Williams v. Schweiker
| Decision Date | 30 June 1982 |
| Docket Number | No. 81-1070C(2).,81-1070C(2). |
| Citation | 541 F. Supp. 1360 |
| Court | U.S. District Court — Eastern District of Missouri |
| Parties | Arelia WILLIAMS, Individually and on behalf of all others similarly situated, Plaintiff, v. Richard SCHWEIKER, Secretary of Health and Human Services, Defendant. |
Richard D. Chase, Legal Services of Eastern Missouri, St. Louis, Mo., for plaintiff.
Joseph B. Moore, Asst. U. S. Atty., St. Louis, Mo., for defendant.
Plaintiff, Arelia Williams brings this action pursuant to 28 U.S.C. § 1361 and 42 U.S.C. § 1383(c)(3) seeking declaratory and injunctive relief. Plaintiff alleges that the failure of the defendant to issue hearing decisions on applications for Supplemental Security Income disability benefits within a reasonable time violates the Social Security Act, 42 U.S.C. § 1381 et seq., the Administrative Procedure Act, 5 U.S.C. §§ 554, 555 and 701 et seq., and the Due Process Clause of the Fifth Amendment. Therefore, through this action, the plaintiff is seeking an order compelling the Social Security Administration to issue administrative hearing decisions within a reasonable time. In addition, the plaintiff requests that she be certified as the representative of a class composed of all Missouri, Nebraska, Kansas, and Iowa applicants for Supplemental Security Income disability benefits, who have not received or will not receive a hearing decision within a reasonable time following their requests for an administrative hearing.
This case was tried to the Court without a jury. The case was presented by means of a stipulation of facts. Based upon the record herein, the Court makes the following findings of fact and conclusions of law as required by Rule 52 of the Federal Rules of Civil Procedure.
1. Title XVI of the Social Security Act, 42 U.S.C. § 1381 et seq., provides for the monthly payment of Supplemental Security Income hereinafter "SSI" benefits to the needy, aged, blind, or totally disabled individuals. The basic purpose behind the SSI program is to assure a minimum level of income for people who are age sixty-five or older, or blind, or disabled and who do not have sufficient income and resources to maintain a standard of living at the established Federal minimum income level. SSI is a need-based program, requiring recipients to meet certain income and resource standards which are set out in 20 C.F.R., Part 416.
2. In order to qualify for the receipt of SSI disability benefits an applicant must meet the following disability standard:
An individual shall be considered to be disabled for the purpose 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.
42 U.S.C. § 1382c(a)(3).
3. Congress enacted the SSI program and made grants available pursuant to the Social Security Act in 1973. The SSI Scheme replaced financial assistance programs for the aged, blind, and disabled in fifty states and the District of Columbia. Payments are financed from the general funds of the United States Treasury.
4. The Social Security Act authorizes the Secretary of the Department of Health and Human Services to adopt such rules and regulations as are necessary to carry out the provisions of Title XVI of the Act. 42 U.S.C. § 1302. The rules and regulations governing Title XVI are codified at 20 C.F.R., Part 416. The Social Security Administration, which is an agency of the Department of Health and Human Services, implements these regulations. The statute and regulations specify the procedure that an applicant must follow to obtain SSI benefits.
5. Pursuant to these regulations, an individual seeking SSI benefits first must file a written application for benefits at a Social Security Office. 42 C.F.R. § 416.300 et seq. The regulations require the office to make an Initial Determination with respect to the eligibility of the applicant for benefits. In the event the Initial Determination is unfavorable to the applicant, the claimant may request Reconsideration within sixty days. If the agency makes another negative determination at this level, the claimant may request a hearing before an Administrative Law Judge hereinafter "ALJ" within sixty days, 20 C.F.R. § 416.1400 et seq. If the hearing is unfavorable to the claimant, the statute and regulations allow the applicant the opportunity to appeal the decision to the Appeals Council in Washington, D. C. and ultimately to the federal courts.
6. The Hearing held in front of the ALJ provides the applicant with his first opportunity in the administrative process to make his claim in person. The purpose of the Hearing is to provide the claimant with a new and independent adjudication of his claim for SSI benefits. Although the hearings are non-adversarial, claimants have the right to appear, to be represented by counsel, to testify, present witnesses, subpoena records, introduce evidence, cross-examine witnesses, and to present oral argument and written briefs. The ALJ who conducts Hearings on applications for SSI disability benefits is an attorney. A complete record of the proceedings is made, and following the Hearing, the ALJ issues a written decision based upon the record and the evidence presented. The hearing decision should contain findings of fact and reasons in support thereof. Plaintiff is objecting to the length of time that the agency is taking to provide applicants with a hearing and to issue a hearing decision.
7. If it is determined at any stage of the proceedings that a claimant meets the income and resource standards required by the SSI program, the agency will authorize the payment of benefits retroactively to the month which the claimant applied for SSI benefits. Benefit payments normally begin within thirty to sixty days from the date of a favorable hearing decision. The maximum amount of SSI benefits currently is $264.70 per month.
8. The Social Security Administration has divided the United States into Regions for the purpose of administering the Social Security Act. The plaintiff and the members of the class of which she is a representative, reside in Region VII of the Social Security Administration which consists of the states of Missouri, Iowa, Nebraska, and Kansas.
9. The average times for processing SSI applications involving the existence of a disability in Region VII of the Social Security Administration are as follows:
Request for Request for
Hearing to Hearing to Hearing to
Hearing (in Hearing Hearing
Month (1981) days) Decision Decision
January 133 58 191
February 134 61 195
March 128 59 187
April 125 51 176
May 139 51 190
The parties stipulated that the above statistics are the most current available. In addition, the parties agreed at the time of the filing of their stipulation, on December 4, 1981, that the average time for processing SSI applications involving the existence of a disability in Region VII was the same as it was for the period from January, 1981 through May, 1981.
10. The number of ALJs that the agency employed in Region VII and the number of hearings held and hearing decisions that ALJs issued with respect to SSI applications involving the existence of a disability are as follows:
Hearing
Hearings Decisions
Month (1981) Held Issued ALJs
January - - - - 28
February 302 362 28
March 392 406 28
April 442 429 27
May 369 404 27
June 385 446 26
July 330 465 25
August 334 407 25
September 408 392 26
11. Administrative hearings on applications for Supplemental Security Income disability benefits account for fifty percent of the hearings held and hearing decisions issued by ALJs in Region VII. Social Security disability claims, without concurrent SSI claims account for nearly all of the remaining hearings held in this Region.
12. In Region VII more than fifty percent of the hearing decisions issued by ALJs on the question of whether an applicant is entitled to Supplemental Security Income disability benefits result in the reversal of earlier determinations that the claimant is not disabled within the meaning of Title XVI of the Social Security Act.
13. The plaintiff in this case is a forty-seven year old resident of St. Louis, Missouri. She applied for SSI disability benefits on August 14, 1980. Her application was denied upon Initial Determination and Reconsideration. On February 19, 1981 the plaintiff filed a Request for Hearing; however, no hearing was held until September 22, 1981. On October 1, 1981, the ALJ issued a decision finding that the plaintiff met the disability standard required for the receipt of SSI benefits.
14. In several regions, courts have ordered the defendant Secretary of Health and Human Services to hold Social Security or Supplemental Security Income disability hearings and to issue hearing decisions within specified periods of time. The defendant estimates that the following levels of compliance have occurred in different regions in response to court order:
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