W.C. v. Heckler

629 F. Supp. 791
CourtDistrict Court, W.D. Washington
DecidedJanuary 15, 1986
DocketC83-865R
StatusPublished
Cited by9 cases

This text of 629 F. Supp. 791 (W.C. v. Heckler) is published on Counsel Stack Legal Research, covering District Court, W.D. Washington primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
W.C. v. Heckler, 629 F. Supp. 791 (W.D. Wash. 1986).

Opinion

ORDER GRANTING PLAINTIFF’S MOTION FOR PARTIAL SUMMARY JUDGMENT

ROTHSTEIN, District Judge.

THIS MATTER comes before the court on cross motions for summary judgment. These motions were referred to Magistrate Philip K. Sweigert, who has now filed a detailed Report and Recommendation. The court has carefully considered the Report and Recommendation and all the materials submitted by the parties in response thereto. The court has also studied the relevant file and records.

This action is composed of two claims for relief. First, plaintiff seeks reversal of a decision by the Secretary of Health and Human Services to terminate his disability benefits under Title II of the Social Security Act and his Supplemental Security Income (“SSI”) benefits under Title XVI of the Social Security Act. Plaintiff alleges that this decision is not supported by substantial evidence and is based on errors of law. Second, plaintiff, as representative of a class of individuals seeking disability and SSI benefits, challenges the validity of the so-called Bellmon Review Program implemented by the Secretary in 1981. Plaintiff alleges that the adoption of the Bellmon Review Program violated the notice and comment requirements of the Administrative Procedure Act (“APA”).

*793 I. FACTUAL BACKGROUND

Plaintiff received disability and SSI benefits for a number of years. On February 17, 1982, the Social Security Administration (“SSA”) terminated his benefits based on a determination that his disability had healed and that, therefore, he was able to return to work. Plaintiff requested and received a hearing before an administrative law judge (“AU”). The AU found that plaintiffs disability continues, and he reversed the termination of plaintiffs benefits. Review of this AU decision was initiated on July 14, 1982, by a motion of the SSA Appeals Council, the body that issues final decisions on behalf of the Secretary of Health and Human Services. On April 21, 1983, the Appeals Council reversed the AU decision and terminated plaintiffs benefits.

It is undisputed that the AU decision in plaintiffs case was reviewed under the Bellmon Review Program. This program was implemented by the Secretary in response to the Bellmon 1 Amendment to the Social Security Act. The Bellmon Amendment provides:

The Secretary of Health and Human Services shall implement a program of reviewing, on his own motion, decisions rendered by administrative law judges as a result of hearings under section 221(d) of the Social Security Act, and shall report to the Congress by January 1, 1982, on his progress.

Social Security Disability Amendments of 1980, Pub.L. No. 96-265, § 304(g), 94 Stat. 441, 456. The Bellmon Amendment grew out of congressional concerns about the increasing number of disability decisions being appealed to AUs, the high number of allowance decisions issued by AUs, the accuracy of those decisions, and the policy that only AU decisions denying claims were subject to review. H.R.Rep. No. 944, 96th Cong., 2d Sess. 57, reprinted in [1980] U.S.Code Cong. & Ad.News 1392, 1405; S.Rep. No. 408, 96th Cong., 2d Sess. 53, reprinted in [1980] U.S.Code Cong. & Ad.News 1277, 1331.

In response to the Bellmon Amendment, the Secretary established the Bellmon Review Program, which was announced in Social Security Ruling (“SSR”) 82-13. 2 The program was described in detail in a memorandum, 3 dated September 24, 1982, from Louis B. Hays, Associate Commissioner of the SSA Office of Hearings and Appeals, to all SSA AUs. According to the Hays memorandum, the program was begun on October 1, 198Í. The program provided for own-motion review of AU decisions allowing disability benefits under Title II of the Social Security Act or allowing both disability and SSI benefits under Titles II and XVI of the Social Security Act. AUs with individual allowance rates 4 of 70 percent or higher and AUs in hearing offices with aggregate allowance rates of 74 percent or higher were targeted for review. Half of the allowance decisions issued by targeted AUs were evaluated by the Office of Hearings and Appeals for possible review, and 7V2 percent of the allowance decisions issued by these AUs were formally reviewed by the Appeals Council. On April 1, 1982, the targeted AUs were divided into four groups based on own-motion rates. 5 Each and every allowance decision by AUs in the group with the highest own-motion rates was evaluated for possible review. In the group with the second-highest rates, 75 percent of the AUs’ allowance decisions were thus evaluated; in the group with the third-highest rates, 50 percent; and in the group with *794 the lowest rates, 25 percent. In addition, the program was expanded so that 15 percent of all allowance decisions by targeted AUs were formally reviewed by the Appeals Council. Finally, the program was expanded to provide review of a national random sample of AU allowance decisions, AU decisions referred from the SSA Office of Disability Operations, and decisions of all new AUs.

While the record does not clearly set forth more recent developments concerning the Bellmon Review Program, the court understands that in early 1983 the Secretary ceased to target AUs for review based on allowance rates. The Secretary continued, however, to target AUs for review based on own-motion rates calculated from cases evaluated or reviewed as part of the national random sample. For a brief period, The Bellmon Review Program included some unappealed denial decisions issued by AUs with high grant-review rates. 6 On June 21, 1984, the Secretary eliminated from the Bellmon Review Program all review targeted at particular AUs on the basis of prior performance.

Under the Bellmon Review Program, four AUs in the State of Washington were targeted for review beginning October 1, 1981. Attachment to Letter of November 4, 1982, from P.J. Kurapka to William Rutzick, filed as Attachment to Declaration of Kristin Houser, May 3, 1984. Two more, including AU George W. Wise, who heard plaintiff’s case, were targeted based on allowance rates for the six-month period ending January 1,1982. Id. The AU decision in plaintiff’s case was therefore among the decisions reviewed by the Appeals Council as a consequence of the decisionmaker’s high allowance rate.

Plaintiff filed this action on June 24, 1983. In the Complaint, plaintiff alleges that the Appeals Council decision to terminate his benefits was not supported by substantial evidence and was based on errors of law. He therefore seeks reversal of the Appeals Council decision. He further alleges that the Bellmon Review Program, as outlined in SSR 82-13 and the Hays memorandum, was improperly adopted without APA notice and comment procedures. He therefore seeks an injunction against enforcement of all Appeals Council decisions in cases reviewed under the Bellmon Review Program. 7 Plaintiff’s APA claim focuses on the Secretary’s former practice of targeting high allowance AUs for own-motion review.

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Bluebook (online)
629 F. Supp. 791, Counsel Stack Legal Research, https://law.counselstack.com/opinion/wc-v-heckler-wawd-1986.