89 F.4th 1211
9th Cir.2024Background
- Juanita L. Cross challenged the denial of her claim for supplemental security income on the grounds that the Social Security Administration’s (SSA) 2017 medical-evidence regulations are partially invalid.
- The case centered on whether these new regulations, which prioritize the “supportability” and “consistency” of medical opinions over the traditional “hierarchy” (treating, examining, non-examining physicians), are consistent with the Social Security Act and the Administrative Procedure Act (APA).
- Under the 2017 regulations, ALJs no longer give special deference to treating or examining physicians and must focus on the supportability and consistency of medical opinions.
- Cross argued that the regulations are invalid because they do not require ALJs to articulate their consideration of certain factors, such as the examining relationship or a medical source’s specialization.
- The district court had affirmed the ALJ’s decision denying Cross’s application, finding the regulations valid; Cross appealed to the Ninth Circuit.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Validity under Social Security Act | SSA lacks authority to omit discussion of examining/specialization factors | Commissioner has broad discretion to set evidentiary standards | Regs are valid under the Act; Commissioner acted within authority |
| Validity under APA | Regs lack a reasoned explanation for change | SSA justified changes based on evolving healthcare and efficiency | Regs are not arbitrary/capricious under APA; sufficient explanation provided |
| ALJ obligations under 2017 regs | ALJs must articulate all medical opinion factors | ALJ needs only discuss supportability/consistency absent equally supported/consistent opinions | ALJs’ limited articulation obligation is valid |
| Applicability of "specific and legitimate" standard | Failure to use prior standard is reversible error | New regs displaced old "specific and legitimate" standard | Court confirms "specific and legitimate" standard is inapplicable under new regs |
Key Cases Cited
- Bowen v. Yuckert, 482 U.S. 137 (establishes broad Commissioner authority to make evidentiary rules under the Social Security Act)
- Heckler v. Campbell, 461 U.S. 458 (upholds agency authority unless overstepping statutory bounds or arbitrary/capricious)
- Chevron, U.S.A., Inc. v. Natural Resources Defense Council, Inc., 467 U.S. 837 (establishes Chevron deference to agency interpretations of statute)
- Encino Motorcars, LLC v. Navarro, 579 U.S. 211 (agency must provide reasoned explanation when changing policy)
- Department of Homeland Security v. Regents of the University of California, 140 S. Ct. 1891 (sets APA standards for agency reason-giving and review)