White v. Mathews

434 F. Supp. 1252, 1976 U.S. Dist. LEXIS 12985
CourtDistrict Court, D. Connecticut
DecidedSeptember 29, 1976
DocketCiv. H-75-34
StatusPublished
Cited by17 cases

This text of 434 F. Supp. 1252 (White v. Mathews) is published on Counsel Stack Legal Research, covering District Court, D. Connecticut primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
White v. Mathews, 434 F. Supp. 1252, 1976 U.S. Dist. LEXIS 12985 (D. Conn. 1976).

Opinion

RULING ON CROSS MOTIONS FOR SUMMARY JUDGMENT AND ON MOTION TO DISMISS

CLARIE, Chief Judge.

The plaintiff, George White, brought this action on behalf of himself and other Connecticut residents who are attempting to assert claims for Social Security disability benefits under 42 U.S.C. § 423, but whose appeals from adverse agency action have been impeded by extensive delays in the scheduling and completion of hearings before an administrative law judge, as provided for in 42 U.S.C. § 405(b) and 20 C.F.R. § 404.917. Plaintiff’s class was certified by this Court on July 18, 1975. 1 Defendant, *1254 the Secretary of the Department of Health, Education and Welfare (HEW), has moved for dismissal based on lack of subject matter jurisdiction and upon mootness. Plaintiff and defendant have in addition entered cross-motions for summary judgment on the merits.

The affidavits and pleadings reveal that this case is a proper one for treatment by summary judgment, there being no genuine issue as to any material fact separating the parties. Defendant’s motion to dismiss is denied, since the Court finds that the case is not moot and the exercise of jurisdiction is not precluded by 42 U.S.C. §§ 405(g) and (h). The plaintiff’s motion for summary judgment is granted and the Court finds that the existing delay in processing appeals from adverse agency action is so great as to deprive the plaintiff of his statutory right and his constitutional guarantee of equal protection and due process.

FACTS

There is no dispute as to the central facts in this case, the parties having entered into a stipulation. The named plaintiff, 2 a man in his fifties, applied to the Social Security Administration (SSA) for disability benefits in July of 1972, complaining of a variety of physical disabilities, including laennec’s cirrhosis and chronic and acute pancreatitis. At that time he was declared totally disabled and began to receive benefits. As a result of a periodic re-examination begun in September of 1973, however, plaintiff was informed — on December 27, 1973 — that he was no longer considered disabled. His benefits were terminated as of January 31, 1974.

He then applied to have his case reconsidered by the SSA, and was informed on July 11, 1974 that his application had been denied. White then petitioned on July 29, 1974 for a hearing before an administrative law judge. No hearing was held on the matter, however, until April 29, 1975, and the final decision was not rendered thereon until May 21, 1975, when the SSA’s earlier decision to terminate White’s benefits was upheld. 3 In all, 306 days passed between the date of plaintiff’s petition for a hearing and the issuance of the final decision.

The plaintiff’s experience with the SSA appeals process is not unique. As a result of various factors discussed in more detail below, an extremely large backlog of cases has developed in the SSA’s Hearings and Appeals Bureau. In April of 1975, there was a record total backlog of 113,000 pending cases nationwide. 4 The result has been a chronic delay in the disposition of appeals. During the period between January 1973 and March 1975 the average waiting period between an initial request for a hearing and the entry of a final decision was 195.2 days nationally, and 211.8 days for petitions in Connecticut 5 — or, approximately six and one-half and seven months respectively. It is of these general lengthy and persistent delays that the plaintiff complains.

*1255 (a) The Social Security Disability System

To establish disability 6 under Title II of the Social Security Act, a wage earner must provide “such medical and other evidence of the existence [of the disability] as the Secretary may require” in support of the application. 42 U.S.C. § 423(d)(5). This evidence must establish disability by means of “medically acceptable clinical and diagnostic techniques.” Id. § 423(d)(3). And it must be shown that the disability in question is sufficiently great that

“[the wage earner] 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, regardless of whether such work exists in the immediate area in which he lives, or whether a specific job vacancy exists for him, or whether he would be hired if he applied for work.” Id. § 423(d)(2)(A).

To qualify for disability benefits, then, the worker’s disability must be total, such that no “substantial gainful work” opportunity exists. The level of benefit payments is based on a variety of factors, including age and the prior average monthly earnings of the worker while employed. Eligibility under Title II of the Social Security Act is not based directly on financial need.

If it is determined that an individual is not disabled, either on an initial application or as the result of a periodic re-examination, a “redetermination hearing” may be sought with the SSA to review the case. 7 This review is undertaken on the basis of forms and affidavits submitted to the Agency by the applicant; no face to face meeting takes place at this time. 8

Should the result of the redetermination hearing be adverse to the applicant, he may then petition for a hearing before an administrative law judge. 9 At this stage a full evidentiary hearing is held with the applicant in attendance. If the result is again unfavorable, a final discretionary review may be sought before the Appeals Council of the SSA Hearings and Appeals Bureau. 10 It was this latter Council that finally overturned the original determination made with respect to plaintiff White in this case.

To judge from the number of reversals at the administrative law judge stage of appellate review the “error rate” in SSA disability determinations is substantial. The incidence of reversals by administrative law judges exceeds 50 percent of all the cases heard. 11 The reversal rate is much lower, to be sure, when measured against the total number of original denials, many of which are not appealed. 12

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Bluebook (online)
434 F. Supp. 1252, 1976 U.S. Dist. LEXIS 12985, Counsel Stack Legal Research, https://law.counselstack.com/opinion/white-v-mathews-ctd-1976.