Leonard Caswell v. Joseph A. Califano, Jr., Etc.

583 F.2d 9, 1978 U.S. App. LEXIS 9505
CourtCourt of Appeals for the First Circuit
DecidedAugust 16, 1978
Docket77-1514
StatusPublished
Cited by80 cases

This text of 583 F.2d 9 (Leonard Caswell v. Joseph A. Califano, Jr., Etc.) is published on Counsel Stack Legal Research, covering Court of Appeals for the First Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Leonard Caswell v. Joseph A. Califano, Jr., Etc., 583 F.2d 9, 1978 U.S. App. LEXIS 9505 (1st Cir. 1978).

Opinion

LEVIN H. CAMPBELL, Circuit Judge.

This appeal is from one of a growing number of successful court challenges to the delays which attend the scheduling by the Social Security Administration (SSA) of administrative hearings afforded to applicants for disability benefits under Title II of the Social Security Act. 42 U.S.C. §§ 401 et seq. 1 The United States District Court for the District of Maine, in an opinion reported at 435 F.Supp. 127 (1977), found that the administrative delays suffered by the eight named plaintiffs and the class they were certified to represent were unreasonable and thus violated section 205(b) of the Social Security Act, 42 U.S.C. § 405(b), and certain provisions of the Administrative Procedure Act, 5 U.S.C. §§ 555(b), 706(1). The Secretary was ordered to reduce the lapse of time between a request for hearing and the scheduling of the hearing to within 90 days, and to submit progress reports to allow the court to monitor compliance. 2 On this appeal, the Secretary raises three principal objections: that the district court lacked subject matter jurisdiction; that the case is not justiciable; and that present delays cannot be considered unreasonable. We shall deal with each of these objections in turn, but before doing so we describe the working of the Title II disability program and the problem of delay in greater detail.

I

To establish disability and maintain the right to benefits under the Title II disability insurance program, a wage earner must adduce “such medical and other evidence of the existence - [of the disability] as the Secretary may require,” 42 U.S.C. § 423(d)(5), to demonstrate that he cannot “engage in any substantial gainful activity.” Id. § 423(d)(1)(A). The evidence must establish the existence of the disability by means of “medically acceptable clinical and laboratory diagnostic techniques,” id. § 423(d)(3), and that the disability is of such severity that

[the claimant] 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 . . .-. Id. § 423(d)(2)(A).

When a person applies for benefits, the initial determination of eligibility is made by the local Social Security Office. If the claim is denied, the claimant may request the appropriate state agency to undertake a de novo reconsideration of the adverse decision upon affidavits and other papers. If still unsuccessful, the claimant becomes entitled to a hearing before an SSA Bureau of Hearings and Appeals administrative law *12 judge (ALJ), which entails a personal appearance and a full evidentiary hearing. Id. § 405(b). It is this administrative hearing which plaintiffs protest is being unreasonably delayed. The record made at that hearing is subject to administrative and, finally, to judicial review. Id. § 405(g). Plaintiffs in no way challenge this complex statutory scheme, but “seek only the opportunity to avail themselves of its procedures within a reasonable time frame.” 435 F.Supp. at 130.

The problem of delays attending the scheduling of hearings and the issuance of decisions by administrative law judges in Title II disability cases is national in scope. See cases cited note 1 supra. The backlog of pending cases reached an all time high of 113,000 in April 1975 up from 36,780 in 1973. In recent years, requests for hearings have substantially increased due to the large volume of benefit claims filed under the Federal Coal Mine Health and Safety Act of 1969, 30 U.S.C. §§ 901 et seq., and under Title XYI of the Social Security Act, 42 U.S.C. §§ 1381 et seq., which provides supplemental security income (SSI) for the aged. These black lung and SSI appeals have substantially increased the workload of the Title II judges. Legislative obstacles exacerbated the problem by preventing efficient use of the three distinct types of hearing officers who were separately handling Title II cases, black lung cases, and SSI cases. Additionally, SSA has had difficulties enlarging the hearing staff because other civil service hearing examiners were paid more.

Delays in the SSA hearing process have caused congressional concern, prompted periodic congressional hearings and led to passage in 1976 of legislation allowing greater flexibility in the use of SSA personnel for administrative hearings, 3 and in 1977 of legislation increasing the number of ALJs. 4 During hearings on the 1976 legislation, both the legislation’s sponsors 5 and the SSA Commissioner 6 expressed the hope that the backlog would be brought under control and that hearings before the ALJs could be scheduled within 90 days of request by July 1977.

The undisputed facts of this case reveal that the SSA has fallen far short of this 90 day goal. Each of the eight named plaintiffs applied for Title II benefits and, following initial and reconsideration denials, requested a hearing under 42 U.S.C. § 405(b). Of the named plaintiffs, the shortest waiting period from request to the scheduled hearing was 369 days, the longest was 439 days and the average was 398 days. In terms of a decision, the average elapsed time from the request for a hearing was 569 days, or some 19 months. None of the named plaintiffs upon whose cases these statistics are based is charged with any default or action which delayed scheduling of the hearings.

The plaintiff class, as certified by the district court, includes all residents of the District of Maine who have applied for disability benefits under Title II; who have received an adverse initial and reconsideration determination; who have filed a timely request for a hearing; whose request has been pending for sixty days or longer; and for whom a hearing has not been scheduled. The delays experienced by the class are only slightly less lengthy than those suffered by the named plaintiffs. In May 1976, the average waiting time between request and hearing was 11.5 months for the New England Region. In Maine, as of March 1976, the median elapsed time was 367 days, over one year. As forty-five percent of all New England claimants who chose to appeal an *13

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Bluebook (online)
583 F.2d 9, 1978 U.S. App. LEXIS 9505, Counsel Stack Legal Research, https://law.counselstack.com/opinion/leonard-caswell-v-joseph-a-califano-jr-etc-ca1-1978.