Smith v. Berryhill ( 2019 )


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  • (Slip Opinion)              OCTOBER TERM, 2018                                       1
    Syllabus
    NOTE: Where it is feasible, a syllabus (headnote) will be released, as is
    being done in connection with this case, at the time the opinion is issued.
    The syllabus constitutes no part of the opinion of the Court but has been
    prepared by the Reporter of Decisions for the convenience of the reader.
    See United States v. Detroit Timber & Lumber Co., 
    200 U. S. 321
    , 337.
    SUPREME COURT OF THE UNITED STATES
    Syllabus
    SMITH v. BERRYHILL, ACTING COMMISSIONER OF
    SOCIAL SECURITY
    CERTIORARI TO THE UNITED STATES COURT OF APPEALS FOR
    THE SIXTH CIRCUIT
    No. 17–1606.       Argued March 18, 2019—Decided May 28, 2019
    The Social Security Act permits judicial review of “any final decision . . .
    after a hearing” by the Social Security Administration (SSA). 
    42 U. S. C. §405
    (g). Claimants for, as relevant here, supplemental secu-
    rity income disability benefits under Title XVI of the Act must gener-
    ally proceed through a four-step administrative process in order to
    obtain federal-court review: (1) seek an initial determination of eligi-
    bility; (2) seek reconsideration of that determination; (3) request a
    hearing before an administrative law judge (ALJ); and (4) seek re-
    view of the ALJ’s decision by the SSA’s Appeals Council. See 
    20 CFR §416.1400
    . A request for Appeals Council review generally must be
    made within 60 days of receiving the ALJ’s ruling, §416.1468; if the
    claimant misses the deadline and cannot show good cause for doing
    so, the Appeals Council dismisses the request, §416.1471.
    Petitioner Ricky Lee Smith’s claim for disability benefits under
    Title XVI was denied at the initial-determination stage, upon recon-
    sideration, and on the merits after a hearing before an ALJ. The Ap-
    peals Council later dismissed Smith’s request for review as untimely.
    Smith sought judicial review of the dismissal in a Federal District
    Court, which held that it lacked jurisdiction to hear the suit. The
    Sixth Circuit affirmed, maintaining that the Appeals Council’s dis-
    missal of an untimely petition is not a “final decision” subject to fed-
    eral-court review.
    Held: An Appeals Council dismissal on timeliness grounds after a
    claimant has had an ALJ hearing on the merits qualifies as a “final
    decision . . . made after a hearing” for purposes of allowing judicial
    review under §405(g). Pp. 5–16.
    (a) The statute’s text supports this reading. In the first clause
    2                         SMITH v. BERRYHILL
    Syllabus
    (“any final decision”), the phrase “final decision” clearly denotes some
    kind of terminal event, and Congress’ use of “any” suggests an intent
    to use that term “expansive[ly],” Ali v. Federal Bureau of Prisons, 
    552 U. S. 214
    , 218–219. The Appeals Council’s dismissal of Smith’s claim
    fits that language: The SSA’s regulations make it the final stage of
    review. See 
    20 CFR §416.1472
    . As for the second clause (“made after
    a hearing”), Smith obtained the kind of hearing that §405(g) most
    naturally suggests: an ALJ hearing on the merits. This case differs
    from Califano v. Sanders, 
    430 U. S. 99
    , where the Court found that
    the SSA’s denial of a claimant’s petition to reopen a prior denial of
    his claim for benefits—a second look that the agency had made avail-
    able to claimants as a matter of grace—was not a final decision under
    §405(g). Here, by contrast, the SSA’s “final decision” is much more
    closely tethered to the relevant “hearing.” A primary application for
    benefits may not be denied without an ALJ hearing (if requested),
    §405(b)(1), and a claimant’s access to this first bite at the apple is a
    matter of legislative right rather than agency grace. There is also no
    danger here of thwarting Congress’ own deadline, where the only po-
    tential untimeliness concerns Smith’s request for Appeals Council re-
    view, not his request for judicial review following the agency’s ulti-
    mate determination. Pp. 6–9.
    (b) The statutory context also weighs in Smith’s favor. Appeals
    from SSA determinations are, by their nature, appeals from the ac-
    tion of a federal agency. In the separate administrative-law context
    of Administrative Procedure Act (APA) review, an action is “final” if
    it both (1) “mark[s] the ‘consummation’ of the agency’s decisionmak-
    ing process” and (2) is “one by which ‘rights or obligations have been
    determined,’ or from which ‘legal consequences will flow.’ ” Bennett v.
    Spear, 
    520 U. S. 154
    , 177–178. Both conditions are satisfied when a
    Social Security claimant has reached the final step of the SSA’s four-
    step process and has had his request for review dismissed as untime-
    ly. While the administrative-exhaustion requirement “should be ap-
    plied with regard for the particular administrative scheme at issue,”
    Weinberger v. Salfi, 
    422 U. S. 749
    , 765, the differences between the
    two Acts here suggest that Congress wanted more oversight by the
    courts rather than less under §405(g) and that “Congress designed
    [the statute as a whole] to be ‘unusually protective’ of claimants,”
    Bowen v. City of New York, 
    476 U. S. 467
    , 480. SSA is also a massive
    enterprise and mistakes will occur; Congress did not suggest that it
    intended for this claimant-protective statute to leave a claimant with
    no recourse to the courts if a mistake does happen. Pp. 9–10.
    (c) Smith’s entitlement to judicial review is confirmed by “the
    strong presumption that Congress intends judicial review of adminis-
    trative action.” Bowen v. Michigan Academy of Family Physicians,
    Cite as: 587 U. S. ____ (2019)                      3
    Syllabus
    
    476 U. S. 667
    , 670. The heavy burden for rebutting this presumption
    is not met here. Congress left it to the SSA to define the procedures
    that claimants like Smith must first pass through, but it has not sug-
    gested that it intended for the SSA to be the unreviewable arbiter of
    whether claimants have complied with those procedures. Pp. 10–11.
    (d) The arguments of amicus in support of the judgment do not
    alter this conclusion. Amicus first argues that the phrase “final deci-
    sion . . . made after a hearing” refers to a conclusive disposition, after
    exhaustion, of a benefits claim on the merits. However, this Court’s
    precedents do not support that reading; the Appeals Council’s dismis-
    sal is not merely collateral but an end to a proceeding in which a sub-
    stantial factual record has already been developed and on which con-
    siderable resources have already been expended; and Smith’s case is
    distinct from Sanders. Amicus also claims that permitting greater
    judicial review could risk a flood of litigation, given the large volume
    of claims handled by the SSA, but that result is unlikely, because the
    number of Appeals Council untimeliness dismissals is comparatively
    small, and because data from the Eleventh Circuit, which follows the
    interpretation adopted here, do not bear out amicus’ warning. Third,
    amicus flags related contexts that could be informed by this ruling,
    but those issues are not before the Court. Finally, amicus argues
    that §405(g) is ambiguous and that the SSA’s longstanding interpre-
    tation of its meaning—prior to a change of position in this case—is
    entitled to deference under Chevron U. S. A. Inc. v. Natural Re-
    sources Defense Council, Inc., 
    467 U. S. 837
    , but this is not the kind of
    question on which courts defer to agencies. Pp. 11–14.
    (e) A reviewing court that disagrees with the procedural ground for
    the Appeals Council dismissal should in the ordinary case remand
    the case to allow the agency to address substantive issues in the first
    place. While there would be jurisdiction for a court to reach the mer-
    its, this general rule comports with fundamental administrative-law
    principles and is confirmed by the Court’s cases discussing exhaus-
    tion in the Social Security context, see City of New York, 
    476 U. S., at 485
    . Pp. 14–16.
    
    880 F. 3d 813
    , reversed and remanded.
    SOTOMAYOR, J., delivered the opinion for a unanimous Court.
    Cite as: 587 U. S. ____ (2019)                              1
    Opinion of the Court
    NOTICE: This opinion is subject to formal revision before publication in the
    preliminary print of the United States Reports. Readers are requested to
    notify the Reporter of Decisions, Supreme Court of the United States, Wash-
    ington, D. C. 20543, of any typographical or other formal errors, in order
    that corrections may be made before the preliminary print goes to press.
    SUPREME COURT OF THE UNITED STATES
    _________________
    No. 17–1606
    _________________
    RICKY LEE SMITH, PETITIONER v. NANCY A.
    BERRYHILL, ACTING COMMISSIONER
    OF SOCIAL SECURITY
    ON WRIT OF CERTIORARI TO THE UNITED STATES COURT OF
    APPEALS FOR THE SIXTH CIRCUIT
    [May 28, 2019]
    JUSTICE SOTOMAYOR delivered the opinion of the Court.
    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). Peti-
    tioner Ricky Lee Smith was denied Social Security bene-
    fits 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 Coun-
    cil’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, re-
    sponding 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
    2                      SMITH v. BERRYHILL
    Opinion of the Court
    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 deci-
    sion[s].” §405(b)(1). Third, and most centrally, Congress
    provided for judicial review of “any final decision of the
    [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 (1984).
    In 1940, the Social Security Board created the Appeals
    Council, giving it responsibility for overseeing and review-
    ing 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 bene-
    ——————
    1 See Koch & Koplow, The Fourth Bite at the Apple: A Study of the
    Operation and Utility of the Social Security Administration’s Appeals
    Council, 
    17 Fla. St. U. L. Rev. 199
    , 234–235 (1990) (Koch & Koplow).
    2 See 
    id., at 235
    .
    3 SSA, Brief History and Current Information About the Appeals
    Council, https://www.ssa.gov/appeals/about_ac.html (all Internet mate-
    rials as last visited May 22, 2019).
    Cite as: 587 U. S. ____ (2019)                     3
    Opinion of the Court
    fits under two programs, known by their statutory head-
    ings as Title II and Title XVI. See §401 et seq. (Title II);
    §1381 et seq. (Title XVI). Title II “provides old-age, survi-
    vor, and disability benefits to insured individuals irrespec-
    tive of financial need.” Bowen v. Galbreath, 
    485 U. S. 74
    ,
    75 (1988). Title XVI provides supplemental security in-
    come 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 (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
    ——————
    4 Because Smith seeks benefits under Title XVI, we cite to the regula-
    tions that govern Title XVI, which are located at 20 CFR pt. 416 (2018).
    The regulations that govern Title II are located at 20 CFR pt. 404.
    5 Of course, if the result at any of the four preceding stages is fully
    favorable, there is generally no need to proceed further.
    4                   SMITH v. BERRYHILL
    Opinion of the Court
    §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 purposes of allowing judicial review under §405(g).
    B
    Petitioner Ricky Lee Smith applied for disability bene-
    fits under Title XVI in 2012. Smith’s claim was denied at
    the initial-determination stage and upon reconsideration.
    Smith then requested an ALJ hearing, which the ALJ held
    in February 2014 before issuing a decision denying
    Smith’s claim on the merits in March 2014.
    The parties dispute what happened next. Smith’s attor-
    ney says that he sent a letter requesting Appeals Council
    review in April 2014, well within the 60-day deadline. The
    SSA says that it has no record of receiving any such letter.
    In late September 2014, Smith’s attorney sent a copy of
    the letter that he assertedly had mailed in April. The
    SSA, noting that it had no record of prior receipt, counted
    the date of the request as the day that it received the copy.
    The Appeals Council accordingly determined that Smith’s
    submission was untimely, concluded that Smith lacked
    good cause for missing the deadline, and dismissed
    Smith’s request for review.
    Smith sought judicial review of that dismissal in the
    U. S. District Court for the Eastern District of Kentucky.
    The District Court held that it lacked jurisdiction to hear
    his suit. The U. S. Court of Appeals for the Sixth Circuit
    affirmed, maintaining that “an Appeals Council decision to
    refrain from considering an untimely petition for review is
    not a ‘final decision’ subject to judicial review in federal
    court.’ ” Smith v. Commissioner of Social Security, 880
    Cite as: 587 U. S. ____ (2019)                   5
    Opinion of the Court
    F. 3d 813, 814 (2018).
    Smith petitioned this Court for certiorari. Responding
    to Smith’s petition, the Government stated that while the
    Sixth Circuit’s decision accorded with the SSA’s longstand-
    ing position, the Government had “reexamined the ques-
    tion and concluded that its prior position was incorrect.”
    Brief for Respondent on Pet. for Cert. 15.
    We granted certiorari to resolve a conflict among the
    Courts of Appeals. 586 U. S. ___ (2018).6 Because the
    Government agrees with Smith that the Appeals Council’s
    dismissal meets §405(g)’s terms, we appointed Deepak
    Gupta as amicus curiae to defend the judgment below.
    586 U. S. ___ (2018). He has ably discharged his duties.
    II
    Section 405(g), as noted above, provides for judicial
    review of “any final decision . . . made after a hearing.”
    This provision, the Court has explained, contains two
    separate elements: first, a “jurisdictional” requirement
    that claims be presented to the agency, and second, a
    “waivable . . . requirement that the administrative reme-
    dies prescribed by the Secretary be exhausted.” Mathews
    v. Eldridge, 
    424 U. S. 319
    , 328 (1976). This case involves
    the latter, nonjurisdictional element of administrative
    exhaustion. While §405(g) delegates to the SSA the au-
    thority to dictate which steps are generally required, see
    Sims, 
    530 U. S., at 106
    , exhaustion of those steps may not
    ——————
    6 Seven Courts of Appeals have held that there is no judicial review
    under these circumstances, while two have held that there is. Compare
    Brandtner v. Department of Health & Human Servs., 
    150 F. 3d 1306
    ,
    1307 (CA10 1998); Bacon v. Sullivan, 
    969 F. 2d 1517
    , 1520 (CA3 1992);
    Matlock v. Sullivan, 
    908 F. 2d 492
    , 494 (CA9 1990); Harper v. Bowen,
    
    813 F. 2d 737
    , 743 (CA5 1987); Adams v. Heckler, 
    799 F. 2d 131
    , 133
    (CA4 1986); Smith v. Heckler, 
    761 F. 2d 516
    , 518 (CA8 1985); Dietsch v.
    Schweiker, 
    700 F. 2d 865
    , 867 (CA2 1983), with Casey v. Berryhill, 
    853 F. 3d 322
    , 326 (CA7 2017); Bloodsworth v. Heckler, 
    703 F. 2d 1233
    ,
    1239 (CA11 1983).
    6                       SMITH v. BERRYHILL
    Opinion of the Court
    only be waived by the agency, see Weinberger v. Salfi, 
    422 U. S. 749
    , 767 (1975), but also excused by the courts, see
    Bowen v. City of New York, 
    476 U. S. 467
    , 484 (1986);
    Eldridge, 
    424 U. S., at 330
    .7
    The question here is whether a dismissal by the Appeals
    Council on timeliness grounds after a claimant has re-
    ceived an ALJ hearing on the merits qualifies as a “final
    decision . . . made after a hearing” for purposes of allowing
    judicial review under §405(g). In light of the text, the
    context, and the presumption in favor of the reviewability
    of agency action, we conclude that it does.
    A
    We begin with the text. Taking the first clause (“any
    final decision”) first, we note that the phrase “final deci-
    sion” clearly denotes some kind of terminal event,8 and
    Congress’ use of the word “any” suggests an intent to use
    that term “expansive[ly],” see Ali v. Federal Bureau of
    Prisons, 
    552 U. S. 214
    , 218–219 (2008). The Appeals
    Council’s dismissal of Smith’s claim fits that language:
    Under the SSA’s own regulations, it was the final stage of
    ——————
    7 While Califano v. Sanders, 
    430 U. S. 99
     (1977), can be read to cabin
    Eldridge and Salfi to only constitutional claims, the Court’s subsequent
    decision in City of New York demonstrates that this understanding of
    §405(g) can extend to cases lacking Eldridge’s and Salfi’s constitutional
    character. See City of New York, 
    476 U. S., at
    474–475, and n. 5, 482–
    484; see also City of New York v. Heckler, 
    578 F. Supp. 1109
    , 1124–1125
    (EDNY 1984) (ruling that the agency’s actions violated the Social
    Security Act and its own regulations and thus declining to reach the
    plaintiffs’ constitutional argument).
    8 See 5 Oxford English Dictionary 920 (2d ed. 1989) (Final: “Marking
    the last stage of a process; leaving nothing to be looked for or expected;
    ultimate”); 4 Oxford English Dictionary 222 (1933) (same); see also
    Webster’s New World College Dictionary 542 (5th ed. 2016) (Final:
    “leaving no further chance for action, discussion, or change; deciding;
    conclusive”); Merriam-Webster’s Collegiate Dictionary 469 (11th ed.
    2011) (Final: “coming at the end: being the last in a series, process, or
    progress”).
    Cite as: 587 U. S. ____ (2019)                     7
    Opinion of the Court
    review. See 
    20 CFR §416.1472
    .
    Turning to the second clause (“made after a hearing”),
    we note that this phrase has been the subject of some
    confusion over the years. On the one hand, the statute
    elsewhere repeatedly uses the word “hearing” to signify an
    ALJ hearing,9 which suggests that, in the ordinary case,
    the phrase here too denotes an ALJ hearing. See, e.g.,
    IBP, Inc. v. Alvarez, 
    546 U. S. 21
    , 34 (2005) (noting “the
    normal rule of statutory interpretation that identical
    words used in different parts of the same statute are
    generally presumed to have the same meaning”). On the
    other hand, the Court’s precedents make clear that an
    ALJ hearing is not an ironclad prerequisite for judicial
    review. See, e.g., City of New York, 
    476 U. S., at 484
     (em-
    phasizing the Court’s “ ‘intensely practical’ ” approach to
    the applicability of the exhaustion requirement and disap-
    proving “mechanical application” of a set of factors).
    There is no need today to give §405(g) a definition for all
    seasons, because, in any event, this is a mine-run case and
    Smith obtained the kind of hearing that §405(g) most
    naturally suggests: an ALJ hearing on the merits.10 In
    other words, even giving §405(g) a relatively strict read-
    ——————
    9 See 
    42 U. S. C. §405
    (b)(1) (entitling claimants to a hearing on the
    merits); §405(b)(2) (discussing “reconsideration” of certain findings
    “before any hearing under paragraph (1) on the issue of such entitle-
    ment”); §405(g) (discussing factual findings and evidence resulting from
    such a “hearing”); §405(h) (discussing binding effect of decision “after a
    hearing”); see also §§1383(c)(1)(A), (3) (similar).
    10 We note as well that the “hearing” referred to in §405(g) cannot be
    a hearing before the Appeals Council. Congress provided for a hearing
    in §405(b) and for judicial review “after a hearing” in §405(g) before the
    Appeals Council even existed. See supra, at 2. Moreover, the Appeals
    Council makes many decisions without a hearing—e.g., denying a
    petition for review without giving reasons—that are nevertheless
    plainly reviewable. See 
    20 CFR §§ 416.1400
    (a)(5), 416.1467, 416.1481.
    Accordingly, the fact that there was no Appeals Council hearing—much
    like the fact that there was no reasoned Appeals Council decision on
    the merits—does not bar review.
    8                       SMITH v. BERRYHILL
    Opinion of the Court
    ing, Smith appears to satisfy its terms.11
    Smith cannot, however, satisfy §405(g)’s “after a hear-
    ing” requirement as a matter of mere chronology.12 In
    Califano v. Sanders, 
    430 U. S. 99
     (1977), the Court consid-
    ered whether the SSA’s denial of a claimant’s petition to
    reopen a prior denial of his claim for benefits qualified as a
    final decision under §405(g). Id., at 102–103, 107–109.
    The Court concluded that it did not, reasoning that a
    petition to reopen was a matter of agency grace that could
    be denied without a hearing altogether and that allowing
    judicial review would thwart Congress’ own deadline for
    seeking such review. See id., at 108–109. That the SSA’s
    denial of the petition to reopen (1) was conclusive and (2)
    postdated an ALJ hearing did not, alone, bring it within
    the meaning of §405(g).
    Here, by contrast, the SSA’s “final decision” is much
    more closely tethered to the relevant “hearing.” Unlike a
    petition to reopen, a primary application for benefits may
    not be denied without an ALJ hearing (assuming the
    claimant timely requests one, as Smith did). §405(b)(1).
    Moreover, the claimant’s access to this first bite at the
    apple is indeed a matter of legislative right rather than
    agency grace. See id., at 108. And, again unlike the
    situation in Sanders, there is no danger here of thwarting
    Congress’ own deadline, given that the only potential
    untimeliness here concerns Smith’s request for Appeals
    ——————
    11 We
    return below to the possibility, suggested by amicus, that “final
    decision . . . made after a hearing” could signify a final decision “on a
    matter on which the Act requires a hearing.” Brief for Court-Appointed
    Amicus Curiae 13; see infra, at 11–12. Here, we note only that while
    Congress certainly could have written something like “final decision on
    the merits . . . made after a hearing,” it did not.
    12 The alternative risks untenable breadth. The Battle of Yorktown
    predates our ruling today, but no one would describe today’s opinion as
    a “decision made after the Battle of Yorktown.” As we explain, how-
    ever, the dismissal of Smith’s claim is tethered to Smith’s hearing in a
    way that more distant events are not.
    Cite as: 587 U. S. ____ (2019)                    9
    Opinion of the Court
    Council review—not his request for judicial review follow-
    ing the agency’s ultimate determination.
    B
    The statutory context weighs in Smith’s favor as well.
    Appeals from SSA determinations are, by their nature,
    appeals from the action of a federal agency, and in the
    separate administrative-law context of the Administrative
    Procedure Act (APA), an action is “final” if it both (1)
    “mark[s] the ‘consummation’ of the agency’s decisionmak-
    ing process” and (2) is “one by which ‘rights or obligations
    have been determined,’ or from which ‘legal consequences
    will flow.’ ” Bennett v. Spear, 
    520 U. S. 154
    , 177–178
    (1997). Both conditions are satisfied when a Social Secu-
    rity claimant has reached the fourth and final step of the
    SSA’s four-step process and has had his request for review
    dismissed as untimely. It is consistent to treat the Ap-
    peals Council’s dismissal of Smith’s claim as a final deci-
    sion as well.
    To be clear, “the doctrine of administrative exhaustion
    should be applied with a regard for the particular admin-
    istrative scheme at issue,” Salfi, 
    422 U. S., at 765
    , and we
    leave this axiom undisturbed today. The Social Security
    Act and the APA are different statutes, and courts must
    remain sensitive to their differences. See, e.g., Sullivan v.
    Hudson, 
    490 U. S. 877
    , 885 (1989) (observing that “[a]s
    provisions for judicial review of agency action go, §405(g)
    is somewhat unusual” in that its “detailed provisions . . .
    suggest a degree of direct interaction between a federal
    court and an administrative agency alien to” APA review).
    But at least some of these differences suggest that Con-
    gress wanted more oversight by the courts in this context
    rather than less, see ibid.,13 and the statute as a whole is
    ——————
    13 The noteworthy counterpoint is §405(h), which withdraws federal-
    court jurisdiction under 
    28 U. S. C. §§ 1331
    , 1346. While that provision
    clearly serves “to route review through” §405(g), see Sanders, 
    430 U. S., 10
                          SMITH v. BERRYHILL
    Opinion of the Court
    one that “Congress designed to be ‘unusually protective’ of
    claimants,” City of New York, 
    476 U. S., at 480
    .
    We note further that the SSA is a massive enterprise,14
    and mistakes will occur. See Brief for National Organiza-
    tion of Social Security Claimants’ Representatives as
    Amicus Curiae 13 (collecting examples).15 The four steps
    preceding judicial review, meanwhile, can drag on for
    years.16 While mistakes by the agency may be admirably
    rare, we do not presume that Congress intended for this
    claimant-protective statute, see City of New York, 
    476 U. S., at 480
    , to leave a claimant without recourse to the
    courts when such a mistake does occur—least of all when
    the claimant may have already expended a significant
    amount of likely limited resources in a lengthy proceeding.
    C
    Smith’s entitlement to judicial review is confirmed by
    “the strong presumption that Congress intends judicial
    review of administrative action.” Bowen v. Michigan
    Academy of Family Physicians, 
    476 U. S. 667
    , 670 (1986).
    “That presumption,” of course, “is rebuttable: It fails when
    a statute’s language or structure demonstrates that Con-
    ——————
    at 103, n. 3; see also Heckler v. Ringer, 
    466 U. S. 602
    , 614–615 (1984),
    that routing choice does not simultaneously constrict the route that
    Congress did provide.
    14 For example, the agency receives roughly 2.5 million new disability
    claims per year. See SSA, Annual Performance Report Fiscal Years
    2017–2019, p. 32 (Feb. 12, 2018), https://www.ssa.gov/budget/FY19Files/
    2019APR.pdf.
    15 See also Koch & Koplow 257 (noting that each Appeals Council
    member “typically spends only ten to fifteen minutes reviewing an
    average case” given “the pressures of the caseload”).
    16 See SSA, FY 2020 Congressional Justification 9 (Mar. 2019)
    (estimating 2019 average processing time for the first three steps at
    113 days, 105 days, and 515 days, respectively), https://www.
    ssa.gov/budget/FY20Files/FY20-JEAC.pdf; Brief for National Organ-
    ization of Social Security Claimants’ Representatives as Amicus
    Curiae 11.
    Cite as: 587 U. S. ____ (2019)                  11
    Opinion of the Court
    gress wanted an agency to police its own conduct.” Mach
    Mining, LLC v. EEOC, 
    575 U. S. 480
    , ___–___ (2015) (slip
    op., at 4–5). But the burden for rebutting it is “ ‘heavy,’ ”
    
    id.,
     at ___ (slip op., at 5), and that burden is not met here.
    While Congress left it to the SSA to define the procedures
    that claimants like Smith must first pass through, see
    Sims, 
    530 U. S., at 106
    , Congress has not suggested that it
    intended for the SSA to be the unreviewable arbiter of
    whether claimants have complied with those procedures.
    Where, as here, a claimant has received a claim-ending
    timeliness determination from the agency’s last-in-line
    decisionmaker after bringing his claim past the key proce-
    dural post (a hearing) mentioned in §405(g), there has
    been a “final decision . . . made after a hearing” under
    §405(g).17
    III
    Amicus’ arguments to the contrary have aided our con-
    sideration of this case, but they have not dissuaded us
    from concluding that the Appeals Council’s dismissal of
    Smith’s claim satisfied §405(g).
    Amicus first argues that the phrase “final decision . . .
    made after a hearing” refers to a conclusive disposition,
    after exhaustion, of a benefits claim on the merits—that
    is, on a basis for which the Social Security Act entitles a
    claimant to a hearing. This reading follows, amicus ar-
    gues, from the Court’s observations that §405(g) generally
    requires exhaustion, and moreover from Sanders’ sugges-
    tion, see 
    430 U. S., at 108
    , that review is not called for
    ——————
    17 A different question would be presented by a claimant who assert-
    edly faltered at an earlier step—e.g., whose request for an ALJ hearing
    was dismissed as untimely and who then appealed that determination
    to the Appeals Council before seeking judicial review. While such a
    claimant would not have received a “hearing” at all, the Court’s prece-
    dents also make clear that a hearing is not always required. See supra,
    at 5–6. Because such a situation is not before us, we do not address it.
    12                  SMITH v. BERRYHILL
    Opinion of the Court
    where a claimant loses on an agency-determined proce-
    dural ground that is divorced from the substantive mat-
    ters for which a hearing is required. Even if Smith did
    receive a hearing on the merits, amicus argues, the con-
    clusive determination was not on that basis, and “[i]t
    would be unnatural to read the statute as throwing open
    the gates to judicial review of any final decision, no matter
    how collateral,” just because such a hearing occurred.
    Brief for Court-Appointed Amicus Curiae 34.
    We disagree. First, as noted above, the Court’s prece-
    dents do not make exhaustion a pure necessity, indicating
    instead that while the SSA is empowered to define the
    steps claimants must generally take, the SSA is not also
    the unreviewable arbiter of whether a claimant has suffi-
    ciently complied with those steps. See supra, at 5–6, and
    n. 7. Second, the Appeals Council’s dismissal is not mere-
    ly collateral; such a dismissal calls an end to a proceeding
    in which a substantial factual record has already been
    developed and on which considerable resources have al-
    ready been expended. See supra, at 10, and n. 16. Accept-
    ing amicus’ argument would mean that a claimant could
    make it to the end of the SSA’s process and then have
    judicial review precluded simply because the Appeals
    Council stamped “untimely” on the request, even if that
    designation were patently inaccurate. While there may be
    contexts in which the law is so unforgiving, this is not one.
    See supra, at 9–11.
    Smith’s case, as noted above, is also distinct from Sand-
    ers. See supra, at 8. Sanders, after all, involved the SSA’s
    denial of a petition for reopening—a second look that the
    agency had made available to claimants as a matter of
    grace. See 
    430 U. S., at
    101–102, 107–108. But Smith is
    not seeking a second look at an already-final denial; he
    argues that he was wrongly prevented from continuing to
    pursue his primary claim for benefits. That primary
    claim, meanwhile, is indeed a matter of statutory entitle-
    Cite as: 587 U. S. ____ (2019)                  13
    Opinion of the Court
    ment. See §405(b).
    Amicus also emphasizes that the SSA handles a large
    volume of claims, such that a decision providing for
    greater judicial review could risk a flood of litigation. That
    result seems unlikely for a few reasons. First, the number
    of Appeals Council untimeliness dismissals is compara-
    tively small—something on the order of 2,500 dismissals
    out of 160,000 dispositions per year.18 Second, the inter-
    pretation that Smith and the Government urge has been
    the law since 1983 in the Eleventh Circuit, and the data
    there do not bear out amicus’ warning. See Reply Brief for
    Respondent 14–15 (collecting statistics). Third, while
    amicus flags related contexts that could be informed by
    today’s ruling, see Brief for Court-Appointed Amicus
    Curiae 36–40, those issues are not before us. We therefore
    do not address them other than to reinforce that such
    questions must be considered in the light of “the particular
    administrative scheme at issue.” See Salfi, 
    422 U. S., at 765
    . Today’s decision, therefore, hardly knocks loose a
    line of dominoes.
    Finally, amicus argues that the meaning of §405(g) is
    ambiguous and that the SSA’s longstanding interpretation
    of §405(g)—prior to its changed position during the pen-
    dency of this case—is entitled to deference under Chevron
    U. S. A. Inc. v. Natural Resources Defense Council, Inc.,
    
    467 U. S. 837
     (1984). The Government and Smith main-
    tain that the statute unambiguously supports the Gov-
    ernment’s new position, and Smith further asserts that
    deference is inappropriate where the Government itself
    has rejected the interpretation in question in its filings.
    We need not decide whether the statute is unambiguous
    ——————
    18 See Brief for Respondent 43, n. 17 (number of timeliness dismis-
    sals); SSA, Annual Statistical Supplement 2018 (Table 2.F11) (number
    of dispositions), https://www.ssa.gov/policy/docs/statcomps/supplement/
    2018/2f8-2f11.pdf.
    14                   SMITH v. BERRYHILL
    Opinion of the Court
    or what to do with the curious situation of an amicus
    curiae seeking deference for an interpretation that the
    Government’s briefing rejects. Chevron deference “ ‘is
    premised on the theory that a statute’s ambiguity consti-
    tutes an implicit delegation from Congress to the agency
    to fill in the statutory gaps.’ ” King v. Burwell, 576 U. S.
    ___, ___ (2015) (slip op., at 8). The scope of judicial review,
    meanwhile, is hardly the kind of question that the Court
    presumes that Congress implicitly delegated to an agency.
    Indeed, roughly six years after Chevron was decided, the
    Court declined to give Chevron deference to the Secretary
    of Labor’s interpretation of a federal statute that would
    have foreclosed private rights of action under certain
    circumstances. See Adams Fruit Co. v. Barrett, 
    494 U. S. 638
    , 649–650 (1990). As the Court explained, Congress’
    having created “a role for the Department of Labor in
    administering the statute” did “not empower the Secretary
    to regulate the scope of the judicial power vested by the
    statute.” 
    Id., at 650
    . Rather, “[a]lthough agency determi-
    nations within the scope of delegated authority are enti-
    tled to deference, it is fundamental ‘that an agency may
    not bootstrap itself into an area in which it has no juris-
    diction.’ ” 
    Ibid.
     Here, too, while Congress has empowered
    the SSA to create a scheme of administrative exhaustion,
    see Sims, 
    530 U. S., at 106
    , Congress did not delegate to
    the SSA the power to determine “the scope of the judicial
    power vested by” §405(g) or to determine conclusively
    when its dictates are satisfied. Adams Fruit Co., 
    494 U. S., at 650
    . Consequently, having concluded that Smith
    and the Government have the better reading of §405(g),
    we need go no further.
    IV
    Although they agree that §405(g) permits judicial review
    of the Appeals Council’s dismissal in this case, Smith and
    the Government disagree somewhat about the scope of
    Cite as: 587 U. S. ____ (2019)                    15
    Opinion of the Court
    review on remand.19 Smith argues that if a reviewing
    court disagrees with the procedural ground for dismissal, it
    can then proceed directly to the merits, while the Govern-
    ment argues that the proper step in such a case would be
    to remand. We largely agree with the Government.
    To be sure, there would be jurisdiction for a federal
    court to proceed to the merits in the way that Smith avers.
    For one, as noted above, exhaustion itself is not a jurisdic-
    tional prerequisite. See supra, at 5–6. Moreover, §405(g)
    states that a reviewing “court shall have power to enter,
    upon the pleadings and transcript of the record, a judg-
    ment affirming, modifying, or reversing the decision of the
    Commissioner of Social Security, with or without remand-
    ing the cause for a rehearing”—a broad grant of authority
    that reflects the high “degree of direct interaction between
    a federal court and an administrative agency” envisioned
    by §405(g). Hudson, 
    490 U. S., at 885
    . In short, there is
    no jurisdictional bar to a court’s reaching the merits.
    Fundamental principles of administrative law, however,
    teach that a federal court generally goes astray if it de-
    cides a question that has been delegated to an agency if
    that agency has not first had a chance to address the
    question. See, e.g., INS v. Orlando Ventura, 
    537 U. S. 12
    ,
    16, 18 (2002) (per curiam); ICC v. Locomotive Engineers,
    
    482 U. S. 270
    , 283 (1987); cf. SEC v. Chenery Corp., 
    318 U. S. 80
    , 88 (1943) (“For purposes of affirming no less than
    reversing its orders, an appellate court cannot intrude
    upon the domain which Congress has exclusively entrusted
    to an administrative agency”). The Court’s cases discuss-
    ing exhaustion in the Social Security context confirm the
    ——————
    19 The parties agree, as do we, on the standard of review: abuse of
    discretion as to the overall conclusion, and “substantial evidence” “as to
    any fact.” See §405(g); see also Brief for Respondent 43–44; Tr. of Oral
    Arg. 5; cf. Bowen v. City of New York, 
    476 U. S. 467
    , 483 (1986) (“Ordi-
    narily, the Secretary has discretion to decide when to waive the ex-
    haustion requirement”).
    16                     SMITH v. BERRYHILL
    Opinion of the Court
    prudence of applying this general principle here, where
    the agency’s final decisionmaker has not had a chance to
    address the merits at all.20 See City of New York, 
    476 U. S., at 485
     (“Because of the agency’s expertise in admin-
    istering its own regulations, the agency ordinarily should
    be given the opportunity to review application of those
    regulations to a particular factual context”); Salfi, 
    422 U. S., at 765
     (explaining that exhaustion serves to “pre-
    ven[t] premature interference with agency processes” and
    to give the agency “an opportunity to correct its own er-
    rors,” “to afford the parties and the courts the benefit of its
    experience and expertise,” and to produce “a record which
    is adequate for judicial review”). Accordingly, in an ordi-
    nary case, a court should restrict its review to the proce-
    dural ground that was the basis for the Appeals Council
    dismissal and (if necessary) allow the agency to address
    any residual substantive questions in the first instance.21
    V
    We hold that where the SSA’s Appeals Council has
    dismissed a request for review as untimely after a claim-
    ant has obtained a hearing from an ALJ on the merits,
    that dismissal qualifies as a “final decision . . . made after
    a hearing” within the meaning of §405(g). The judgment
    of the United States Court of Appeals for the Sixth Circuit
    is therefore reversed, and the case is remanded for further
    proceedings consistent with this opinion.
    It is so ordered.
    ——————
    20 We make no statement, by contrast, regarding the applicability of
    this line of cases to situations in which the Appeals Council has had a
    chance to address the merits. Cf. Sims v. Apfel, 
    530 U. S. 103
    , 110–112
    (2000) (plurality opinion) (discussing why the inquisitorial nature
    of SSA proceedings counsels against imposing an issue-exhaustion
    requirement).
    21 By the same token, remand may be forgone in rarer cases, such as
    where the Government joins the claimant in asking the court to reach
    the merits or where remand would serve no meaningful purpose.
    

Document Info

Docket Number: 17-1606

Judges: Sonia Sotomayor

Filed Date: 5/28/2019

Precedential Status: Precedential

Modified Date: 10/19/2024

Authorities (25)

Califano v. Sanders ( 1977 )

Sims v. Apfel ( 2000 )

Charles J. SMITH, Appellant, v. Margaret M. HECKLER, ... ( 1985 )

Bowen v. Michigan Academy of Family Physicians ( 1986 )

Bowen v. Galbreath ( 1988 )

Adams Fruit Co. v. Barrett ( 1990 )

Jack Bloodsworth v. Margaret M. Heckler, Secretary of ... ( 1983 )

United States v. Detroit Timber & Lumber Co. ( 1906 )

Mathews v. Eldridge ( 1976 )

Interstate Commerce Commission v. Brotherhood of Locomotive ... ( 1987 )

Sullivan v. Hudson ( 1989 )

Bennett v. Spear ( 1997 )

IBP, Inc. v. Alvarez ( 2005 )

Chevron U. S. A. Inc. v. Natural Resources Defense Council, ... ( 1984 )

George Dietsch v. Richard Schweiker, as Secretary of the ... ( 1983 )

James MATLOCK, Plaintiff-Appellant, v. Louis W. SULLIVAN, ... ( 1990 )

Jane C. BACON, Appellant, v. Louis W. SULLIVAN, Secretary ... ( 1992 )

17-socsecrepser-44-unemplinsrep-cch-17324-michelle-d-harper-a ( 1987 )

Gladene S. ADAMS, Appellant, v. Margaret M. HECKLER, ... ( 1986 )

City of New York v. Heckler ( 1984 )

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