Lois M. Grant, on Behalf of Herself and All Other Similarly Situated Persons v. Donna E. Shalala, Secretary of Health and Human Services

989 F.2d 1332
CourtCourt of Appeals for the Third Circuit
DecidedApril 7, 1993
Docket91-5675
StatusPublished
Cited by76 cases

This text of 989 F.2d 1332 (Lois M. Grant, on Behalf of Herself and All Other Similarly Situated Persons v. Donna E. Shalala, Secretary of Health and Human Services) is published on Counsel Stack Legal Research, covering Court of Appeals for the Third Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Lois M. Grant, on Behalf of Herself and All Other Similarly Situated Persons v. Donna E. Shalala, Secretary of Health and Human Services, 989 F.2d 1332 (3d Cir. 1993).

Opinions

OPINION OF THE COURT

ALITO, Circuit Judge:

This is an interlocutory appeal in a class action brought pursuant to Section 205(g) of the Social Security Act, 42 U.S.C. § 405(g). The question presented is whether the district court may hold a trial and make its own findings of fact regarding the alleged general bias of a Department of Health and Human Services (HHS) administrative law judge (AU) or whether the court must instead review the Secretary’s findings on this question. Based on the express language of Section 205(g), binding circuit precedent, and the effect that such litigation would have on the independence of administrative law judges, we hold that the district court may not make its own findings but may only review the Secretary’s findings and, if necessary, remand to the agency for further proceedings.

I.

In September 1985, Lois Grant filed an application for Social Security Insurance disability benefits. She asserted that she could not perform any substantial gainful employment because of an injury to her knee, as well as pain, depression, and other conditions stemming from that injury. The state agency handling the application de[1334]*1334nied her claim. Grant then requested a hearing before an HHS Administrative Law Judge, and her case was assigned to ALJ Russell Rowell. After a hearing, AU Rowell concluded that Grant was not entitled to benefits. He found that the medical evidence did not show that Grant could not perform sedentary work, such as that in which she had previously engaged. App. 36, 39. Furthermore, he found that Grant’s complaints of pain were not credible. App. 37. In reaching this conclusion, he relied on what he termed “a large element of secondary gain” and noted that following her injury Grant’s after-tax benefits from workers’ compensation exceeded her before-tax income prior to the injury. App. 37-38. Grant then sought review of the AU’s decision before the HHS Appeals Council, but the Appeals Council denied her application for review.

In 1988, Grant filed a complaint in the United States District Court for the Middle District of Pennsylvania pursuant to Section 205(g) of the Social Security Act, 42 U.S.C. § 405(g),1 against the Secretary of Health and Human Services, asserting that the decision denying her benefits was contrary to the Social Security Act and the Due Process Clause of the Fifth Amendment. Her complaint specifically alleged (App. 44):

ALJ Rowell is inclined in every disability case to deny benefits; he uses his discretion to determine credibility to effect this bias against claimants.

Several months later, Grant filed an amended complaint, which added two additional named plaintiffs, Jamie P. Donnelly and Harold Wallace.2 In addition, the amended complaint was brought on behalf of a class consisting of certain disability claimants whose cases had been or would in the future be assigned to ALJ Rowell. Among other things, the complaint sought a declaratory judgment that ALJ Rowell was biased against disability claimants and [1335]*1335that this bias had deprived or would deprive the plaintiffs of a fair hearing. The complaint also sought an injunction requiring that all of the plaintiffs’ claims that AU Rowell had rejected be reheard before other AUs, as well as prohibiting the Secretary “from assigning AU Rowell in the future to any tasks which involve the discretion to determine Social Security and/or SSI disability claims.”3 App. 62.

The Secretary opposed class certification and moved for a protective order preventing the plaintiffs from conducting further discovery.4 The district court denied the Secretary’s motions.5 Grant v. Sullivan, 720 F.Supp. 462 (M.D.Pa.1989).

In February 1990, the district court certified a class consisting of “all claimants for Social Security disability benefits or Supplemental Security Income disability benefits, or both, who have received, or will receive, an adverse decision from Administrative Law Judge Russell Rowell on or after January 1, 1985, and all disability claimants whose claims have been or will be assigned to AU Rowell for a decision.” Grant v. Sullivan, 131 F.R.D. 436, 450 (M.D.Pa.1990).6

In the meantime, the Chair of the Social Security Administration Appeals Council, Eileen Bradley, had determined that the agency should conduct its own investigation into the allegations that AU Rowell was generally biased against disability claimants. Ms. Bradley appointed a three-member panel and instructed it to examine the records in a random sample of the disability cases decided by AU Rowell. She stated that the sample was “anticipated to consist of at least 200 eases.” App. 105. She also stated that the panel would seek to determine whether the records in these cases “manifest instances of a pattern of bias of any sort on the part of AU Rowell, based, inter alia, on the conduct of the hearings, the language of the decisions, credibility determinations, evidentiary inferences and the accuracy of characterization of medical exhibits.” Id. In addition, she stated that the plaintiffs and AU Ro-well would have the opportunity to appear, testify, introduce evidence, and call and examine witnesses. Id.

After the decision to conduct this administrative investigation was announced, the Secretary filed a motion in the district court asking the court to dismiss or, in the alternative, to stay the case in favor of the administrative investigation. The magistrate judge recommended that the stay be granted provided that the Secretary agreed to postpone the administrative proceeding until the plaintiffs could complete their discovery. The district court, however, rejected this recommendation, stating (App. 133) that it had already decided that the .plaintiffs were entitled to a trial in district court on their claims of bias and that exhaustion of administrative remedies should not be required.7

[1336]*1336Despite the district court’s denial of the motion, the special panel proceeded with the investigation of AU Rowell and set out to examine the records in a statistically significant sampling of his cases. The panel did not attempt to analyze other evidence, such as depositions and statements of co-workers, regarding AU Rowell’s personality or views.

The panel determined that AU Rowell had decided 948 disability cases during a five-year period. From these, the panel selected a random sample and was eventually able to examine the files in 212 cases. All pertinent documents in the files were reviewed, and tape recordings of the hearings were studied.

In October 1990, the panel issued its report. The panel reported that it had “detected no patterns of irregularity during the hearing process, and no indication in the hearing tapes or transcripts it reviewed that Judge Rowell entertains any bias against any of the claimants, and certainly not against all of them.” App. 168. The report continued (id. at 169):

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

Related

Cite This Page — Counsel Stack

Bluebook (online)
989 F.2d 1332, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lois-m-grant-on-behalf-of-herself-and-all-other-similarly-situated-ca3-1993.