Association of Administrative Law Judges, Inc. v. Heckler

594 F. Supp. 1132, 1984 U.S. Dist. LEXIS 23729
CourtDistrict Court, District of Columbia
DecidedSeptember 10, 1984
DocketCiv. A. 83-0124
StatusPublished
Cited by26 cases

This text of 594 F. Supp. 1132 (Association of Administrative Law Judges, Inc. v. Heckler) is published on Counsel Stack Legal Research, covering District Court, District of Columbia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Association of Administrative Law Judges, Inc. v. Heckler, 594 F. Supp. 1132, 1984 U.S. Dist. LEXIS 23729 (D.D.C. 1984).

Opinion

MEMORANDUM OPINION AND ORDER

JOYCE HENS GREEN, District Judge.

Plaintiff, the Association of Administrative Law Judges, is a not-for-profit corporation whose members are administrative law judges (AUs) employed by the Department of Health and Human Services (HHS) and assigned to the Office of Hearings and Appeals (OHA) of the Social Security Administration (SSA). Plaintiff’s members adjudicate claims for disability benefits under Titles II and XVI of the Social Security Act, 42 U.S.C. §§ 401 et seq. (1982) and 42 U.S.C. §§ 1381 et seq. (1982). Plaintiff brought this lawsuit to challenge the “Bellmon Review Program”, which defendants instituted to implement Section 304(q) of the Social Security Disability Amendments of 1980, the “Bellmon Amendment”. 1 Plaintiff alleges that this program violates the rights of its members to decisional independence under the Administrative Procedure Act (APA), 5 U.S.C. § 551 et seq. (1982).

State agencies administer the Social Security Disability Insurance Program pursuant to agreements with the SSA. Based upon medical information received from various sources and applying SSA guidelines, the state disability determination service issues the decision of SSA. A claimant who is denied benefits may file for reconsideration at the state level and if dissatisfied may then seek relief on the federal level. The AU hearing is a de novo proceeding. The AU is the first agency personnel in the review process to interview the claimant in person. .The claimant may submit additional evidence, produce expert witnesses, and be represented by counsel. If his or her claim is denied by the AU, the claimant may appeal to the Appeals Council, which is the last step in the administrative process.

The Appeals Council has the authority to review all decisions of AUs, at its own discretion (“own motion”), or at the request of a claimant. In either case, the Appeals Council is authorized to exercise jurisdiction only when: (1) there appears to be an abuse of discretion by the'AU; (2) there is an error of law; (3) the action, findings or conclusions of the AU are not supported by substantial evidence; or (4) there is a broad policy or procedural issue that may affect the general public interest. 20 C.F.R. § 404.970(a), 416.1470(a) (1984). Based upon its review, the Appeals Council may modify, affirm, reverse or remand the AU’s decision. When the Appeals Council reverses or remands an AU’s decision, it issues an opinion stating the grounds for reversal or remand and identifying dispositive abuses of discretion, errors of law, problems with conclusions of law and findings of fact, insufficiencies of evidence, and policy or procedural issues of concern to SSA. If a case is remanded, the AU must take any action ordered by the Appeals *1134 Council, but may also take any additional action that is not inconsistent with the remand order.

The Bellmon Amendment directed the Secretary of HHS to resume review of decisions of ALJs on her own motion. Congress expressed concern at that time about the high rate at which AUs were reversing determinations made at the state level and the variance in these rates among AUs. See H.R.Rep. No. 944, 96th Cong., 2d Sess. 57 (1980), reprinted in [1980] U.S.Code Cong. & Ad.News 1392,. 1405; S.Rep. No. 408, 96th Cong., 2d Sess. 53 (1980), reprinted in [1980] U.S.Code Cong. & Ad.News 1277, 1331.

A study performed pursuant to the Bellmon Amendment and described in a report to Congress in January 1982 (PX-1), indicated that the Appeals Council more often would have changed decisions by AUs allowing benefits made by AUs with above average allowance rates than allowance decisions made by AUs with average or below-average allowance rates. 2 The Bellmon Review Program, a series of measures designed to improve decisional quality and accuracy, began in October, 1981. Associate Commissioner of SSA, Louis B. Hays, announced that four categories of cases would be selected for possible “own motion” review:

(1) National random sample 21%

(2) Allowance decisions of new AUs

(3) Decisions referred by SSA’s Office of Disability Operations 16%

Individual AUs 63%

Initially, individual AUs with allowance rates of 70% or higher were to have 100% of their allowance decisions reviewed for accuracy and hearing offices with allowance rates of 74% or higher would also be reviewed. 106 AUs, or approximately 13% of all AUs in SSA, were placed on Bellmon Review because of their high allowance rates. The selection of entire hearing offices for review was soon discontinued. The other three categories of review were not yet operative.

An overview of the program was communicated to the AU corps in a Memorandum dated September 24, 1982 from Mr. Hays. (PX-111) (“Hays Memorandum”). That Memorandum explained that Bellmon Review was being instituted because of Congressional concern about high allowance rates and because only AU decisions denying benefits were generally subject to further review. Allowance rates were used as the basis for selecting the initial review group, in part, because studies had shown that decisions in this group would be the most likely to contain errors which would otherwise go uncorrected.

Based upon own-motion rates (the frequency with which the Appeals Council takes action to correct an AUs decision, as calculated by the Office of Appraisal) the individual AUs were divided into four groups: 100% review; 75% review; 50% review and 25% review. In determining whether an ÁU should be removed from review, the Appeals Council considered only decisional accuracy, defined as a 5% own motion rate for three consecutive months. An AU with a 5% own motion rate could be said to be 95% accurate. Shortly after implementation, the criteria for removing targeted AUs from review were amended. 3 The 5% own motion rate *1135 was abandoned in-favor of an own motion rate approximating that of the national random sample. 4

A companion system for providing individualized feedback and counseling on the results of the review was also described in the Hays Memorandum. Never implemented, this feedback system was intended to complement the case-by-case feedback which occurs through the process of reversals and remands by advising ALJs of “decisional weaknesses and providing] a mechanism for achieving long term improvement.” Plaintiffs members believed that the feedback memoranda developed for peer counseling sessions that were scheduled to be held in January 1983 would direct high allowance AUs how to develop, hear and decide cases. No counseling sessions under this program were ever conducted.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

CropLife Amer v. EPA
329 F.3d 876 (D.C. Circuit, 2003)
Asmussen v. Commissioner, New Hampshire Department of Safety
766 A.2d 678 (Supreme Court of New Hampshire, 2000)
Harrison v. Coffman
35 F. Supp. 2d 722 (E.D. Arkansas, 1999)
NEC Corp. v. U.S. Department of Commerce
21 Ct. Int'l Trade 198 (Court of International Trade, 1997)
Ward v. Shalala
898 F. Supp. 261 (D. Delaware, 1995)
United States v. Mitchell
37 M.J. 903 (U.S. Navy-Marine Corps Court of Military Review, 1993)
Ramos v. District of Columbia Department of Consumer & Regulatory Affairs
601 A.2d 1069 (District of Columbia Court of Appeals, 1992)
Nash v. Bowen
869 F.2d 675 (Second Circuit, 1989)
Nesvold v. Bowen
683 F. Supp. 1246 (N.D. Indiana, 1988)
George L. Barry v. Otis R. Bowen
825 F.2d 1324 (Ninth Circuit, 1987)
Sumler v. Bowen
656 F. Supp. 1322 (W.D. Arkansas, 1987)
W.C. v. Heckler
629 F. Supp. 791 (W.D. Washington, 1986)
Stieberger v. Heckler
615 F. Supp. 1315 (S.D. New York, 1985)

Cite This Page — Counsel Stack

Bluebook (online)
594 F. Supp. 1132, 1984 U.S. Dist. LEXIS 23729, Counsel Stack Legal Research, https://law.counselstack.com/opinion/association-of-administrative-law-judges-inc-v-heckler-dcd-1984.