Sullivan v. Zebley

• Court: United States Supreme Court
• Citation: 110 S.Ct. 885,493 U.S. 521,107 L.Ed.2d 967
• Docket Number: No. 88-1377,88-1377
• Parties: Louis W. SULLIVAN, Secretary of Health and Human Services, Petitioner v. Brian ZEBLEY et al
• Decision Date: 20 February 1990

493 U.S. 521

110 S.Ct. 885

107 L.Ed.2d 967

Louis W. SULLIVAN, Secretary of Health and Human Services, Petitioner

v Brian ZEBLEY et al.

No. 88-1377.

Argued Nov. 28, 1989.

Decided Feb. 20, 1990.

Syllabus

The Social Security Act authorizes the payment of Supplemental Security Income (SSI) benefits to, inter alios, a child who suffers from an impairment of "comparable severity" to one that would render an adult disabled. An adult is disabled if he is prevented from engaging in any substantial gainful activity by reason of certain medically determinable physical or mental impairments. Petitioner Secretary of Health and Human Services has created a five-step test to determine adult disability. At the test's third step, a claimant may be found to be disabled if medical evidence of his impairment matches or is equal to one of a listing of impairments presumed severe enough to preclude any gainful activity, thus making further inquiry unnecessary. However, since the listings' medical criteria are more restrictive than the statutory disability standard, an adult claimant who does not qualify at the third step may do so after showing, at the fourth and fifth steps, that he cannot engage in his past work or other work in the economy, given his age, education, and work experience. In contrast, the Secretary's test for determining whether a child claimant is disabled ends if the claimant cannot show that his impairment matches or is equal to a listed impairment, there being no further inquiry corresponding to the final, vocational steps of the adult test. Respondent Zebley, a child who was denied SSI benefits, brought a class action in the District Court challenging the child-disability regulations. The court granted summary judgment for the Secretary. The Court of Appeals vacated the judgment in part, finding the regulatory scheme to be inconsistent with the Act because the listings-only approach does not account for all impairments of "comparable severity" and denies child claimants the individualized functional assessment that the statutory standard requires and that the Secretary provides to adults.

Held: The child-disability regulations are inconsistent with the statutory standard of "comparable severity." Pp. 528-541.

(a) While adults who do not qualify under the listings still have the opportunity to show that they are disabled at the last steps of the Secretary's test, no similar opportunity exists for children, who are denied benefits even if their impairments are of "comparable severity" to ones that would actually (though not presumptively) disable adults. Pp. 529-536.

(b) The Secretary's regulatory scheme—which applies the same approach to child-disability claimants and to claimants for widows' and widowers' Social Security disability benefits, despite the fact that the Act uses a stricter standard for widows' benefits—nullifies the congressional choice to link the child-disability standard to the more liberal test applied to adult disability claims. Pp. 536-537.

(c) The Secretary's argument that the listings-only approach is the only practicable way to determine whether a child's impairment is comparable to one that would disable an adult is rejected. Even if they were set at the statutory level of severity, no set of listings could ensure that child claimants would receive benefits whenever their impairments are of comparable severity to ones that would qualify an adult for benefits under the individualized functional analysis contemplated by the statute and provided to adults. That a vocational analysis is inapplicable to children does not mean that a functional analysis cannot be applied to them, since an inquiry into an impairment's impact on a child's normal daily activities is no more amorphous or unmanageable than an inquiry into the impact of an adult's impairment on his ability to perform any kind of substantial gainful work that exists in the economy. Moreover, the Secretary tacitly acknowledges that functional assessment of child claimants is possible in that some of his own listings are defined in terms of functional criteria, and the test for cessation of disability involves an examination of a child claimant's ability to perform age-appropriate activities. Pp. 538-541.

855 F.2d 67 (CA3 1988), affirmed.

BLACKMUN, J., delivered the opinion of the Court, in which BRENNAN, MARSHALL, STEVENS, O'CONNOR, SCALIA, and KENNEDY, JJ., joined. WHITE, J., filed a dissenting opinion, in which REHNQUIST, C.J., joined, post, p. 541.

Edwin S. Kneedler, Washington, D.C., for petitioner.

Richard P. Weishaupt, Philadelphia, Pa., for respondents.

Justice BLACKMUN delivered the opinion of the Court.

This case concerns a facial challenge to the method used by the Secretary of Health and Human Services to determine whether a child is "disabled" and therefore eligible for benefits under the Supplemental Security Income Program, Title XVI of the Social Security Act, as added, 86 Stat. 1465, and amended, 42 U.S.C. § 1381 et seq. (1982 ed. and Supp. V).

I

In 1972, Congress enacted the Supplemental Security Income (SSI) Program to assist "individuals who have attained age 65 or are blind or disabled" by setting a guaranteed minimum income level for such persons. 42 U.S.C. § 1381 (1982 ed.). The program went into effect January 1, 1974. Currently, about 2 million claims for SSI benefits are adjudicated each year. Of these, about 100,000 are child-disability claims.¹

A person is eligible for SSI benefits if his income and financial resources are below a certain level, § 1382(a), and if he is "disabled." Disability is defined in § 1382c(a)(3) as follows:

"(A) An individual shall be considered to be disabled for purposes of this subchapter if he is unable 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 not less than twelve months (or, in the case of a child under the age of 18, if he suffers from any medically determinable physical or mental impairment of comparable severity).

"(B) For purposes of subparagraph (A), an individual shall be determined to be under a disability only if his physical or mental impairment or impairments are of such severity that he is not only unable to do his previous work but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy. . . .

"(C) For purposes of this paragraph, a physical or mental impairment is an impairment that results from anatomical, physiological, or psychological abnormalities which are demonstrable by medically acceptable clinical and laboratory diagnostic techniques."

This statutory definition of disability was taken from Title II of the Social Security Act, 70 Stat. 815, as amended, 42 U.S.C. § 423 et seq. (1982 ed. and Supp. V) (providing for payment of insurance benefits to disabled workers who have contributed to the Social Security Program). See §§ 423(d)(1)(A) and (d)(2)(A) (definitions of disability).

Pursuant to his statutory authority to implement the SSI Program,² the Secretary has promulgated regulations creating a five-step test to determine whether an adult claimant is disabled. See Bowen v. Yuckert, 482 U.S. 137, 140-142, 107 S.Ct. 2287, 2290-91, 96 L.Ed.2d 119 (1987).³ The first two steps involve threshold determinations that the claimant is not presently working and has an impairment which is of the required duration and which significantly limits his ability to work. See 20 CFR §§ 416.920(a) through (c) (1989). In the third step, the medical evidence of the claimant's impairment is compared to a list of impairments presumed severe enough to preclude any gainful work. See 20 CFR pt. 404, subpt. P, App. 1 (pt. A) (1989). If the claimant's impairment matches or is "equal" to one of the listed impairments, he qualifies for benefits without further inquiry. § 416.920(d). If the claimant cannot qualify under the listings, the analysis proceeds to the fourth and fifth steps. At these steps, the inquiry is whether the claimant can do his own past work or any other work that exists in the national economy, in view of his age, education, and work experience. If the claimant cannot do his past work or other work, he qualifies for benefits. §§ 416.920(e) and (f).

The Secretary's test for determining whether a child claimant is disabled is an abbreviated version of the adult test. A child qualifies for benefits if he "is not doing any substantial gainful activity," § 416.924(a), if his impairment meets the duration requirement, § 416.924(b)(1), and if it matches or is medically equal to a listed impairment, §§ 416.924(b)(2) and (3). In evaluating a child's claim, both the general listings and a special listing of children's impairments, 20 CFR pt. 404, subpt. P, App. 1 (pt. B) (1989), are considered. If a child cannot qualify under these listings, he is denied benefits. There is no further inquiry corresponding to the fourth and fifth steps of the adult test.

II

Respondent Brian Zebley, a child who had been denied SSI benefits, brought a class action in the United States District Court for the Eastern District of Pennsylvania to challenge the child-disability regulations.⁴ His complaint alleges that the Secretary

"has promulgated regulations and issued instructions . . . whereby children have their entitlement to SSI disability benefits based solely on the grounds that they have a listed impairment or the medical equivalent of a listed impairment . . . in contravention of the Act's requirement that a child be considered disabled 'if he suffers from any medically determinable physical or mental impairment of comparable severity' to that which disables an adult under the program." Complaint in Civil Action No. 83-3314, ¶ 2.

The District Court, on January 10, 1984, certified a...