Stieberger v. Heckler

Decision Date19 August 1985
Docket NumberNo. 84 CIV 1302 (LBS).,84 CIV 1302 (LBS).
Citation615 F. Supp. 1315
PartiesTheresa STIEBERGER, individually and on behalf of other persons similarly situated; and the City of New York, Plaintiffs, v. Margaret M. HECKLER, Secretary, United States Department of Health and Human Services; Martha McSteen, Commissioner of the Social Security Administration; Louis B. Hays, Acting Director, Office of Programs and Policy, Social Security Administration; Frank V. Smith III, Associate Commissioner of Hearings and Appeals, Social Security Administration; and Paul Rosenthal, Chief Administrative Law Judge, Office of Hearings and Appeals, Social Security Administration, Defendants.
CourtU.S. District Court — Southern District of New York

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M.F.Y. Legal Services, Inc., New York City (Carolyn A. Kubitschek, Ralph Bird, New York City, of counsel), American Civil Liberties Union Foundation, New York City (Burt Neuborne, Carl Loewenson, Jr., New York City, of counsel), for individual plaintiffs and class representatives.

Frederick A.O. Schwarz, Jr., Corp. Counsel of City of New York, New York City (Mary McCorry, Asst. Corp. Counsel, New York City, of counsel), for City of New York.

Richard K. Willard, Acting Asst. Atty. Gen., Civ. Div., Dept. of Justice, Washington, D.C. (Brook Hedge, Lewis K. Wise, Brian G. Kennedy, Robert S. Lavet, Washington, D.C., of counsel), Terry Coleman Acting Gen. Counsel, Dept. of Health and Human Services, Washington, D.C. (Donald Gonya, Washington, D.C., of counsel), Rudolph W. Giuliani, U.S. Atty., S.D.N.Y., New York City (Frederick M. Lawrence, Asst. U.S. Atty., Mark S. Sochaczewsky, Sp. Asst. U.S. Atty., New York City, of counsel), for defendants.

                                                 TABLE OF CONTENTS
                I.   INTRODUCTION                                                                1321
                II.  FACTS                                                                       1323
                III. MOTIONS CONCERNING INDIVIDUAL NAMED PLAINTIFFS                              1325
                     A. Defendants' Motion to Remand (Stieberger)                                1325
                     B. Motions to Intervene (Happy, Vega)                                       1326
                     C. Motions to Consolidate (Sullivan, Johnson)                               1326
                IV. CLASS CERTIFICATION                                                          1327
                V.  JURISDICTIONAL ISSUES                                                        1328
                    A. Social Security Act Jurisdiction: Section 405(g)                          1328
                       1. Presentment                                                            1329
                       2. Exhaustion                                                             1329
                       3. Sixty Day Limitation                                                   1330
                    B. Mandamus Jurisdiction: Section 1361                                       1334
                    C. Standing of City of New York                                              1337
                VI. PRELIMINARY INJUNCTION                                                       1340
                    A. The Standard                                                              1340
                    B. Irreparable Harm                                                          1341
                    C. Likelihood of Success on the Merits                                       1342
                       1. Non-Acquiescence                                                       1342
                          a. Non-Acquiescence in Second Circuit Precedent                        1343
                          b. Congressional Ratification of Defendants' Treating Physician
                             Rule                                                                1349
                          c. The Legality of Non-Acquiescence                                    1350
                             (i) The Original Non-Acquiescence Policy                            1351
                             (ii) Interim Circular No. 185                                       1367
                          d. Propriety of Injunctive Relief                                      1375
                       2. Bellmon Review                                                         1376
                          a. Introduction                                                        1376
                          b. Legal Issues                                                        1379
                             (i)   Standing                                                      1380
                             (ii)  Mootness                                                      1381
                             (iii) Waiver                                                        1381
                             (iv)  The Legality of Bellmon Review                                1386
                                   (a) The Bellmon Amendment                                     1388
                                   (b) Justification for Agency Focus on Allowance Decisions     1390
                                   (c) Evidence of Bellmon Review's Impact on ALJ Impartiality   1393
                       3. Conclusion                                                             1398
                VII.  RELIEF                                                                     1399
                
                                                 APPENDIX
                    A. Order
                    B. Papers Filed by Parties in Connection with Motions
                    C. Interim Circular No. 185
                
OPINION

SAND, District Judge.

I. INTRODUCTION

Plaintiffs, Theresa Stieberger and the City of New York, have instituted this action to challenge two policies of the United States Department of Health and Human Services ("HHS") and the Social Security Administration ("SSA"), as implemented by the abovenamed defendants.1 Plaintiffs challenge: (1) the "non-acquiescence" policy, under which Administrative Law Judges ("ALJs") have been instructed to disregard the decisions of federal courts within the circuit in which they sit when those decisions conflict with the Secretary's own policies; and (2) the "Bellmon Review" policy, under which, inter alia, the decisions of ALJs with a high percentage of pro-claimant determinations in disability benefit cases were subject to agency-initiated review by the agency's Appeals Council.

Plaintiffs contend that the non-acquiescence policy has deprived them of access to impartial and decisionally independent ALJs and has unlawfully discriminated between those claimants who are able to secure judicial review and those who do not have access to judicial review in violation of the Administrative Procedure Act ("APA"), the Social Security Act, the Due Process Clause of the Fifth Amendment to the United States Constitution, and the principle of separation of powers. Plaintiffs contend that the Bellmon Review policy has deprived them of access to impartial and decisionally independent ALJs in violation of the APA, the Social Security Act, and the Due Process Clause of the Fifth Amendment to the United States Constitution and has unlawfully discriminated against disability benefits claimants in violation of the Due Process Clause of the Fifth Amendment2 by subjecting ALJ decisions to Bellmon Review because such decisions are unfavorable to the government. Plaintiffs seek declaratory and injunctive relief pursuant to 28 U.S.C. §§ 2201 and 2202.

Six motions are presently pending before this Court. Plaintiffs' four motions were filed on October 23, 1984. First, Patricia Happy and Angel Vega have moved pursuant to F.R.Civ.P. 24 to intervene. Second, Milagros Sullivan and Harold Johnson have moved pursuant to F.R.Civ.P. 42 to have their cases consolidated with the above-captioned action. Third, plaintiffs3 have moved pursuant to F.R.Civ.P. 23 to certify this action as a class action. Fourth, plaintiffs have moved pursuant to F.R.Civ.P. 65 for a preliminary injunction (1) enjoining defendants from continuing their Bellmon Review and non-acquiescence policies, (2) notifying agency employees and their agents who adjudicate disability claims in New York that they are to decide cases in accordance with the precedents of the United States Court of Appeals for the Second Circuit, (3) an order granting the individual named plaintiffs interim benefits pending final judgment;4 and (4) ordering defendants to (a) identify class members, (b) notify them that their denial or termination of benefits may have been wrongful,5 and (c) develop a procedure for claimants to renew their claims.6

On October 4, 1984, defendants moved pursuant to 42 U.S.C. § 405(g) to remand plaintiff Stieberger's case to the Secretary. Defendants subsequently moved on February 4, 1985 to dismiss pursuant to F.R. Civ.P. 12(b)(1) and (6) or alternatively for summary judgment pursuant to F.R.Civ.P. 56. Defendants' motion to dismiss or for summary judgment seeks to dismiss the Bellmon Review claim in its entirety based on lack of standing, mootness, waiver, and on the merits, and seeks to dismiss the non-acquiescence claim on mootness grounds based on alleged congressional ratification of the Secretary's policy for evaluating the opinion of a claimant's treating physician. See Defendants' Memorandum of Law (i) In Support of Motion to Dismiss, etc., at 2, 12-24.7

On February 4, 1985, oral argument was held on the aforementioned motions. At that time, the Court directed counsel for defendants to secure a review of the SSA's non-acquiescence policy by officials at the highest levels of HHS and to submit a supplemental memorandum concerning the legal issues raised by the policy. See Transcript of Oral Argument ("Tr. I") 52, 58, 64. After a review of the policy by the Undersecretary of HHS, the Acting Commissioner of Social Security and the Acting General Counsel of HHS, defendants filed their Memorandum Concerning Instruction to Administrative Law Judges on March 4, 1985. The Court also requested plaintiffs to address the issue of the scope of the proposed class and to give consideration to whether the proposed class definition could be narrowed so as to exclude claimants whose claims were denied for reasons unrelated to the issues in this case. Tr. I 22-23.

By order dated March 8, 1985, plaintiffs' class certification and ...

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