AR 99-4(11)
EFFECTIVE/PUBLICATION DATE: 10/26/1999
Acquiescence Ruling 99-4 (11)
Bloodsworth v. Heckler, 703 F.2d 1233 (11th Cir. 1983) — Judicial Review of an Appeals Council Dismissal of a Request for Review of an Administrative Law Judge Decision—Titles II and XVI of the Social Security Act.
Issue:
Whether a dismissal by the Appeals Council of a request for review of an ALJ decision is a "final decision" which is judicially reviewable.
Statute/Regulation/Ruling Citation:
Sections 205(g) and (h) and 1631(c)(3) of the Social Security Act (42 U.S.C. sections 405(g) and (h) and 1383(c)(3)); 20 CFR 404.955, 404.967, 404.968, 404.971, 404.972, 404.981, 404.982, 416.1455, 416.1467, 416.1468, 416.1471, 416.1472, 416.1481, 416.1482 and 422.210.
Circuit:
Eleventh (Alabama, Florida, Georgia)
Bloodsworth v. Heckler, 703 F.2d 1233 (11th Cir. 1983)
Applicability of Ruling:
This Ruling applies only to the Appeals Council dismissals of requests for review of ALJ decisions.
Description of Case:
In 1979, Mr. Jack Bloodsworth, the claimant in this case, filed applications for a period of disability, disability insurance benefits, and supplemental security income payments. The applications were denied initially, on reconsideration, and by an ALJ after a hearing. The claimant missed the 60-day time limit for filing his request for review of the ALJ's decision to the Appeals Council because it was filed approximately two weeks after the deadline. Therefore, the Appeals Council dismissed the request for review on the basis of untimeliness without good cause.
The claimant then filed a complaint in Federal district court, alleging that denial of the extension of time to file was not supported by substantial evidence. The district court rejected the Social Security Administration's (SSA) argument that it lacked jurisdiction, reviewed the Appeals Council's denial of an extension of time, and remanded the case for consideration of the merits of the claim.[1] On remand, the Appeals Council restated its position that the claimant's request for review was untimely filed, but considered the claim on the merits as ordered, and denied the claimant's request for review. The district court affirmed the decision and the claimant appealed. On appeal, SSA again argued that the district court lacked jurisdiction.[2]
Holding:
The Eleventh Circuit held that an Appeals Council dismissal of a request for review of an ALJ decision for reasons of untimeliness is a "final decision of the Secretary made after a hearing" within the meaning of section 205(g) of the Social Security Act[3] and, therefore, subject to judicial review.
Regarding the right to judicial review, the Eleventh Circuit stated that neither the statute nor the regulations make any distinction between Appeals Council dismissals and "determinations on the merits." The court found that both actions are equally final and that both trigger a right to review by the district court. The court interpreted 20 CFR 404.972 and 404.981[4] to provide that "an Appeals Council review determination, on whatever grounds, is perceived as the appropriately 'final decision' from which to take an appeal to the district court under section 405(g)."
Statement as to How Bloodsworth Differs From SSA's Interpretation of the Regulations
The Eleventh Circuit held that an Appeals Council dismissal of a request for review of an ALJ decision is a "final decision of the Secretary made after a hearing" (now a "final decision of the Commissioner of Social Security") within the meaning of section 205(g) of the Social Security Act and, therefore, subject to judicial review.[5]
Contrary to the holding of the court in Bloodsworth, SSA policy is that the regulations make a clear distinction in regard to rights of judicial review between dismissals and determinations on the merits by the Appeals Council. The Appeals Council may take three types of action following an ALJ decision: (1) it may grant a request for review; (2) it may deny a request for review; or (3) it may dismiss a request for review. The dismissal of a request for review of an ALJ decision is binding and not subject to further review. 20 CFR 404.972, 416.1472. See also 20 CFR 404.955, 416.1455, 422.210. The Appeals Council will dismiss a request for review if it is untimely filed and the time for filing has not been extended.[6] The Appeals Council may also dismiss a request for review for other prescribed reasons. 20 CFR 404.971, 416.1471.
SSA's position, based on the above-cited regulations, is that an Appeals Council dismissal is not a "final decision of the Commissioner of Social Security made after a hearing." Therefore, such a dismissal is not judicially reviewable under section 205(g) of the Social Security Act (42 U.S.C. 405(g)).
Explanation of How SSA Will Apply The Bloodsworth Decision Within the Circuit
This Ruling applies only to cases involving claimants who reside in Alabama, Florida, or Georgia at the time of the Appeals Council dismissal of the request for review.
Notices sent by the Appeals Council which dismiss requests for review of ALJ decisions will advise claimants in these states of their right to request judicial review.
[1] Under the Social Security Independence and Program Improvements Act of 1994, Pub.L.No. 103-296, effective March 31, 1995, Social Security Administration (SSA) became an independent Agency in the Executive Branch of the United States Government and was provided ultimate responsibility for administering the Social Security and Supplemental Security Income programs under titles II and XVI of the Act. Prior to March 31, 1995, the Secretary of Health and Human Services had such responsibility.
[2] The Government argued that the district court lacked subject matter jurisdiction under sections 205(g) and (h) of the Social Security Act (42 U.S.C. section 405(g) and (h)) because the plaintiff failed to meet the "final decision" and "made after a hearing" requirements of these sections. The Government contended that: (1) dismissal of a request for review on the basis of untimeliness without "good cause" is not a "final decision" for it does not constitute a determination on the merits; and (2) it is not "made after a hearing" because no hearing is granted solely and specifically on the request for review itself.
[3] Section 205(g) of the Social Security Act (42 U.S.C. section 405(g)) currently provides in pertinent part that "[a]ny individual, after any final decision of the Commissioner of Social Security made after a hearing to which he was a party, . . . may obtain a review of such decision by a civil action commenced within sixty days after the mailing to him of notice of such decision or within such further time as the Commissioner of Social Security may allow." At the time of the decision in Bloodsworth, however, the statute referred to a "final decision of the Secretary."
[4] 20 CFR 404.981 and 416.1481 state, in pertinent part, that "[t]he Appeals Council's decision, or the decision of the administrative law judge if the request for review is denied, is binding unless you or another party file an action in Federal district court, or the decision is revised."
[5] As the Supreme Court has noted, the term "final decision" is not defined in the Social Security Act, but the Act gives authority to the agency to prescribe its meaning by regulation. Weinberger v. Salfi, 422 U.S. 749, 766 (1975).
[6] The Appeals Council, upon good cause shown, may extend the time for filing a request for review of an ALJ decision. 20 CFR 404.968(b), 416.1468(b).