Pickett v. Bowen, 86-5463

• Decision Date: 04 December 1987
• Docket Number: No. 86-5463,86-5463
• Citation: 833 F.2d 288
• Parties: , 19 Soc.Sec.Rep.Ser. 576, Unempl.Ins.Rep. CCH 17,688 Eugene PICKETT, on behalf of himself and persons similarly situated, Plaintiff- Appellee, v. Otis R. BOWEN, Secretary of the Department of Health and Human Services, Defendant-Appellant.
• Court: U.S. Court of Appeals — Eleventh Circuit

Page 288

833 F.2d 288

93 A.L.R.Fed. 151, 19 Soc.Sec.Rep.Ser. 576,

Unempl.Ins.Rep. CCH 17,688

Eugene PICKETT, on behalf of himself and persons similarly situated, Plaintiff- Appellee, v. Otis R. BOWEN, Secretary of the Department of Health and Human Services, Defendant-Appellant.

No. 86-5463.

United States Court of Appeals Eleventh Circuit.

Dec. 4, 1987.

Leon B. Kellner, U.S. Atty., Samuel D. Armstrong, Asst. U.S. Atty., Miami, Fla., Jason R. Baron, Office of the General Counsel, Social Sec. Div., Dept. Health & Human Services, Baltimore, Md., for defendant-appellant.

Paulette Ettachild, Legal Services of Greater Miami, Inc., Miami, Fla., for plaintiff-appellee.

Appeal from the United States District Court for the Southern District of Florida.

Before JOHNSON and EDMONDSON, Circuit Judges, and HOFFMAN ^*, Senior District Judge.

JOHNSON, Circuit Judge:

Otis Bowen, the Secretary of Health and Human Services, appeals the order by the United States District Court for the Southern District of Florida that "closed period" claimants ¹ are members of the certified class and therefore are entitled to the benefits of the district court's earlier order of remand. We affirm.

I.

After this Court's pronouncement in Simpson v. Schweiker, 691 F.2d 966 (11th Cir.1982), that the Secretary of Health and Human Services must apply the "medical improvement" standard before terminating disability benefits, the Secretary engaged in a policy of nonacquiescence. This class action sought to require the Secretary's compliance with Schweiker. The district court certified the class as

[a]ll residents of the State of Florida whose disability benefits under Title II and Title XVI of the Social Security Act are, have been, or will be terminated without substantial medical improvement as required by Simpson v. Schweiker, 691 F.2d 966 (11th Cir.1982) and whose claims for disability were administratively active on or after November 12, 1982. This class excludes recipients whose benefits are or will be terminated upon proof of any of the following: a. Return to substantial gainful employment; b. Whereabouts unknown; c. Failure to cooperate; d. Admission of recovery; e. Financial ineligibility.

After certification, Congress passed the 1984 Social Security Disability Amendments, Pub.L. No. 98-460, adopting the "medical improvement" standard as the standard of review for the termination of disability benefits and requiring that all claims in certified class actions be remanded to the Secretary. In addition, Congress provided that upon notification certified class members could have their benefits reinstated pending a new determination by the Secretary.

The district court remanded the claims, but retained jurisdiction. Pickett v. Heckler, 10 Soc.Sec.Law Rep. 451, 608 F.Supp. 841 (S.D.Fla.1985). The Secretary began excluding "closed period" claimants from the redetermination. Upon a motion by the appellees, the district court issued an order expressly stating that "closed period" claimants were part of the certified class, enjoying all benefits of the earlier remand order. Consequently, the Secretary was to reexamine their terminations under the "medical improvement" standard, and continue to pay them benefits pending the redetermination. The Secretary filed this timely appeal.

II.

We first examine whether we have jurisdiction. "Generally, an order of a district court remanding a case to the Secretary of Health and Human Services for further consideration is not an appealable order." Huie v. Bowen, 13 Soc.Sec.Law Rep. 256, 788 F.2d 698, 701 (11th Cir.1986). Huie, however, held that, although the remand was not a final order, jurisdiction existed because the remand was an appealable collateral order under Cohen v. Beneficial Industrial Loan Corp., 337 U.S. 541, 69 S.Ct. 1221, 93 L.Ed. 1528 (1949). "The Cohen doctrine allows appeals to be taken from orders that (1) finally determine claims entirely collateral to and separable from the substance of other claims in the action, (2) require review because they present significant, unsettled questions, and (3) cannot be reviewed effectively once the case is finally decided." Huie, 788 F.2d at 702.

Huie provides the framework for holding that jurisdiction exists in the present case. Huie involved a situation where, pursuant to the Disability Amendments, this Court and the district court remanded pending cases to the Secretary. In addition, the district court ordered that the Secretary reinstate the claimants' benefits from the date of termination. The Secretary appealed the district court's award of retroactive benefits. Under the first Cohen prong, this Court noted in Huie that "[t]he issue of whether a court may order the Secretary to pay retroactive benefits prior to the determination of whether the claimants were improperly taken off the rolls is separable from the issue of whether the claimants have experienced a medical improvement." Id. at 703. Similarly here, the issue of whether "closed period" claimants are entitled to redetermination and benefits pending redetermination is separable from the issue of whether the claimants have experienced a medical improvement.

Under the second Cohen prong, this Court recognized in Huie that "this case presents an unsettled question which requires that we make a proper determination involving significant interests of the Secretary in protecting the public fisc. Likewise, the case involves important interests of the claimants in financial well-being and, perhaps, survival." Id. Similar considerations apply here as well, especially because the present case provides a question of first impression in determining whether Congress intended that the Disability Amendments apply to "closed period" claimants.

Under the third Cohen prong, this Court reasoned in Huie that "once this case is remanded and the Secretary pays benefits, the fundamental legal issues of whether payments are permitted prior to a determination of the disability claim under the Act will become moot. Thus, review at a later time will be meaningless." Id. Similar reasoning governs here. The Secretary argues that the claims of "closed period" class members are not entitled to remand, redetermination, and benefits pending redetermination. By not hearing the Secretary's appeal now, the Secretary would have to redetermine the claim and pay benefits pending redetermination, thereby rendering his present objection moot and judicial review meaningless.

III.

This appeal presents a question of first impression in this Circuit: Are "closed period" claimants entitled to the relief and benefits created by Congress in the Disability Amendments? The Secretary argues that a reading of the statutory language and an examination of the legislative history reveal that Congress did not intend that the Disability Amendments apply to "closed period" claimants. In light of the Amendment's broad remedial purposes, we hold that Congress intended a broad reading of the statutory language. Consequently, we affirm the district court, concluding that "closed period" claimants are entitled to a redetermination under the "medical improvement" standard, benefits pending redetermination, and any other benefits of the district court's order.

We begin with an examination of the statutory language. The Disability Amendments apply to "actions relating to medical improvement" pending before courts on the date Congress enacted the Disability Amendments. Such actions must be remanded to the Secretary for redetermination based upon the "medical improvement" standard. Pub.L. No. 98-460, Sec. 2(d)(2), 98 Stat. 1794, 1797-98 (codified at 42 U.S.C.A. Sec. 423 note). The Secretary argues that "closed period" claims are not "actions relating to medical improvement," defined as follows by Section 2(d)(6) of the Amendments:

[T]he term "action relating to medical improvement" means an action raising the issue of whether an individual who has had his entitlement to benefits ... based on disability terminated (or period of disability ended) should not have had such entitlement terminated (or period of disability ended) without consideration of whether there has been medical improvement in the condition of such individual (or another individual on whose disability such entitlement is based) since the time of a prior determination that the individual was under a disability.

98 Stat. at 1798 (emphasis added).

The Secretary, seizing upon the emphasized language of Section 2(d)(6), argues:

This definition plainly requires two elements: 1) that there be a decision, later in time from the decision which originally awarded benefits; and 2) that the action before the court raise the issue of the propriety of that later decision which terminated the individual's continued receipt of disability benefits awarded in the earlier decision. As we have emphasized throughout, a closed period case does not involve an earlier and a later decision; it involves only one decision. Accordingly, a closed period case is not an "action relating to medical improvement" and is, for this reason, not a case that fits within the class definition.

Appellant's Brief at 10-11 (footnote omitted).

We do not share the Secretary's narrow reading of Section 2(d)(6)'s language. The Secretary's argument is flawed because, even in a closed period case, the ALJ can only determine that a person is no longer entitled to benefits "since the time [the ALJ made] a prior determination that the individual was under a disability." Termination of benefits cannot become an issue until after there has been a determination of entitlement to benefits (i.e., the claimant is under a disability). The example in footnote one illustrates that Section 2(d)(6) applies to closed period cases. There, the ALJ first determined that the claimant was under a disability in January 1982. The ALJ, having made "a prior determination that the individual was under a disability" by focusing on the...