Document: 493 U.S. 521 110 S.Ct. 885 107 L.Ed.2d 967 Louis W. SULLIVAN, Secretary of Health and Human Services, Petitionerv.Brian ZEBLEY et al. No. 88-1377. Argued Nov. 28, 1989. Decided Feb. 20, 1990. Syllabus The Social Security Act authorizes the payment Supplemental Income (SSI) benefits to, inter alios, a child who suffers from an impairment "comparable severity" to one that would render adult disabled. An is disabled if he prevented engaging in any substantial gainful activity by reason certain medically determinable physical or mental impairments. Petitioner Services has created five-step test determine disability. At test's third step, claimant may be found medical evidence his matches equal listing impairments presumed severe enough preclude activity, thus making further inquiry unnecessary. However, since listings' criteria are more restrictive than statutory disability standard, does not qualify at step do so after showing, fourth fifth steps, cannot engage past work other economy, given age, education, experience. In contrast, Secretary's for determining whether ends show listed impairment, there being no corresponding final, vocational steps test. Respondent Zebley, was denied SSI benefits, brought class action District Court challenging child-disability regulations. court granted summary judgment Secretary. Appeals vacated part, finding regulatory scheme inconsistent with because listings-only approach account all denies claimants individualized functional assessment standard requires provides adults. Held: regulations severity." Pp. 528-541. (a) While adults under listings still have opportunity they last test, similar exists children, even their ones actually (though presumptively) disable 529-536. (b) scheme—which applies same widows' widowers' despite fact uses stricter benefits—nullifies congressional choice link liberal applied claims. 536-537. (c) argument only practicable way child's comparable rejected. Even were set level severity, could ensure receive whenever severity analysis contemplated statute provided That inapplicable children mean them, into impairment's impact on normal daily activities amorphous unmanageable adult's ability perform kind economy. Moreover, tacitly acknowledges possible some own defined terms criteria, cessation involves examination claimant's age-appropriate activities. 538-541. 855 F.2d 67 (CA3 1988), affirmed. BLACKMUN, J., delivered opinion Court, which BRENNAN, MARSHALL, STEVENS, O'CONNOR, SCALIA, KENNEDY, JJ., joined. WHITE, filed dissenting opinion, REHNQUIST, C.J., joined, post, p. 541. Edwin S. Kneedler, Washington, D.C., petitioner. Richard P. Weishaupt, Philadelphia, Pa., respondents. Justice BLACKMUN Court. 1 This case concerns facial challenge method used "disabled" therefore eligible Program, Title XVI Act, as added, 86 Stat. 1465, amended, 42 U.S.C. § 1381 seq. (1982 ed. Supp. V). 2 * 1972, Congress enacted Program assist "individuals attained age 65 blind disabled" setting guaranteed minimum income such persons. ed.). program went effect January 1, 1974. Currently, about million claims adjudicated each year. Of these, 100,000 claims.1 3 A person financial resources below level, 1382(a), "disabled." Disability 1382c(a)(3) follows: 4 "(A) individual shall considered purposes this subchapter unable can expected result death lasted continuous period less twelve months (or, 18, severity). 5 "(B) For subparagraph (A), determined previous but cannot, considering experience, national . 6 "(C) paragraph, results anatomical, physiological, psychological abnormalities demonstrable acceptable clinical laboratory diagnostic techniques." definition taken II 70 815, 423 V) (providing insurance workers contributed Program). See §§ 423(d)(1)(A) (d)(2)(A) (definitions disability). 7 Pursuant authority implement Program,2 promulgated creating Bowen v. Yuckert, 482 137, 140-142, 2287, 2290-91, 96 119 (1987).3 first two involve threshold determinations presently working required duration significantly limits work. 20 CFR 416.920(a) through (1989). compared list pt. 404, subpt. P, App. (pt. A) If "equal" impairments, qualifies without inquiry. 416.920(d). listings, proceeds steps. these view work, benefits. 416.920(e) (f). 8 abbreviated version "is doing activity," 416.924(a), meets requirement, 416.924(b)(1), it 416.924(b)(2) (3). evaluating claim, both general special children's B) (1989), considered. There 9 Brian had been United States Eastern Pennsylvania regulations.4 His complaint alleges 10 "has issued instructions whereby entitlement based solely grounds equivalent contravention Act's requirement 'if severity' disables program." Complaint Civil Action 83-3314, ¶ 2. 11 10, 1984, certified persons "who now, future will be, entitled administrative determination supplemental security payable disabled, improperly denied, terminated, should resumed." 26, 29. 12 due course favor claims, ruling "facially invalid incomplete permi[t] award conformity intent Congress." Zebley Heckler, 642 F.Supp. 220, 222 (1986). Third Circuit part judgment. ex rel. Bowen, (1988). Id., 69. Although recognized interpretation deference, rejected contrary clear intent. remanded direction entered plaintiff claim must give limitations. 77. We certiorari resolve conflict among Circuits validity 490 1064, 109 2062, 104 627 (1989).5 III 13 Since expressly grants rulemaking power, see n. 2, supra, " 'our review limited exceeded arbitrary capricious.' U.S., 145, S.Ct., 2293 (quoting Heckler Campbell, 461 458, 466, 103 1952, 1957, 76 66 (1983)); Chevron U.S.A. Inc. Natural Resources Defense Council, Inc., 467 837, 843-844, 2778, 2782, 81 694 (1984) ("If explicitly left gap agency fill, express delegation elucidate specific provision regulation. Such legislative controlling weight unless arbitrary, capricious, manifestly statute"). conclude, however, reconciled purport implement. 14 generally defines "disability" individualized, problems person's 146, (Social adopts "functional approach"); 459-460, 467, 1953, 1957 (Act "defines 'disability' function workplace"; "statutory contemplates hearings determinations"). 15 linked functional, "if "unable activity." 1382c(a)(3)(A) next paragraph elaborates providing either 1382c(a)(3)(B). plain words, provisions together prevent working. 16 question presented conforms standard. Respondents argue, agreed, not, match those whose disabling though meaningfully listings. concedes cover every insists equivalence determination, 416.924(b)(3) sufficient carry out mandate To decide question, we take closer look issue. IV 17 descriptions various illnesses abnormalities, most categorized body system affect.6 Each several signs, symptoms, results.7 listing, meet specified criteria. manifests matter how severely, qualify.8 Ruling (SSR) 83-19,9 Dept. Rulings 90 (Jan.1983) ("An 'meets' condition when findings described impairment." "The particular section depicted degree single finding—no what extent exceed value"). 91. (Emphasis original.) 18 showing unlisted combination "equivalent" present impairment.10 416.926(a) (1989) (a least "the like [the claimant's] impairment"); SSR 83-19, 91 "at to" individual's impairment(s)"; combined impairment").11 "equivalence" overall impairment. 91-92 ("[I]t incorrect consider equaled basis consequences irrespective nature extent, justify equivalence") (emphases original). 19 defining higher define adult, regardless performing just "substantial 416.925(a) (purpose describe "severe activity"); (listings "medical conditions ordinarily activity"). difference between that, adults, designed operate presumption makes is, awarded prior 141, 2291 (if "meets equals conclusively disabling, evaluation step"); id., 153, 2297 (the "streamlin[e] decision process identifying likely background"); City New York, 476 471, 106 2022, 2025, 462 (1986) benefits"; moves 460, 1953 ("The recognize pursuing establishes retains [work]"). When developed Fed.Reg. 14705 (1977) "of 'comparable listing"); SSA Insurance Letter12 III-11 (Jan. 9, 1974), 97 (child-disability affect "to criteria" adults' work). 21 Thus, ways First, obviously disabling. himself characterized merely containing "over 100 examples prevent" working, "it difficult include sets work." (emphasis added). also 50 50068, 50069 (1985) contain "frequently diagnosed" impairments); 44 18170, 18175 (1979) Listing intended identify commonly occurring impairments"). Similarly, published comment 1977, them including "more common impairments" affecting children. 14706 childdisability "provide means efficiently equitably evaluate impairments").13 22 Second, covered exclude form quite level—that activity. Third, precludes its actual effects him—such pain, medication, symptoms vary greatly individual14—and Fourth, excludes combinations fulfill obvious categories nonetheless 23 shortcomings remedied reasons above, prevents him (f) (1989); "impairment proceeds" steps); impairment" former demanding employment").15 24 opportunity. Children rise presumptively listings; might symptomatic nausea, side etc., educational background, circumstances; impairments16 listing—all simply disabled.17 25 severity."18 inconsistency aptly illustrated II, Under rulings, widows listing. 93. provides: "A widow [or] widower her prescribed deemed 423(d)(2)(B) ed., provide chose instead forth 423(d)(2)(A) (any activity" benefits). regulations, treating nullify choice. 163-164, 2302-03 (dissenting opinion) (contrasting 423(d)(2)(A)/§ work); S.Rep. 744, 90th Cong., 1st Sess., 49 (1967), U.S.Code Cong. & Admin.News 1967, pp. 2834, 2883 (disabled "test somewhat workers").19 V 26 seriously dispute disparity child- adult-disability determinations. He argues, instead, "comparable" adult. feasible, asserts, work; available measure abilities analogous compare claimants' Laying point comparison properly current statute, persuasive. expanded many childhood No restricted comparing fixed, finite respond adequately infinite variety thereof, varying characteristics, constant evolution techniques. 27 feasible unconvincing. them. age—speaking, walking, washing, dressing, feeding oneself, going school, playing, etc. our view, "any economy," 1382c(a)(3)(B).20 possible, See, e.g., B), 101.03 (listing "Deficit musculoskeletal function" difficulty walking "[i]nability age-related personal self-care involving feeding, hygiene"); 111.02(B) "Major motor seizures" "Significant interference communication" emotional disorder," "Where significant adverse medication interfere major activities"); 112.05(C) (mental retardation IQ 60-69 requiring "a imposing additional restriction developmental progression").21 Also, "perform activities." 416.994(c) Finally, insistence assessed perspective alone, consideration residual capacity," Brief 45, seems us make little sense light techniques often disorder.22 VI 28 conclude rulings implementing 1382c(a)(3)(A). reason, "manifestly statute," Chevron, 844, exceeds authority. 29 Appeals, vacating Court's grant class, 30 It ordered. 31 whom THE CHIEF JUSTICE joins, dissenting. 32 Only Terms ago, reviewing aspect methodology applications emphasized "Congress 'conferred exceptionally broad authority' context, stated great deference. 2293, (1987), quoting (1983). Because majority failed abide principle, I respectfully dissent. 33 As agency's entrusted administer, (1984), framework review. ask expressed issue here; so, enforce think case, defer long permissible. 842-845, 2781-83. 34 Section 1614(a)(3)(A) ed.), employment; subsection (a)(3)(B) enough, employment implemented respect will, more, employment. subt. suffering equivalent, then order nonmedical factors labor market. 35 end disability, parenthetical term 18: "or, reference references produce. Furthermore, neither "comparable," "severity," nor words elsewhere meaning anything clear. measured But yardstick useful inability stage development Given task apples oranges, understandable different manner did surely employ groups. 36 applying Part disease's processes younger considerations largely beside dealing children—a submits referring (a)(3)(A)'s factors. Instead, evaluated B Appendix subpart which, child. preamble B, 14705, establish child, placed primary emphasis restrictions growth, learning, imposed 37 find impermissible implementation rather ambiguous directives Surely said insofar use singly combination, void face. And understand it, are. What submitted first, second, Parts factors, 38 These alleged deficiencies invalidate true, demonstrate go far enough. supported anecdotal evidence, none me, adjudged equivalents, fail comparably diseases before Secretary, rejected.1 attack regulation factors—the contends reasonable construction 3(A) confine where concerned. event, declaring wholly partly face, better advised insist cases; confidently say identifiable nevertheless hence 39 agree Judge Fullam's case: 40 "Plaintiff's well valid, errors cases invalidity themselves. 416.925, facially incomplete, necessary flexibility, and, my permits Congress. misapplied misinterpreted, remedy lies appeal cases, class-action decree." (ED Pa.1986). 41 difference, furthermore, toward accords underlying programs basic replacing earnings lost disability" "are able support themselves ." H.R.Rep. 92-231, 146-147 (1971), 4989, 5132, 5133. concerned, disabilities workplace. purpose, appropriate capacity By mind Recognizing low-income households "among disadvantaged Americans," "because needs greater nondisabled children." 147-148, 5134. Congress' aim individuals replace income, health care expenses, home costs arising consistent distinct purpose focus capacity. contribute family's necessarily benefits.2 43 note faults multiple together. Ante, 534. 1382c(a)(3)(F) IV) requires, add up 416.923 faithfully "by throughout process." 67, 1988). cross-petition below, expand relief obtained Appeals. sum, Administration over amount funds conduct unspecified applicant fails satisfy otherwise imposes detract pool unfortunate sought protect Program. Administration, Office Disability, Preliminary Staff Report: Childhood Study, B-1 (Sept. 1989). 405(a), made applicable 1383(d)(1) V), reads: full power rules procedures, subchapter, provisions, adopt proper regulate proofs right hereunder." 423(d), identical 1382c(a)(3), relevant respects. Compare 404.1520-1530 416.920-930 Joseph Love Evelyn Raushi, named plaintiffs action. All three plaintiffs' eventually Court; remain First Eleventh upheld Hinckley Martin 742 (CA1 1984); Powell Schweiker, 688 1357 (CA11 1982). Fifth Eighth ruled deny addressing valid. Nash Alexander 882 1291 (CA8 1989); Burnside 845 587 (CA5 acknowledged conflict. 75 125 57 are: musculoskeletal, senses speech, respiratory, cardiovascular, digestive, genitourinary, hemic lymphatic, skin, endocrine. addition, four groups system: neurological disorders, malignant neoplastic diseases. include, addition category growth example, "growth 100.00 require "[f]all percentiles height sustained" "[b]one deviations chronological age." 100.03. Another example "mental retardation," "[a]chievement milestones acquired one-half age," "IQ 59 less," 60-69, inclusive, progression." 112.05. 7, "bone age" slightly much normal. "published Commissioner binding components Administration." 422.408 Edwards, 465 870, 873, 3, 1532, 1534, 79 878 (1984). Down's syndrome (which currently impairment), congenital disorder usually manifested retardation, skeletal deformity, cardiovascular digestive problems, whichever resembled. National Easter Seal Society, Amici Curiae 17, 9. 100.03, mentally retarded above cut-off 112.04, analysis—no devastating impaired growth. Letter (DIL) internal directive sent state agencies responsible 36. are, yet, well-known spina bifida, syndrome, muscular dystrophy, autism, AIDS, infant drug dependency, fetal alcohol syndrome. American Medical Association, (AMA Brief) 22. proposed new "Down Hereditary, Congenital, Acquired Disorders." 52 37161 (1987). Reply 19, 16. perceived pain bearing 82-58, 121 (Cum. 1982) ("No reported intensity substituted elevate equivalency. [C]omplaints 'severe,' 'extreme,' 'constant' compensate missing permit 'equals' determination") deleted). About 25% House Committee Ways Means, Background Material Data On Programs Within Jurisdiction 101st 46 (Comm.Print dissent points out, 546-547, [multiple] process," promises "we your impairments." assurance value claimants, within confines "whether 416.926(a). noted, afforded F.2d, 76. Empirical suggests rigidity claimants. rare AMA 6, (it unlikely "that physician meaningful comparisons extremely Secretary"). disregards dependence equipment, confinement home, frequent hospitalization, case. recent study prepared Department young subjected tests H. Fox A. Greaney, Disabled Children's Access Medicaid Benefits telling Wilkinson 847 660 1987) (child liver causing swelling, food allergies, fever, listing); 1988) (plaintiff brain damage, delay, eye listing). treatment thrown sharp unsuccessful claimant, upon reaching insufficient Wills 686 171, 172, (WD Mich.1987); Organization Claimants' Representatives Amicus A-3 A-24 (Administrative Law decisions awarding turns 18). Tr. Oral Arg. 13-14. proposes "make rejected." Post, 545. why falls compelled raise separate, as-applied response systemic dissent, 547, appears accept indicated approval 1976, directed "publish employed cases. Unemployment Compensation Amendments 501(b), 2685. time, known exact contours approach. 1973 1974 DIL's accompanying guides" became 1624 (1974). scope determination. DIL says "childhood factors," "disability engage, namely development," "[d]escriptions activities, behavioral adjustment, school achievement relationship history regarding (1973), 90-91. reflect approach, discussion broader allow. III-11, (1974), (" '[M]edical equivalency' concept takes disease childhood"; "[e]ach 'equal' impact"). guessed early evolve scheme. "determined childhood, Fed.Reg., 1626. equivalence" "only thereto Ibid.; cf. 416.926 (current "equivalence," impairment). gave warning current, strictly analysis. until 83-19 1983, become rigidly, proof strict matching 1976 publish statute. "do standing, lifting, carrying, pushing, pulling, reaching, handling," remember instructions, appropriately supervision, co-workers pressures setting." 416.945(b) considerations. 42. unavailing. small comfort discussed above. pediatric illness injury accepted community. biological abstraction, proxies, familiar physiological burden illness"). conceded lists suffer difficult, particularly extract admission responsibilities. specifically "[t]he law "[i]f you compares 18) disabled." 416.905, 416.906 acquiescence technique assessing supports position reasonable. payments Despite majority's contention contrary, legislation indicates understood implicitly, condoned Senate Report states: regard listed, eligibility met 'singly impairment.' 94-1265, (1976), 5997, 6018.

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