Sims v. Apfel

• Citation: 530 U.S. 103
• Decision Date: 05 June 2000
• Docket Number: No. 98-9537.,98-9537.
• Parties: SIMS v. APFEL, COMMISSIONER OF SOCIAL SECURITY
• Court: United States Supreme Court

530 U.S. 103

SIMS v. APFEL, COMMISSIONER OF SOCIAL SECURITY

No. 98-9537.

United States Supreme Court.

Argued March 28, 2000.

Decided June 5, 2000.

COPYRIGHT MATERIAL OMITTED

CERTIORARI TO THE UNITED STATES COURT OF APPEALS FOR THE FIFTH CIRCUIT

Thomas, J., announced the judgment of the Court and delivered the opinion of the Court with respect to Parts I and II—A, in which Stevens, O'Connor, Souter, and Ginsburg, JJ., joined, and an opinion with respect to Part II—B, in which Stevens, Souter, and Ginsburg, JJ., joined. O'Connor, J., filed an opinion concurring in part and concurring in the judgment, post, p. 112. Breyer, J., filed a dissenting opinion, in which Rehnquist, C. J., and Scalia and Kennedy, JJ., joined, post, p. 114.

Sarah H. Bohr argued the cause for petitioner. With her on the briefs were Chantal J. Harrington, Gary R. Parvin, and Jon C. Dubin.

Malcolm L. Stewart argued the cause for respondent. With him on the brief were Solicitor General Waxman, Acting Assistant Attorney General Ogden, Deputy Solicitor General Kneedler, William Kanter, and Robert D. Kamenshine.^*

Justice Thomas announced the judgment of the Court and delivered the opinion of the Court with respect to Parts I and II—A, and an opinion with respect to Part II—B, in which Justice Stevens, Justice Souter, and Justice Ginsburg join.

A person whose claim for Social Security benefits is denied by an administrative law judge (ALJ) must in most cases, before seeking judicial review of that denial, request that the Social Security Appeals Council review his claim. The question is whether a claimant pursuing judicial review has waived any issues that he did not include in that request. We hold that he has not.

I

In 1994, petitioner Juatassa Sims filed applications for disability benefits under Title II of the Social Security Act, 49 Stat. 622, 42 U. S. C. § 401 et seq., and for supplemental security income benefits under Title XVI of that Act, 86 Stat. 1465, 42 U. S. C. § 1381 et seq. She alleged disability from a variety of ailments, including degenerative joint diseases and carpal tunnel syndrome. After a state agency denied her claims, she obtained a hearing before a Social Security ALJ. See generally Heckler v. Day, 467 U. S. 104, 106-107 (1984) (describing stages of review of claims for Social Security benefits). The ALJ, in 1996, also denied her claims, concluding that, although she did have some medical impairments, she had not been and was not under a "disability," as defined in the Act. See 42 U. S. C. §§ 423(d) (1994 ed. and Supp. III) and 1382c(a)(3) (1994 ed., Supp. III); Sullivan v. Zebley, 493 U. S. 521, 524-526 (1990).

Petitioner then requested that the Social Security Appeals Council review her claims. A claimant may request such review by completing a one-page form provided by the Social Security Administration (SSA)—Form HA-520—or "by any other writing specifically requesting review." 20 CFR § 422.205(a) (1999). Petitioner, through counsel, chose the latter option, submitting to the Council a letter arguing that the ALJ had erred in several ways in analyzing the evidence. The Council denied review.

Next, petitioner filed suit in the District Court for the Northern District of Mississippi. She contended that (1) the ALJ had made selective use of the record; (2) the questions the ALJ had posed to a vocational expert to determine petitioner's ability to work were defective because they omitted several of petitioner's ailments; and (3) in light of certain peculiarities in the medical evidence, the ALJ should have ordered a consultative examination. The District Court rejected all of these contentions. App. 74-84.

The Court of Appeals for the Fifth Circuit affirmed. 200 F. 3d 229 (1998). That court affirmed on the merits with regard to petitioner's first contention. With regard to the second and third contentions, it concluded that, under its decision in Paul v. Shalala, 29 F. 3d 208, 210 (1994), it lacked jurisdiction because petitioner had not raised those contentions in her request for review by the Appeals Council. We granted certiorari, 528 U. S. 1018 (1999), to resolve a conflict among the Courts of Appeals over whether a Social Security claimant waives judicial review of an issue if he fails to exhaust that issue by presenting it to the Appeals Council in his request for review. Compare Paul, supra, at 210; James v. Chater, 96 F. 3d 1341, 1343-1344 (CA10 1996), with Harwood v. Apfel, 186 F. 3d 1039, 1042-1043 (CA8 1999); Johnson v. Apfel, 189 F. 3d 561, 563-564 (CA7 1999).¹

II

A

The Social Security Act provides that "any individual, after any final decision of the Commissioner of Social Security made after a hearing to which he was a party, . . . may obtain a review of such decision by a civil action" in federal district court. 42 U. S. C. § 405(g). But the Act does not define "final decision," instead leaving it to the SSA to give meaning to that term through regulations. See § 405(a); Weinberger v. Salfi, 422 U. S. 749, 766 (1975). SSA regulations provide that, if the Appeals Council grants review of a claim, then the decision that the Council issues is the Commissioner's final decision. But if, as here, the Council denies the request for review, the ALJ's opinion becomes the final decision. See 20 CFR §§ 404.900(a)(4)—(5), 404.955, 404.981, 422.210(a) (1999).² If a claimant fails to request review from the Council, there is no final decision and, as a result, no judicial review in most cases. See § 404.900(b); Bowen v. City of New York, 476 U. S. 467, 482-483 (1986). In administrative-law parlance, such a claimant may not obtain judicial review because he has failed to exhaust administrative remedies. See Salfi, supra, at 765-766.

The Commissioner rightly concedes that petitioner exhausted administrative remedies by requesting review by the Council. Petitioner thus obtained a final decision, and nothing in § 405(g) or the regulations implementing it bars judicial review of her claims.

Nevertheless, the Commissioner contends that we should require issue exhaustion in addition to exhaustion of remedies. That is, he contends that a Social Security claimant, to obtain judicial review of an issue, not only must obtain a final decision on his claim for benefits, but also must specify that issue in his request for review by the Council. (Whether a claimant must exhaust issues before the ALJ is not before us.) The Commissioner argues, in particular, that an issue-exhaustion requirement is "an important corollary" of any requirement of exhaustion of remedies. Brief for Respondent 13. We think that this is not necessarily so and that the corollary is particularly unwarranted in this case.

Initially, we note that requirements of administrative issue exhaustion are largely creatures of statute. Marine Mammal Conservancy, Inc. v. Department of Agriculture, 134 F. 3d 409, 412 (CADC 1998). Our cases addressing issue exhaustion reflect this fact. For example, in Woelke & Romero Framing, Inc. v. NLRB, 456 U. S. 645 (1982), we held that the Court of Appeals lacked jurisdiction to review objections not raised before the National Labor Relations Board. We so held because a statute provided that "`no objection that has not been urged before the Board . . . shall be considered by the court.' " Id., at 665 (quoting 29 U. S. C. § 160(e) (1982 ed.)). Our decision in FPC v. Colorado Interstate Gas Co., 348 U. S. 492, 497-498 (1955), followed similar reasoning. See also United States v. L. A. Tucker Truck Lines, Inc., 344 U. S. 33, 36, n. 6 (1952) (collecting statutes); Washington Assn. for Television and Children v. FCC, 712 F. 2d 677, 681-682, and n. 6 (CADC 1983) (interpreting issueexhaustion requirement in 47 U. S. C. § 405 (1982 ed.) and collecting statutes). Here, the Commissioner does not contend that any statute requires issue exhaustion in the request for review.

Similarly, it is common for an agency's regulations to require issue exhaustion in administrative appeals. See, e. g., 20 CFR § 802.211(a) (1999) (petition for review to Benefits Review Board must "list the specific issues to be considered on appeal"). And when regulations do so, courts reviewing agency action regularly ensure against the bypassing of that requirement by refusing to consider unexhausted issues. See, e. g., South Carolina v. United States Dept. of Labor, 795 F. 2d 375, 378 (CA4 1986); Sears, Roebuck and Co. v. FTC, 676 F. 2d 385, 398, n. 26 (CA9 1982). Yet, SSA regulations do not require issue exhaustion. (Although the question is not before us, we think it likely that the Commissioner could adopt a regulation that did require issue exhaustion.)

It is true that we have imposed an issue-exhaustion requirement even in the absence of a statute or regulation. But the reason we have done so does not apply here. The basis for a judicially imposed issue-exhaustion requirement is an analogy to the rule that appellate courts will not consider arguments not raised before trial courts. As the Court explained in Hormel v. Helvering, 312 U. S. 552 (1941):

"Ordinarily an appellate court does not give consideration to issues not raised below. For our procedural scheme contemplates that parties shall come to issue in the trial forum vested with authority to determine questions of fact. This is essential in order that parties may have the opportunity to offer all the evidence they believe relevant to the issues which the trial tribunal is alone competent to decide; it is equally essential in order that litigants may not be surprised on appeal by final decision there of issues upon which they have had no opportunity to introduce evidence. And the basic reasons which support this general principle applicable to trial courts make it equally desirable that parties should have an opportunity to offer evidence on the general issues involved in the less formal proceedings before administrative agencies entrusted with the responsibility of fact finding." Id

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