Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-ca10-89-04012/USCOURTS-ca10-89-04012-0/pdf.json

Nature of Suit Code: 865
Nature of Suit: Social Security - RSI (405(g))
Cause of Action: 

---

UNITED STATES COURT OF APPEALS 

TENTH CIRCUIT 

ELIZABETH D. MOOSMAN, 

Plaintiff-Appellant, 

F I LED 

United Stat£;, Co· !rt. of. Appeals '!",,,,,,.i. ,,;,..,.ult 

FEB O 7 1991 

!lOBERT L. HOECKER 

Clerk 

v. 

LOUIS W. SULLIVAN, M.D., 

Secretary of Health and 

Human Services, 

) 

) 

) 

) 

) 

) 

) 

) 

) 

) 

) 

No. 89-4012 

(D.C. No. 88-NC-034G) 

(D. Utah) 

Defendant-Appellee. 

ORDER AND JUDGMENT* 

Before MCKAY and EBEL, Circuit Judges and WEST, District Judge.* 

After examining the briefs and appellate record, this panel 

has determined unanimously that oral argument would not materially 

assist the determination of this appeal. See Fed. R. App. P. 

34(a); 10th Cir. R. 34.1.9. Therefore, the case is ordered 

submitted without oral argument. 

BACKGROUND 

In October 1981, plaintiff-appellant Elizabeth Moosman was 

notified by the Social Security Administration that her condition, 

* This order and judgment has no precedential value and shall not 

be cited, or used by any court within the Tenth Circuit, except 

for purposes of establishing the doctrines of the law of the case, 

res judicata, or collateral estoppel. 10th Cir. R. 36.3. 

* The Honorable Lee R. West, United States District Judge for the 

Western District of Oklahoma, sitting by designation. 

Appellate Case: 89-4012 Document: 010110098486 Date Filed: 02/07/1991 Page: 1 
for which she had been receiving benefits since 1971, was no 

longer considered disabling. She requested review of that 

decision, and on October 27, 1982, an Administrative Law Judge 

("ALJ") found that she was no longer disabled. The Social 

Security Appeals Council affirmed the decision of the ALJ denying 

her benefits. Plaintiff did not seek review of the Appeals 

Council's decision in federal district court. 

In 1985, plaintiff again applied for disability benefits, and 

that request was denied. She requested a hearing on that denial 

before an ALJ, as well as a reopening of the unfavorable 1982 

decision. On May 1, 1987, after a hearing, the ALJ ruled that 

plaintiff had been disabled since October 28, 1982, but refused to 

reopen the unfavorable 1982 decision. Plaintiff then sought 

review by the Appeals Council of the ALJ's refusal to reopen the 

1982 decision. The Appeals Council affirmed that decision, but 

vacated the ALJ's decision that plaintiff had been disabled since 

1982 and remanded for a second hearing. Plaintiff then filed an 

action in federal district court. 

Plaintiff's first claim in the district court was that the 

Appeals Council should have reversed the ALJ's refusal to reopen 

the 1982 decision. Because that claim is still before the 

district court so far as the record before us indicates, we do not 

consider it. Plaintiff's second claim was that the Appeals 

Council should not have reversed and remanded the finding of 

disability from 1982 forward because the Appeals Council allegedly 

failed to give her adequate notice that issues other than those 

which she had appealed would be reviewed on appeal of the ALJ's 

2 

Appellate Case: 89-4012 Document: 010110098486 Date Filed: 02/07/1991 Page: 2 
decision. She sought an injunction to stop the ALJ from reviewing 

the issue of her disability on remand, arguing that the Appeals 

Council improperly vacated the 1987 decision of the ALJ. The 

district court dismissed the second claim, holding that it was 

without jurisdiction. The district court also denied plaintiff's 

request for a preliminary injunction to prevent the hearing before 

an ALJ on remand. 

Plaintiff appealed the district court's dismissal of her 

second claim and the denial of her motion for a preliminary 

injunction. Both the district court and a panel of this court 

denied plaintiff's motion for a preliminary injunction pending 

determination of her appeal. On May 12, 1989, while this appeal 

was pending, the ALJ held the hearing ordered by the Appeals 

Council. On December 12, 1989, the ALJ issued a decision somewhat 

favorable to plaintiff, finding that she had been disabled since 

1986. Plaintiff appealed that decision to the Appeals Council. 

So far as the record before us indicates, the Appeals Council has 

not yet issued its decision. 

By order filed June 18, 1990, this panel dismissed 

plaintiff's appeal from the denial of her motion for a preliminary 

injunction as moot because the hearing before the ALJ had already 

been held. We also ruled that her appeal from the district 

court's dismissal of her second claim (challenging the Appeals 

Council's notice procedures) was not a final, appealable judgment 

because her first claim (challenging the Appeals Council's refusal 

to reopen the ALJ's unfavorable decision in 1982) remained in the 

district court. We ordered that if plaintiff failed to obtain 

3 

Appellate Case: 89-4012 Document: 010110098486 Date Filed: 02/07/1991 Page: 3 
certification of her second claim under Fed. R. Civ. P. 54(b) (or 

a final judgment of her first claim) within thirty days of our 

order, we would dismiss the case for lack of appellate 

jurisdiction. On July 17, 1990, the district court granted 

plaintiff's motion and certified her second claim pursuant to Rule 

54(b). 

DISCUSSION 

I. Plaintiff's Procedural Claim 

Plaintiff argues that the Appeals Council violated the 

Secretary's regulations by reviewing issues other than those which 

she raised in her July 1, 1987 appeal without providing her 

written notice. 1 As noted above, plaintiff appealed the ALJ's 

1 Although plaintiff never received written notice that the 

Appeals Council intended to review specific issues besides the one 

that she challenged in her appeal, the cover sheet which 

accompanied the ALJ's partially favorable decision contained the 

following advisement: 

When you appeal, you request the Appeals Council to 

review the decision. If the Appeals Council grants your 

request, it will review the entire record in your case. 

It will review those parts of the decision which you 

think are wrong. It will also review those parts which 

you think are correct and may make them unfavorable or 

less favorable to you. 

Plaintiff's Br., Attachment A-1 (emphasis added). 

Plaintiff argues that the Appeals Council's action in 

reviewing her favorable disability determination without providing 

her written notice beyond that which accompanied the ALJ's 

decision violated the following Social Security Administration 

regulations: 

Anytime within 60 days after the date of a hearing 

decision or dismissal, the Appeals Council itself may 

decide to review the action that was taken. If the 

Appeals Council does review the hearing decision or 

dismissal, notice of the action will be mailed to all 

parties at their last known address. 

[Footnote continued on next page ..• ] 

4 

Appellate Case: 89-4012 Document: 010110098486 Date Filed: 02/07/1991 Page: 4 
refusal to reopen the unfavorable 1982 disability decision, but 

not the ALJ's favorable determination that she was disabled from 

1982 forward. 

II. The District Court's Jurisdiction Under§ 405(q) 

The district court has jurisdiction to review "any final 

decision of the Secretary made after a hearing." 42 U.S.C. 

§ 405(g). The Supreme Court has explained that§ 405(g)'s "final 

decision" requirement 

consists of two elements, only one of which is purely 

"jurisdictional" in the sense that it cannot be "waived" 

by the Secretary in a particular case. The waivable 

element is the requirement that the administrative 

remedies prescribed by the Secretary be exhausted. The 

nonwaivable element is the requirement that a claim for 

benefits shall have been presented to the Secretary. 

Absent such a claim there can be no "decision" of any 

type. And some decision by the Secretary is clearly 

required by the statute. 

Mathews v. Eldridge, 424 U.S. 319, 329 (1976). In this case, 

there is no question that the nonwaivable component has been 

satisfied. However, the Secretary maintains that because 

plaintiff has not yet exhausted her administrative remedies, and 

because he has not waived the requirement that she do so, the 

[ ... footnote continued] 

When the Appeals Council decides to review a case, 

it shall mail a notice to all parties at their last 

known address stating the reasons for the review and the 

issues to be considered. 

20 C.F.R. §§ 404.969, 404.973 (1988). Because we hold that the 

district court correctly dismissed plaintiff's claim for lack of 

jurisdiction, we do not pass on the merits of plaintiff's claim. 

5 

Appellate Case: 89-4012 Document: 010110098486 Date Filed: 02/07/1991 Page: 5 
district court properly dismissed the action for want of a final 

decision. 

Plaintiff does not dispute the Secretary's assertion that she 

has not exhausted her administrative remedies. See Appellant's 

Br. at 28-29. However, plaintiff maintains that her challenge to 

the notice procedures of the Appeals Council is a claim falling 

within the exception to the administrative exhaustion requirement. 

In Mathews, the Supreme Court recognized that "cases may arise 

where a claimant's interest in having a particular issue resolved 

promptly is so great that deference to the agency's judgment [that 

exhaustion of administrative remedies is required] is 

inappropriate." Mathews, 424 U.S. at 330. The Court held that in 

order to circumvent the administrative exhaustion requirement, the 

claim had to be one "entirely collateral to [the] substantive 

claim of entitlement" and the claimant must make a "colorable" 

argument "that full relief cannot be obtained at a postdeprivation 

hearing." Id. at 331. The Court concluded that both of those 

requirements were satisfied in Mathews because (1) the claimant's 

due process challenge to the Secretary's procedures for 

terminating benefits was collateral to the underlying claim of 

entitlement, and (2) termination of the disability benefits upon 

which the claimant was dependent upon could arguably cause 

irreparable injury. 

We agree with plaintiff that her challenge to the Appeals 

Council's notice procedures is entirely collateral to her 

underlying claim for disability benefits. Plaintiff's claim is at 

least as removed from the underlying benefits claim as the 

6 

Appellate Case: 89-4012 Document: 010110098486 Date Filed: 02/07/1991 Page: 6 
procedural challenge brought in Mathews. Cf. Bowen v. City of New 

York, 476 U.S. 467, 483 (1986) (claim challenging an allegedly 

illegal secret procedure of the Secretary was collateral to 

underlying benefits claims). 

However, plaintiff does not satisfy the second Mathews 

requirement for excusing nonexhaustion of administrative remedies. 

Plaintiff suggests that, like the claimant in Mathews, she "has 

raised a strong claim that the likely deterioration of her 

physical and emotional condition prevents her from being afforded 

full relief at a postdeprivation hearing." Appellant's Br. at 29. 

In Mathews, the Court was persuaded that the claimant had made a 

colorable claim of irreparable injury because he was threatened 

with termination of his existing benefits upon which he was 

entirely dependent. Mathews, 424 U.S. at 331. By contrast, the 

plaintiff here is contesting the deprivation of her benefits for 

the years 1982-86 (the difference between the first and second 

ALJs' disability determinations). Neither the ALJ nor the Appeals 

Council has ever ruled that plaintiff's current disability 

benefits ought to be terminated. Thus, plaintiff is not 

threatened by the type of irremediable injury recognized in 

Mathews. 

Plaintiff's claim that she will suffer irreparable injury by 

exhausting her administrative remedies and attending the hearing 

is at least partially moot now that the ALJ has conducted the 

hearing and issued a partially favorable decision. If plaintiff 

is arguing that the proceedings before the Appeals Council will 

impose an irreparable physical and mental hardship, that position 

7 

Appellate Case: 89-4012 Document: 010110098486 Date Filed: 02/07/1991 Page: 7 
is not "colorable" because this is not a case in which there has 

been a finding that "[t]he ordeal of having to go through the 

administrative appeal process may trigger a severe medical 

setback." City of New York, 476 U.S. at 483. 

Finally, the Supreme Court has cautioned that "[t]he ultimate 

decision of whether to waive exhaustion should not be made solely 

by mechanical application of the [Mathews v.J Eldridge factors, 

but should also be guided by the policies underlying the 

exhaustion requirement." Id. at 484. The Court in City of New 

York noted that there are important policies underlying 

exhaustion: allowing an agency to correct its own errors and 

affording an agency with acquired expertise the opportunity to 

conduct review. Id. at 484-85. However, the Court there 

concluded that these policies would not be advanced by further 

administrative review because the plaintiffs were alleging "a 

systemwide, unrevealed policy that was inconsistent in critically 

important ways with established regulations." Id. The Court 

emphasized that "[t]his case is materially distinguishable from 

one in which a claimant sues in district court, alleging mere 

deviation from the applicable regulations in his particular 

administrative proceeding." Id. at 484. 

Plaintiff contends that, like the plaintiffs in City of New 

York, it would be futile to require her to exhaust her 

administrative remedies because the Secretary has already 

determined conclusively the amount of notice to which she is 

entitled under the applicable regulations. We disagree. Because 

plaintiff is claiming that the Secretary deviated from the 

8 

Appellate Case: 89-4012 Document: 010110098486 Date Filed: 02/07/1991 Page: 8 
applicable regulations in her particular case, her due process 

challenge falls squarely within that class of cases identified in 

City of New York as not justifying excusing failure to exhaust. 

Plaintiff points to no evidence in the record which indicates that 

the Appeals Council would be reluctant to entertain her due 

process arguments in her appeal from the second ALJ's 

determination. 

Plaintiff suggests that "there is no question that the 

Secretary's policy of not giving notice under section 404.973 

affects more than her individual claim. The Secretary's refusal 

to give her the required notice is no 'mere deviation' but rather 

a systemwide refusal to abide by his own regulations." 

Appellant's Reply Br. at 8. The record is devoid of any support 

for this allegation. Accordingly, we conclude that the policies 

underlying the exhaustion of administrative remedies doctrine 

would not be advanced, and might be frustrated, by excusing 

plaintiff's noncompliance. 

Although plaintiff's due process challenge to the adequacy of 

notice provided by the Appeals Council is a claim collateral to 

her disability claim, we hold that the district court correctly 

dismissed the claim for lack of jurisdiction under§ 405(g) 

because plaintiff cannot make a colorable showing of irreparable 

injury or demonstrate the futility of requiring her to exhaust her 

administrative remedies so as to justify excusing her failure to 

exhaust her administrative remedies. 

9 

Appellate Case: 89-4012 Document: 010110098486 Date Filed: 02/07/1991 Page: 9 
III. The District Court's Mandamus Jurisdiction 

Plaintiff argues in the alternative that the district court 

had mandamus jurisdiction over her due process claim. See R. Doc. 

1 at 2 (asserting jurisdiction was proper under 28 U.S.C. § 1361). 

We analyze plaintiff's claim by assuming, but not deciding, that 

under some circumstances mandamus relief is available against the 

Secretary. 2 

In Heckler v. Ringer, 466 U.S. 602, 616 (1984), the Supreme 

Court stated that "[t]he common law writ of mandamus, as codified 

in 28 u.s.c. § 1361, is intended to provide a remedy for a 

plaintiff only if he has exhausted all other avenues of relief and 

only if the defendant owes him a clear nondiscretionary duty." 

Id. at 616. The Court in Ringer concluded that the plaintiffs had 

"an adequate remedy in§ 405(g) for challenging all aspects of the 

Secretary's denial of their claims." Id. at 617. Like the 

plaintiff here, the plaintiffs in Ringer had failed to exhaust 

their administrative remedies and their failure could not be 

excused. Id. at 617-18. Following Ringer, we hold that because 

plaintiff will have a fully adequate remedy under§ 405(g), once 

the Secretary has rendered a final decision, the district court 

properly ruled that mandamus jurisdiction was unavailable. 

2 The Secretary maintains that mandamus jurisdiction is 

foreclosed by 42 u.s.c. § 405(h). See Appellee's Br. at 17. The 

Supreme Court declined to resolve this issue in Bowen v. City of 

New York, 476 U.S. at 478 n.9; see Heckler v. Ringer, 466 U.S. 

602, 616 (1984) ("[a]ssuming without deciding that the third 

sentence of§ 405 does not foreclose mandamus jurisdiction in all 

Social Security cases"). We specifically decline to address this 

question because we hold that the district court was without 

mandamus jurisdiction in this case. 

10 

Appellate Case: 89-4012 Document: 010110098486 Date Filed: 02/07/1991 Page: 10 
CONCLUSION 

Because plaintiff has not exhausted her remedies and cannot 

show that to do so would be futile or would cause irreparable 

injury, we AFFIRM the district court's ruling dismissing 

plaintiff's second claim for lack of jurisdiction under§ 405(g). 

In addition, since plaintiff will have an adequate remedy under 

§ 405(g), we AFFIRM the district court's ruling dismissing 

plaintiff's claim for lack of mandamus jurisdiction. 

Entered for the Court 

David M. Ebel 

Circuit Judge 

11 

Appellate Case: 89-4012 Document: 010110098486 Date Filed: 02/07/1991 Page: 11