Legal Document

424 U.S. 319 96 Supreme Court Reporter 893 47 United States Reports Lawyer’s Edition 2d Series KF101.8 U54 18 Federal KF105 F3 David MATHEWS, Secretary of Health, Education, and Welfare, Petitioner,v.George or Haw. Hawai‘i KFH45 A2 ELDRIDGE. Number 74-204. Argued Oct. 6, 1975. Decided Feb. 24, 1976. Syllabus In order to establish initial continued entitlement disability benefits under the Social Security Act (Act), a worker must demonstrate that, inter alia, he is unable "to engage in any substantial gainful activity by reason medically determinable physical mental impairment . ." The bears continuing burden showing, means "medically acceptable techniques" that his such severity cannot perform previous work other kind work. A state agency makes assessment worker's eligibility for benefits, obtaining information from sources medical treatment. may arrange an independent examination resolve conflicting information. If agency's tentative beneficiary's condition differs own, beneficiary informed be terminated, provided summary evidence, afforded opportunity review evidence. then final determination, which reviewed Administration (SSA). SSA accepts determination it gives written notification reasons decision right de novo reconsideration. Upon acceptance SSA, are terminated effective two months after month recovery found have occurred. If, reconsideration review, remains adverse recipient, notified evidentiary hearing before administrative law judge. results, recipient request discretionary Appeals Council, finally obtain judicial review. determined claimant's extended beyond date cessation initially established, entitled retroactive payments. Retroactive adjustments also made overpayments. few years respondent was first awarded received completed questionnaire monitoring agency. After considering contained therein reports doctor consultant, wrote had tentatively ceased May 1972 advised him might reasonable time furnish additional reply letter disputed one characterization indicated enough evidence disability. its reaffirming decision. This accepted July would end within six months. Instead requesting brought this action challenging constitutionality procedures terminating seeking reinstatement pending hearing. District Court, relying part on Goldberg versus Kelly, 397 254, 90 1011, 25 287, held termination violated procedural due process concluded prior type welfare beneficiaries Title IV Act. affirmed. Petitioner contends, barred respondent's Weinberger Salfi, 422 749, 95 2457, 45 522, district courts precluded exercising jurisdiction over Welfare regarding except as 42 Code KF62 § 405(g), grants only "final" party. Held : 1. constitutional claim, since denial with respect claim purposes 405(g) jurisdiction. Pp. 326-332. (a) finality requirement consists waivable remedies prescribed exhausted nonwaivable shall been presented Secretary. Respondent's answers specifically should not because still disabled, thus satisfied requirement. 328-330. (b) Although concededly did exhaust Secretary's internal-review ordinarily has power waive exhaustion, case where interest having particular issue promptly resolved so great deference judgment inappropriate. facts challenge collateral substantive (contrary situation Salfi ) colorably claimed erroneous damage way compensable through payments warrant conclusion sufficiently "final decision" satisfy statutory exhaustion 330-332. 2. An required fully comport process. 332-349. "(D)ue flexible calls protections demands," Morrissey Brewer, 408 471, 481, 92 2593, 2600, 33 484. Resolution here involving sufficiency requires consideration three factors: (1) private will affected official action; (2) risk deprivation used, probable value, if any, safeguards; (3) Government's interest, including fiscal burdens substitute entail. 332-335. adversely likely less disabled than like claimants Goldberg, supra. Eligibility based financial need, although hardship imposed upon erroneously need recipient. view forms government assistance available there depart ordinary principle something sufficient action. 339-343. (c) implicates more sharply focused easily documented typical entitlement. whether discontinue normally turn "routine, standard, unbiased physician specialists," Richardson Perales, 402 389, 404, 91 1420, 1428-1429, 28 842. potential value substantially context. 343-345. (d) Written submissions provide communicating decision-maker. detailed identifies particularity relevant Information critical derived directly sources. Finally, representative full access relied agency, underlying assessment, given submit arguments 345-346. (e) Requiring demand all cases entail out proportion countervailing benefits. model neither required, nor even most effective, method decisionmaking circumstances, claimant asserting but assure well subsequent becomes final, no 347-349. 493 Reporter, 2nd 1230, reversed. Donald E. Earls, Norton, Va., respondent. Mr. Justice POWELL delivered opinion Court. 1 Due Process Clause Fifth Amendment benefit 2 * Cash workers during periods they completely insurance program created 1956 amendments II 70 Statutes-at-Large 815, 423.1 Respondent Eldridge June 1968. March 1972, charged condition. questionnaire, indicating improved identifying sources, physicians, whom treatment recently. obtained psychiatric consultant. these file 1972. included statement proposed pertaining 3 response, already disability.2 (SSA), terminate month. seek 4 commenced validity established assessing exists He sought immediate disability.3 361 F.Supp. 520 (W.D.Va.1973). moved dismiss grounds Eldridge's accordance valid regulations failed remedies. support contention pretermination hearing, exclusively Court's 287 (1970), "evidentiary hearing" benefits.4 contended controlling unlike issues credibility veracity do play significant role decision, turns primarily 5 pursuant abridged court viewed uninterrupted indistinguishable Goldberg. It further noted decisions demonstrated hearings limited situations vital necessities. See Fuentes Shevin, 407 67, 88-89, 1983, 1998-1999, 32 556 (1972); Bell Burson, 535, 539, 1586, 1589, 29 (1971). Reasoning determinations involve subjective judgments nonmedical F.Supp., at 528.5 Relying entirely opinion, Fourth Circuit affirmed injunction barring 1230 (1974).6 We reverse. 6 At outset we confronted question suit. contends our last Term 522 (1975), bars Act's duration-of-relationship requirements surviving wives stepchildren deceased wage earners. 405(h)7 precludes federal-question avenue jurisdictional prerequisite. Section provides: 7 "Any individual, party, irrespective amount controversy, civil sixty days mailing notice allow."8 8 On face until "hearing." uncontested could yet determination. Since "waived" supra, 767, S.Ct., 2467-2468, concludes properly invoke basis disagree. 9 identified several conditions 405(g). Of these, regarded "central requisite grant subject-matter .." U.S., 764, 2466.9 Implicit however, elements, purely "jurisdictional" sense case. element exhausted. Absent can "decision" type. And some clearly statute. 10 That second essential distinct precondition evident different conclusions reached named appellees unnamed members class. As latter complaint jurisdictionally deficient "contain(ed) allegations filed application 2466. With appellees, alleged "fully their claims 'to Office and, denial, Regional reconsideration.' " Id., 764-765, fulfilled crucial Through response ceased, disabled. denied SSA. 11 fact raise controlling.10 construed Indeed, present O.T.1974, 74-214, App. 11, 17-21. identical for, while amend statute unconstitutional case, does authority determine timing content challenged here. V.S.C. 405(a). not, regard difference significant. unrealistic expect consider changes current system behest single aid raising adjudicatory challenge. 12 satisfied, next element. concedes set 20 Regulations §§ 404.910, 404.916, 404.940 (1975). recognized, satisfies himself, stage process, warranted either internal needs relief confer. suggested when occurred rests ultimate responsibility integrity his. But arise 13 Moreover, distinction between nature asserted raised Salfi. predeprivation matter proposition postdeprivation Rail Reorganization Cases, 419 102, 156, 335, 365, 320 (1974). light decisions, see, e. g., (1970); (1972), least colorable dependency recompensable payments.11 Thus, denying "for reasons" upholding "under provisions" post-termination stage, 762, 2465, answer 14 conclude constitutes claim. now proceed merits claim.12 III Atlantic 15 Procedural imposes constraints governmental deprive individuals "liberty" "property" interests meaning Fourteenth Amendment. contend inapplicable terminations recognizes, implicit Belcher, 404 78, 80-81, 256-257, 30 231 (1971); 401-402, 1427-1428, 842 Flemming Nestor, 363 603, 611, 80 1367, 1372-1373, 1435 (1960), individual receipt statutorily protected Cf. Arnett Kennedy, 416 134, 166, 94 1633, 1650, 40 (Powell, J., concurring part) (1974); Board Regents Roth, 564, 576-578, 2701, 2708-2710, 548 1589; 261-262, 1016-1017. Rather, existing procedures, below, constitutionally deprived interest. 16 consistently form property Wolff McDonnell, 418 557-558, 2963, 2975-2976, 41 935 See, g. Phillips Commissioner Internal Revenue, 283 589, 596-597, 51 608, 611-612, 75 L.Ed. 1289 (1931). Dent West Virginia, 129 114, 124-125, 231, 234, 623 (1889). "right heard being condemned suffer grievous loss kind, though stigma hardships criminal conviction, basic society." Joint Anti-Fascist Comm. McGrath, 341 123, 168, 71 624, 646, 817 (1951) (Frankfurter, concurring). fundamental "at meaningful manner." Armstrong Manzo, 380 545, 552, 85 1187, 1191, 62 (1965). Grannis Ordean, 234 385, 394, 34 779, 783, 58 1363 (1914). agrees ineligibility adequate were dispute centers what 17 recent increasingly occasion extent thereafter. 266-271, 1019-1022, closely approximating trial necessary. requiring spoken sparingly about procedures. SniaDach Family Finance Corp., 395 337, 89 1820, 23 349 (1969), garnishment wages, silent matter. 96-97, 2002-2003, 556, said replevin suit parties ex parte proceeding clerk. Similarly, 540, 1590, 90, held, context revocation state-granted driver's license, prerevocation probable-cause fault licensee, noting "need take adjudication liability." North Georgia Finishing, Incorporated Di-Chem, Inc., 601, 607, 719, 751 More recently, sustained federal employee dismissed cause. They sought, copy charge, filing oral appearance. Following dismissal, provided. 142-146, 1638-1640. These underscore truism '(d)ue process,' legal rules, technical conception fixed unrelated time, place circumstances." Cafeteria Workers McElroy, 367 886, 895, 81 1743, 1748, (1961). demands." 484 (1972). Accordingly, resolution analysis affected. 167-168, 1650-1651 part); 263-266, 1018-1020; 1748-1749. precisely, indicate identification specific dictates generally First, second, finally, function involved 263-271, 1018-1022. 19 description thereafter factors bearing adequacy B administered jointly agencies. State agencies make exists, began, ceased. 421(a).13 standards applied followed Secretary, see 421(b), who delegated responsibilities powers Fed.Reg. 4473 21 22 expected result death lasted continuous period 423(d)(1)(A). To test clinical laboratory diagnostic techniques," 423(d)(3), 24 "he cannot, age, education, experience, national economy, regardless area lives, job vacancy him, hired work." 423(d)(2)(A).14 principal longer returned cases.15 26 continuing-eligibility investigation acting "team" consisting person trained evaluation. periodically communicates worker, usually mail sent telephone, requests concerning condition, restrictions treatment, considers CM 6705.1; Disability Insurance Manual (DISM) 353.3 (TL 137, Mar. 5, 1975).16 27 recipient's DISM 353.4. conflict physician, consulting physician.17 Ibid. Whenever own based, file.18 respond writing 353.6. examiner Bureau Insurance. 421(c); 6701(b), (c).19 notifies writing, informing 404.907, 404.909 (1975).20 (Supp. III) 423(a) (1970 ed., Supp. III). seeks adverse, reviews 404.917, 404.927 nonadversary, represented counsel. stages counsel spokesmen. 404.934. results 404.945, 405(g); 404.951 (1975).21 Should point 404. 423(b); 404.501, 404.503, 404.504 hand, receives later entitled, authorizes attempt recoup funds specified circumstances. 404.22 Contract 31 Despite elaborate character below them inadequate, concluding termination. stake think error. whose ultimately prevails, sole source income His injury similar 263-264, 1018-1019, nonprobationary Arnett, 146, 1640, 1641, earner Sniadach. 341-342, 1822-1823.23 Only temporary deprivation. emphasized persons very margin subsistence: "The factor virtually anyone else entitlements ended controversy eligible live waits." 264, 1018 (emphasis original). 35 contrast, need.24 wholly many earnings family members, workmen's compensation awards,25 tort awards, savings, insurance, public pensions, veterans' food stamps, assistance, "many important programs, both private, contain provisions affecting portion force 85-87, 259 (Douglas, dissenting). Staff House Committee Ways Means, Report Program, 93d Cong., Sess., 9-10, 419-429 (1974) (hereinafter Report). 36 illustrates, degree considered overstated. emphasized, remain "unable activity." 423; 523. contrast discharged little possibility able find employment ameliorate interim loss. 37 recognized Fusari Steinberg, 379, 533, 521 "the possible length wrongful (also) impact interests." delay judge currently prerequisite invoking actual cutoff exceeds year. 38 torpidity cf. id., 383-384, 386, 536-537, 538, typically modest resources unit physically worker,26 Still, addition resources, become places subsistence level.27 169, 1651-1652 201-202, 1667-1668 (White, dissenting part). income, principle, Defendant 39 fairness reliability safeguards. Central evaluation inquiry. Mitchell W. T. Grant Co., 600, 617, 1895, 1905, 406 Friendly, Some Kind Hearing, 123 U.Pa.L.Rev. 1267, 1281 423(d)(1)(A) supplied). short, required. wide variety deemed relevant, witness often circumstances "written unsatisfactory decision." 269, 1021. By turn, cases, 1428, subject personally examined.28 "reliability probative worth reports," emphasizing "professional disagreement conclusions" "specter questionable present." 405, 407, 1430. sure, cases. rules shaped error inherent truthfinding generality rare exceptions. presentation decisionmaker, inadequate communicate decisionmaker. option, recipients lacked "educational attainment necessary write effectively" afford professional assistance. addition, "flexibility presentations" "permit mold argument maker appears important." disability-benefits-entitlement objections. sends invited local office completing questionnaire. important, treating physician. Such effectively documents lay witnesses supporting physicians supported X-rays tests, amenable presentation. Gellhorn & C. Byse, Administrative Law Cases Comments 860-863 (6th ed. 1974). 43 safeguard against mistake policy allowing informs therefor, provides relevant. Opportunity arguments, enabling accuracy correctness conclusions. again contrasted those enable "mold" precise decisionmaker regards crucial. 44 carefully structured amici reversal rate appealed clear inadequate. Depending base selected line followed, rates urged contending vary high 58.6% For overall 3.3%.29 Bare statistics rarely satisfactory measure Their especially suspect operated open-file basis. always new examinations. fresh examinations approximately 30% 40% 1973, 238. context, evaluating diminished. certainly E striking appropriate balance assessed includes societal costs associated requiring, right, visible incremental cost resulting increased number expense providing ineligible No predict increase, continue attractive option. Nor theoretical recover undeserved result, practical matter, offset added outlay funds. widely varying estimates cost. say experience constitutionalizing suggests terms money insubstantial. 46 Financial alone weight determining hence public, conserving scarce weighed. society assurance just, outweighed Significantly, protecting preliminary undeserving come pockets deserving social unlimited. U.Pa.L.Rev., 1276, 1303. implicated ad hoc weighing category claimants. involves when, system, judicial-type fairness. reiterate wise admonishment Frankfurter differences origin "preclude wholesale transplantation procedure, evolved history courts." FCC Pottsville Broadcasting 309 143, 60 437, 441, 84 656 (1940). essence "a jeopardy serious (be given) meet it." 171-172, 649. All tailored, made, capacities heard," 268-269, 1021 (footnote omitted), insure good-faith Congress administration programs fair individuals. 202, where, here, action, final. Boddie Connecticut, 401 371, 378, 780, 786, 113 48 49 Reversed. 50 STEVENS took BRENNAN, MARSHALL concurs, dissenting. 52 stated my Wright, 405 208, 212, 788, 791, 151 N Dec. Immigration Nationality Decisions agree Act, 601 et seq. (1970). add discontinuance cause argument. speculative. legislative without fact, presumes denigrate. foreclosure home family's furniture repossessed, forcing Eldridge, wife, children sleep bed. Tr. Oral Arg. 39, 47-48. placed untenable position 53 George Pacific KF135 P2 McLAUGHLIN, petitioner, Douglas VINZANT, Superintendent, Massachusetts Correctional Institution. 75-5671. 54 Former 423 1037, 573. 55 Facts Cir., 448. 56 Jan. 26, Petition rehearing denied. 57 petition. financed revenues employer payroll taxes. 3101(a), 3111(a); 401(b). monthly worked long insured status, interval preceding onset 423(c)(1)(A) (B). Benefits dependents 402(b)-(d). When reaches age 65 automatically converted retirement 416(i)(2)(D), 423(a)(1). 1974 3,700,000 program. Administration, Year Review originally chronic anxiety back strain. subsequently diabetes. diabetes control, existed limitations movements impose severe functional restrictions, suffered emotional problems preclude qualified. 12-13. arthritis spine rather strained back. ordered disposition merits. include following elements: "timely detailing termination"; "an (for recipient) defend confronting presenting orally"; retained counsel, desired; (4) "impartial" decisionmaker; (5) resting "solely adduced hearing"; (6) on. 1019-1022. term refers HEW direct each plan categorical containing safeguards, requirements. 205.10(a) (1975); n. 4, Circuit, simply correctly decided same Williams Weinberger, 494 1191 (1974), cert. pending, 74-205. 405(h) full: "(h) Finality findings binding person, tribunal, herein States, officer thereof section arising subchapter." plaintiff resides, business, or, reside business district, Columbia. enter, pleadings transcript record, affirming, modifying, reversing remanding rehearing. conclusive permit, court. specify venue, parties. 763-764, 2465-2466. timely Fed.Rules Civ.Proc. 8(c), 12(h)(1), failure bar 1370-1371, (1960). contexts consequences deferment satisfied. illustrated intensely "practical" approach adopted, Cohen Beneficial Ind. Loan 337 541, 546, 69 1221, 1225-1226, 93 1528 (1949), applying 1291, appeals decisions" courts, 1257, empowers judgments" courts. Harris Washington, 55, 183, 212 Construction Laborers Curry, 371 542, 549-550, 83 531, 536, 537, 514 (1963); Mercantile Nat. Bank Langdeau, 555, 520, 521-522 545-546, 1225-1226. certain considerations 1257 1291 Compare Laborers, 550, 536-537; Bank, 558, McKart 185, 193-195, 1657, 1662-1663, 194 (1969); L. Jaffe, Judicial Control Action 424-426 core should, possible, lost potentially irreparable injuries applicable. Given proper unnecessary notwithstanding mandamus statute, 1361, Procedure 701 vocational rehabilitation administering Vocational Rehabilitation 1920, 735, amended, III), acts "state agency" 148 assignment intended encourage contacts utilize well-established relationships profession. H.R.Rep.No.1698, 83d 23-24 (1954). Work "exists economy" defined "work numbers region lives regions country." 423(d)(2)(A). Because continuing-disability done Insurance, involvement, differ recovery. similar, relies principally communications provision inquiry types self-employment agricultural employment, nearest conducts interview Claims (CM) 6705.2(c). requested belief return work, past year, services receiving. medical-source used absence identified. 353.4C. permitted examine file. restriction choice, friend member, 7314. 401.3(a)(2) us curious limitation itself revise manner favorable beneficiary. believes SSA's views. free reaffirm original assessment. originally. R. Dixon, Mass (1973). Both adduce Unlike levels novo, treat reduce payment refund, unless "without fault" adjustment defeat "against equity good conscience." 404(b). 404.501-404.515 This, course, assumes wages garnisheed wages. level average disability, related 415 423(a)(2). Workmen's deducted formula. 424a III); 404.408 Amici cite compiled 1965 mean $3,803, median $2,836. liquid assets i. e., cash, stocks, bonds units $4,862; $940. into account unit's nonliquid automobile, real estate, like. Brief AFL-CIO al. Curiae 4a. n.29, infra. emphasize definition employed Program companion Supplemental Income (SSI), compare 423(d)(1) 1382c(a)(3) disability-benefits SSI Program. There exist, supplement income. household qualify stamps meets 2013(c), 2014(b); 271 1974, 480,000 2,000,000 receiving criterion program, majority terminated. And, provided, requested. 1383(c) 416.1336(c) 1512 346. diagnosis "age, experience" "engage economy Yet characteristics presentation, accurate appear substantial. opportunities exist impaired skills necessarily advanced K. Davis, Treatise 7.06, 429 (1958). statistical focusing solely overstate rate. 383 assess denials Here 12.2%. 75% reversals occur months, 4a, significantly concomitant lengthier Netting reversals, falls 3.3%. Reply 14.

Classification Label: 1