Heckler v. Lopez

• Decision Date: 11 October 1983
• Docket Number: No. A-145,A-145
• Citation: 464 U.S. 879,78 L.Ed.2d 217,104 S.Ct. 221
• Parties: Margaret M. HECKLER, Secretary of Health and Human Services v. Mario LOPEZ et al
• Court: U.S. Supreme Court

464 U.S. 879

104 S.Ct. 221

78 L.Ed.2d 217

Margaret M. HECKLER, Secretary of Health and Human Services

v Mario LOPEZ et al

No. A-145

Supreme Court of the United States

October 11, 1983

On Emergency Application for Stay.

The emergency application to vacate the stay entered by Justice REHNQUIST is denied.

Justice STEVENS with whom Justice BLACKMUN joins, dissenting in part.

The Secretary of Health and Human Services ("the Secretary") has taken the position that she may, at any time, terminate the payment of disability benefits to persons who have previously been found to be disabled and entitled to benefits under Titles II and XVI of the Social Security Act notwithstanding the complete absence of evidence that the recipient's medical condition has improved. In maintaining this position, the Secretary refused to follow the settled law in the Ninth Circuit, which requires her to adduce some evidence of medical improvement before terminating disability benefits. See Patti v. Schweiker, 669 F.2d 582 (CA9 1982); Finnegan v. Mathews, 641 F.2d 1340 (CA9 1981). Nevertheless, for the purposes of the stay application under review, the Secretary assumes that the Ninth Circuit's interpretation of the law is correct. Her stay application was predicated entirely on procedural grounds. A review of the procedural history of the case is therefore necessary.

Respondents filed a class action in the United States District Court for the Central District of California challenging the Secretary's policy. On June 16, 1983, the District Court entered an injunction requiring the Secretary to comply with the law of the Ninth Circuit with respect to recipients of disability benefits who reside in that circuit. The only portion of the District Court's injunction presently at issue in this Court is ¶ 4(c), which applies to all persons whose disability benefits have been terminated since August 30, 1981 (or August 25, 1980 in the case of recipients who were "grandfathered" into the federal program from state disability programs). Paragraph 4(c) enjoins the Secretary to notify all such persons that they may reapply for benefits, and upon reapplication, to reinstate their benefits pending a termination hearing at which the Secretary must produce some evidence of medical improvement.¹ It is this portion of the District Court's injunction which Justice REHNQUIST, acting as Circuit Justice, stayed pending the Secretary's appeal to the Ninth Circuit.

Today the Court declines to vacate the stay entered by Justice REHNQUIST. Of course, in considering an application of this kind, substantial deference must be paid the judgment of the Circuit Justice. See Rosenberg v. United States, 346 U.S. 273, 286-287, 73 S.Ct. 1152, 1159, 97 L.Ed. 1607 (1953). The Circuit Justice's decision should not be disturbed simply because the other members of the Court would have declined to grant the stay as an original matter. Nonetheless, there are cases in which reexamination is proper, see id., at 287-288, 73 S.Ct., at 1159-1160; I am persuaded that this is such a case.

In Justice REHNQUIST's view, the District Court's injunction extended to persons over whom the District Court had no jurisdiction. That conclusion does not, however, justify a stay of the injunction to the extent that it granted relief to persons over whom the District Court does have jurisdiction. Moreover, the extent of the overbreadth is less than Justice REHNQUIST assumed when he was persuaded to enter his stay.

The jurisdiction of the District Court over this action was based on 42 U.S.C. § 405(g), which provides in pertinent part:

"Any individual, after any final decision of the Secretary made after a hearing to which he was a party, irrespective of the amount in controversy, may obtain a review of such decision by a civil action commenced within sixty days after the mailing to him of notice of such decision or within such further time as the Secretary may allow."

Under the statute, persons whose benefits have been terminated must seek judicial review of their termination within 60 days of a "final decision" of the Secretary. It is my understanding that this class action was filed on February 4, 1983, and that the class certified by the District Court includes persons who were entitled to, but did not seek judicial review of an adverse final decision by the Secretary more than 60 days before February 4, 1983 (December 6, 1982). As I understand ¶ 4(c) of the injunction entered by the District Court, it grants relief to class members over whom the District Court had no jurisdiction—specifically, to class members who had received "final decisions" from the Secretary more than 60 days prior to February 4, 1983, and who had not timely sought judicial review. To the extent that the stay entered by Justice REHNQUIST applies to such persons, I agree that it was properly entered. These persons' right to seek administrative or judicial review of their termination decisions had expired, and they could obtain benefits only by requesting that the Secretary reopen their cases. However, the District Court had no jurisdiction to review the Secretary's refusal to reopen these cases. Califano v. Sanders, 430 U.S. 99, 97 S.Ct. 980, 51 L.Ed.2d 192 (1977). Hence, the District Court had no jurisdiction over these persons and should not have granted them relief, see Califano v. Yamasaki, 442 U.S. 682, 701, 704, 99 S.Ct. 2545, 2557, 2559, 61 L.Ed.2d 176 (1979); Mathews v. Diaz, 426 U.S. 67, 71, n. 3, 96 S.Ct. 1883, 1887, n. 3, 48 L.Ed.2d 478 (1976).

I believe, however, that the application to vacate the stay should be granted insofar as it applies to persons who sought judicial review of a termination of their benefits ordered by the Secretary on or after December 6, 1982, and persons whose right to administrative review of that termination had not expired before December 6, 1982. As to these persons, I believe both the waivable and non-waivable elements of 42 U.S.C. § 405(g) were satisfied; hence the District Court had jurisdiction to enter injunctive relief.

The non-waivable exhaustion requirement is simply the requirement that the Secretary have made some sort of decision on a claim for benefits. "The nonwaivable element is the requirement that a claim for benefits shall have been presented to the Secretary. Absent such a claim there can be no 'decision' of any type. And some decision by the Secretary is clearly required by the statute." Mathews v. Eldridge, 424 U.S. 319, 328, 96 S.Ct. 893, 899, 47 L.Ed.2d 18 (1976). As I understand the submissions of the parties, every class member had returned a questionnaire distributed by the Secretary and had thereby indicated in writing that he or she was still disabled and desired benefits. Thus, all of them had made adequate claims to continued benefits. Their benefits were terminated on the basis of a regulation that is assumed for the purpose of this proceeding to be invalid. In terminating benefits after receiving these questionnaires, it cannot be doubted that the Secretary knew these individuals claimed an entitlement to continue to receive disability benefits or that she then, by terminating their benefits, made a "decision" on the merits of their claims. That is all the non-waivable element of the statute requires. As the Court expressly held in Eldridge, "§ 405(g) requires only that there be a 'final decision' by the Secretary with respect to the claim of entitlement to benefits." Id., at 329, 96 S.Ct., at 900 (emphasis supplied). In fact, the questionnaires returned by these respondents made the same claim and received the same decision that was held sufficient to satisfy the statute in Mathews v. Eldridge.²

Mathews v. Eldridge also makes it clear that the waivable element of the statute has been satisfied. As was true in that case, further administrative review might have enabled a claimant to recover retroactive benefits but could not have vindicated the right to have correct procedures followed before the request for continued benefits was denied. As I understand respondents' position on the merits, they assert that a recipient need not respond at all to a claim that he or she is no longer disabled unless the Secretary first comes forward with some evidence that his or her condition has improved. There is no way that right can be vindicated in the administrative process—the Secretary has already taken a firm position on the issue which the administrative judges are not free to ignore.³ Even if the recipient is ultimately determined to be eligible for benefits for some other reason, the administrative process cannot vindicate the right asserted in this litigation, and hence further exhaustion of administrative remedies as to the claim made in this case is unnecessary. Eldridge, 424 U.S., at 330-332, 96 S.Ct., at 900-901. When exhaustion is futile, this element may be deemed waived even over the Secretary's objection. Mathews v. Diaz, 426 U.S. 67, 75-77, 96 S.Ct. 1883, 1889-1890, 48 L.Ed.2d 478 (1976); see also Eldridge, 424 U.S., at 328, 330, 96 S.Ct., at 899, 900. I agree with Justice REHNQUIST that respondents' contention that their claim is a "constitutional" one should be disregarded, but it should make no difference whether plaintiffs' claim is based on the statute or the Constitution. Even as to a statutory claim which could not be sustained on administrative review, "further exhaustion would not merely be futile for the applicant, but would also be a commitment of administrative resources unsupported by any administrative or judicial interest." Weinberger v. Salfi, 422 U.S. 749, 765-766, 95 S.Ct. 2457, 2466-2467, 45 L.Ed.2d 522 (1975). Congress could not have intended such a result.⁴

In reaching this conclusion, I express no opinion on the merits of the underlying controversy because the Secretary has assumed, for the purpose of our consideration of the stay application, that the Ninth Circuit's requirement that the Secretary produce...