Smith v. Berryhill

587 U.S. 471, 139 S. Ct. 1765, 204 L. Ed. 2d 62, 2019 U.S. LEXIS 3555
Supreme Court of the United States·Decided May 28, 2019·No. 17-1606·Published·Cited by 494 cases

Opinion

Justice SOTOMAYOR delivered the opinion of the Court.

*1771 The Social Security Act allows for judicial review of "any final decision ... made after a hearing" by the Social Security Administration (SSA). 42 U.S.C. § 405 (g). Petitioner Ricky Lee Smith was denied Social Security benefits after a hearing by an administrative law judge (ALJ) and later had his appeal from that denial dismissed as untimely by the SSA's Appeals Council-the agency's final decisionmaker. This case asks whether the Appeals Council's dismissal of Smith's claim is a "final decision ... made after a hearing" so as to allow judicial review under § 405(g). We hold that it is.

I

A

Congress enacted the Social Security Act in 1935, responding to the crisis of the Great Depression. 49 Stat. 620 ; F. Bloch, Social Security Law and Practice 13 (2012). In its early days, the program was administered by a body called the Social Security Board; that role has since passed on to the Board's successor, the SSA. 1

In 1939, Congress amended the Act, adding various provisions that-subject to changes not at issue here-continue to govern cases like this one. See Social Security Act Amendments of 1939, ch. 666, 53 Stat. 1360 . First, Congress gave the agency "full power and authority to make rules and regulations and to establish procedures ... necessary or appropriate to carry out" the Act. § 405(a). Second, Congress directed the agency "to make findings of fac[t] and decisions as to the rights of any individual applying for a payment" and to provide all eligible claimants-that is, people seeking benefits-with an "opportunity for a hearing with respect to such decision[s]." § 405(b)(1). Third, and most centrally, Congress provided for judicial review of "any final decision of the *1772 [agency] made after a hearing." § 405(g). At the same time, Congress made clear that review would be available only "as herein provided"-that is, only under the terms of § 405(g). § 405(h) ; see Heckler v. Ringer , 466 U.S. 602 , 614-615, 104 S.Ct. 2013 , 80 L.Ed.2d 622 (1984).

In 1940, the Social Security Board created the Appeals Council, giving it responsibility for overseeing and reviewing the decisions of the agency's hearing officers (who, today, are ALJs). 2 Though the Appeals Council originally had just three members, its ranks have since swelled to include over 100 individuals serving as either judges or officers. 3 The Appeals Council remains a creature of regulatory rather than statutory creation.

Today, the Social Security Act provides disability benefits under two programs, known by their statutory headings as Title II and Title XVI. See § 401 et seq. (Title II); § 1381 et seq. (Title XVI). Title II "provides old-age, survivor, and disability benefits to insured individuals irrespective of financial need." Bowen v. Galbreath , 485 U.S. 74 , 75, 108 S.Ct. 892 , 99 L.Ed.2d 68 (1988). Title XVI provides supplemental security income benefits "to financially needy individuals who are aged, blind, or disabled regardless of their insured status." Ibid. The regulations that govern the two programs are, for today's purposes, equivalent. See Sims v. Apfel , 530 U.S. 103 , 107, n. 2, 120 S.Ct. 2080 , 147 L.Ed.2d 80 (2000). 4 Likewise, § 405(g) sets the terms of judicial review for each. See § 1383(c)(3).

Modern-day claimants must generally proceed through a four-step process before they can obtain review from a federal court. First, the claimant must seek an initial determination as to his eligibility. Second, the claimant must seek reconsideration of the initial determination. Third, the claimant must request a hearing, which is conducted by an ALJ. Fourth, the claimant must seek review of the ALJ's decision by the Appeals Council. See 20 CFR § 416.1400 . If a claimant has proceeded through all four steps on the merits, all agree, § 405(g) entitles him to judicial review in federal district court. 5

The tension in this case stems from the deadlines that SSA regulations impose for seeking each successive stage of review. A party who seeks Appeals Council review, as relevant here, must file his request within 60 days of receiving the ALJ's ruling, unless he can show "good cause for missing the deadline." § 416.1468.

The Appeals Council's review is discretionary: It may deny even a timely request without issuing a decision. See § 416.1481. If a claimant misses the deadline and cannot show good cause, however, the Appeals Council does not deny the request but rather dismisses it. § 416.1471. Dismissals are "binding and not subject to further review" by the SSA. § 416.1472. The question here is whether a dismissal for untimeliness, after the claimant has had an ALJ hearing, is a "final decision ... made after a hearing" for *1773 purposes of allowing judicial review under § 405(g).

B

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Smith v. Berryhill, 587 U.S. 471, 139 S. Ct. 1765, 204 L. Ed. 2d 62, 2019 U.S. LEXIS 3555 (2019).

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