The Social Security Act (Act) and implementing regulations
provide a four-step process for the administrative review and
adjudication of disputed disability benefit claims under Title II
of the Act. First, a state agency determines whether the claimant
has a disability and the date it began or ceased. Second, if the
claimant is dissatisfied with that determination, he may request a
de novo reconsideration, and in some cases a full
evidentiary hearing. Third, if the claimant receives an adverse
reconsideration determination, he is entitled to an evidentiary
hearing and
de novo review by an administrative law judge.
Finally, if the claimant is dissatisfied with the administrative
law judge's decision, he may appeal to the Appeals Council of the
Department of Health and Human Services (HHS). Respondents brought
an action in Federal District Court on behalf of a statewide class
of claimants in Vermont, seeking declaratory and injunctive relief
from delays encountered in steps two and three that allegedly
violated their right under 42 U.S.C. § 405(b) (1976 ed., Supp. V)
to a hearing within a reasonable time. Holding that delays of more
than 90 days in making reconsideration determinations, and delays
of more than 90 days in granting a hearing request, were
unreasonable and violated claimants' statutory rights, the District
Court issued an injunction in favor of the statewide class
requiring the Secretary of HHS in the future to issue
reconsideration determinations within 90 days of requests for
reconsideration, to conduct hearings within 90 days of requests for
hearings, and to pay 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. The Court of Appeals
affirmed.
Held: The District Court's injunction constituted an
unwarranted judicial intrusion into the pervasively regulated area
of claims adjudication under Title II. The legislative history
shows that Congress, in striking the balance between the need for
timely disability determinations and the need to ensure the
accuracy and consistency of such determinations in the face of
heavy workloads and limited agency resources, has concluded that
mandatory deadlines for adjudication of disputed disability
Page 467 U. S. 105
claims are inconsistent with the Act's primary objectives. 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
been contemplated that courts should have authority to impose
judicially the very deadlines Congress repeatedly has rejected. Pp.
467 U. S.
111-118.
685 F.2d 19, vacated and remanded.
POWELL, J., delivered the opinion of the Court, in which BURGER,
C.J., and WHITE, REHNQUIST, and O'CONNOR, JJ., joined. MARSHALL,
J., filed a dissenting opinion, in which BRENNAN, BLACKMUN, and
STEVENS, JJ., joined,
post, p.
467 U. S.
120.
JUSTICE POWELL delivered the opinion of the Court.
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. Among other
things, it provides for the payment of disability insurance
Page 467 U. S. 106
benefits to those whose disability prevents them from pursuing
gainful employment. 42 U.S.C. § 423. [
Footnote 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. 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,
402 U. S. 399
(1971). Approximately two million disability claims were filed
under these two Titles in fiscal year 1983. [
Footnote 2] Over 320,000 of these claims must be
heard by some 800 administrative law judges each year. [
Footnote 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. [
Footnote 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,
Page 467 U. S. 107
and in some cases a full evidentiary hearing. §§
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); 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). [
Footnote 5] §§ 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. [
Footnote 6] After suffering similar delays, Amedie Maurais
intervened in the action. [
Footnote
7] On June 14, 1979, the District Court certified a statewide
class consisting of:
"All present and future Vermont residents seeking to secure
Social Security disability benefits who, following an initial
determination by the defendant that no disability
Page 467 U. S. 108
exists, experience an unreasonable delay in the scheduling of
and/or issuance of decisions in reconsiderations and fair
hearings."
App. to Pet. for Cert. 12a, n. 1.
Plaintiffs argued before the District Court that the delays they
had experienced violated their statutory right under 42 U.S.C. §
405(b) (1976 ed., Supp. V) to a hearing within a reasonable time.
[
Footnote 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.
[
Footnote 9] It granted partial
summary judgment to the plaintiff class on that issue in December,
1979.
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
Page 467 U. S. 109
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."
Id. at 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. [
Footnote
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.
[
Footnote 11]"
The injunction also required ALJs to provide hearings within 90
days after the
Page 467 U. S. 110
request is made by claimants. [
Footnote 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. [
Footnote
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. Schweiker, 685 F.2d 19 (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. 461 U.S. 904
(1983). [
Footnote 14] We
conclude that the legislative history makes
Page 467 U. S. 111
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 vacate 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. [
Footnote 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
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. [
Footnote
16] She argues
Page 467 U. S. 112
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.
[
Footnote 17] It has
inspired almost annual congressional debate since that time.
[
Footnote 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, [
Footnote 19] and 60
Members of the House sponsored a bill imposing statutory deadlines
for each step in the
Page 467 U. S. 113
administrative review of disputed SSA claims. [
Footnote 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). [
Footnote 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 Subcommittee on
Social Security of the House Committee on Ways and Means, Appeals
Process: Areas of Possible Administrative or Legislative Action,
94th Cong., 1st Sess., 1-2 (Comm.Print 1975). [
Footnote 22] Congress agreed and refused to
impose statutory deadlines on the Secretary.
Bills proposing statutory deadlines have been proposed almost
annually since 1975, [
Footnote
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
Page 467 U. S. 114
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, § 308, 94 Stat. 458, note following 42 U.S.C. §
401. 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). [
Footnote 24] The Secretary submitted a report in October,
1980, suggesting deadlines of 150 days for reconsideration
determinations and 165 days from hearing to posthearing decision,
both subject to certain exceptions. U.S. Dept. of Health and Human
Services, Report to Congress, Implementation of Section 308, Public
Law 96-265, p. 1 (Oct. 21, 1980). The Secretary, however, cautioned
Congress that budget and staff limitations and burgeoning workloads
"mitigate [
sic] 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
Page 467 U. S. 115
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) (WD 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, [
Footnote 25] the Committee reported:
"[The] Committee believes that a disability claimant is entitled
to a timely hearing and decision on his appeal, but it also
recognizes that the time needed before a well-reasoned and sound
disability hearing decision can be made may vary widely on a
case-by-case basis. . . . Establishing strict time limits for the
adjudication of every case could result in incorrect determinations
because time was not available to . . . reach well-reasoned
decisions in difficult cases."
H.R.Rep. No. 97-588, pp.19-20 (1982). [
Footnote 26]
Page 467 U. S. 116
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 (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). [
Footnote 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
Page 467 U. S. 117
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). At the same time, Congress added §
421(i) 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(i). 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). [
Footnote
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
of 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. [
Footnote 29]
Finally, in 1983, 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,
Page 467 U. S. 118
it hardly could have contemplated that courts should have
authority to impose the very deadlines it repeatedly has rejected.
[
Footnote 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, however, § 1383(c)(2)
requires a posthearing decision within 90 days of the hearing
request, except in the case of disputed disability 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. [
Footnote 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
Page 467 U. S. 119
discretion with which Congress has granted the Secretary to
adopt rules and procedures for the adjudication of claims.
See
Heckler v. Campbell, 461 U. S. 458,
461 U. S. 466
(1983);
Schweiker v. Gray Panthers, 453 U. S.
34,
453 U. S. 43-44
(1981);
Batterton v. Francis, 432 U.
S. 416,
432 U. S. 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.
[
Footnote 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. [
Footnote 33] Accordingly, we vacate the judgment of the
Court of Appeals, and remand the case for further proceedings
consistent with this opinion. [
Footnote 34]
It is so ordered.
Page 467 U. S. 120
[
Footnote 1]
Section 423(d)(1) 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).
[
Footnote 2]
Social Security Administration, 1983 Annual Report to Congress
43-44 (1983).
[
Footnote 3]
U.S. Dept. of Health and Human Services, Office of Hearings and
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.
[
Footnote 4]
The state agency acts under the authority and control of the
Secretary.
See 42 U.S.C. § 421(a).
[
Footnote 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).
[
Footnote 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.
[
Footnote 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.
Id. at 14a.
[
Footnote 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."
[
Footnote 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.
Id. at 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."
Id. at 17a-18a.
[
Footnote 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."
Id. at 27a. That reasoning is not challenged here.
[
Footnote 11]
The order exempted reconsideration determinations from the
90-day deadline in the following circumstances:
"(a) The claimant offers new medical evidence or reports new
medical treatment since his initial determination;"
"(b) The claimant agrees to undergo a consultative examination
when one is suggested by the defendant;"
"(c) The claimant or his representative causes a delay by
failing to provide information needed for reconsideration;"
"(d) The claimant or his representative requests a delay;
or,"
"(e) The delay is in some other way attributable to the
aggrieved claimant or his representative."
Id. at 33a.
[
Footnote 12]
The order exempted hearing requests from the 90-day deadline in
the following circumstances:
"(a) The claimant or his representative causes a delay by
failing to provide information needed for adjudication;"
"(b) The claimant or his representative requests a delay;"
"(c) The claimant or his representative fails to appear for the
scheduled hearing[;]"
"(d) The delay is in some other way attributable to the claimant
or his representative."
Id. at 34a.
[
Footnote 13]
Because the District Court held that the challenged delays
violated § 405(b), it did not reach plaintiffs' claims that the
delays violated the Administrative Procedure Act or their due
process rights under the Fourteenth Amendment.
[
Footnote 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,
424 U. S. 328
(1976);
Weinberger v. Salfi, 422 U.
S. 749,
422 U. S.
763-767 (1975). The nonwaivable 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, supra, at
422 U. S.
767.
[
Footnote 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.
[
Footnote 16]
The delays are not a recent development. In fiscal year 1973,
the median time between hearing request and posthearing 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.
[
Footnote 17]
See Delays in Social Security Appeals: Hearings before
the Subcommittee on Social Security of the House Committee on Ways
and Means, 94th Cong., 1st Sess. (1975) (hereinafter 1975
Hearings).
[
Footnote 18]
See, e.g., Disability Insurance Program: Public
Hearings before the Subcommittee on Social Security of the House
Committee on Ways and Means, 94th Cong., 2d Sess., 341-343 (1976);
Administrative Law Judges, HEW Executive Level Positions, and
Salary Adjustment for Director of Office of Management and Budget:
Hearings before the Subcommittee on Employee Ethics and Utilization
of the House Committee on Post Office and Civil Service, 95th
Cong., 1st Sess., 10-11, 16-17 (1977); Disability Insurance Program
-- 1978: Hearings before the Subcommittee on Social Security of the
House Committee on Ways and Means, 95th Cong., 2d Sess., 15-17,
97-99 (1978).
[
Footnote 19]
See 1975 Hearings.
[
Footnote 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 posthearing decision; and 120 days for a
decision by the Appeals Council.
[
Footnote 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 posthearing decision. Key Workload Indicators 1.
[
Footnote 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 workloads and efforts
to increase individual ALJ production place more strain on the
quality of adjudication").
[
Footnote 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).
[
Footnote 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 Subcommittee on Social Security of the House Committee
on Ways and Means, 96th Cong., 1st Sess., 114 (1979) (statement of
Dennis M. Sweeney and 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").
[
Footnote 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 (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, 722 F.2d 1282 (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, 465 U.
S. 1301 (1984).
[
Footnote 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
467 U. S.
125-126. 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 courts more
specific direction.'"
Post at
467 U. S. 127,
n. 8 (quoting
White v. Mathews, 559 F.2d 852, 861 (CA2
1977),
cert. denied, 435 U.S. 908 (1978)).
A 1981 Committee Staff Report recommended that quality should no
longer be sacrificed for promptness:
"Back in 1975, [the SSA] gave lip service to quality, worrying
primarily about processing time and case backlog. . . ."
"
* * * *"
"Beginning in 1978, the Subcommittee examined in some depth two
State agencies -- New York and New Jersey -- which were expediting
cases at the expense of quality with the tacit consent of SSA's
Regional Office in New York. Their operations have still not fully
recovered. . . . One of the recommendations made by the Social
Security Administration . . . was that the State adjudicators
'should be reminded that (1) the goal of adjudication quality takes
precedence over that of expeditious processing and (2) that
adjudicators should use whatever time is necessary to secure
essential medical evidence.'"
Staff of the Subcommittee on Social Security of the House
Committee on Ways and Means, Status of the Disability Insurance
Program, 97th Cong., 1st Sess., 12-13 (Comm.Print 1981).
[
Footnote 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,
pp. 52-56 (1979).
[
Footnote 28]
The 1980 amendments also authorized the Secretary to review
determinations of ineligibility on her own motion. 42 U.S.C. §
421(c)(1).
[
Footnote 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).
[
Footnote 30]
The suggestion made by the dissent that this legislative history
"has little relevance to the task before us,"
post at
467 U. S. 125,
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.
[
Footnote 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 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).
[
Footnote 32]
In view of Congress' 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
467 U. S.
121-122, n. 1,
467 U. S.
132-133,
467 U. S.
134-135. The dissent states that the injunction at issue
is "carefully tailored," and assumes that the Secretary would have
no difficulty complying with it.
Post at
467 U. S. 120.
Even if this assumption were correct, it hardly suggests that this
Court should disregard the considered determination of Congress
that mandatory deadlines are inappropriate.
[
Footnote 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.
[
Footnote 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.
JUSTICE MARSHALL, with whom JUSTICE BRENNAN, JUSTICE BLACKMUN,
and JUSTICE STEVENS join, dissenting.
This case determines an issue of vital importance to the Social
Security Administration, to disabled Vermont residents, and to
federal courts. By failing to ground its opinion in the factual
record of the case at hand, the majority has discarded a balanced
remedy crafted to effectuate a federal statute. Far from intruding
clumsily into a pervasively regulated area,
ante at
467 U. S. 119,
the District Court fashioned a meaningful, carefully tailored
statewide remedy that mandated feasible, expeditious
reconsideration determinations and hearings, that did not cause
extra cost to the Secretary or reallocation to Vermont of resources
from other States, and that did not harm other statutory goals such
as quality and accuracy of decisionmaking. Because that remedy is
not expressly or impliedly prohibited by the Constitution or by
statute, and is not an abuse of discretion, I would affirm the
judgment of the Court of Appeals.
I
A
As the majority opinion makes clear, the District Court's
declaratory judgment that the plaintiff class is entitled to relief
is not at issue. The Secretary concedes that 42 U.S.C. § 405(b)
compels her to provide claimants a hearing on disputed disability
determinations within a reasonable time.
Cf, e.g., White v.
Mathews, 559 F.2d 852, 858 (CA2 1977),
cert. denied,
435 U.S. 908 (1978). The Secretary does not contest the District
Court's conclusion that, because under the Secretary's regulations
a hearing must be preceded by a reconsideration determination,
see ante at
467 U. S.
106-107, such reconsiderations must also be completed
within a reasonable time. The undisputed factual record, submitted
primarily by the Secretary herself, supports the District Court's
declaratory judgment that the Secretary had failed to fulfill her
statutory duty to provide the class representatives and a large
portion of the plaintiff class reconsideration determinations
Page 467 U. S. 121
and hearings within reasonable periods of time. While the
Secretary challenges classwide relief, she has not challenged the
District Court's certification of the plaintiff class. Our review,
therefore, is limited to the equitable remedy crafted by the
District Court and affirmed by the Court of Appeals.
B
A fair assessment of the validity of the District Court's order
requires a clear view of its content and the record on which it was
based. In brief, the District Court ordered that a member of the
plaintiff class -- Vermont disability claimants whose benefits have
been terminated and new applicants for disability entitlements --
who requests review of an initial determination by the Secretary
that he or she is not disabled must receive the Secretary's
reconsideration within 90 days of his or her request for review. If
the reconsideration is adverse and the claimant requests a hearing,
the hearing must be held within 90 days of the request. However,
both of these time limits are subject to exceptions which have
tolling effect. If the Secretary does not provide a hearing within
the time limits, she is required to provide interim benefits, which
she may recoup if the claimant is ultimately found not to be
entitled to benefits. [
Footnote
2/1]
Page 467 U. S. 122
The District Court was careful to ensure that its order had no
repercussions outside the State of Vermont. The certified class was
limited to Vermont Title II claimants. The Secretary stated that
the resources allocated by Congress to process hearing requests in
that State were the resources she needed to do the job. [
Footnote 2/2] There was no evidence before
the court that enforcing Vermont claimants' statutory right to
timely hearings would require the Secretary to reallocate her
resources to the detriment of disability claimants in other States.
[
Footnote 2/3]
The District Court ordered compliance with the prescribed time
limits only after reviewing extensive responses to interrogatories,
in which the Secretary acknowledged not only that she was able to
comply with those limits but that it was her stated policy to do
so. [
Footnote 2/4] The record also
supported the court's decision to craft nine exceptions to those
time limits. The Secretary argued that the review process required
some flexibility, and specified a variety of circumstances in which
delay in completing a reconsideration or scheduling a hearing was
justified. The District Court tailored its remedy to accommodate
each of the Secretary's submissions. If a claimant offers new
medical evidence, reports new medical treatment
Page 467 U. S. 123
since the initial determination, agrees to undergo a
consultative examination when the Secretary so suggests, causes a
delay by failing to provide the information needed to reconsider
the initial determination of nondisability, or otherwise causes a
delay, the District Court ordered that the 90-day limit on the time
from a reconsideration request to issuance of the notice of the
result be tolled. App. to Pet. for Cert. 33a. Because the Secretary
urged that it was frequently in the claimant's interest to delay,
the court also tolled the time limit for any period of delay
requested by the claimant or his representative.
Ibid.
Similarly, the District Court tolled the 90-day limit on the time
from a request for a hearing to the provision of a hearing when the
claimant or his representative either fails to provide information
needed by the Administrative Law Judge (ALJ) for adjudication,
requests a delay, fails to appear for the scheduled hearing, or
otherwise causes delay.
Id. at 34a.
Finally, the remedy pertains only to the Secretary's statutory
obligation to provide hearings within a reasonable time. The order
places no time limit on the Secretary's issuance of decisions,
although the plaintiffs, relying on the Social Security Act, the
Administrative Procedure Act, 5 U.S.C. §§ 555(b),(e), 706(1), and
the Constitution, included in their request for relief a plea that
"a hearing decision be rendered promptly" after a hearing. App. 24.
By its repeated references to decisions and overall processing
time, the majority implies that the District Court tied the hands
of ALJs, forcing them to evaluate complex disability claims in a
race against the clock. The order we are reviewing simply does not
speak to decisionmaking; it interprets and enforces only a
claimant's right to a timely hearing.
In sum, the District Court's order was based on an extensive
record of the actual operation of the disability program by the
State of Vermont and the Secretary, and the plaintiff class
members' experience in attempting to assert their statutory
Page 467 U. S. 124
right to timely hearings. The order mirrored the Secretary's
stated policy of holding hearings within 90 days of a request, a
policy she was capable of implementing without additional
resources. The District Court created nine exceptions to the
mandatory time limits, exceptions directly linked to the
Secretary's responsibility to make accurate determinations of
disability. And the order placed no time limit on the rendering of
decisions. With this clearer understanding of the relief granted by
the District Court, we turn to the question whether such an
equitable remedy is precluded by law.
II
A
In the absence of a clear command to the contrary from Congress,
federal courts have equitable power to issue injunctions in cases
over which they have jurisdiction.
Porter v. Warner Holding
Co., 328 U. S. 395,
328 U. S. 398
(1946). This Court has expressly rejected the arguments that the
judicial review provision of the Social Security Act
"does not encompass the equitable power to direct that the
statute be implemented through procedures other than those
authorized by the Secretary,"
and that class injunctive relief is not available under 42
U.S.C. § 405(g).
Califano v. Yamasaki, 442 U.
S. 682,
442 U. S. 705,
and n. 17 (1979). Although Congress has delegated to the Secretary
"full power and authority to make rules and regulations and to
establish procedures," 42 U.S.C. § 405(a), that discretion is
limited by the requirement that procedures be consistent with the
Social Security Act, and necessary or appropriate to carry out its
provisions.
Ibid. Courts may require the Secretary to
comply with the statute. A federal court thus is not precluded by
statute from ordering injunctive relief when the record in a case
supports the conclusions that the plaintiffs are entitled to relief
and that the likelihood of irreparable harm renders an available
remedy at law inadequate.
Page 467 U. S. 125
B
The dominant rationale of the Court's opinion is that an
inconclusive debate in Congress during the past decade regarding
the wisdom of establishing nationwide time limits on the
Secretary's review of disability applications clearly evinces the
Legislature's hostility to the statewide remedy ordered by the
District Court. The postenactment legislative history emphasized by
the Secretary and the majority has little relevance to the task
before us. If any legislative history were helpful, it would be the
history of the statutory provision that first accorded claimants a
right to review of adverse determinations and a "reasonable . . .
opportunity for a hearing." Act of Aug. 10, 1939, ch. 666, § 201,
53 Stat. 1368. [
Footnote 2/5] That
provision has remained intact for 45 years.
Although Congress has amended § 205(b) in various respects on
seven occasions, it has repeatedly reenacted the "right to a
hearing" provision without change or limitation, [
Footnote 2/6] and has done so over the past decade
with a full awareness that courts were enjoining unreasonable
delays as contrary
Page 467 U. S. 126
to the statutory purpose and violative of the rights conferred
on disabled persons by the Social Security Act. This affirmative
action deserves acknowledgment and weight.
Cf. Merrill Lynch,
Pierce, Fenner & Smith, Inc. v. Curran, 456 U.
S. 353,
456 U. S.
379-82 (1982);
Cannon v. University of Chicago,
441 U. S. 677,
441 U. S.
696-698 (1979);
Lorillard v. Pons, 434 U.
S. 575,
434 U. S.
580-581 (1978). The postenactment legislative history
simply does not support the conclusion reached by the majority,
because Congress' failure itself to remedy the delay problem cannot
be read to exclude judicial responses. Congress has long been aware
of efforts by several federal courts to compel the Secretary to
accelerate her review of adverse disability determinations,
[
Footnote 2/7] and has not taken
any action to curtail such judicial innovation. [
Footnote 2/8]
Page 467 U. S. 127
What insight can be gleaned from the recent history supports the
proposition that the District Court's statewide prospective
injunction setting time limits for reconsideration
Page 467 U. S. 128
determinations and hearings, far from being inconsistent
with
"repeated congressional rejection of the imposition of mandatory
deadlines on agency adjudication of disputed disability
claims,"
ante at
467 U. S. 119,
effectively accommodates Congress' concern that review of disputed
disability determinations be both accurate and expeditious. While
it is correct that Congress hitherto has not enacted a nationwide
standard in statutory form, that inaction is relevant to the
equitable remedy under review only if statutory nationwide time
limits are functionally no different from time limits imposed by a
court on the operations within one State. Clearly, they are not. A
statutory response is inflexible, requires a concomitant commitment
by Congress to provide the resources to enable the Secretary to
comply with the standard across the Nation, and is difficult to
amend in response to changing experience. A court-ordered timetable
is a flexible response to a particular factual record. It can be
narrowly tailored to accommodate both the Secretary's obligation
and the claimants' rights within the framework of resources and
practices in a defined jurisdiction. If new factual developments
alter the equitable balance, a court can modify relief.
See Fed.Rule Civ.Proc. 60(b)(5);
New York Assn. for
Retarded Children, Inc. v. Carey, 706 F.2d 956, 967 (CA2),
cert. denied, 464 U.S. 915 (1983).
Congress' discussion and inaction might be relevant if, in
rejecting a statutory remedy, Congress also rejected the existence
of the problem. If any theme emerges from the postenactment
legislative history, however, it is that delay is inconsistent with
the Social Security Act, and imposition of
Page 467 U. S. 129
deadlines would be consistent. [
Footnote 2/9] Congress repeatedly suggested to the
Secretary that she formulate standards and report back to Congress
on the feasibility of time limits. [
Footnote 2/10] The Secretary repeatedly assured
Congress that administrative steps would reduce hearing delays to
an acceptable level. [
Footnote
2/11]
Page 467 U. S. 130
In fact, albeit under court pressure, the Secretary published
proposed rules in the Federal Register in 1980, setting nationwide
time limits on the review process, and in 1981 characterized
revised rules as "realistic [time limits], which we plan to
achieve, and for which we expect to be held accountable," and as
"time limits which can and should be achieved in the operation of
the adjudicatory system as it currently exists," without
"significantly greater resources" or "decreases in decisional
accuracy." [
Footnote 2/12]
In sum, for several independent reasons, Congress' reluctance to
establish nationwide time limits within which the Secretary must
resolve disputed disability claims does not support the inference
that Congress disapproves the exercise by federal courts of their
equitable power to ensure that disability claimants in particular
jurisdictions are not deprived of their statutory entitlements. If
any aspect of the post-enactment legislative history of § 205(b) of
the Social Security
Page 467 U. S. 131
Act bears directly on the problem before us, it is the fact that
Congress has repeatedly reenacted the provision with the awareness
that the courts had been ordering the Secretary to comply with time
limits when necessary to prevent unreasonable delays in providing
reconsiderations and hearings. There is thus no basis for the
majority's conclusion that the equitable remedy ordered by the
District Court in this case is barred by implication.
III
Because the District Court's remedy is barred neither by an
explicit statutory restriction nor by implication, it should be
upheld unless it constitutes an abuse of discretion. The abuse of
discretion standard is not toothless in this context. We have
cautioned the lower federal courts against "engrafting their own
notions of proper procedures upon agencies entrusted with
substantive functions by Congress."
Vermont Yankee Nuclear
Power Corp. v. Natural Resources Defense Council, Inc.,
435 U. S. 519,
435 U. S. 525
(1978). Congress has mandated hearings on disputed disability
determinations, but has committed implementation of the review and
hearing process to the Secretary. I agree that the Secretary has
substantial discretion, with which the courts should not interfere,
in determining how to comply with her statutory obligations.
These general principles of judicial deference to agency
discretion in devising procedures to achieve legislatively defined
objectives are reinforced by some pragmatic considerations.
Excepting, of course, those cases where denial of benefits rises to
the level of violations of due process, I would agree that the
problem of delay may, at times, not be susceptible to judicial
solution. For example, when crowded administrative dockets are
directly linked to limited congressional appropriations and lack of
personnel, the only solution may lie in the hands of Congress.
Similarly, when delays are directly linked to the fairness and
accuracy of the adjudicatory process -- for example, when delays
result from the need to gather additional medical evidence relevant
to the core issue
Page 467 U. S. 132
of disability -- only the agency charged with determining
disability within the terms of the statute may be able to alleviate
the problem.
On the other hand, the Secretary's discretion cannot be
boundless, and courts must determine whether her actions are
sufficient to effectuate the individual entitlements created by
Congress. Therefore, many situations quite appropriately call for
judicial intervention. For example, when a standard for processing
similar cases can be established from the agency's own records,
lengthy delays beyond that norm may indicate a dilatory agency
response inconsistent with the statutory directive to provide a
claimant a timely hearing. Similarly, if the agency's records
disclose specific inefficiencies or inactivity that bear no
definable relationship to resource constraints or the need to
ensure accurate decisionmaking, courts would be remiss in deferring
to the agency's unreasonably dilatory processing of claimants'
requests for review.
The record in the present case supports the conclusion that the
District Court tailored its remedy to respond to causes of delay
that are properly susceptible to judicial scrutiny and solution.
The District Court considered record evidence of the agency's
standard for processing disability hearing requests. The Secretary
offered the 90-day figure as her established policy for scheduling
hearings. Prior to the District Court's order, she provided
hearings within that time in only 57% of the cases, with a 2- to
9-month range of delay. App. to Pet. for Cert. 15a. Yet the
Secretary did not complain that she was prevented from complying
with her own policy because of lack of resources. To the contrary,
she stated that she had the proper complement of ALJs needed to
conduct Title II disability hearings in Vermont. [
Footnote 2/13] Therefore,
Page 467 U. S. 133
when the District Court ordered relief, no record evidence
suggested that the Secretary would have difficulty complying.
When the District Court turned its attention to delays in the
reconsideration process, it based its order on 77 representative
case summaries provided by the Secretary. Again, the Secretary's
own standard was disposition in less than 90 days. The court
accepted her description of the "complex and time-consuming"
reconsideration process, which encompasses a
de novo
review of the existing record and any necessary supplemental
evidence. The court therefore allowed a
"reasonable time for locating the claim folder, forwarding it to
the appropriate agency, obtaining and assessing additional
evidence, and generating notices."
Id. at 29a. In each of the 27 cases in which
reconsideration took longer than 90 days, however, the court found
"periods of unexplained delay, not directly attributable to
necessary steps in the reconsideration process."
Id. at
28a. It further found that,
"when the
explained delays in the case summaries are
subtracted, most, if not all, of the cases could have been
completed within 90 days."
Ibid. (emphasis in original).
Thus, far from imposing an arbitrary deadline on an embattled
agency, the court looked first to the standard adopted by the
agency itself for meeting its statutory obligation to provide
timely hearings within the constraints of the resources available
to it. Further, the court explicitly rejected the respondents'
contentions that delays beyond a specific number of days violated
the statute, and that the mere passage of time justified the
extraordinary relief sought by the plaintiff
Page 467 U. S. 134
class. App. 99-100. Rather, the court framed the question as the
reasonableness of the delays. [
Footnote 2/14] The court's demands to the parties over
a 3-year period to produce a record sufficient to answer the
question presented [
Footnote
2/15] evinces its reluctance to substitute its own sense of
proper agency procedure for that of the Secretary.
The court's remedy similarly reflects its sensitivity to the
special difficulties of administering the massive Social Security
system, and to the challenges the Secretary faces in meeting the
administrative goals of accuracy and promptness.
Cf. Califano
v. Boles, 443 U. S. 282,
443 U. S. 285
(1979). By exempting from its order circumstances in which the
agency needed to gather medical evidence and reports, the court
responded to the Secretary's concern that she not be forced to
sacrifice accuracy for the sake of providing more expeditious
hearings. By exempting circumstances in which the claimant failed
to cooperate in the process or contributed to the delay, the court
accommodated the Secretary's concern that
Page 467 U. S. 135
she be permitted the degree of flexibility required in the best
interests of the claimants as well as the agency. And, of course, a
significant accommodation to the Secretary's concern for accurate
determinations in the court's order is its total exemption of the
decisionmaking, as opposed to the information-gathering, process.
There is no time limit whatsoever placed on ALJs' deliberations and
issuance of decisions. ALJs have sufficient time to deliberate to
ensure accurate decisions, and to schedule new consultative
examinations if additional evidence is required.
Finally, the consequences of the injunction are a further
indication of the reasonableness of the court's interpretation of
the statutory mandate.
Cf. Califano v. Yamasaki, 442 U.S.
at
442 U. S. 697.
During the 28 months in which a hearing injunction has been in
effect, the Secretary has met the standard in all but one case,
without additional allocation of resources and subsequent adverse
impact elsewhere in the Social Security Title II disability claims
system. Brief for Respondents 30, n. 32; Tr. of Oral Arg. 33, 51.
This record suggests both that the injunction has not had the
slightest impact on the Secretary's nationwide management of the
disability review process and that the injunction has had the
desired effect of enforcing disabled Vermonters' rights to timely
hearings.
A remedy manifestly attentive to the Secretary's practical and
policy concerns should not be held to be an abuse of discretion.
The District Court's order applied only to delay that was found as
fact
not to be the "direct and foreseeable consequenc[e] .
. . of the conscientious implementation of the Social Security
Act." Brief for Petitioner 33. Given the additional record evidence
that 21.3% of the initial determinations that a claimant was not
disabled within the meaning of the Social Security Act were found
on reconsideration to be erroneous, and 56.2% of the decisions were
reversed at the hearing stage, App. 53, the court properly
responded to the
Page 467 U. S. 136
special urgency of enjoining unreasonable barriers to claimants'
receipt of benefits mandated by Congress. [
Footnote 2/16]
IV
In summary, the relief ordered in this case was founded on three
correct premises. First, a federal court has a responsibility to
enforce the right to a hearing expressly granted in the Social
Security Act. The Act requires that such a hearing be timely.
Second, the mere length of processing times does not constitute an
adequate basis for classwide injunctive relief, for the delay may
be attributable to reasons related to the Secretary's mandate to
make accurate as well as expeditious disability determinations
within the constraints of the resources at her disposal. However,
if the causes of delay are unrelated to the adjudicative process,
the delay is unreasonable. Third, the unreasonableness of delay is
of magnified significance when the record establishes that more
than half of the Vermont claimants who pursue their right to an
administrative hearing are found to have been disabled and to be
entitled to the payments initially denied by the Secretary. By
definition, a disabled person has been unable "to engage in
any substantial gainful activity," 42 U.S.C. §
423(d)(1)(A) (emphasis supplied), and deprivation of income works
hardships that cannot adequately be compensated by
Page 467 U. S. 137
retroactive payments following a delayed decision in his or her
favor. Therefore, in the face of irreparable harm to the plaintiff
class, which has established a statutory right to relief, a federal
court properly may order injunctive relief, and properly did so in
the present case. I dissent.
[
Footnote 2/1]
The occurrence of one of three events triggers the requirement
that interim benefits be paid: the Secretary does not issue a
reconsideration decision within 180 days of request; the Secretary
fails to hold a hearing within 180 days (plus any delay
attributable to the claimant) of a prior request for
reconsideration followed by a request for a hearing; the Secretary
fails to hold a hearing within 90 days of a request. App. to Pet.
for Cert. 34a-35a. The Secretary retains the option under the
District Court's conditional order either to conduct review within
the established time periods or to initiate recoupable payments.
The agency thus is not operating under the threat of contempt
actions for failure to comply with the time limits, and the remedy
is consequently minimally intrusive.
Nor has the District Court intruded into the day-to-day
operations of the agency. The District Court requested and accepted
a plan drafted by the Secretary to implement the order.
See App.196-200. Vermont Title II claimants' requests for
reviews of adverse initial determinations of disability are flagged
with a coversheet that notes the dates by which reconsiderations
and hearings should be held, and permits easy recordkeeping of any
applicable exceptions that toll the time limits.
[
Footnote 2/2]
Defendant's Answer to Interrogatories Nos. 16, 17, App. 49
(averring that three Administrative Law Judges are needed to
conduct Title II disability hearings in Vermont, and three have
been assigned to the State).
[
Footnote 2/3]
The Secretary agrees that she has been able to fulfill her
obligation to provide timely hearings as defined by the District
Court. Since the District Court's first injunction went into
effect, the Secretary has been able to comply with the hearing
timetable in all but one case, and she has done so without
transferring any personnel or other resources into Vermont. Tr. of
Oral Arg. 33, 51.
[
Footnote 2/4]
Defendant's Answer to Interrogatories, Nos.19, 24, App. 50, 52
(agency's established policy is to conduct hearings within 90 days
of request).
[
Footnote 2/5]
The legislative history of § 205(b) is sparse, but generally
supports respondents' position. The bill embodying the "right to a
hearing" provision was intended "to strengthen and extend the
principles and objectives of the Social Security Act." H.R.Rep. No.
728, 76th Cong. , 1st Sess., 5 (1939). The agency charged with
implementation of the Act believed the timely provision of hearings
to be "the essence of the task to be performed." Federal Security
Agency, Social Security Board, Basic Provisions Adopted by the
Social Security Board for the Hearing and Review of Claims (1940),
reprinted in Attorney General's Committee on Administrative
Procedure, Administrative Procedure in Government Agencies, S. Doc.
No. 10, 77th Cong., 1st Sess., pt. 3, p. 37 (1941). The Social
Security Board stated that all hearings should be held within 30
days of request.
Id. at 45.
[
Footnote 2/6]
Act of Aug. 28, 1950, ch. 809, § 108(a), 64 Stat. 518; Act of
Aug. 1, 1956, Pub.L. 880, § 111, 70 Stat. 831; Act of July 30,
1965, Pub.L. 89-97, § 308(d)(9), 79 Stat. 379; Act of Jan. 2, 1976,
Pub.L. 94-202, § 4, 89 Stat. 1136; Act of June 9, 1980, Pub.L.
96-265, § 305(a), 94 Stat. 457; Act of Jan. 12, 1983, Pub.L.
97-455, § 4, 96 Stat. 2499; Social Security Amendments of 1983,
Pub.L. 98-21, §§ 301(d)(1), 309(i)(1), 97 Stat. 111, 117.
[
Footnote 2/7]
See, e.g., H.R.Conf.Rep. No. 96-944, p. 59 (1980)
(Conference Report accompanying Social Security Disability
Amendments of 1980, noting without criticism that, in the absence
of a statutory time limit on adjudication of claims, several
District Courts had imposed such limits at the hearing level).
Cases in which federal courts presented with unreasonable delays
by the Secretary have imposed deadlines include
Sharpe v.
Harris, 621 F.2d 530 (CA2 1980) (affirming time limits in
Supplemental Security Income (SSI) hearings, decisions, and
payments to New York State class);
Blankenship v. Secretary of
HEW, 587 F.2d 329 (CA6 1978),
on
remand, 532 F.
Supp. 739 (WD Ky.1982),
aff'd in part, stayed in part,
722 F.2d 1282 (1983) (per curiam) (Title II and SSI claimants'
hearings must be held within 180 days; those whose benefits have
been terminated have right to decision from Appeals Council within
90 days; order of interim payments after 180-day delay stayed
pending decision in the present case),
stayed,
465 U. S. 1301
(1984);
Caswell v. Califano, 583 F.2d 9 (CA1 1978) (90-day
limit from request to hearing for Maine Title II claimants);
Barnett v. Califano, 580 F.2d 28 (CA2 1978) (order
applicable to Vermont SSI disability claimants, requiring hearings
in most cases within 90 days of request);
White v.
Mathews, 559 F.2d 852 (CA2 1977) (Connecticut disability
claimants entitled to hearing and final decision within 120 days;
l-year phase-in of time limit; interim payment of benefits
ordered),
cert. denied, 435 U.S. 908 (1978);
Chagnon
v. Schweiker, 560 F. Supp.
71 (Vt.1982) (Secretary ordered to provide disability and SSI
payments to those found eligible within 60 days after determination
of eligibility by an ALJ or the Appeals Council);
Crosby v.
Social Security Administration, 550
F. Supp. 1278 (Mass.1982) (Title II and SSI disability
claimants have right to a decision within 180 days of request for a
hearing (plus time attributable to specified reasonable causes for
delay) and to award of interim benefits if deadline not met),
appeal pending, No. 83-1077 (CA1).
But see Wright v.
Califano, 587 F.2d 345 (CA7 1978) (reversing order to phase in
time limits for review of disputed old-age and survivors' benefits
claims, finding delays not so unreasonable as to justify court's
exercise of equitable power).
[
Footnote 2/8]
The only congressional suggestion of disapproval of
court-ordered timely hearings that the majority has cited,
ante at
467 U. S.
114-115, and n. 25, when read in context, supports only
the inference that Congress chose not to "assert its power to give
the district courts more specific direction,"
White v. Mathews,
supra, at 861. If the Committee's remarks are at all germane
to our discussion, then it is surely relevant that the Committee
reported favorably on a proposed amendment to the Social Security
Act that would have limited courts' injunctive authority in
remedying delay, an amendment that Congress chose not to enact.
H.R. 6181, § 10, 97th Cong., 2d Sess. (1982). Moreover, in
expressing its disapproval of the
Blankenship decision,
see ante at
467 U. S. 115,
and n. 25, the Committee appeared to distinguish that decision,
which involved a nationwide remedial order, from six other court
orders which "apply only in the areas under the jurisdiction of the
court." H.R.Rep. No. 97-588, p.19 (1982). Finally, the Committee's
concern that strict time limits
"could result in incorrect determinations because time was not
available to obtain needed medical evidence or to reach
well-reasoned decisions,"
id. at 20, is accommodated in the present case by the
tolling provisions in the District Court's order and by the absence
of any time limits on the rendering of hearing decisions.
In fact, since the District Court's order, Congress can be said
to have endorsed the courts' conclusion that claimants should not
bear the entire burden of delay by the Secretary. The 97th Congress
substantially enhanced the protection of persons, like respondents
Day and Maurais, who have been receiving Title II benefits but whom
the Secretary determines are no longer disabled within the meaning
of the SSA. If they appeal the Secretary's initial determination,
they may elect to continue to receive payments during the pendency
of the appeal, subject to return of any overpayment. Act of Jan.
12, 1983, Pub.L. 97-455, § 2, 96 Stat. 2498, 42 U.S.C. § 423(g).
The Senate Committee Report explained that
"some emergency relief is warranted for workers who are having
benefits terminated by State agencies and then -- in more than half
the cases appealed -- having their benefits reinstated by an
ALJ."
S.Rep. No. 97-648, p. 6 (1982). Although passed as an interim
measure expiring in June, 1984, the 98th Congress has moved to make
continuation of benefits permanent. The Social Security Disability
Benefits Reform Act of 1984, H.R. 3755, § 223(g), 98th Cong., 2d
Sess. (1984), has passed the House and has been read twice in the
Senate.
See also Brief for the Alliance of Social Security
Disability Recipients
et al. as
Amici Curiae.
[
Footnote 2/9]
Had the Secretary adopted mandatory time limits pursuant to her
rulemaking authority, and was now facing a challenge, rather than
bringing one, I have no doubt that she would be citing this same
legislative history for the proposition that Congress thought time
limits consistent with the Social Security Act.
Cf. Heckler v.
Campbell, 461 U. S. 458
(1983). In
Campbell, the Court upheld the Secretary's
reliance on medical-vocational guidelines, noting that, since
amending the Social Security Act to provide for disability benefits
in 1954, Congress repeatedly suggested that the Secretary adopt
rules defining the criteria for evaluating disability.
"While these sources do not establish the original congressional
intent, they indicate that later Congresses perceived that
regulations such as the guidelines would be consistent with the
statute."
Id. at
461 U. S. 466,
n. 10. The same inferences are available to the Court in the
present case.
[
Footnote 2/10]
See, e.g., Pub.L. 96-265, § 308, 94 Stat. 458, note
following 42 U.S.C. § 401. The Social Security Disability
Amendments of 1980 required the Secretary to report to Congress
"recommending the establishment of appropriate time limitations
governing decisions on claims for benefits under title II of the
Social Security Act . . . tak[ing] into account both the need for
expeditious processing . . . and the need to assure that all such
claims will be thoroughly considered and accurately
determined."
[
Footnote 2/11]
See, e.g., H.R.Rep. No. 94-679, p. 2 (1975) (relying on
agency's estimate that a limited reform bill could reduce hearing
backlog by 3,000 cases a month "so that, in 18 months, cases can be
adjudicated within 90 days"); S.Rep. No. 94-550, p. 3 (1975)
(same); Delays in Social Security Appeals, Hearings before
Subcommittee on Social Security of the House Committee on Ways and
Means, 94th Cong., 1st Sess., 74 (1975) (assurances of SSA
Commissioner Cardwell that backlog could be brought under control
and hearings scheduled within 90 days of request by June 1977).
The Secretary has given similar assurances in litigating
challenges to delays in the review process.
See, e.g., Sharpe
v. Harris, 621 F.2d at 531;
White v.
Mathews, 434 F.
Supp. 1252, 1256-1257 (Conn.1976),
aff'd, 559 F.2d 852
(CA2 1977);
Crosby v. Social Security Administration,
supra, at 1282. In the present case, the Secretary opposed the
plaintiffs' motion for summary judgment on the issue of liability
in part on the ground that she was ready to issue regulations
setting 90-day hearing deadlines, and the court should therefore
abstain. App. to Pet. for Cert. 18a-19a.
[
Footnote 2/12]
Subcommittee on Social Security of the House Committee on Ways
and Means, Status of the Disability Insurance Program, 97th Cong.,
1st Sess., 45-46 (Comm.Print 1981) (hereinafter 1981 Comm.Print)
(response of Social Security Commissioner Driver to Rep. Pickle).
The proposed rulemaking set a 90-day limit on hearings, subject to
exceptions very similar to the nine exceptions in the present case,
and required that hearing decisions issue within 30 days after a
hearing is held and the record closed. 45 Fed.Reg. 12838-12839
(1980). Reporting to Congress 10 months later, the Secretary
recommended 150 days from application for reconsideration to
decision, and 165 days from request for a hearing to issuing a
decision, because experience had indicated that, nationwide, the
agency could provide hearings within 90 days only in about 70% of
the cases, and issue decisions within 30 days in about 80% of the
cases. U.S. Dept. of Health and Human Services, Report to Congress,
Implementation of Section 308, Public Law 96-265 (Oct. 21, 1980),
reprinted in 1981 Comm.Print, at 43.
Whether Congress might have acted affirmatively but for the
Secretary's assurances is a matter for conjecture, but it is as
valid an inference as the majority's inference that Congress'
failure to enact nationwide deadlines, or to order the Secretary to
do so pursuant to her rulemaking authority, is an affirmative
rejection of the proposition that a claimant's § 205(b) right to a
timely hearing should be effectuated through promulgation of time
limits.
[
Footnote 2/13]
The Secretary hypothesized four categories of reasons for not
scheduling hearings within 90 days: lack of claimant cooperation in
providing necessary information; delay in response from medical
sources cited by the claimant; logistical and scheduling problems
due to distant travel; and agency assistance to claimants in
obtaining complex and specialized medical development. Answers to
Interrogatories Nos. 23, 24, APP. 52. The Secretary provided no
evidence that any of these reasons caused delays in scheduling the
class representatives' hearings.
[
Footnote 2/14]
Midway through the litigation, the court found the record
"devoid of information concerning the reasons why the delays
occurred. The plaintiffs have recognized that there will be times
when the delay is either requested by the recipients to enable them
to provide additional information or is caused by the recipients'
failure to cooperate with the Secretary's requests. Similarly, the
Secretary has acknowledged that delays may have been the result of
increased caseload or insufficient staffing. It is clear, then,
that the record is inconclusive with respect to the reasonableness
of the delays. And since the reasonableness of the delays is the
prime question before the court, the motions for summary judgment
must be denied."
Memorandum Decision of July 14, 1980, App. 99-100. Only after
continued discovery did the court rule that delays beyond 90 days
were unreasonable. App. to Pet. for Cert. 28a-29a.
[
Footnote 2/15]
In response to plaintiffs' third request for interrogatories,
seeking the data demanded by Judge Holden, the Secretary chose to
submit 77 randomly selected disability reconsideration cases
selected by her from a total of 453 reconsiderations performed
between October 1, 1977, and January 31, 1980. Defendant's Answers
to Third Interrogatories, Mar. 30, 1981, App. 105-149, 193-195.
[
Footnote 2/16]
The significance we place on the reversal rate must be tempered
by the fact that the administrative appeals process permits
introduction of additional evidence of disability at each stage.
Therefore, a denial of disability status at one stage could well
have been "correct" based on the evidence available to the
decisionmaker.
Cf. Mathews v. Eldridge, 424 U.
S. 319,
424 U. S.
346-347 (1976). Nonetheless, the fact remains that
hundreds of disabled Vermonters endure grave hardship because they
do not receive entitlements during the delayed review process. The
Government has an obligation to the rightful beneficiaries of its
insurance program. Members of the plaintiff class were once
workers, paying into the Social Security system for the required
number of years to earn entitlement to income when disabling
illness or accident keeps them from the workplace.