Opinion ID: 537609
Heading Depth: 2
Heading Rank: 1

Heading: Jurisdiction Under Sec. 405(g)

Text: 21 Contrary to Morris' contention, Sanders does control this case. In Sanders, as here, appellant filed a claim with the SSA alleging the same bases of eligibility for disability benefits that he had alleged in a claim seven years earlier. The ALJ viewed the new application as barred by res judicata, but also treated the application as requiring a determination of  'whether the claimant is entitled to have his prior application reopened....'  Sanders 430 U.S. at 103, 97 S.Ct. at 983. Without holding a hearing, the ALJ concluded that respondent's evidence was merely repetitious and cumulative, and consequently denied reopening and dismissed the claim. 22 On appeal, the district court dismissed the claim for lack of jurisdiction. The Court of Appeals reversed, finding jurisdiction conferred by Sec. 10 of the APA. The Supreme Court reversed the Court of Appeals, holding that Sec. 10 of the APA did not confer jurisdiction and that Sec. 405(g) of the Act limits judicial review of final decisions of the Secretary to those made after mandatory Sec. 405(b) hearings. 7 23 Morris, however, does not read Sanders this way. Rather, she understands the holding of that case to be that a final decision ... not to reopen a claim [is] not subject to judicial review under ... Sec. 405(g). Appellant's Brief at 14. She thus argues as she did below that Sanders is distinguishable because her claim was in fact reopened as a matter of law prior to the Secretary's formal conclusion to the contrary. In making this argument, Morris relies primarily on language from Poulin v. Bowen, 260 U.S.App.D.C. 142, 817 F.2d 865 (1987.) 8 That language reads:[E]ven though the subsequent claim may be the same claim for res judicata purposes, if it has nevertheless been reconsidered on the merits to any extent and at any administrative level, it is thereupon properly treated as having been, to that extent, reopened as a matter of administrative discretion.... In that event a final decision of the Secretary denying the claim is also subject to judicial review to the extent of the reopening. 24 Poulin, 817 F.2d at 869, citing McGowen v. Harris, 666 F.2d 60, 65-66 (4th Cir.1981) (emphasis added). Morris then contends that the agency's and the ALJ's examination of the new evidence she proffered met the to any extent at any administrative level standard of reopening articulated in Poulin. While we admit that the language cited might by itself support Morris' claim that her petition was in fact reopened on the merits, such a reading would conflict with the Sec. 405(g) rule enunciated in Sanders and thus we must reject it. It is clear from Sanders that agency officials and ALJs may consider the merits of a petition to reopen in any number of ways that do not involve the holding of a mandatory Sec. 405(b) hearing. Indeed, that is precisely what happened here, where the ALJ held a preliminary hearing to evaluate the new evidence so as to determine whether Morris' claim should be reopened and its merits entirely reconsidered. 9 25 We are of course bound to construe Poulin, if at all possible, in a way that does not conflict with the Supreme Court's ruling in Sanders, and so we do. We interpret it as applicable only when the agency has clearly stated or otherwise demonstrated that it has in fact reopened the original case on the merits and consequently has held a mandatory Sec. 405(b) hearing to reconsider the prior claim afresh. 10 But even were we not compelled to such an interpretation to accommodate Supreme Court precedent, we would be attracted to the Sanders rationale as the one most consistent with the regulatory scheme set up by Congress for processing benefits claims. As the Second Circuit explained in a similar case involving a petition to reopen, subjecting agency decisions not to reopen to judicial review would not only interfere with the expeditious processing of claims but would disadvantage applicants for reopening. 26 On a strictly literal reading, Sec. 405(g) could be interpreted as applying to any final decision of the Secretary that was handed down after a hearing, albeit a hearing not required by the statute. Such an interpretation, however, would be unnatural and unsound.... In enacting the Social Security Act, Congress recognized that the agency established to carry out such a vast scheme of public insurance would be confronted with a volume of applications probably unparalleled in federal administration.... Accordingly, in addition to wide-ranging powers suitable to effective achievement of the assigned task, the agency was authorized to make an initial determination of each claim ex parte and ... was compelled to hold a hearing in only one instance--where an adverse ex parte determination had been made and timely request for a hearing was filed, 42 U.S.C. Sec. 405(b). In this context, the reasonable reading of Sec. 405(g) is that it was intended to apply to a final decision rendered after a hearing thus made mandatory, not to a decision which could lawfully have been made without any hearing at all and in that event plainly would not have come under the terms of the section.... Indeed, the broader reading [might] operate adversely to claimants generally since if a nonmandatory hearing would entail judicial review not otherwise available this might deter the agency from giving a procedural protection which the statute does not demand. 27 Cappadora, 356 F.2d at 4-5 (emphasis added). The court thus found no jurisdiction to review the Secretary's denial of the appellant's petition to reopen. 28 Cappadora's reasoning applies to any discretionary proceeding held by an ALJ, but it is most compelling in situations like the one presented here, where appellant appears to argue that the agency's review of the new evidence she submitted in and of itself constituted a reopening of her old claim and that judicial review is therefore available. Accepting that rule would place the agency in the quintessential Catch-22. Every time a claimant petitioned the agency to reopen an old claim based on newly submitted evidence, the agency would be faced with a choice: Looking at the evidence to determine if it really is new and material, thereby risking a whole new round of appeals, or blindly denying the petition so as to avoid judicial review. Subjecting the agency to such a choice is obviously absurd. The agency must have more latitude in such cases so that it will process petitions to reopen both expeditiously and fairly. The Fourth Circuit has reasoned similarly: 29 Of necessity when a social security claimant presents any claim that is arguably the same one earlier denied on the merits, the Secretary must in fairness look far enough into the proffered factual and legal support to determine whether it is the same claim, and if so, whether it should nevertheless be reopened as a discretionary matter.... 30 In fairness to the claimant, the results of this threshold inquiry may be reported as a prelude to reporting the dispositive administrative action taken.... Thus, an ALJ may state in a formal decision that ... [the] new evidence ... was not sufficiently new and material to warrant reopening.... When, as here, this is followed by a specific conclusion that the claim should be denied on res judicata grounds, the threshold inquiry into the nature of the evidence should not be read as a reopening of this claim on the merits. 31 McGowen, 666 F.2d at 67-68. See also Torres v. Dept. of Health and Human Services, 845 F.2d 1136, 1139 (1st Cir.1988) (the ALJ was entitled to make a threshold inquiry and review the evidence presented by the claimant in order to resolve the reopening issue without subjecting herself to judicial review by so doing); Krumpelman v. Heckler, 767 F.2d 586, 588-89 (9th Cir.1985). 32 It is not only the rational administration of SSA benefits claims, however, that leads us to prefer Sanders' strict interpretation of Sec. 405(g)'s reviewability grant. Adhering to the result desired by appellant would also conflict with the traditional model of federal judicial review of agency decisions. Courts do not normally review the interim actions of ALJs and lower level agency officials. Rather, they review final agency decisions. Here, the ultimate decision of the agency was made by the Appeals Council, which made clear that it was denying the petition to reopen. 11 It is that decision only that constitutes the final decision of the agency; and clearly, Sanders denies us jurisdiction to review that affirmance of the ALJ's denial. 12