Eldridge failed to raise with the Secretary his
constitutional claim to a pre-termination hearing is not
controlling. [
Footnote 10]
As construed in
Salfi, § 405(g) requires only that there
be a "final decision" by the Secretary with respect to the claim of
entitlement to benefits. Indeed, the named appellees in
Salfi did not present their constitutional claim to the
Secretary.
Weinberger v. Salfi, O.T. 1974, No. 74-214,
App. 11, 17-21. The situation here is not identical to
Salfi, for, while the
Page 424 U. S. 330
Secretary had no power to amend the statute alleged to be
unconstitutional in that case, he does have authority to determine
the timing and content of the procedures challenged here. 4 2
U.S.C. § 405(a). We do not, however, regard this difference as
significant. It is unrealistic to expect that the Secretary would
consider substantial changes in the current administrative review
system at the behest of a single aid recipient raising a
constitutional challenge in an adjudicatory context. The Secretary
would not be required even to consider such a challenge.
As the nonwaivable jurisdictional element was satisfied, we next
consider the waivable element. The question is whether the denial
of Eldridge's claim to continued benefits was a sufficiently
"final" decision with respect to his constitutional claim to
satisfy the statutory exhaustion requirement. Eldridge concedes
that he did not exhaust the full set of internal review procedures
provided by the Secretary.
See 20 CFR §§ 404.910, 404.916,
404.940 (1975). As
Salfi recognized, the Secretary may
waive the exhaustion requirement if he satisfies himself, at any
stage of the administrative process, that no further review is
warranted either because the internal needs of the agency are
fulfilled or because the relief that is sought is beyond his power
to confer.
Salfi suggested that, under § 405(g), the power
to determine when finality has occurred ordinarily rests with the
Secretary, since ultimate responsibility for the integrity of the
administrative program is his. But cases may arise where a
claimant's interest in having a particular issue resolved promptly
is so great that deference to the agency's judgment is
inappropriate. This is such a case.
Eldridge's constitutional challenge is entirely collateral to
his substantive claim of entitlement. Moreover, there
Page 424 U. S. 331
is a crucial distinction between the nature of the
Constitutional claim asserted here and that raised in
Salfi. A claim to a pre-deprivation hearing as a matter of
constitutional right rests on the proposition that full relief
cannot be obtained at a post-deprivation hearing.
See Regional
Rail Reorganization Act Cases, 419 U.
S. 102,
419 U. S. 156
(1974). In light of the Court's prior decisions,
see, e.g.,
Goldberg v. Kelly, 397 U. S. 254
(1970);
Fuentes v. Shevin, 407 U. S.
67 (1972), Eldridge has raised at least a colorable
claim that, because of his physical condition and dependency upon
the disability benefits, an erroneous termination would damage him
in a way not recompensable through retroactive payments. [
Footnote 11] Thus, unlike the
situation in
Salfi, denying Eldridge's substantive
Page 424 U. S. 332
claim "for other reasons" or upholding it "under other
provisions" at the post-termination stage, 422 U.S. at
422 U. S. 762,
would not answer his constitutional challenge.
We conclude that the denial of Eldridge's request for benefits
constitutes a final decision for purposes of § 405(g) jurisdiction
over his constitutional claim. We now proceed to the merits of that
claim. [
Footnote 12]
III
A
Procedural due process imposes constraints on governmental
decisions which deprive individuals of "liberty" or "property"
interests within the meaning of the Due Process Clause of the Fifth
or Fourteenth Amendment. The Secretary does not contend that
procedural due process is inapplicable to terminations of Social
Security disability benefits. He recognizes, as has been implicit
in our prior decisions,
e.g., Richardson v. Belcher,
404 U. S. 78,
404 U. S. 80-81
(1971);
Richardson v. Perales, 402 U.
S. 389,
402 U. S.
401-402 (1971);
Flemming v. Nestor,
363 U. S. 603,
363 U. S. 611
(1960), that the interest of an individual in continued receipt of
these benefits is a statutorily created "property" interest
protected by the Fifth Amendment.
Cf. Arnett v. Kennedy,
416 U. S. 134,
416 U. S. 166
(POWELL, J., concurring in part) (1974);
Board of Regents v.
Roth, 408 U. S. 564,
408 U. S.
576-578 (1972);
Bell v Burson, 402 U.S. at
402 U. S. 539;
Goldberg v. Kelly, 397 U.S. at
397 U. S.
261-262. Rather, the Secretary contends that the
existing administrative procedures, detailed below, provide all the
process
Page 424 U. S. 333
that is constitutionally due before a recipient can be deprived
of that interest.
This Court consistently has held that some form of hearing is
required before an individual is finally deprived of a property
interest.
Wolff v. McDonnell, 418 U.
S. 539,
418 U. S.
557-558 (1974).
See, e.g., Phillips v.
Commissioner, 283 U. S. 589,
283 U. S.
596-597 (1931).
See also Dent v. West Virginia,
129 U. S. 114,
129 U. S.
124-125 (1889). The
"right to be heard before being condemned to suffer grievous
loss of any kind, even though it may not involve the stigma and
hardships of a criminal conviction, is a principle basic to our
society."
Joint Anti-Fascist Comm. v. McGrath, 341 U.
S. 123,
341 U. S. 168
(1951) (Frankfurter, J., concurring). The fundamental requirement
of due process is the opportunity to be heard "at a meaningful time
and in a meaningful manner."
Armstrong v. Manzo,
380 U. S. 545,
380 U. S. 552
(1965).
See Grannis v. Ordean, 234 U.
S. 385,
234 U. S. 394
(1914). Eldridge agrees that the review procedures available to a
claimant before the initial determination of ineligibility becomes
final would be adequate if disability benefits were not terminated
until after the evidentiary hearing stage of the administrative
process. The dispute centers upon what process is due prior to the
initial termination of benefits, pending review.
In recent years, this Court increasingly has had occasion to
consider the extent to which due process requires an evidentiary
hearing prior to the deprivation of some type of property interest
even if such a hearing is provided thereafter. In only one case,
Goldberg v. Kelly, 397 U.S. at
397 U. S.
26-271, has the Court held that a hearing closely
approximating a judicial trial is necessary. In other cases
requiring some type of pre-termination hearing as a matter of
constitutional right, the Court has spoken sparingly about the
requisite procedures.
Sniadach
Page 424 U. S. 334
v. Family Finance Corp., 395 U.
S. 337 (1969), involving garnishment of wages, was
entirely silent on the matter. In
Fuentes v. Shevin, 407
U.S. at
407 U. S. 96-97,
the Court said only that, in a replevin suit between two private
parties, the initial determination required something more than an
ex parte proceeding before a court clerk. Similarly,
Bell v. Burson, supra at
402 U. S. 540,
held, in the context of the revocation of a state-granted driver's
license, that due process required only that the pre-revocation
hearing involve a probable cause determination as to the fault of
the licensee, noting that the hearing "need not take the form of a
full adjudication of the question of liability."
See also North
Georgia Finishing, Inc. v. Di-Chem, Inc., 419 U.
S. 601,
419 U. S. 607
(1975). More recently, in
Arnett v. Kennedy, supra, we
sustained the validity of procedures by which a federal employee
could be dismissed for cause. They included notice of the action
sought, a copy of the charge, reasonable time for filing a written
response, and an opportunity for an oral appearance. Following
dismissal, an evidentiary hearing was provided. 416 U.S. at
416 U. S.
142-146.
These decisions underscore the truism that "
[d]ue process,'
unlike some legal rules, is not a technical conception with a fixed
content unrelated to time, place and circumstances." Cafeteria
Workers v. McElroy, 367 U. S. 886,
367 U. S. 895
(1961). "[D]ue process is flexible, and calls for such procedural
protections as the particular situation demands." Morrissey v.
Brewer, 408 U. S. 471,
408 U. S. 481
(1972). Accordingly, resolution of the issue whether the
administrative procedures provided here are constitutionally
sufficient requires analysis of the governmental and private
interests that are affected. Arnett v. Kennedy, supra at
416 U. S.
167-168 (POWELL, J., concurring in part); Goldberg
v. Kelly, supra at 397 U. S.
263-266; Cafeteria Workers v. McElroy, supra at
367 U. S. 895.
More precisely, our prior decisions
Page 424 U. S. 335
indicate that identification of the specific dictates of due
process generally requires consideration of three distinct factors:
first, the private interest that will be affected by the official
action; second, the risk of an erroneous deprivation of such
interest through the procedures used, and the probable value, if
any, of additional or substitute procedural safeguards; and,
finally, the Government's interest, including the function involved
and the fiscal and administrative burdens that the additional or
substitute procedural requirement would entail.
See, e.g.,
Goldberg v. Kelly, supra at
397 U. S.
263-271.
We turn first to a description of the procedures for the
termination of Social Security disability benefits, and thereafter
consider the factors bearing upon the constitutional adequacy of
these procedures.
B
The disability insurance program is administered jointly by
state and federal agencies. State agencies make the initial
determination whether a disability exists, when it began, and when
it ceased. 42 U.S.C. § 421(a). [
Footnote 13] The standards applied and the procedures
followed are prescribed by the Secretary,
see § 421(b),
who has delegated his responsibilities and powers under the Act to
the SSA.
See 40 Fed.Reg. 4473 (1975).
Page 424 U. S. 336
In order to establish initial and continued entitlement to
disability benefits, a worker must demonstrate that he is
unable
"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. . .
."
42 U.S.C. § 423(d)(1)(A). To satisfy this test, the worker bears
a continuing burden of showing, by means of "medically acceptable
clinical and laboratory diagnostic techniques," § 423(d)(3), that
he has a physical or mental impairment of such severity that
"he is not only unable to do his previous work, but cannot,
considering his age, education, and work experience, engage in any
other kind of substantial gainful work which exists in the national
economy, regardless of whether such work exists in the immediate
area in which he lives, or whether a specific job vacancy exists
for him, or whether he would be hired if he applied for work."
§ 423(d)(2)(A). [
Footnote
14] The principal reasons for benefits terminations are that
the worker is no longer disabled or has returned to work. As
Eldridge's benefits were terminated because he was determined to be
no longer disabled, we consider only the sufficiency of the
procedures involved in such cases. [
Footnote 15]
Page 424 U. S. 337
The continuing eligibility investigation is made by a state
agency acting through a "team" consisting of a physician and a
nonmedical person trained in disability evaluation. The agency
periodically communicates with the disabled worker, usually by mail
-- in which case he is sent a detailed questionnaire -- or by
telephone, and requests information concerning his present
condition, including current medical restrictions and sources of
treatment, and any additional information that he considers
relevant to his continued entitlement to benefits. CM § 6705.1;
Disability Insurance State Manual (DISM) § 353.3 (TL No. 137, Mar.
5, 1975). [
Footnote 16]
Information regarding the recipient's current condition is also
obtained from his sources of medical treatment. DISM § 353.4. If
there is a conflict between the information provided by the
beneficiary and that obtained from medical sources such as his
physician, or between two sources of treatment, the agency may
arrange for an examination by an independent consulting physician.
[
Footnote 17]
Ibid.
Whenever the agency's tentative assessment of the beneficiary's
condition differs from his
Page 424 U. S. 338
own assessment, the beneficiary is informed that benefits may be
terminated, provided a summary of the evidence upon which the
proposed determination to terminate is based, and afforded an
opportunity to review the medical reports and other evidence in his
case file. [
Footnote 18] He
also may respond in writing and submit additional evidence.
Id., § 353.6.
The state agency then makes its final determination, which is
reviewed by an examiner in the SSA Bureau of Disability Insurance.
42 U.S.C. § 421(c); CM §§ 6701(b), (c). [
Footnote 19] If, as is usually the case, the SSA
accepts the agency determination, it notifies the recipient in
writing, informing him of the reasons for the decision, and of his
right to seek
de novo reconsideration by the state agency.
20 CFR §§ 404.907, 404.909 (1975). [
Footnote 20] Upon acceptance by the SSA, benefits are
terminated effective two months after the month in which medical
recovery is found to have occurred. 42 U.S.C. § 423(a) (1970 ed.,
Supp. III).
Page 424 U. S. 339
If the recipient seeks reconsideration by the state agency and
the determination is adverse, the SSA reviews the reconsideration
determination and notices the recipient of the decision. He then
has a right to an evidentiary hearing before an SSA administrative
law judge. 20 CFR §§ 404.917, 404.927 (1975). The hearing is
nonadversary, and the SSA is not represented by counsel. As at all
prior and subsequent stages of the administrative process, however,
the claimant may be represented by counsel or other spokesmen. §
404.934. If this hearing results in an adverse decision, the
claimant is entitled to request discretionary review by the SSA
Appeals Council, § 404.945, and finally may obtain judicial review.
42 U.S.C. § 405(g); 20 CFR § 404.951 (1975). [
Footnote 21]
Should it be determined at any point after termination of
benefits, that the claimant's disability extended beyond the date
of cessation initially established, the worker is entitled to
retroactive payments. 42 U.S.C. § 404.
Cf. § 423(b); 20
CFR §§ 404.501, 404.503, 404.504 (1975). If, on the other hand, a
beneficiary receives any payments to which he is later determined
not to be entitled, the statute authorizes the Secretary to attempt
to recoup these funds in specified circumstances. 42 U.S.C. § 404.
[
Footnote 22]
C
Despite the elaborate character of the administrative procedures
provided by the Secretary, the courts
Page 424 U. S. 340
below held them to be constitutionally inadequate, concluding
that due process requires an evidentiary hearing prior to
termination. In light of the private and governmental interests at
stake here and the nature of the existing procedures, we think this
was error.
Since a recipient whose benefits are terminated is awarded full
retroactive relief if he ultimately prevails, his sole interest is
in the uninterrupted receipt of this source of income pending final
administrative decision on his claim. His potential injury is thus
similar in nature to that of the welfare recipient in
Goldberg,
see 397 U.S. at
397 U. S.
263-264, the nonprobationary federal employee in
Arnett, see 416 U.S. at
416 U. S. 146,
and the wage earner in
Sniadach. See 395 U.S. at
395 U. S.
341-342. [
Footnote
23]
Only in
Goldberg has the Court held that due process
requires an evidentiary hearing prior to a temporary deprivation.
It was emphasized there that welfare assistance is given to persons
on the very margin of subsistence:
"The crucial factor in this context -- a factor not present in
the case of . . . virtually anyone else whose governmental
entitlements are ended -- is that termination of aid pending
resolution of a controversy over eligibility may deprive an
eligible recipient of the very means by which to live
while he waits."
397 U.S. at
397 U. S. 264
(emphasis in original). Eligibility for disability benefits, in
contrast, is not based upon financial need. [
Footnote 24] Indeed, it is wholly unrelated
to
Page 424 U. S. 341
the worker's income or support from many other sources, such as
earnings of other family members, workmen's compensation awards,
[
Footnote 25] tort claims
awards, sayings, private insurance, public or private pensions,
veterans' benefits, food stamps, public assistance, or the
"many other important programs, both public and private, which
contain provisions for disability payments affecting a substantial
portion of the workforce. . . ."
Richardson v. Belcher, 404 U.S. at
404 U. S. 85-87
(Douglas, J., dissenting).
See Staff of the House
Committee on Ways and Means, Report on the Disability Insurance
Program, 93d Cong., 2d Sess., 910, 419-429 (1974) (hereinafter
Staff Report).
As
Goldberg illustrates, the degree of potential
deprivation that may be created by a particular decision is a
factor to be considered in assessing the validity of any
administrative decisionmaking process.
Cf. Morrissey v.
Brewer, 408 U. S. 471
(1972). The potential deprivation here is generally likely to be
less than in
Goldberg, although the degree of difference
can be overstated. As the District Court emphasized, to remain
eligible for benefits, a recipient must be "unable to engage in
substantial gainful activity." 42 U.S.C. § 423; 361 F. Supp. at
523. Thus, in contrast to the discharged federal employee in
Arnett, there is little possibility that the terminated
recipient will be able to find even temporary employment to
ameliorate the interim loss.
As we recognized last Term in
Fusari v. Steinberg,
419 U. S. 379,
419 U. S. 389
(1975),
"the possible length of wrongful deprivation of . . . benefits
[also] is an important factor in assessing the impact of official
action on the private interests."
The Secretary concedes that the delay between
Page 424 U. S. 342
a request for a hearing before an administrative law judge and a
decision on the claim is currently between 10 and 11 months. Since
a terminated recipient must first obtain a reconsideration decision
as a prerequisite to invoking his right to an evidentiary hearing,
the delay between the actual cutoff of benefits and final decision
after a hearing exceeds one year.
In view of the torpidity of this administrative review process,
cf. id. at
419 U. S.
383-384,
419 U. S. 386,
and the typically modest resources of the family unit of the
physically disabled worker, [
Footnote 26] the hardship imposed upon the erroneously
terminated disability recipient may be significant. Still, the
disabled worker's need is likely to be less than that of a welfare
recipient. In addition to the possibility of access to private
resources, other forms of government assistance will become
available where the termination of disability benefits places a
worker or his family below the subsistence level. [
Footnote 27]
See Arnett v.
Kennedy, 416 U.S.
Page 424 U. S. 343
at
416 U. S. 169
(POWELL, J., concurring in part);
id. at
416 U. S.
201-202 (WHITE, J., concurring in part and dissenting in
part). In view of these potential sources of temporary income,
there is less reason here than in
Goldberg to depart from
the ordinary principle, established by our decisions, that
something less than an evidentiary hearing is sufficient prior to
adverse administrative action.
D
An additional factor to be considered here is the fairness and
reliability of the existing pre-termination procedures, and the
probable value, if any, of additional procedural safeguards.
Central to the evaluation of any administrative process is the
nature of the relevant inquiry.
See Mitchell v. W. T. Grant
Co., 416 U. S. 600,
416 U. S. 617
(1974); Friendly, Some Kind of Hearing, 123 U.Pa.L.Rev. 1267, 1281
(1975). In order to remain eligible for benefits, the disabled
worker must demonstrate by means of "medically acceptable clinical
and laboratory diagnostic techniques," 42 U.S.C. § 423(d)(3), that
he is unable "to engage in any substantial gainful activity by
reason of any
medically determinable physical or mental
impairment. . . ." § 423(d)(1)(A) (emphasis supplied). In short, a
medical assessment of the worker's physical or mental condition is
required. This is a more sharply focused and easily documented
decision than the typical determination of welfare entitlement. In
the latter case, a wide variety of information may be deemed
relevant, and issues of witness credibility and
Page 424 U. S. 344
veracity often are critical to the decisionmaking process.
Goldberg noted that, in such circumstances "written
submissions are a wholly unsatisfactory basis for decision." 397
U.S. at
397 U. S.
269.
By contrast, the decision whether to discontinue disability
benefits will turn, in most cases, upon "routine, standard, and
unbiased medical reports by physician specialists,"
Richardson
v. Perales, 402 U.S. at
402 U. S. 404,
concerning a subject whom they have personally examined. [
Footnote 28] In
Richardson,
the Court recognized the "reliability and probative worth of
written medical reports," emphasizing that, while there may be
"professional disagreement with the medical conclusions" the
"specter of questionable credibility and veracity is not present."
Id. at
402 U. S. 405,
403 U. S. 407.
To be sure, credibility and veracity may be a factor in the
ultimate disability assessment in some cases. But procedural due
process rules are shaped by the risk of error inherent in the
truthfinding process as applied to the generality of cases, not the
rare exceptions. The potential value of an evidentiary hearing, or
even oral presentation to the decisionmaker,
Page 424 U. S. 345
is substantially less in this context than in
Goldberg.
The decision in
Goldberg also was based on the Court's
conclusion that written submissions were an inadequate substitute
for oral presentation because they did not provide an effective
means for the recipient to communicate his case to the
decisionmaker. Written submissions were viewed as an unrealistic
option, for most recipients lacked the "educational attainment
necessary to write effectively," and could not afford professional
assistance. In addition, such submissions would not provide the
"flexibility of oral presentations" or "permit the recipient to
mold his argument to the issues the decisionmaker appears to regard
as important." 397 U.S. at
397 U. S. 269. In the context of the disability benefits
entitlement assessment, the administrative procedures under review
here fully answer these objections.
The detailed questionnaire which the state agency periodically
sends the recipient identifies with particularity the information
relevant to the entitlement decision, and the recipient is invited
to obtain assistance from the local SSA office in completing the
questionnaire. More important, the information critical to the
entitlement decision usually is derived from medical sources, such
as the treating physician. Such sources are likely to be able to
communicate more effectively through written documents than are
welfare recipients or the lay witnesses supporting their cause. The
conclusions of physicians often are supported by X-rays and the
results of clinical or laboratory tests, information typically more
amenable to written than to oral presentation.
Cf. W.
Gellhorn & C. Byse, Administrative Law -- Cases and Comments
860-863 (6th ed.1974).
A further safeguard against mistake is the policy of allowing
the disability recipient's representative full access
Page 424 U. S. 346
to all information relied upon by the state agency. In addition,
prior to the cutoff of benefits, the agency informs the recipient
of its tentative assessment, the reasons therefor, and provides a
summary of the evidence that it considers most relevant.
Opportunity is then afforded the recipient to submit additional
evidence or arguments, enabling him to challenge directly the
accuracy of information in his file, as well as the correctness of
the agency's tentative conclusions. These procedures, again as
contrasted with those before the Court in
Goldberg, enable
the recipient to "mold" his argument to respond to the precise
issues which the decisionmaker regards as crucial.
Despite these carefully structured procedures,
amici
point to the significant reversal rate for appealed cases as clear
evidence that the current process is inadequate. Depending upon the
base selected and the line of analysis followed, the relevant
reversal rates urged by the contending parties vary from a high of
58.6% for appealed reconsideration decisions to an overall reversal
rate of only 3.3%. [
Footnote
29] Bare statistics rarely provide a satisfactory measure of
the fairness of a decisionmaking process. Their adequacy is
especially suspect here, since
Page 424 U. S. 347
the administrative review system is operated on an open file
basis. A recipient may always submit new evidence, and such
submissions may result in additional medical examinations. Such
fresh examinations were held in approximately 30% to 40% of the
appealed cases in fiscal 1973, either at the reconsideration or
evidentiary hearing stage of the administrative process. Staff
Report 238. In this context, the value of reversal rate statistics
as one means of evaluating the adequacy of the pre-termination
process is diminished. Thus, although we view such information as
relevant, it is certainly not controlling in this case.
E
In striking the appropriate due process balance, the final
factor to be assessed is the public interest. This includes the
administrative burden and other societal costs that would be
associated with requiring, as a matter of constitutional right, an
evidentiary hearing upon demand in all cases prior to the
termination of disability benefits. The most visible burden would
be the incremental cost resulting from the increased number of
hearings and the expense of providing benefits to ineligible
recipients pending decision. No one can predict the extent of the
increase, but the fact that full benefits would continue until
after such hearings would assure the exhaustion in most cases of
this attractive option. Nor would the theoretical right of the
Secretary to recover undeserved benefits result, as a practical
matter, in any substantial offset to the added outlay of public
funds. The parties submit widely varying estimates of the probable
additional financial cost. We only need say that experience with
the constitutionalizing of government procedures suggests that the
ultimate additional cost in terms of money and administrative
burden would not be insubstantial.
Page 424 U. S. 348
Financial cost alone is not a controlling weight in determining
whether due process requires a particular procedural safeguard
prior to some administrative decision. But the Government's
interest, and hence that of the public, in conserving scarce fiscal
and administrative resources is a factor that must be weighed. At
some point, the benefit of an additional safeguard to the
individual affected by the administrative action and to society in
terms of increased assurance that the action is just may be
outweighed by the cost. Significantly, the cost of protecting those
whom the preliminary administrative process has identified as
likely to be found undeserving may, in the end, come out of the
pockets of the deserving, since resources available for any
particular program of social welfare are not unlimited.
See Friendly,
supra, 123 U.Pa.L.Rev. at 1276,
1303.
But more is implicated in cases of this type than
ad
hoc weighing of fiscal and administrative burdens against the
interests of a particular category of claimants. The ultimate
balance involves a determination as to when, under our
constitutional system, judicial-type procedures must be imposed
upon administrative action to assure fairness. We reiterate the
wise admonishment of Mr. Justice Frankfurter that differences in
the origin and function of administrative agencies "preclude
wholesale transplantation of the rules of procedure, trial, and
review which have evolved from the history and experience of
courts."
FCC v. Pottsville Broadcasting Co., 309 U.
S. 134,
309 U. S. 143
(1940). The judicial model of an evidentiary hearing is neither a
required, nor even the most effective, method of decisionmaking in
all circumstances. The essence of due process is the requirement
that "a person in jeopardy of serious loss [be given] notice of the
case against him and opportunity to meet it."
Joint
Anti-Fascist Comm. v. McGrath, 341 U.S. at
341 U. S.
171-172 (Frankfurter,
Page 424 U. S. 349
J., concurring). All that is necessary is that the procedures be
tailored, in light of the decision to be made, to "the capacities
and circumstances of those who are to be heard,"
Goldberg v.
Kelly, 397 U.S. at
397 U. S.
268-269 (footnote omitted), to insure that they are
given a meaningful opportunity to present their case. In assessing
what process is due in this case, substantial weight must be given
to the good faith judgments of the individuals charged by Congress
with the administration of social welfare programs that the
procedures they have provided assure fair consideration of the
entitlement claims of individuals.
See Arnett v. Kennedy,
416 U.S. at
416 U. S. 202
(WHITE, J., concurring in part and dissenting in part). This is
especially so where, as here, the prescribed procedures not only
provide the claimant with an effective process for asserting his
claim prior to any administrative action, but also assure a right
to an evidentiary hearing, as well as to subsequent judicial
review, before the denial of his claim becomes final.
Cf.
Boddie v. Connecticut, 401 U. S. 371,
401 U. S. 378
(1971).
We conclude that an evidentiary hearing is not required prior to
the termination of disability benefits, and that the present
administrative procedures fully comport with due process.
The judgment of the Court of Appeals is
Reversed.
MR. JUSTICE STEVENS took no part in the consideration or
decision of this case.
[
Footnote 1]
The program is financed by revenues derived from employee and
employer payroll taxes. 26 U.S.C. §§ 3101(a), 3111(a); 42 U.S.C. §
401(b). It provides monthly benefits to disabled persons who have
worked sufficiently long to have an insured status, and who have
had substantial work experience in a specified interval directly
preceding the onset of disability. 42 U.S.C. §§ 423(c)(1)(A) and
(b). Benefits also are provided to the worker's dependents under
specified circumstances. §§ 402(b)(d). When the recipient reaches
age 65 his disability benefits are automatically converted to
retirement benefits. §§ 416(i)(2)(D), 423(a)(1). In fiscal 1974,
approximately 3,700,000 persons received assistance under the
program. Social Security Administration, The Year in Review 21
(1974).
[
Footnote 2]
Eldridge originally was disabled due to chronic anxiety and back
strain. He subsequently was found to have diabetes. The tentative
determination letter indicated that aid would be terminated because
available medical evidence indicated that his diabetes was under
control, that there existed no limitations on his back movements
which would impose severe functional restrictions, and that he no
longer suffered emotional problems that would preclude him from all
work for which he was qualified. App. 113. In his reply letter, he
claimed to have arthritis of the spine, rather than a strained
back.
[
Footnote 3]
The District Court ordered reinstatement of Eldridge's benefits
pending its final disposition on the merits.
[
Footnote 4]
In
Goldberg, the Court held that the pre-termination
hearing must include the following elements: (1) "timely and
adequate notice detailing the reasons for a proposed termination";
(2) "an effective opportunity [for the recipient] to defend by
confronting any adverse witnesses and by presenting his own
arguments and evidence orally"; (3) retained counsel, if desired;
(4) an "impartial" decisionmaker; (5) a decision resting "solely on
the legal rules and evidence adduced at the hearing"; (6) a
statement of reasons for the decision and the evidence relied on.
397 U.S. at
397 U. S.
266-271. In this opinion, the term "evidentiary hearing"
refers to a hearing generally of the type required in
Goldberg.
[
Footnote 5]
The HEW regulations direct that each state plan under the
federal categorical assistance programs must provide for
pre-termination hearings containing specified procedural
safeguards, which include all of the
Goldberg
requirements.
See 45 CFR § 205.10(a) (1975);
n 4,
supra.
[
Footnote 6]
The Court of Appeals for the Fifth Circuit, simply noting that
the issue had been correctly decided by the District Court in this
case, reached the same conclusion in
Williams v.
Weinberger, 494 F.2d 1191 (1974),
cert. pending, No.
74-205.
[
Footnote 7]
Title 42 U.S.C. § 405(h) provides in full:
"(h) Finality of Secretary's decision."
"The findings and decisions of the Secretary after a hearing
shall be binding upon all individuals who were parties to such
hearing. No findings of fact or decision of the Secretary shall be
reviewed by any person, tribunal, or governmental agency except as
herein provided. No action against the United States, the
Secretary, or any officer or employee thereof shall be brought
under section 41 of Title 28 to recover on any claim arising under
this subchapter."
[
Footnote 8]
Section 405(g) further provides:
"Such action shall be brought in the district court of the
United States for the judicial district in which the plaintiff
resides, or has his principal place of business, or, if he does not
reside or have his principal place of business within any such
judicial district, in the United States District Court for the
District of Columbia. . . . The court shall have power to enter,
upon the pleadings and transcript of the record, a judgment
affirming, modifying, or reversing the decision of the Secretary,
with or without remanding the cause for a rehearing. The findings
of the Secretary as to any fact, if supported by substantial
evidence, shall be conclusive. . . ."
[
Footnote 9]
The other two conditions are (1) that the civil action be
commenced within 60 days after the mailing of notice of such
decision, or within such additional time as the Secretary may
permit, and (2) that the action be filed in an appropriate district
court. These two requirements specify a statute of limitations and
appropriate venue, and are waivable by the parties.
Salfi,
422 U.S. at
422 U. S.
763-764. As in
Salfi, no question as to whether
Eldridge satisfied these requirements was timely raised below,
see Fed.Rules Civ.Proc. 8(c), 12(h)(1), and they need not
be considered here.
[
Footnote 10]
If Eldridge had exhausted the full set of available
administrative review procedures, failure to have raised his
constitutional claim would not bar him from asserting it later in a
district court.
Cf. Flemming v. Nestor, 363 U.
S. 603,
363 U. S. 607
(1960).
[
Footnote 11]
Decisions in different contexts have emphasized that the nature
of the claim being asserted and the consequences of deferment of
judicial review are important factors in determining whether a
statutory requirement of finality has been satisfied. The role
these factors may play is illustrated by the intensely "practical"
approach which the Court has adopted,
Cohen v. Beneficial Ind.
Loan Corp., 337 U. S. 541,
337 U. S. 546
(1949), when applying the finality requirements of 28 U.S.C. §
1291, which grants jurisdiction to courts of appeals to review all
"final decisions" of the district courts, and 28 U.S.C. § 1257,
which empowers this Court to review only "final judgments" of state
courts.
See, e.g., Harris v. Washington, 404 U. S.
55 (1971);
Construction Laborers v. Curry,
371 U. S. 542,
371 U. S.
549-550 (1963);
Mercantile Nat. Bank v.
Langdeau, 371 U. S. 555,
371 U. S.
557-558 (1963);
Cohen v. Beneficial Ind. Loan Corp.,
supra at
337 U. S.
545-546. To be sure, certain of the policy
considerations implicated in §§ 1257 and 1291 cases are different
from those that are relevant here.
Compare Construction
Laborers, supra at
371 U. S. 550;
Mercantile Nat. Bank, supra at
371 U. S. 558,
with McKart v. United States, 395 U.
S. 185,
395 U. S.
193-195 (1969); L. Jaffe, Judicial Control of
Administrative Action 424-426 (1965). But the core principle that
statutorily created finality requirements should, if possible, be
construed so as not to cause crucial collateral claims to be lost
and potentially irreparable injuries to be suffered remains
applicable.
[
Footnote 12]
Given our conclusion that jurisdiction in the District Court was
proper under § 405(g), we find it unnecessary to consider
Eldridge's contention that, notwithstanding § 405(h), there was
jurisdiction over his claim under the mandamus statute, 28 U.S.C. §
1361, or the Administrative Procedure Act, 5 U.S.C. § 701
et
seq.
[
Footnote 13]
In all but six States, the state vocational rehabilitation
agency charged with administering the state plan under the
Vocational Rehabilitation Act of 1920, 41 Stat. 735, as amended, 29
U.S.C. § 701
et seq. (1970 ed., Supp. III), acts as the
"state agency" for purposes of the disability insurance program.
Staff of the House Committee on Ways and Means, Report on the
Disability Insurance Program, 93d Cong., 2d Sess., 148 (1974). This
assignment of responsibility was intended to encourage
rehabilitation contacts for disabled workers and to utilize the
well established relationships of the local rehabilitation agencies
with the medical profession. H.R.Rep. No. 1698, 83d Cong., 2d
Sess., 23-24 (1954).
[
Footnote 14]
Work which "exists in the national economy" is, in turn, defined
as "work which exists in significant numbers either in the region
where such individual lives or in several regions of the country."
§ 423(d)(2)(A)
[
Footnote 15]
Because the continuing disability investigation concerning
whether a claimant has returned to work is usually done directly by
the SSA Bureau of Disability Insurance, without any state agency
involvement, the administrative procedures prior to the
post-termination evidentiary hearing differ from those involved in
cases of possible medical recovery. They are similar, however, in
the important respect that the process relies principally on
written communications and there is no provision for an evidentiary
hearing prior to the cutoff of benefits. Due to the nature of the
relevant inquiry in certain types of cases, such as those involving
self employment and agricultural employment, the SSA office nearest
the beneficiary conducts an oral interview of the beneficiary as
part of the pre-termination process. SSA Claims Manual (CM) §
6705.2(c).
[
Footnote 16]
Information is also requested concerning the recipient's belief
as to whether he can return to work, the nature and extent of his
employment during the past year, and any vocational services he is
receiving.
[
Footnote 17]
All medical-source evidence used to establish the absence of
continuing disability must be in writing, with the source properly
identified. DISM § 353.4C.
[
Footnote 18]
The disability recipient is not permitted personally to examine
the medical reports contained in his file. This restriction is not
significant, since he is entitled to have any representative of his
choice, including a lay friend or family member, examine all
medical evidence. CM § 7314.
See also 20 CFR § 401.3(a)(2)
(1975). The Secretary informs us that this curious limitation is
currently under review.
[
Footnote 19]
The SSA may not itself revise the state agency's determination
in a manner more favorable to the beneficiary. If, however, it
believes that the worker is still disabled, or that the disability
lasted longer than determined by the state agency, it may return
the file to the agency for further consideration in light of the
SSA's views. The agency is free to reaffirm its original
assessment.
[
Footnote 20]
The reconsideration assessment is initially made by the state
agency, but usually not by the same persons who considered the case
originally. R. Dixon, Social Security Disability and Mass Justice
32 (1973). Both the recipient and the agency may adduce new
evidence.
[
Footnote 21]
Unlike all prior levels of review, which are
de novo,
the district court is required to treat findings of fact as
conclusive if supported by substantial evidence. 42 U.S.C. §
405(g).
[
Footnote 22]
The Secretary may reduce other payments to which the beneficiary
is entitled, or seek the payment of a refund, unless the
beneficiary is "without fault" and such adjustment or recovery
would defeat the purposes of the Act or be "against equity and good
conscience." 42 U.S.C. § 404(b).
See generally 20 CFR §§
404.501-404.515 (1975).
[
Footnote 23]
This, of course, assumes that an employee whose wages are
garnisheed erroneously is subsequently able to recover his back
wages.
[
Footnote 24]
The level of benefits is determined by the worker's average
monthly earnings during the period prior to disability, his age,
and other factors not directly related to financial need, specified
in 42 U.S.C. § 415 (1970 ed., Supp. III).
See §
423(a)(2).
[
Footnote 25]
Workmen's compensation benefits are deducted in part in
accordance with a statutory formula. 42 U.S.C. § 424a (1970 ed.,
Supp. III); 20 CFR § 404.408 (1975);
see Richardson v.
Belcher, 404 U. S. 78
(1971).
[
Footnote 26]
Amici cite statistics compiled by the Secretary which
indicate that, in 1965, the mean income of the family unit of a
disabled worker was $3,803, while the median income for the unit
was 2,836. The mean liquid assets --
i.e., cash, stocks,
bonds -- of these family units was $4,862; the median was $940.
These statistics do not take into account the family unit's
nonliquid assets --
i.e., automobile, real estate, and the
like. Brief for AFL-CIO
et al. as
Amici Curiae
App. 4a.
See n 29,
infra.
[
Footnote 27]
Amici emphasize that, because an identical definition
of disability is employed in both the Title II Social Security
Program and in the companion welfare system for the disabled,
Supplemental Security Income (SSI),
compare 42 U.S.C. §
423(d)(1)
with § 1382c(a)(3) (1970 ed., Supp. III), the
terminated disability benefits recipient will be ineligible for the
SSI Program. There exist, however, state and local welfare programs
which may supplement the worker's income. In addition, the worker's
household unit can qualify for food stamps if it meets the
financial need requirements.
See 7 U.S.C. §§ 2013(c),
2014(b); 7 CFR § 271 (1975). Finally, in 1974, 480,000 of the
approximately 2,000,000 disabled workers receiving Social Security
benefits also received SSI benefits. Since financial need is a
criterion for eligibility under the SSI program, those disabled
workers who are most in need will, in the majority of cases, be
receiving SSI benefits when disability insurance aid is terminated.
And, under the SSI program, a pre-termination evidentiary hearing
is provided, if requested. 42 U.S.C. § 1383(c) (1970 ed., Supp.
III); 20 CFR § 416.1336(c) (1975); 40 Fed Reg. 1512 (1975);
see Staff Report 346.
[
Footnote 28]
The decision is not purely a question of the accuracy of a
medical diagnosis, since the ultimate issue which the state agency
must resolve is whether, in light of the particular worker's "age,
education, and work experience," he cannot "engage in any . . .
substantial gainful work which exists in the national economy. . .
." 42 U.S.C. § 423(d)(2)(A). Yet information concerning each of
these worker characteristics is amenable to effective written
presentation. The value of an evidentiary hearing, or even a
limited oral presentation, to an accurate presentation of those
factors to the decisionmaker does not appear substantial.
Similarly, resolution of the inquiry as to the types of employment
opportunities that exist in the national economy for a physically
impaired worker with a particular set of skills would not
necessarily be advanced by an evidentiary hearing.
Cf. 1
K. Davis, Administrative Law Treatise § 7.06, p. 429 (1958). The
statistical information relevant to this judgment is more amenable
to written than to oral presentation.
[
Footnote 29]
By focusing solely on the reversal rate for appealed
reconsideration determinations,
amici overstate the
relevant reversal rate. As we indicated last Term in
Fusari v.
Steinberg, 419 U. S. 379,
419 U. S. 383
n. 6 (1975), in order fully to assess the reliability and fairness
of a system of procedure, one must also consider the overall rate
of error for all denials of benefits. Here, that overall rate is
12.2%. Moreover, about 75% of these reversals occur at the
reconsideration stage of the administrative process. Since the
median period between a request for reconsideration review and
decision is only two months, Brief for AFL-CIO
et al. as
Amici Curiae, App. 4a, the deprivation is significantly
less than that concomitant to the lengthier delay before an
evidentiary hearing. Netting out these reconsideration reversals,
the overall reversal rate falls to 3.3%.
See Supplemental
and Reply Brief for Petitioner 14.
MR. JUSTICE BRENNAN, with whom MR. JUSTICE MARSHALL concurs,
dissenting.
For the reasons stated in my dissenting opinion in
Richardson v. Wright, 405 U. S. 208,
405 U. S. 212
(1972), I agree with the District Court and the Court of Appeals
that, prior to termination of benefits, Eldridge must be
afforded
Page 424 U. S. 350
an evidentiary hearing of the type required for welfare
beneficiaries under Title IV of the Social Security Act, 42 U.S.C.
§ 601
et seq. See Goldberg v. Kelly, 397 U.
S. 254 (1970). I would add that the Court's
consideration that a discontinuance of disability benefits may
cause the recipient to suffer only a limited deprivation is no
argument. It is speculative. Moreover, the very legislative
determination to provide disability benefits, without any
prerequisite determination of need in fact, presumes a need by the
recipient which is not this Court's function to denigrate. Indeed,
in the present case, it is indicated that, because disability
benefits were terminated, there was a foreclosure upon the Eldridge
home and the family's furniture was repossessed, forcing Eldridge,
his wife, and their children to sleep in one bed. Tr. of Oral Arg.
39, 47-48. Finally, it is also no argument that a worker, who has
been placed in the untenable position of having been denied
disability benefits may still seek other forms of public
assistance.