Crayton v. Callahan

• Decision Date: 03 September 1997
• Docket Number: No. 96-6002,96-6002
• Citation: 120 F.3d 1217
• Parties: , 23 A.D.D. 595, 11 Fla. L. Weekly Fed. C 468 Sterling CRAYTON, on behalf of himself and all others similarly situated, et al., Plaintiffs-Appellants, v. John J. CALLAHAN, Acting Commissioner of the Social Security Administration, et al., Defendants-Appellees.
• Court: U.S. Court of Appeals — Eleventh Circuit

Page 1217

120 F.3d 1217

53 Soc.Sec.Rep.Ser. 914, 23 A.D.D. 595,

11 Fla. L. Weekly Fed. C 468

Sterling CRAYTON, on behalf of himself and all others similarly situated, et al., Plaintiffs-Appellants, v. John J. CALLAHAN, Acting Commissioner of the Social Security Administration, et al., Defendants-Appellees.

No. 96-6002.

United States Court of Appeals Eleventh Circuit.

Sept. 3, 1997.

Douglas Alan Wright, Florence, AL, Gerald A. McIntyre, National Senior Citizens Law Center, Los Angeles, CA, for Plaintiffs-Appellants.

Caryl Privett, U.S. Attorney, Birmingham, AL, Linda Sullivan Trippe, Asst. U.S. Atty., Frank W. Hunger, Brian G. Kennedy, Civil Division, U.S. Dept. of Justice, Andrew C. Phelan, U.S. Dept. of Justice, Federal Programs Branch, Civil Division, Washington, DC, Jim R. Ippolito, Jr., Richard N. Meadows, Montgomery, AL, Barbara C. Biddle, Howard S. Scher, U.S. Dept. of Justice, Appellate Staff, Civil Div., Washington, DC, Mary Ann Sloan, Office of the General Counsel, Joseph P. Palermo, Elyse Sharfman, Mack A. Davis, Atlanta, GA, for Defendants-Appellees.

Appeal from the United States District Court for the Northern District of Alabama.

Before BIRCH, Circuit Judge, RONEY, Senior Circuit Judge, and O'KELLEY ^*, Senior District Judge.

RONEY, Senior Circuit Judge:

This is an appeal from the district court's dismissal of a class action brought by mentally disabled persons who alleged that the defendants, the Commissioner of Social Security and Alabama's Division of Disability Determination ("DDD"), failed to properly process their disability claims in that the persons considering a claim of disability do not develop evidence of mental disability, even though that is not a basis upon which the claim has been made.

Plaintiffs, ten persons with limited mental capacity, on behalf of themselves and others similarly situated, claimed defendants violated the Social Security Act, section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794, and the Due Process Clause of the Fourteenth Amendment. The district court dismissed these claims for lack of subject matter jurisdiction. The court held that plaintiffs failed to exhaust their administrative remedies and their claims did not satisfy the elements necessary to require waiver of the exhaustion requirement. We affirm.

In July 1994, claimants filed their complaint, alleging that the state agency's practice operated to deny benefits to persons with mental disabilities. Plaintiffs sought certification of a class; a judgment declaring that the process at the state level, as then administered, violated federal law and the Fourteenth Amendment's due process clause; preliminary and permanent injunctions enjoining the improper practices; and a writ of mandamus (in effect) directing defendants to perform the non-discretionary duties owed plaintiffs under applicable law. Defendants opposed plaintiffs' motion for class certification and a hearing was held. The defendants filed motions to dismiss the complaint for lack of subject matter jurisdiction. After defendants filed their motions, the district court stayed discovery and deferred ruling on class certification pending the decision on the motions to dismiss.

On May 3, 1995, the district court dismissed all claims against the Secretary for lack of jurisdiction, and dismissed the claims brought under the Social Security Act and the Due Process Clause against the state defendants, leaving only claims against the state that were predicated on section 504 of the Rehabilitation Act. After the parties briefed the issue, the district court dismissed the remaining claims for lack of jurisdiction in an Order entered in October 1995. Because of the court's disposition of the jurisdictional issue, it never ruled upon class certification.

Plaintiffs allege that they should have been considered for benefits under two similar programs administered by the Social Security Administration (SSA). The Social Security Disability Insurance program (SSDI) pays benefits to persons who have contributed to the program and who are determined to be "disabled" due to a physical and/or mental impairment. Title II, Social Security Act, 49 Stat. 622, as amended. 42 U.S.C. § 401 et seq. The Supplemental Security Income program (SSI) extends such benefits to indigent disabled persons. Title XVI, Social Security Act, 86 Stat. 1465, as amended, 42 U.S.C. § 1381 et seq. Both Titles define "disability" as the "inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of less than 12 months...." 42 U.S.C. §§ 423(d)(1)(A), 1382c(a)(3)(A). Under express statutory authority, 42 U.S.C. § 405(a), the Commissioner has promulgated detailed regulations governing eligibility for SSDI and SSI benefits. 20 C.F.R. Part 404, Subpart P (SSDI); 20 C.F.R. Part 416, Subpart I(SSI). Both programs follow the same five-step "sequential evaluation" process to determine whether a claimant is disabled. Compare 42 U.S.C. § 423(d) with 42 U.S.C. § 1382c; compare also 20 C.F.R. § 404.1520 with 20 C.F.R. § 416.920.

The disability examiner determines first, whether the claimant is engaged in "substantial gainful activity." If not, the examiner decides second whether the claimant's condition or impairment is "severe," i.e., whether it significantly limits claimant's physical or mental ability to do basic work activities. 20 C.F.R. §§ 404.1520(c), 416.920(c). If so, the examiner decides at the third step whether the claimant's impairment meets or equals the severity of the specified impairments acknowledged by SSA to be of sufficient severity to preclude any gainful work activity (the "Listings"), Subpart P, Appendix 1 of the Regulations, 20 C.F.R. §§ 404.1520(d), 416.920(d). If the claimant's condition meets or equals the level of severity of a listed impairment, the claimant at this point is conclusively presumed to be disabled based on his or her medical condition.

If the claimant has a severe impairment that does not equal or meet the severity of a listed impairment, the examiner proceeds to the fourth step and assesses the claimant's "residual functional capacity" ("RFC"). This assessment measures whether a claimant can perform past relevant work despite his or her impairment. If the claimant is unable to do past relevant work, the examiner proceeds to the fifth and final step of the evaluation process to determine whether in light of RFC, age, education and work experience the claimant can perform other work. 20 C.F.R. §§ 404.1520(f), 416.920(f).

Plaintiffs' contentions in this case concern the third step in the process, i.e., whether claimant's impairment meets or equals the impairment in the Listings. Specifically, plaintiffs challenge the DDD's failure to determine whether the mental retardation Listings apply to them. 20 C.F.R. Part 404, Subpart P, Appendix 1 at § 12.05 (Mental Retardation and Autism).

To be considered for disability benefits under section 12.05, a claimant must at least (1) have significantly subaverage general intellectual functioning; (2) have deficits in adaptive behavior; and (3) have manifested deficits in adaptive behavior before age 22.

Generally, the claimant meets the criteria for presumptive disability under section 12.05(b) when the claimant presents a valid IQ score of 59 or less, or under section 12.05(c) when the claimant presents a valid IQ score of 60 through 70 inclusive, and when the claimant presents evidence of an additional mental or physical impairment significantly affecting claimant's ability to work. See Lowery v. Sullivan, 979 F.2d 835, 837 (11th Cir.1992) (a valid IQ score need not be conclusive of mental retardation, where the IQ score is inconsistent with other evidence in the record concerning the claimant's daily activities and behavior).

In addition to describing plaintiffs generally as persons with limited mental capacity, the complaint alleges facts about each of the named plaintiffs, including their ages and their limited educational background and work experience; the dates they applied for and were denied benefits at the agency level; the IQ levels of some of the plaintiffs and their physical disabilities where relevant.

It appears plaintiffs' claims were not based on limited mental capacity. The complaint does not allege which of the above facts, if any, were presented to the agency. Plaintiffs fault the state disability examiners for failing to develop evidence sua sponte of limited mental capacity, even when such a claim is not made, but when there is some indication in the record that the claimant has a limited mental capacity.

Specifically, plaintiffs allege:

Defendants do not request information from disability applicants which would show that limited mental capacity is likely. Defendants fail and refuse to obtain consultative exams for I.Q. testing even when mental retardation is suggested by evidence of record (such as an adult having only a fourth grade education). Defendants do not obtain school records which would show that limitation of mental capacity was evident early in applicant's life. This failure to develop is particularly important because people with limited mental capacities often do not allege this deficiency as a basis for their disability claims, either because they do not appreciate the extent of their mental limitation or because they do not realize that their mental limitation can constitute a basis for disability. Defendants also deny benefits in cases where the record includes a valid I.Q. score of 60 or less or a valid I.Q. score between 61 to 70 and an additional significant work-related impairment.

We presume the truth of all factual allegations in the complaint and review defendants' facial challenge to jurisdiction de novo. The motion to dismiss is appropriately granted if the plaintiffs...