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SUPREME COURT OF THE UNITED STATES
_________________
No. 17–1606
_________________
RICKY LEE SMITH, PETITIONER
v. NANCY A.
BERRYHILL, ACTING COMMISSIONER OF SOCIAL SECURITY
on writ of certiorari to the united states
court of appeals for the sixth circuit
[May 28, 2019]
Justice Sotomayor delivered the opinion of the
Court.
The Social Security Act allows for judicial
review of “any final decision . . . made after a hearing”
by the Social Security Administration (SSA). 42 U. S. C.
§405(g). Petitioner Ricky Lee Smith was denied Social Security
benefits after a hearing by an administrative law judge (ALJ) and
later had his appeal from that denial dismissed as untimely by the
SSA’s Appeals Council—the agency’s final decisionmaker. This case
asks whether the Appeals Council’s dismissal of Smith’s claim is a
“final decision . . . made after a hearing” so as to
allow judicial review under §405(g). We hold that it is.
I
A
Congress enacted the Social Security Act in
1935, responding to the crisis of the Great Depression. 49Stat.
620; F. Bloch, Social Security Law and Practice 13 (2012). In its
early days, the program was administered by a body called the
Social Security Board; that role has since passed on to the Board’s
successor, the SSA.[
1]
In 1939, Congress amended the Act, adding
various provisions that—subject to changes not at issue
here—continue to govern cases like this one. See Social Security
Act Amendments of 1939, ch. 666, 53Stat. 1360. First, Congress gave
the agency “full power and authority to make rules and regulations
and to establish procedures . . . necessary or
appropriate to carry out” the Act. §405(a). Second, Congress
directed the agency “to make findings of fac[t] and decisions as to
the rights of any individual applying for a payment” and to provide
all eligible claimants—that is, people seeking benefits—with an
“opportunity for a hearing with respect to such decision[s].”
§405(b)(1). Third, and most centrally, Congress provided for
judicial review of “any final decision of the [agency] made after a
hearing.” §405(g). At the same time, Congress made clear that
review would be available only “as herein provided”—that is, only
under the terms of §405(g). §405(h); see
Heckler v.
Ringer,
466 U.S.
602, 614–615 (1984).
In 1940, the Social Security Board created the
Appeals Council, giving it responsibility for overseeing and
reviewing the decisions of the agency’s hearing officers (who,
today, are ALJs).[
2] Though the
Appeals Council originally had just three members, its ranks have
since swelled to include over 100 individuals serving as either
judges or officers.[
3] The
Appeals Council remains a creature of regulatory rather than
statutory creation.
Today, the Social Security Act provides
disability benefits under two programs, known by their statutory
headings as Title II and Title XVI. See §401
et seq.
(Title II); §1381
et seq. (Title XVI). Title II
“provides old-age, survivor, and disability benefits to insured
individuals irrespective of financial need.”
Bowen v.
Galbreath,
485 U.S.
74, 75 (1988). Title XVI provides supplemental security income
benefits “to financially needy individuals who are aged, blind, or
disabled regardless of their insured status.”
Ibid. The
regulations that govern the two programs are, for today’s purposes,
equivalent. See
Sims v.
Apfel,
530
U.S. 103, 107, n. 2 (2000).[
4] Likewise, §405(g) sets the terms of judicial review for
each. See §1383(c)(3).
Modern-day claimants must generally proceed
through a four-step process before they can obtain review from a
federal court. First, the claimant must seek an initial
determination as to his eligibility. Second, the claimant must seek
reconsideration of the initial determination. Third, the claimant
must request a hearing, which is conducted by an ALJ. Fourth, the
claimant must seek review of the ALJ’s decision by the Appeals
Council. See 20 CFR §416.1400. If a claimant has proceeded through
all four steps on the merits, all agree, §405(g) entitles him to
judicial review in federal district court.[
5]
The tension in this case stems from the
deadlines that SSA regulations impose for seeking each successive
stage of review. A party who seeks Appeals Council review, as
relevant here, must file his request within 60 days of receiving
the ALJ’s ruling, unless he can show “good cause for missing the
deadline.” §416.1468.
The Appeals Council’s review is discretionary:
It may deny even a timely request without issuing a decision. See
§416.1481. If a claimant misses the deadline and cannot show good
cause, however, the Appeals Council does not deny the request but
rather dismisses it. §416.1471. Dismissals are “binding and not
subject to further review” by the SSA. §416.1472. The question here
is whether a dismissal for untimeliness, after the claimant has had
an ALJ hearing, is a “final decision . . . made after a
hearing” for purposes of allowing judicial review under
§405(g).
B
Petitioner Ricky Lee Smith applied for
disability benefits under Title XVI in 2012. Smith’s claim was
denied at the initial-determination stage and upon reconsideration.
Smith then requested an ALJ hearing, which the ALJ held in February
2014 before issuing a decision denying Smith’s claim on the merits
in March 2014.
The parties dispute what happened next. Smith’s
attorney says that he sent a letter requesting Appeals Council
review in April 2014, well within the 60-day deadline. The SSA says
that it has no record of receiving any such letter. In late
September 2014, Smith’s attorney sent a copy of the letter that he
assertedly had mailed in April. The SSA, noting that it had no
record of prior receipt, counted the date of the request as the day
that it received the copy. The Appeals Council accordingly
determined that Smith’s submission was untimely, concluded that
Smith lacked good cause for missing the deadline, and dismissed
Smith’s request for review.
Smith sought judicial review of that dismissal
in the U. S. District Court for the Eastern District of
Kentucky. The District Court held that it lacked jurisdiction to
hear his suit. The U. S. Court of Appeals for the Sixth
Circuit affirmed, maintaining that “an Appeals Council decision to
refrain from considering an untimely petition for review is not a
‘final decision’ subject to judicial review in federal
court.’ ”
Smith v.
Commissioner of Social
Security, 880 F.3d 813, 814 (2018).
Smith petitioned this Court for certiorari.
Responding to Smith’s petition, the Government stated that while
the Sixth Circuit’s decision accorded with the SSA’s longstanding
position, the Government had “reexamined the question and concluded
that its prior position was incorrect.” Brief for Respondent on
Pet. for Cert. 15.
We granted certiorari to resolve a conflict
among the Courts of Appeals. 586 U. S. ___ (2018).[
6] Because the Government agrees with
Smith that the Appeals Council’s dismissal meets §405(g)’s terms,
we appointed Deepak Gupta as
amicus curiae to defend the
judgment below. 586 U. S. ___ (2018). He has ably discharged
his duties.
II
Section 405(g), as noted above, provides for
judicial review of “any final decision . . . made after a
hearing.” This provision, the Court has explained, contains two
separate elements: first, a “jurisdictional” requirement that
claims be presented to the agency, and second, a “waivable
. . . requirement that the administrative remedies
prescribed by the Secretary be exhausted.”
Mathews v.
Eldridge,
424 U.S.
319, 328 (1976). This case involves the latter,
nonjurisdictional element of administrative exhaustion. While
§405(g) delegates to the SSA the authority to dictate which steps
are generally required, see
Sims, 530 U. S., at 106,
exhaustion of those steps may not only be waived by the agency, see
Weinberger v.
Salfi,
422 U.S.
749, 767 (1975), but also excused by the courts, see
Bowen v.
City of New York,
476
U.S. 467, 484 (1986);
Eldridge, 424 U. S., at
330.[
7]
The question here is whether a dismissal by the
Appeals Council on timeliness grounds after a claimant has received
an ALJ hearing on the merits qualifies as a “final decision
. . . made after a hearing” for purposes of allowing
judicial review under §405(g). In light of the text, the context,
and the presumption in favor of the reviewability of agency action,
we conclude that it does.
A
We begin with the text. Taking the first
clause (“any final decision”) first, we note that the phrase “final
decision” clearly denotes some kind of terminal event,[
8] and Congress’ use of the word “any”
suggests an intent to use that term “expansive[ly],” see
Ali
v.
Federal Bureau of Prisons,
552 U.S.
214, 218–219 (2008). The Appeals Council’s dismissal of Smith’s
claim fits that language: Under the SSA’s own regulations, it was
the final stage of review. See 20 CFR §416.1472.
Turning to the second clause (“made after a
hearing”), we note that this phrase has been the subject of some
confusion over the years. On the one hand, the statute elsewhere
repeatedly uses the word “hearing” to signify an ALJ
hearing,[
9] which suggests
that, in the ordinary case, the phrase here too denotes an ALJ
hearing. See,
e.g.,
IBP,
Inc. v.
Alvarez,
546 U.S.
21, 34 (2005) (noting “the normal rule of statutory
interpretation that identical words used in different parts of the
same statute are generally presumed to have the same meaning”). On
the other hand, the Court’s precedents make clear that an ALJ
hearing is not an ironclad prerequisite for judicial review. See,
e.g.,
City of New York, 476 U. S., at 484
(emphasizing the Court’s “ ‘intensely practical’ ”
approach to the applicability of the exhaustion requirement and
disapproving “mechanical application” of a set of factors).
There is no need today to give §405(g) a
definition for all seasons, because, in any event, this is a
mine-run case and Smith obtained the kind of hearing that §405(g)
most naturally suggests: an ALJ hearing on the merits.[
10] In other words, even giving
§405(g) a relatively strict reading, Smith appears to satisfy its
terms.[
11]
Smith cannot, however, satisfy §405(g)’s “after
a hearing” requirement as a matter of mere chronology.[
12] In
Califano v.
Sanders,
430 U.S.
99 (1977), the Court considered whether the SSA’s denial of a
claimant’s petition to reopen a prior denial of his claim for
benefits qualified as a final decision under §405(g).
Id.,
at 102–103, 107–109. The Court concluded that it did not, reasoning
that a petition to reopen was a matter of agency grace that could
be denied without a hearing altogether and that allowing judicial
review would thwart Congress’ own deadline for seeking such review.
See
id., at 108–109. That the SSA’s denial of the petition
to reopen (1) was conclusive and (2) postdated an ALJ hearing did
not, alone, bring it within the meaning of §405(g).
Here, by contrast, the SSA’s “final decision” is
much more closely tethered to the relevant “hearing.” Unlike a
petition to reopen, a primary application for benefits may not be
denied without an ALJ hearing (assuming the claimant timely
requests one, as Smith did). §405(b)(1). Moreover, the claimant’s
access to this first bite at the apple is indeed a matter of
legislative right rather than agency grace. See
id., at 108.
And, again unlike the situation in
Sanders, there is no
danger here of thwarting Congress’ own deadline, given that the
only potential untimeliness here concerns Smith’s request for
Appeals Council review—not his request for judicial review
following the agency’s ultimate determination.
B
The statutory context weighs in Smith’s favor
as well. Appeals from SSA determinations are, by their nature,
appeals from the action of a federal agency, and in the separate
administrative-law context of the Administrative Procedure Act
(APA), an action is “final” if it both (1) “mark[s] the
‘consummation’ of the agency’s decisionmaking process” and (2) is
“one by which ‘rights or obligations have been determined,’ or from
which ‘legal consequences will flow.’ ”
Bennett v.
Spear,
520 U.S.
154, 177–178 (1997). Both conditions are satisfied when a
Social Secu- rity claimant has reached the fourth and final step of
the SSA’s four-step process and has had his request for review
dismissed as untimely. It is consistent to treat the Appeals
Council’s dismissal of Smith’s claim as a final decision as
well.
To be clear, “the doctrine of administrative
exhaustion should be applied with a regard for the particular
administrative scheme at issue,”
Salfi, 422 U. S., at
765, and we leave this axiom undisturbed today. The Social Security
Act and the APA are different statutes, and courts must remain
sensitive to their differences. See,
e.g.,
Sullivan
v.
Hudson,
490 U.S.
877, 885 (1989) (observing that “[a]s provisions for judicial
review of agency action go, §405(g) is somewhat unusual” in that
its “detailed provisions . . . suggest a degree of direct
interaction between a federal court and an administrative agency
alien to” APA review). But at least some of these differences
suggest that Congress wanted more oversight by the courts in this
context rather than less, see
ibid.,[
13] and the statute as a whole is one that
“Congress designed to be ‘unusually protective’ of claimants,”
City of New York, 476 U. S., at 480.
We note further that the SSA is a massive
enterprise,[
14] and mistakes
will occur. See Brief for National Organization of Social Security
Claimants’ Representatives as
Amicus Curiae 13
(collecting examples).[
15]
The four steps preceding judicial review, meanwhile, can drag on
for years.[
16] While
mistakes by the agency may be admirably rare, we do not presume
that Congress intended for this claimant-protective statute, see
City of New York, 476 U. S., at 480, to leave a
claimant without recourse to the courts when such a mistake does
occur—least of all when the claimant may have already expended a
significant amount of likely limited resources in a lengthy
proceeding.
C
Smith’s entitlement to judicial review is
confirmed by “the strong presumption that Congress intends judicial
review of administrative action.”
Bowen v.
Michigan
Academy of Family Physicians,
476 U.S.
667, 670 (1986). “That presumption,” of course, “is rebuttable:
It fails when a statute’s language or structure demonstrates that
Congress wanted an agency to police its own conduct.”
Mach
Mining,
LLC v.
EEOC, 575 U.S. 480, ___–___ (2015)
(slip op., at 4–5). But the burden for rebutting it is
“ ‘heavy,’ ”
id., at ___ (slip op., at 5), and
that burden is not met here. While Congress left it to the SSA to
define the procedures that claimants like Smith must first pass
through, see
Sims, 530 U. S., at 106, Congress has not
suggested that it intended for the SSA to be the unreviewable
arbiter of whether claimants have complied with those procedures.
Where, as here, a claimant has received a claim-ending timeliness
determination from the agency’s last-in-line decisionmaker after
bringing his claim past the key procedural post (a hearing)
mentioned in §405(g), there has been a “final decision
. . . made after a hearing” under §405(g).[
17]
III
Amicus’ arguments to the contrary have
aided our consideration of this case, but they have not dissuaded
us from concluding that the Appeals Council’s dismissal of Smith’s
claim satisfied §405(g).
Amicus first argues that the phrase
“final decision . . . made after a hearing” refers to a
conclusive disposition, after exhaustion, of a benefits claim on
the merits—that is, on a basis for which the Social Security Act
entitles a claimant to a hearing. This reading follows,
amicus argues, from the Court’s observations that §405(g)
generally requires exhaustion, and moreover from
Sanders’
suggestion, see 430 U. S., at 108, that review is not called
for where a claimant loses on an agency-determined procedural
ground that is divorced from the substantive matters for which a
hearing is required. Even if Smith did receive a hearing on the
merits,
amicus argues, the conclusive determination was not
on that basis, and “[i]t would be unnatural to read the statute as
throwing open the gates to judicial review of any final decision,
no matter how collateral,” just because such a hearing occurred.
Brief for Court-Appointed
Amicus Curiae 34.
We disagree. First, as noted above, the Court’s
precedents do not make exhaustion a pure necessity, indicating
instead that while the SSA is empowered to define the steps
claimants must generally take, the SSA is not also the unreviewable
arbiter of whether a claimant has sufficiently complied with those
steps. See
supra, at 5–6, and n. 7. Second, the Appeals
Council’s dismissal is not merely collateral; such a dismissal
calls an end to a proceeding in which a substantial factual record
has already been developed and on which considerable resources have
already been expended. See
supra, at 10, and n. 16.
Accepting
amicus’ argument would mean that a claimant could
make it to the end of the SSA’s process and then have judicial
review precluded simply because the Appeals Council stamped
“untimely” on the request, even if that designation were patently
inaccurate. While there may be contexts in which the law is so
unforgiving, this is not one. See
supra, at 9–11.
Smith’s case, as noted above, is also distinct
from
Sanders. See
supra, at 8.
Sanders, after
all, involved the SSA’s denial of a petition for reopening—a second
look that the agency had made available to claimants as a matter of
grace. See 430 U. S., at 101–102, 107–108. But Smith is not
seeking a second look at an already-final denial; he argues that he
was wrongly prevented from continuing to pursue his primary claim
for benefits. That primary claim, meanwhile, is indeed a matter of
statutory entitlement. See §405(b).
Amicus also emphasizes that the SSA
handles a large volume of claims, such that a decision providing
for greater judicial review could risk a flood of litigation. That
result seems unlikely for a few reasons. First, the number of
Appeals Council untimeliness dismissals is comparatively
small—something on the order of 2,500 dismissals out of 160,000
dispositions per year.[
18]
Second, the interpretation that Smith and the Government urge has
been the law since 1983 in the Eleventh Circuit, and the data there
do not bear out
amicus’ warning. See Reply Brief for
Respondent 14–15 (collecting statistics). Third, while
amicus flags related contexts that could be informed by
today’s ruling, see Brief for Court-Appointed
Amicus
Curiae 36–40, those issues are not before us. We therefore
do not address them other than to reinforce that such questions
must be considered in the light of “the particular administrative
scheme at issue.” See
Salfi, 422 U. S., at 765. Today’s
decision, therefore, hardly knocks loose a line of dominoes.
Finally,
amicus argues that the meaning
of §405(g) is ambiguous and that the SSA’s longstanding
interpretation of §405(g)—prior to its changed position during the
pendency of this case—is entitled to deference under
Chevron
U. S. A. Inc. v.
Natural Resources Defense
Council,
Inc.,
467 U.S.
837 (1984). The Government and Smith maintain that the statute
unambiguously supports the Government’s new position, and Smith
further asserts that deference is inappropriate where the
Government itself has rejected the interpretation in question in
its filings.
We need not decide whether the statute is
unambiguous or what to do with the curious situation of an
amicus curiae seeking deference for an interpretation that
the Government’s briefing rejects.
Chevron deference
“ ‘is premised on the theory that a statute’s ambiguity
constitutes an implicit delegation from Congress to the agency to
fill in the statutory gaps.’ ”
King v.
Burwell,
576 U. S. ___, ___ (2015) (slip op., at 8). The scope of
judicial review, meanwhile, is hardly the kind of question that the
Court presumes that Congress implicitly delegated to an agency.
Indeed, roughly six years after
Chevron
was decided, the Court declined to give
Chevron deference to
the Secretary of Labor’s interpretation of a federal statute that
would have foreclosed private rights of action under certain
circumstances. See
Adams Fruit Co. v.
Barrett,
494 U.S.
638, 649–650 (1990). As the Court explained, Congress’ having
created “a role for the Department of Labor in administering the
statute” did “not empower the Secretary to regulate the scope of
the judicial power vested by the statute.”
Id., at 650.
Rather, “[a]lthough agency determinations within the scope of
delegated authority are entitled to deference, it is fundamental
‘that an agency may not bootstrap itself into an area in which it
has no jurisdiction.’ ”
Ibid. Here, too, while Congress
has empowered the SSA to create a scheme of administrative
exhaustion, see
Sims, 530 U. S., at 106, Congress did
not delegate to the SSA the power to determine “the scope of the
judicial power vested by” §405(g) or to determine conclusively when
its dictates are satisfied.
Adams Fruit Co., 494 U. S.,
at 650. Consequently, having concluded that Smith and the
Government have the better reading of §405(g), we need go no
further.
IV
Although they agree that §405(g) permits
judicial review of the Appeals Council’s dismissal in this case,
Smith and the Government disagree somewhat about the scope of
review on remand.[
19] Smith
argues that if a reviewing court disagrees with the procedural
ground for dismissal, it can then proceed directly to the merits,
while the Government argues that the proper step in such a case
would be to remand. We largely agree with the Government.
To be sure, there would be jurisdiction for a
federal court to proceed to the merits in the way that Smith avers.
For one, as noted above, exhaustion itself is not a jurisdictional
prerequisite. See
supra, at 5–6. Moreover, §405(g) states
that a reviewing “court shall have power to enter, upon the
pleadings and transcript of the record, a judgment affirming,
modifying, or reversing the decision of the Commissioner of Social
Security, with or without remanding the cause for a rehearing”—a
broad grant of authority that reflects the high “degree of direct
interaction between a federal court and an administrative agency”
envisioned by §405(g).
Hudson, 490 U. S., at 885. In
short, there is no jurisdictional bar to a court’s reaching the
merits.
Fundamental principles of administrative law,
however, teach that a federal court generally goes astray if it
decides a question that has been delegated to an agency if that
agency has not first had a chance to address the question. See,
e.g.,
INS v.
Orlando Ventura,
537 U.S.
12, 16, 18 (2002) (
per curiam);
ICC v.
Locomotive Engineers,
482 U.S.
270, 283 (1987); cf.
SEC v.
Chenery Corp.,
318 U.S.
80, 88 (1943) (“For purposes of affirming no less than
reversing its orders, an appellate court cannot intrude upon the
domain which Congress has exclusively entrusted to an
administrative agency”). The Court’s cases discussing exhaustion in
the Social Security context confirm the prudence of applying this
general principle here, where the agency’s final decisionmaker has
not had a chance to address the merits at all.[
20] See
City of New York, 476 U. S.,
at 485 (“Because of the agency’s expertise in administering its own
regulations, the agency ordinarily should be given the opportunity
to review application of those regulations to a particular factual
context”);
Salfi, 422 U. S., at 765 (explaining that
exhaustion serves to “preven[t] premature interference with agency
processes” and to give the agency “an opportunity to correct its
own errors,” “to afford the parties and the courts the benefit of
its experience and expertise,” and to produce “a record which is
adequate for judicial review”). Accordingly, in an ordinary case, a
court should restrict its review to the procedural ground that was
the basis for the Appeals Council dismissal and (if necessary)
allow the agency to address any residual substantive questions in
the first instance.[
21]
V
We hold that where the SSA’s Appeals Council
has dismissed a request for review as untimely after a claimant has
obtained a hearing from an ALJ on the merits, that dismissal
qualifies as a “final decision . . . made after a
hearing” within the meaning of §405(g). The judgment of the United
States Court of Appeals for the Sixth Circuit is therefore
reversed, and the case is remanded for further proceedings
consistent with this opinion.
It is so ordered.
