Barbara COMBS, Plaintiff-Appellant, v. COMMISSIONER OF SOCIAL SECURITY, Defendant-Appellee.
No. 04-5275.
United States Court of Appeals, Sixth Circuit.
Argued: Dec. 7, 2005. Decided and Filed: Aug. 16, 2006.
459 F.3d 640
ROGERS, J., announced the judgment of the court and delivered an opinion. GILMAN, J., delivered a separate opinion concurring in the judgment. GRIFFIN, J., delivered a separate opinion concurring in part and dissenting in part. CLAY, J., delivered a separate dissenting opinion.
Before: BOGGS, Chief Judge; MARTIN, BATCHELDER, DAUGHTREY, MOORE, COLE, CLAY, GILMAN, GIBBONS, ROGERS, SUTTON, COOK, McKEAGUE, GRIFFIN, and NEILSON, Circuit Judges.
VACATED AND REMANDED.
Gilman, Circuit Judge, concurred in judgment and filed opinion.
Griffin, Circuit Judge, filed opinion concurring in part and dissenting in part.
Clay, Circuit Judge, filed dissenting opinion in which Martin, Daughtrey, Moore, and Cole, Circuit Judges, joined.
Before: BOGGS, Chief Judge; MARTIN, BATCHELDER, DAUGHTREY, MOORE, COLE, CLAY, GILMAN, GIBBONS, ROGERS, SUTTON, COOK, McKEAGUE, GRIFFIN, and NEILSON, Circuit Judges.*
ROGERS, J., announced the judgment of the court and delivered an opinion in which BOGGS, C. J., BATCHELDER, GIBBONS, SUTTON, COOK, and McKEAGUE, JJ., joined. GILMAN, J. (pp. 652-657), delivered a separate opinion concurring in the judgment. GRIFFIN, J. (pp. 657-661), delivered a separate opinion
ROGERS, Circuit Judge.
This case presents the question of whether a change in a rule governing the adjudication of social security disability benefits claims that is applied as of its effective date to all pending cases has an impermissibly retroactive effect. In 1999 the Social Security Administration required more detailed proof of disability from obese claimants by eliminating a presumption of disability for obesity. Such presumptions govern the process of administrative adjudication. Changes to such rules, therefore, have their primary effect on claimants’ applications when the claimants appear before the agency to have their claims decided on the merits. The change in the rule is thus not impermissibly retroactive.
Plaintiff Barbara Combs initially filed an application for social security disability benefits in November of 1996. At that time, the Social Security Administration (SSA) afforded obese claimants a generous presumption of disability. The Social Security Commissioner deleted obesity from the list of conditions that benefit from this presumption in 1999. In 2003 Combs’ claim came before an Administrative Law Judge (ALJ) on remand from an administrative appeal. The ALJ denied her claim for benefits due in part to the deletion of this obesity listing. Combs appealed the decision administratively without success. She then filed suit in federal district court. There Combs argued that the agency had exceeded its powers granted by the Social Security Act (the Act) by applying the changed listings to her claim retroactively. The Act does not generally give the SSA the power to promulgate retroactive regulations.
The district court rejected Combs’ arguments, holding that the SSA had properly determined her eligibility for benefits without analyzing the deleted listing. This appeal followed. Because the changed listing had its effect on Combs’ claim after its effective date, when Combs’ claim was administratively adjudicated, it was not impermissibly retroactive in its effect. Moreover, the district court correctly concluded that the Agency‘s determination in this case is supported by substantial evidence. We therefore affirm.
An understanding of the effect of the change in the regulation requires a brief look at the five-step procedure used by the SSA to determine eligibility for disability benefits. The Act entitles to benefits payments certain claimants who, by virtue of a medically determinable physical or mental impairment of at least a year‘s expected duration, cannot engage in “substantial gainful activity.”
In step one, the SSA identifies claimants who “are doing substantial gainful activity” and concludes that these claimants are not disabled. Id.
At step three, the SSA examines the severity of claimants’ impairments but with a view not solely to their duration but also to the degree of affliction imposed. Id.
In the fourth step, the SSA evaluates claimants’ “residual functional capacity,” defined as “the most [the claimant] can still do despite [her] limitations.”
For use at step three, the Commissioner has promulgated an extensive list of impairments. See generally
9.09 Obesity. Weight equal to or greater than the values specified in Table I for males, Table II for females (100 percent above desired level), and one of the following:
A. History of pain and limitation of motion in any weight-bearing joint or the lumbosacral spine (on physical examination) associated with findings on medically acceptable imaging techniques of arthritis in the affected joint or lumbosacral spine; or
B. Hypertension with diastolic blood pressure persistently in excess of 100 mm. Hg measured with appropriate size cuff; or
C. History of congestive heart failure manifested by past evidence of vascular congestion such as hepatomegaly, peripheral or pulmonary edema; or
D. Chronic venous insufficiency with superficial varicosities in a lower extremity with pain on weight bearing and persistent edema; or
E. Respiratory disease with total forced vital capacity equal to or less than 2.0 L. or a level of hypoxemia at rest equal to or less than the values specified in Table III-A or III-B or III-C.
Id.
The Commissioner deleted listing 9.09 effective October 25, 1999, following notice and comment.
The deletion of listing 9.09, the Commissioner stated in response to comments, would have prospective effect only. See id. at 46127. “We will not review prior allowances based on listing 9.09 under the new rules,” the agency explained. Id. The revised listings were to apply to pending applications for benefits, i.e., claims filed but not yet finally adjudicated before listing 9.09 was deleted. See
Combs first filed for disability benefits with the SSA on November 4, 1996. She alleged in her application that she had been disabled since May 30, 1996, due to a wide variety of impairments. The SSA initially denied Combs’ application in December of 1996, and upon reconsideration a few months later in February of 1997. Combs requested a hearing before an ALJ later that year in August. The ALJ denied Combs’ request for a hearing in January of 1998. Combs appealed the 1998 denial to the Appeals Council. The Council reversed the ALJ‘s decision in October of 1998, granting Combs’ request for a hearing. In the subsequent hearing in March of 1999, the ALJ denied Combs’ claim under the five-step test. The ALJ did not find that Combs’ obesity and other impairments were severe enough for her to prevail at step three under listing 9.09 for obesity or any other listing. The ALJ denied her claim at step five. Combs appealed the ALJ‘s decision administratively.
During the pendency of her administrative appeal, the Agency deleted listing 9.09 for obesity on October 25, 1999. The Appeals Council in March of 2000 vacated the ALJ‘s 1998 denial of benefits and remanded Combs’ claim for further consideration. On remand, the ALJ in September of 2001 again at step five determined that Combs was not disabled. The ALJ observed at step three that Combs’ medically determinable “impairments do not meet or medically equal one of the listed impairments” needed for her to prevail. Admin. R. at 213. Combs appealed once again. In Sep-
This second ALJ issued a decision on February 21, 2003, denying Combs’ claim at step five. The ALJ identified Combs’ medically determinable impairments and concluded, like the previous ALJ, that they “do not meet or medically equal one of the listed impairments” that could entitle her to benefits at step three. Admin. R. at 27. Combs administratively appealed again, this time without success. The second ALJ‘s 2003 denial of benefits became the Agency‘s final decision.
Combs sought review of the 2003 denial of benefits in the district court below. The district court granted the SSA‘s motion for summary judgment, thereby upholding the 2003 denial of benefits. In its opinion, the district court held that the agency‘s determination was supported by substantial evidence. The district court also concluded that the SSA acted properly when it did not apply former listing 9.09 to Combs’ claim, because that listing had been deleted prior to the 2003 hearing.
The district court properly refused to require the SSA to apply listing 9.09, notwithstanding the fact that Combs’ claim was initially filed before the deletion of that listing. Combs argues that the application of the current version of the listing was improper because application of the current listing had a retroactive effect on Combs, by virtue of the fact that she had filed her claim before the change in the listing.
While Congress has the power to permit the SSA to promulgate retroactive regulations, Congress generally has not done so. Bowen, 488 U.S. at 213 & n. 3. Neither party in this case argues that Congress has authorized the SSA to promulgate regulations that would operate “retroactively,” where such retroactivity is of the type that would be presumed to be against the intent of Congress if the provision were contained in a statute. We accordingly assume, for purposes of our analysis of whether the regulation at issue in this case is consistent with the statute, that we are to apply the same analysis that we would apply in determining whether a statute—unless construed otherwise—operates retroactively so as to invoke the Supreme Court‘s presumption against retroactivity. In other words, the regulations as of October 25, 1999, are consistent with the Social Security Act if they are not retroactive under the tests that the Supreme Court has used to determine whether certain unclear federal statutes operated retroactively. In Landgraf v. USI Film Products, 511 U.S. 244, 247 (1994), the Court held that the application to pre-amendment activity of amendments to Title VII of the Civil Rights Act, newly providing for compensatory and punitive damages, would violate the presumption against retroactive legislation. Id. at 247. Later in Republic of Austria v. Altmann, 541 U.S. 677, 692-700 (2004), the Court held that application to pre-statute activity of exceptions to sovereign immunity contained in the 1976 Foreign Sovereign Immunities Act did not violate the presumption against retroactive legislation. Id. at 692-700. Assuming the applicability of the Landgraf-Altmann distinction to the issue of agency power presented in this case, it is apparent that the regulatory change in this case is not impermissibly retroactive.
As Landgraf teaches, not all statutes raise retroactivity concerns. “A statute does not operate ‘retrospectively’ merely because it is applied in a case arising from conduct antedating the statute‘s enactment ....” Id. at 269; Campos v. INS, 16 F.3d 118, 122 (6th Cir.1994); Patel v. Gonzales, 432 F.3d 685, 690 (6th Cir.2005). The application of law existing at the time of decision does not violate the presumption against retroactivity unless the statute in question has retroactive effects. Landgraf, 511 U.S. at 269-70; Patel, 432 F.3d at 690. A statute has retroactive effects if the statute
attaches new legal consequences to events completed before its enactment. The conclusion that a particular rule operates “retroactively” comes at the end of a process of judgment concerning the nature and extent of the change in the law and the degree of connection between the operation of the new rule and a relevant past event.... [F]amiliar considerations of fair notice, reasonable reliance, and settled expectations offer sound guidance.
The factors articulated in Landgraf—fair notice, reasonable reliance, and settled expectations—weigh against finding a retroactive effect. See id. at 269-70. It can hardly be argued that claimants become obese or otherwise become impaired in reliance on the availability of the presumption in the listing. Nor is there any indication that they file their claims, or decide what to put in their claims, based on how the agency determines whether they meet the statutory requirements for disability eligibility. Similarly, claimants have no settled expectation that the agency will use one as opposed to another algorithm for determining whether the statutory requirements are met. Finally, there is no basis for claimants to argue that they need “fair notice” of a change in the step three presumptions.
This analysis tracks precisely the reasoning of our recent decision in Patel v. Gonzales. In that case we dealt with two versions of a statutory provision for discretionary waiver of removal of relatives of U.S. citizens. The older version applied to parents, spouses, or children of U.S. citizens; the newer version did not apply to parents. We held that the newer version applied to the Patels, even though they fraudulently entered the United States (i.e., committed the acts that formed the basis for their removal) before the change in the statute. Application of the later version of the statute was not impermissibly retroactive because
The factors articulated in Landgraf—fair notice, reasonable reliance, and settled expectations—weigh against finding a retroactive effect. In likelihood, Petitioners did not enter the United States through fraud in reliance on the availability of the discretionary waiver. Nor did Petitioners have a settled expectation, given the fact that Petitioners’ son was not a naturalized citizen in 1993, that they would receive a discretionary waiver based on their relationship with their son. Finally, unless Petitioners had notice of the waiver in the first place, they cannot rely on the argument that they need “fair notice” of the change.
Patel, 432 F.3d at 691 (citation omitted). It is less likely that Combs became impaired in reliance on the unamended listing than that the Patels entered the United States fraudulently in reliance on the availability of a discretionary waiver.1 It
Moreover, the Supreme Court in Landgraf and Altmann, and our court in Patel, have recognized that changes to procedural rules generally do not have retroactive effect because procedural rules regulate secondary as opposed to primary conduct. See Landgraf, 511 U.S. at 275; Altmann, 541 U.S. at 693; Patel, 432 F.3d at 690. In contrast, rules that deprive persons of vested substantive rights may have retroactive effects if applied to conduct occurring prior to their enactment. See Landgraf, 511 U.S. at 272; Altmann, 541 U.S. at 693; Patel, 432 F.3d at 690. Thus, the Supreme Court has distinguished between provisions involving the right to a jury and the lifting of sovereign immunity as being on the non-substantive side of the line, while the addition of new elements of damages are on the substantive side of the line. See Altmann, 541 U.S. at 696 (foreign sovereign immunity); Landgraf, 511 U.S. at 280-81 (right to a jury trial is procedural but new right to compensatory and punitive damages is substantive). Applying this distinction, the change in step three is more procedural than substantive in nature. The ultimate criteria of disability eligibility are not changed. Instead, a presumption designed for administrative workability was changed to conform agency determinations more closely with the statutory requirements. While the change may be outcome-determinative for some claimants, the same can be said for a jury trial right or the lifting of an immunity. The difference has to do with whether there is a change in substantive obligation as opposed to a change in the way in which the same obligation is adjudicated. In that light, the change in administrative presumption in step three is more like the latter. The substantive requirements for disability eligibility have not changed, only the way in which the agency goes about determining whether they are present. Doubtless there are situations in which a procedural rule will have such substantive effects, see Landgraf, 511 U.S. at 275 n. 29 (“[n]or do we suggest that concerns about retroactivity have no application to procedural rules“), but the modification of the step three listing does not fall on the substantive side of the distinction.
Our conclusion is buttressed by the requirement suggested in Landgraf and emphasized in Altmann—that we focus on the “relevant conduct regulated by the [legislative provision]” to determine whether the provision is impermissibly retroactive. In Landgraf, the Supreme Court
The critical issue, I think, is not whether the rule affects ‘vested rights,’ or governs substance or procedure, but rather what is the relevant activity that the rule regulates. Absent clear statement otherwise, only such relevant activity which occurs after the effective date of the statute is covered. Most statutes are meant to regulate primary conduct, and hence will not be applied in trials involving conduct that occurred before their effective date. But other statutes have a different purpose and therefore a different relevant retroactivity event.
Id. at 697 n. 17 (quoting Landgraf, 511 U.S. at 291 (Scalia, J., concurring in judgment)).
A focus on the “relevant activity” in this case leads inexorably to the conclusion that the change in the regulation was not
The October 1999 listing did not operate retroactively here because, as part of step three in the sequential evaluation process, it regulated only the process of adjudicating social security disability benefits claims—i.e., adjudicatory conduct—and the adjudicatory conduct regulated here took place years after these listings went into effect when Combs’ claim was finally adjudicated by the SSA.
The entire five-step sequential evaluation process has been designed to regulate adjudicatory conduct for the purpose of making adjudication of claims efficient and flexible. Step three regulates a narrow category of adjudicatory conduct, also to promote adjudicatory efficiency. See Bowen v. Yuckert, 482 U.S. 137, 153 (1987). Step three governs the organization of evaluation of proof of listed impairments that, if supplied, renders entitlement to benefits a foregone conclusion. See id. (noting that step “three streamlines the decision process by identifying those claimants whose medical impairments are so severe that it is likely they would be found disabled regardless of their vocational background.“) (emphasis added); Sullivan v. Zebley, 493 U.S. 521, 532 (1990) (observing that the regulations “set the medical criteria defining the listed impairments at a higher level of severity than the statutory standard“). Step three effectively allows the SSA to skip the extensive and costly factual inquiry of steps four and five in obvious cases. See Yuckert, 482 U.S. at 153. As a tool for efficient and organized administrative adjudication, step three regulates the orderly evaluation and presentation of proof of listed impairments. Changes to these listings consequently have their effect on benefits applications when claimants reach step three in the process of adjudicating their claims.
A rule regulating the evaluation and presentation of proof does not normally operate retroactively if it is applied to pending cases. The SSA may freely change rules that purely govern the conduct of adjudication, without fear of retroactive effect, if those changes apply only to pending cases. Naturally, if the SSA had attempted to retry cases that had been adjudicated previously, that might be a different story. But that did not happen here. The application of the October 1999 listing to Combs’ claim was prospective.
Our upholding of the application of the revised listing to pending applications is supported by the unpublished opinion, albeit cursory in this regard, of the Seventh Circuit in Barthelemy v. Barnhart, 107 Fed.Appx. 689, 693 (7th Cir.2004).
We recognize that several district court cases and one unpublished circuit court opinion have stated or assumed that applying the October 1999 listing to pending claims has an impermissibly retroactive effect. Nash v. Apfel, 215 F.3d 1337, 2000 WL 710491 (10th Cir. June 1, 2000); Cherry v. Barnhart, 327 F.Supp.2d 1347 (N.D.Okla.2004); Portlock v. Barnhart, 208 F.Supp.2d 451 (D.Del.2002); Kokal v. Massanari, 163 F.Supp.2d 1122 (N.D.Cal.2001). The reasoning of these cases is not compelling.
Kokal and Portlock, two district court opinions, rely upon the assertion that “Plaintiff‘s rights would be substantively altered if the revision to 20 C.F.R. pt. 404, subpt. P, app. 1 [deleting listing 9.09] was deemed applicable to pending claims, because the revised regulation would raise the bar on proof of disability based on obesity.” Kokal, 163 F.Supp.2d at 1131; see also Portlock, 208 F.Supp.2d at 461-62 (following Kokal). While deletion of listing 9.09 indeed requires more detailed proof with respect to obese claimants, that fact as explained above does not establish that their rights have been “substantively altered.” The SSA deleted listing 9.09 precisely because some clearly non-disabled obese claimants were getting benefits to which they were not entitled. See
The actual substantive right to benefits derives from the Act‘s definition of disability, not step three. Combs does not argue that deleting listing 9.09 created a conflict between the Act‘s definition of disability and the sequential evaluation process. Such a conflict might result if deleting listing 9.09 truly altered claimants’ substantive rights to benefits, but instead it provides a more accurate way of determining the substantive right to benefits resulting from obesity. For this reason, Kokal and Portlock are not persuasive.
In harmony with Kokal, the district court in Cherry concluded that applying the October 1999 listing to pending claims has a retroactive effect on claimants who filed their claims before the new listing became effective. 327 F.Supp.2d at 1358-59. The Cherry court said that the past “act” to which the changed listing attached new legal consequences “is the filing of a claim.” Id. at 1358. The Cherry court identified no new legal consequences that the October 1999 listing attached to the “act” of filing a claim. A change in step three requiring more detailed proof simply does not attach new legal consequences to the act of filing a claim.
The application of the revised listing to claims filed before the change is accordingly not retroactive in a way that would make the regulation beyond the authorized rulemaking power of the Commissioner.3
The ALJ stated, “[u]pon reviewing all of the evidence of the record, the undersigned Administrative Law Judge concludes that claimant is not disabled within the meaning of the Social Security Act.” Admin. R. at 22. The ALJ found that Combs still had the residual functional capacity to perform light and sedentary work, her impairments notwithstanding. See Admin. R. at 26, 27. The ALJ based much of his decision on the 2001 ALJ‘s recitation of the medical evidence, see Admin. R. at 23, which relied on the examinations and opinions of Dr. Anthony Uy, a state agency physician consultant. See Admin. R. at 209-10 (relying on Dr. Uy), 469-76 (Dr. Uy‘s findings). The ALJ stated that he “substantially concurs with, adopts, and incorporates by reference the recitation of the medical evidence contained in the decision dated September 21, 2001.” Admin. R. at 23. The ALJ also noted that Combs had supplied some new evidence of disability.
Dr. Uy found that Combs could lift and carry up to 20 pounds frequently, could stand or walk for up to 6 hours, and could sit without medical limitation. See Admin. R. at 474. Dr. Uy also found that Combs was capable of climbing and balancing frequently. See Admin. R. at 475. When the ALJ incorporated the 2001 ALJ‘s recitation of the evidence, he incorporated the 2001 ALJ‘s rationale discounting Dr. Templin‘s residual functional capacity determination. See Admin. R. at 205-07. In October of 1997, according to the 2001 ALJ, Dr. Templin in effect found that Combs could not perform any gainful work, not even sedentary work. See Admin. R. at 206. Specifically, the 2001 ALJ related that Templin precluded Combs from
At step five of the sequential evaluation process, the ALJ relied on expert testimony and concluded that Combs could perform a significant number of jobs in the economy. See Admin R. at 26-27; Born v. Sec‘y of Health and Human Servs., 923 F.2d 1168, 1174 (6th Cir.1990). In a 1999 hearing vocational expert testimony indicated that a hypothetical person with Combs’ characteristics could do light or sedentary work as an information clerk, general office clerk, or security monitor. See Admin R. at 90-91. In a 2001 hearing, a vocational expert stated that someone with attributes like Combs’ could work as a service station attendant or cafeteria attendant. Admin. R. at 116-17. In a 2003 hearing, a vocational expert testified that a hypothetical person like Combs could work as an assembler of parts and components, and as a weigher, measurer, and inspector. Admin. R. at 162. Based on such testimony, the ALJ found that Combs’ impairments permitted her “to perform a significant range of light work.” Admin. R. at 25, 27. The ALJ concluded that Combs was not under a disability as defined in the Act. See Admin R. at 28.
Combs objects mainly to the ALJ‘s discounting of Dr. Templin‘s residual functional capacity determination and his crediting of Dr. Uy‘s assessment. Given the lack of objective evidence of disability in Dr. Templin‘s reports and the ALJ‘s other observations, the ALJ could discount his opinion. As we held in Bogle v. Sullivan, 998 F.2d 342, 347-48 (6th Cir.1993), a social security ALJ may properly discount a treating physician‘s opinion of disability: “[t]his court has consistently stated that the Secretary is not bound by the treating physician‘s opinions, and that such opinions receive great weight only if they are supported by sufficient clinical findings and are consistent with the evidence.”
There is substantial evidence in the record as a whole to support the ALJ‘s determination that Combs is not disabled.
For the foregoing reasons, the district court‘s judgment is affirmed.
GILMAN, Circuit Judge, concurring in the judgment.
“Any test of retroactivity,” the Supreme Court has acknowledged, “will leave room
As luck would have it, however, the rule as applied to Combs‘s claim did change in the middle of the game. The Commissioner‘s decision to apply the new rule has prompted my colleagues, almost seven years after that change, to spar at length over whether it was substantive or procedural in nature. Of the two positions articulated on that issue, I find Judge Clay‘s dissent and Judge Griffin‘s separate opinion more persuasive than the lead opinion in explaining why a shift in the burden of proof, or analogous changes that directly affect a party‘s prospects for success on the merits, are substantive rather than procedural. In particular, I find both persuasive and apposite the D.C. Circuit‘s decision in National Mining Association v. Department of Labor, 292 F.3d 849 (D.C.Cir.2002) (per curiam), a case that counsel for the Commissioner was unable to distinguish at oral argument and that the lead opinion unconvincingly attempts to explain away. Lead Op. at 650-51 n.3.
I also believe, however, that both the lead opinion and the dissent have failed to see the forest for the trees by allowing these labels—substantive and procedural—to dictate the outcome of this appeal. See Lead Op. at 649 (“The substantive requirements for disability eligibility have not changed, only the way in which the agency goes about determining whether
Heeding that warning, I cannot agree with the dissent that applying the new rule to Combs‘s application is impermissibly retroactive simply because the legal change is more substantive than procedural in nature. Nor do I find persuasive the argument that Combs “planned for the possibility of becoming disabled in reliance on the disability benefits scheme available at the time,” or that “her disability planning would have been significantly different” had she known about possible changes in the rules. Dissent at 674-75.
At the same time, I remain unconvinced by key aspects of the lead opinion, including its reliance on Republic of Austria v. Altmann, 541 U.S. 677 (2004), and its conclusion that the relevant date for retroactivity purposes is “the time of adjudication.” See Lead Op. at 619. I find more compelling the decision in National Mining Association, 292 F.3d at 860, where the D.C. Circuit considered the relevant date to be the date when the miners’ disability claims were filed. The lead opinion also minimizes the impact of deleting the obesity listing by coining a new phrase, “adjudicatory conduct,” which it says is all that the regulatory change affected. Lead Op. at 619. Although I do not understand the
I am thus left with the Supreme Court‘s general guidance from Landgraf. There, the Court cited with approval Justice Story‘s description of an impermissibly retroactive statute as one that “takes away or impairs vested rights acquired under existing laws, or creates a new obligation, imposes a new duty, or attaches a new disability.” Landgraf, 511 U.S. at 269 (citations and quotation marks omitted); id. at 280 (explaining that a court deciding a retroactivity question must ask whether applying the new statute or regulation “would impair rights a party possessed when he acted, increase his liability for past conduct, or impose new duties with respect to transactions already completed“). Deciding whether “a statute operates ‘retroactively’ is not always a simple or mechanical task,” the Court advised, and courts should make the retroactivity determination by taking into account “familiar considerations of fair notice, reasonable reliance, and settled expectations.” id. at 268, 270.
I concur in the judgment affirming the decision below principally because I am not convinced that applying the new rule to Combs‘s claims for benefits impaired any “vested right” that Combs may have had, increased her liability “for past conduct,” or “impose[d] new duties” on her with respect to a completed transaction. See id. at 269, 280 (citation
The First Circuit found no retroactivity problem with the use of the new guidelines, squarely rejecting “the proposition that filing an application with an agency essentially fixes an entitlement to the application of those substantive regulations in force on the filing date.” id. at 122 (emphasis in original). I would follow this reasoning and reject Combs‘s retroactivity challenge on the ground that she had no settled expectation—let alone a vested right—in the use of the “substantive regulations in force” when she filed her disability claim. See id. The fact that the change may have been fatal to the success of her claim does not alter the conclusion that Combs had no right to expect that filing an application would freeze the law in its then-current state.
In my view, there is a faint yet discernible line that separates Pine Tree Medical Associates and the present case on the one
Similarly, the D.C. Circuit in National Mining Association declared impermissibly retroactive one regulation that created a rebuttable presumption in favor of the applicant and another that expanded the scope of the employers’ liability “by making more dependents and survivors eligible for benefits.” 292 F.3d at 865-868. The former regulation increased the likelihood that mining companies would be held liable for past conduct, whereas the latter altered the amount that the companies would be required to pay in the event that they were found liable. See id. Like the statutory provisions at issue in Landgraf, therefore, the regulations both increased the mining companies’ potential liability for past conduct and impacted the companies’ planning by altering the cost/benefit calculus of operators and insurers. To put the issue in Landgraf‘s parlance, the regulations “attache[d] new legal consequences to events completed before [their] enactment.” 511 U.S. at 270.
In both Pine Tree Medical Associates and in the present case, in contrast, the change in the administrative regulations did not impose any kind of liability on either the healthcare provider or Combs, respectively. What the healthcare provider lost was a more favorable regulatory scheme that might have increased its chances of securing reimbursement, just as Combs lost a provision that might have entitled her to a conclusive finding of disability. Both of these parties, in other words, saw a more favorable regulation replaced with one that, while still permitting them to prove their entitlement to the requested funds, made their eventual success less likely. Awareness that the law might change during the application process, however, would not have dissuaded either applicant from seeking the benefits in the first place. That is to say, the possibility of change did not “impact” the “parties’ planning.” Landgraf, 511 U.S. at 282.
I also do not believe that the rule change in the present case, or the one in Pine Tree Medical Associates, “attache[d] new legal consequences” to completed events. See id. at 270. The applications for prospective governmental benefits in these cases simply do not constitute “completed events” that engender any justifiable reliance on then-existing regulations. When Combs sought disability benefits, and when Pine Tree sought MUP status, the “legal consequence” of applying was either the grant or denial of the requested benefit. After the change in the law, the legal consequences remained exactly the same—the applicant either received or was denied the sought-after benefit. This stands in clear contrast to the examples of Landgraf (having to pay compensatory damages for past acts of discrimination) and National Mining Association (having to pay a larger number of beneficiaries), where the companies faced new kinds of liabilities for conduct undertaken before the passage of the laws at issue.
In sum, I agree with the lead opinion that the “familiar considerations of fair notice, reasonable reliance, and settled expectations” cut against finding that the application of the new obesity standard to Combs‘s case was impermissibly retroactive. See Landgraf, 511 U.S. at 270; Lead Op. at 646-47 & n. 1. Combs could not have had a “settled expectation” that the law would remain the same indefinitely, since almost every change in the law—as the Court has noted—is detrimental to some person‘s interests. See Landgraf, 511 U.S. at 269 n. 24 (giving examples of “uncontroversially prospective statutes” that “unsettle expectations and impose burdens on past conduct“). And although Combs undoubtedly relied on the availability of disability benefits when she submitted her application, the rule change did not deprive her of the ability to prove entitlement to those benefits, even if it did make her success less likely. In the end, I cannot say that the fact that the rule change adversely affected Combs‘s chances of prevailing converted an otherwise permissible application of the current law into an impermissible one.
This last point—that applying the current law to pending cases is the rule rather than the exception—is the final consideration that informs my resolution of this case. We should not forget that at the heart of Landgraf is an attempt to reconcile two general principles of law that seemingly point in opposite directions: (1) that “a court should ‘apply the law in effect at the time it renders its decision,‘” id. at 264 (quoting Bradley v. School Bd. of Richmond, 416 U.S. 696, 711 (1974)); and (2) that “congressional enactments and administrative rules will not be construed to have retroactive effect unless their language requires this result,” id. (quoting Bowen v. Georgetown Univ. Hosp., 488 U.S. 204, 208 (1988)).
As I read Landgraf, the Court resolved “the apparent tension” inherent in these principles by instructing that the current law be applied unless that law would have an impermissible retroactive effect as that concept is defined by the Court‘s cases. id. at 264 (citation and quotation marks omitted); see id. at 269 (emphasizing that “[a] statute does not operate ‘retrospectively’ merely because it is applied in a case arising from conduct antedating the statute‘s enactment....“) (citation omitted). That is, application of the current law is the default position from which courts should stray only if one of the narrow fairness-based criteria set forth in Landgraf is satisfied. See Patel v. Gonzales, 432 F.3d 685, 691 (6th Cir.2005) (“Courts should apply the law in effect at the time
I would also note that Combs would hardly be complaining if Listing 9.09 had first come into existence after she had filed her application and while her case was still pending. Cf. United States v. Real Prop. in Section 9, Town 29 North, Range 1 West Township of Charlton, 241 F.3d 796, 799-800 (6th Cir.2001) (applying to a pending case a new statute that increased the government‘s burden of proof in civil forfeiture proceedings). Applying the current law, in other words, leads to consequences that are far from universally negative. In addition to the other reasons set forth above, therefore, I believe that the sound practice of generally applying current law to pending cases tips the balance in favor of the ALJ‘s decision in the context of this admittedly close case.
Because I do not believe that applying the new obesity standard to Combs‘s application was impermissibly retroactive, and because substantial evidence in the record supports the decision of the ALJ, I concur in the judgment reached in the lead opinion. I do not, however, agree with key aspects of the lead opinion‘s analysis and would therefore enter judgment only on the strength of the reasons set forth above.
GRIFFIN, Circuit Judge, concurring in part and dissenting in part.
I concur in the result of the plurality‘s opinion for the claimed disability period post-October 25, 1999. However, I respectfully dissent from the denial of plaintiff‘s claim for disability benefits for the period of May 30, 1996, through October 25, 1999. Regarding this portion of plaintiff‘s claim arising prior to the repeal of Listing 9.09, I would remand for a new hearing with instructions to apply 9.09 to the closed period.
I.
In Landgraf v. USI Film Prods., 511 U.S. 244 (1994), the Supreme Court addressed the issue of retroactivity with respect to statutes. There, the Court adopted a presumption against retroactivity because prospectively “accords with widely held intuitions about how statutes ordinarily operate” and “will generally coincide with legislative and public expectations.” id. at 272. The Court noted, however, that exceptions exist to the general rule favoring prospectively. As a result, to analyze retroactivity, the Court set forth the following framework: (1) whether the statute on its face provides for prospective or retroactive application; (2) in the absence of such an express provision governing the statute‘s reach, whether the statute would have retroactive effect; and (3) if the statute would have retroactive effect, whether Congress
The second step of the Landgraf analysis requires a determination of whether application of the Revised Medical Criteria would have “retroactive” effect. 511 U.S. at 280; see Portlock v. Barnhart, 208 F.Supp.2d 451, 461 (D.Del.2002) (“The starting point for the court‘s analysis is to determine whether applying the revised regulations in the manner urged by the SSA in SSR 00-3p would constitute a retroactive application of a rule.“). Black‘s Law Dictionary defines the term “retroactive” as that which extends a statute or regulation “in scope or effect to matters that have occurred in the past.” BLACK‘S LAW DICTIONARY 1343 (8th ed.2004). A regulation therefore has “retroactive effect” if it “impair[s] the rights the party had when he acted, increase[s] a party‘s liability for past conduct or impose[s] new duties with respect to transactions already completed.” Landgraf, 511 U.S. at 280. See also Fernandez-Vargas v. Gonzales, 548 U.S. 30, 37-38 (2006).
In this case, several courts have agreed that application of the Revised Medical Criteria to a claimant with a claim pending when Listing 9.09 was deleted would have a “retroactive effect.” Nash v. Apfel, 215 F.3d 1337, 2000 WL 710491 (10th Cir. June 1, 2000) (unpublished); see, e.g., Portlock, 208 F.Supp.2d at 461 (“[T]he application of the revised listings to [claimant‘s] claim would constitute a retroactive application of the rule.“); Kokal v. Massanari, 163 F.Supp.2d 1122, 1131 (N.D.Cal.2001) (holding new listing substantively alters a claimant‘s rights); Cherry v. Barnhart, 327 F.Supp.2d 1347, 1359 (N.D.Okla.2004) (noting deletion of Listing 9.09 “clearly alters the standard for evaluating disability claims“), aff‘d, 125 Fed.Appx. 913 (10th Cir.2005) (unpublished). The logic of the forgoing cases is sound; indeed, the administrative record reflects that Combs likely meets the requirements of Listing 9.09, yet does not meet the disability parameters outlined by the Revised Medical Criteria. Cf. Landgraf, 511 U.S. at 280 (noting retroactive effect arises when statute or regulation “impair[s] rights possessed when [claimant] acted... and impose[s] new duties with respect to transactions already completed“). Thus, “Plaintiff‘s rights would be substantively altered if the revision to 20 C.F.R. pt. 404, subpt. P, app. 1 was deemed applicable..., because the revised regulation would raise the bar on proof of disability based on obesity.” Kokal, 163 F.Supp.2d at 1131. Accordingly, application of the Revised Medical Criteria to Combs would have a “retroactive effect.”
The Commissioner argues that “[the] agency‘s rules here are akin to procedural rules that the Court has previously found not to be retroactive.” Burdens of proof,
Moreover, other courts have previously rejected similar arguments from the Commissioner. The Cherry court, for example, noted that “[t]he Supreme Court emphasized in Landgraf that the presumption against retroactivity is not restricted to cases involving contractual or property rights or ‘vested rights.‘” 327 F.Supp.2d at 1359 (citing Landgraf, 511 U.S. at 275 n. 29). Additionally, the Landgraf Court expressly noted, contrary to the Commissioner‘s arguments, that retroactivity concerns may arise in the context of so-called “procedural rules.” Landgraf, 511 U.S. at 275 n. 29; accord Ibrahim v. District of Columbia, 208 F.3d 1032, 1036 (D.C.Cir.2000) (observing that where a rule “changes the law in a way that adversely affects [a party‘s] prospects for success on the merits of the claim,” it may operate retroactively even if designated as “procedural” by the Commissioner). Accordingly, I conclude that the “procedural” label assigned to the Revised Medical Criteria by the Commissioner is meaningless.
II.
Next, the parties dispute the date upon which retroactivity should be determined.
Combs argues that whether the repeal of Listing 9.09 is retroactive should be measured from November 4, 1996, the date that Combs filed her application for benefits. On the other hand, the Commissioner asserts, and the plurality agrees, that retroactivity should be determined by reference to the date of the adjudication of Combs’ claim for benefits; i.e., January or February 2003.3 I disagree and would hold that retroactivity should be determined by a third date—October 25, 1999—the date upon which the regulation change became effective.
In my view, because a final determination of disability has never been made in this case due to the numerous appeals and convoluted procedural history, I would remand for a new hearing. For purposes of the hearing, I would afford Combs the benefit of Listing 9.09 for the claimed disability period of May 30, 1996, until the effective date of its repeal, October 25, 1999. In regard to the claimed disability period post-October 25, 1999, I would affirm the denial of disability benefits on the basis that the ALJ‘s findings of fact for the period after the effective date of the repeal were supported by substantial evidence.
At oral argument, the Commissioner argued that bifurcating plaintiff‘s disability claims into the periods of pre- and post-regulation repeal would be unduly burdensome and may violate
simply as a matter of convenience. See Bowen, 488 U.S. at 213, 109 S.Ct. 468 (“Deference to what appears to be nothing more than an agency‘s convenient litigating position would be entirely inappropriate.“). Regardless of the Commissioner‘s assertion of an increased administrative burden, it is axiomatic that the Commissioner must apply new regulations prospectively, only. Id. (holding that
As to the second argument, the text of
A recipient of benefits under this title [
42 U.S.C. §§ 401-434 ] or title XVIII [42 U.S.C. §§ 1395-1395hhh ] based on the disability of any individual may be determined not to be entitled to such benefits on the basis of a finding that the physical or mental impairment on the basis of which such benefits are provided has ceased, does not exist, or is not disabling only if such finding is supported by -(1) substantial evidence which demonstrates that -
(A) there has been any medical improvement in the individual‘s impairment or combination of impairments (other than medical improvement which is not related to the individual‘s ability to work), and
(B) the individual is now able to engage in substantial gainful activity; or
(2) substantial evidence which -
(A) consists of new medical evidence and a new assessment of the individual‘s residual functional capacity, and demonstrates that -
(i) although the individual has not improved medically, he or she is nonetheless a beneficiary of advances in medical or vocational therapy or technology (related to the individual‘s ability to work), and
(ii) the individual is now able to engage in substantial gainful activity, or
(B) demonstrates that -
(i) although the individual has not improved medically, he or she has undergone vocational therapy (related to the individual‘s ability to work), and
(ii) the individual is now able to engage in substantial gainful activity; or
(3) substantial evidence which demonstrates that, as determined on the basis of new or improved diagnostic techniques or evaluations, the individual‘s impairment or combination of impairments is not as disabling as it was considered to be at the time of the most recent prior decision that he or she was under a disability or continued to be under a disability, and that therefore the individual is able to engage in substantial gainful activity; or
(4) substantial evidence (which may be evidence on the record at the time any prior determination of the entitlement to benefits based on disability was made, or newly obtained evidence which relates to that determination) which demonstrates that a prior determination was in error.
In the present case, this statutory provision is not applicable because, as a result of numerous appeals, there has not been a final determination and Combs has not received benefits. By its terms, the plain language of
We will not find good cause to reopen your case if the only reason for reopening is a change of legal interpretation or administrative ruling upon which the determination or decision was made.
Again, however, because there has not been a final disposition of Combs’ disability claim, the reopening of a prior decision is not at issue. The same is true with Social Security Ruling, SSR 02-10p, regarding “periodic continuing disability review” of previously awarded disability benefits.
In summary, the parties have poorly postured this case as an all or nothing proposition. To avoid the prohibition against retroactive rulemaking, Combs asks this court to hold that the determinative date for purposes of retroactivity is the date on which the claim is filed, while defendant argues that this court should base any retroactivity analysis on the date of adjudication. I disagree with both positions and would hold that the operative date for purposes of retroactivity is the effective date that the regulation was changed.
Although disability insurance benefits are determined “for each month [claimed] beginning with the first month after his waiting period, ...”
III.
For these reasons, I respectfully concur in part and dissent in part.
CLAY, Circuit Judge, with whom MARTIN, DAUGHTREY, MOORE, and COLE, Circuit Judges, join, dissenting.
In finding that the application of newly promulgated obesity rules did not have an impermissible retroactive effect on Plaintiff with respect to her pending application for Social Security disability benefits, the lead opinion seriously misapprehends and oversimplifies the Supreme Court‘s retroactivity jurisprudence. At its core, the lead opinion asserts two positions: (1) the shift from Listing 9.09 to the new obesity rules was merely a procedural change that did not have an impermissible retroactive effect; and (2) Plaintiff did not rely on Listing 9.09 in becoming disabled. These positions are incorrect and irrelevant, re-
I.
Plaintiff is a former seamstress and daycare employee. Plaintiff claims that as of May 30, 1996, she was disabled due to morbid obesity, fibromyalgia, degenerative disc disease of the lumbosacral spine, degenerative arthritis bilateral knees, and other severe physical ailments, as well as depression. Plaintiff filed an application for disability benefits on November 4, 1996. After an initial denial of her application, Plaintiff requested a hearing before an Administrative Law Judge (“ALJ“). On January 26, 1998, the ALJ denied the request. On October 23, 1998, the appeals council vacated the decision of the ALJ and granted Plaintiff a hearing. In February 1999, over two years after Plaintiff‘s initial application, the ALJ held a hearing and then subsequently denied Plaintiff‘s application.
The appeals council vacated the decision of the ALJ and remanded Plaintiff‘s case on the ground that the ALJ failed to properly analyze Plaintiff‘s impairments. On September 21, 2001, on remand, the ALJ again denied Plaintiff‘s application. The appeals council again vacated the decision of the ALJ and remanded Plaintiff‘s case on the grounds that the ALJ failed to properly analyze Plaintiff‘s impairments and the ALJ incorrectly analyzed Plaintiff‘s credibility. The case was remanded to another ALJ, who in February 2003 denied Plaintiff‘s application as well. The appeals council declined to reverse this decision.
When Plaintiff filed her application for disability benefits in 1996, Listing 9.09 was in effect. That listing stated that an applicant who met a certain weight/height combination so as to demonstrate morbid obesity and who also suffered from an additional, specific impairment would be presumed to be disabled and would be entitled to disability benefits.1 Listing 9.09 was still in effect in February 1999, when the ALJ erroneously analyzed Plaintiff‘s impairments and denied Plaintiff‘s application. From the record, it is clear that Plaintiff had a strong case for presumptive disability under Listing 9.09. At the first hearing, had the ALJ correctly analyzed Plaintiff‘s impairments, he most likely would have found Plaintiff to be disabled. The Social Security Administration (“SSA“) deleted Listing 9.09 on August 24, 1999, almost three years after Plaintiff applied for disability benefits. The final, binding decision of the ALJ did not occur until February 2003, so that Plaintiff could not employ Listing 9.09 to establish her disability.
II.
The lead opinion expends a scant amount of ink in explaining the nuances of
The Supreme Court‘s current position on retroactivity is best described in Landgraf v. USI Film Products. In that case, the plaintiff was employed by the defendant from 1984 to 1986. Id. at 247-48. A fellow employee harassed the plaintiff with inappropriate remarks and physical contact. Id. at 248. The plaintiff complained to the defendant‘s management, and management conducted an investigation, reprimanded the harassing employee, and transferred that employee to another department. Id. Four days later, the plaintiff quit. Id. The plaintiff filed a charge against the defendant with the Equal Employment Opportunity Commission (“EEOC“), but the EEOC dismissed the charge because it found that while the plaintiff had suffered from a hostile work environment, the defendant had adequately remedied the situation. Id. The plaintiff then filed suit in federal district court. Id. In a bench trial, the court dismissed the plaintiff‘s complaint; it found that while the plaintiff had suffered from a hostile work environment, she was not constructively discharged by the defendant. Id. The plaintiff appealed.
On November 21, 1991, while the plaintiff‘s appeal was pending, the President signed into law the
The plaintiff argued before the court of appeals that the court should remand her case to the district court for a jury trial on the issues of compensatory and punitive damages pursuant to the
The Supreme Court affirmed. The Court found that the
The first question the Court addressed was “whether the statutory text on which [the plaintiff] relies manifests an intent that the 1991 Act should be applied to cases that arose and went to trial before its enactment.” Id. at 257. The Court answered in the negative, finding that the text of the statute was ambiguous as to a congressional intent of retroactive application of the 1991 Act. The Court reasoned, “It is entirely possible-indeed, highly probable-that because it was unable to resolve the retroactivity issue ... Congress viewed the matter as an open issue to be resolved by the courts.” Id. at 261, 114 S.Ct. 1483.
Next, the Court addressed whether, despite the lack of clear congressional intent, the 1991 Act could be retroactively applied to the defendant. The Court found that there was a long-established presumption against retroactive legislation: “Elementary considerations of fairness dictate that individuals should have an opportunity to know what the law is and to conform their conduct accordingly; settled expectations should not be lightly disrupted.” Id. at 265, 114 S.Ct. 1483. On the other hand, “[r]etroactivity provisions often serve entirely benign and legitimate purposes, whether to respond to emergencies, to correct mistakes, to prevent circumvention of a new statute in the interval immediately preceding its passage, or simply to give comprehensive effect to a new law Congress considers salutary.” Id. at 267-68, 114 S.Ct. 1483. The Court warned that “deciding when a statute operates ‘retroactively’ is not always a simple or mechanical task.” Id. at 268, 114 S.Ct. 1483. More specifically:
A statute does not apply “retrospectively” merely because it is applied in a case arising from conduct antedating the statute‘s enactment ... or upsets expectations based in prior law. Rather, the court must ask whether the new provision attaches new legal consequences to events completed before its enactment. The conclusion that a particular rule operates “retroactively” comes at the end of a process of judgment concerning the nature and extent of the change in the law and the degree of connection between the operation of the new rule and a relevant past event. Any test of retroactivity will leave room for disagreement in hard cases, and is unlikely to classify the enormous variety of legal changes with perfect philosophical clarity. However, retroactivity is a matter on which judges have “sound instinct[s],” ... and familiar considerations of fair notice, reasonable reliance, and settled expectations offer sound guidance.
Id. at 269-70, 114 S.Ct. 1483 (alteration in the original) (internal citations omitted).
Despite the presumption against retroactivity, the Court “recognized that, in many situations, a court should ‘apply the law in effect at the time it renders its decision,’ ... even though that law was enacted after the events that gave rise to the suit.” Id. at 273, 114 S.Ct. 1483 (internal citation omitted). For example, “[w]hen the intervening statute authorizes or affects the propriety of prospective relief, application of the new provision is not retroactive.” Id. In another example, the Court stated, “We have regularly applied intervening statutes conferring or ousting jurisdiction, whether or not jurisdiction lay when the underlying conduct occurred or when the suit was filed.” Id. at 274, 114 S.Ct. 1483.
Importantly for Plaintiff‘s case, the Court also reasoned that
[c]hanges in procedural rules may often be applied in suits arising before their enactment without raising concerns about retroactivity.... We [have] noted
the diminished reliance interests in the matter of procedure.... Because rules of procedure regulate secondary rather than primary conduct, the fact that a new procedural rule was instituted after the conduct giving rise to the suit does not make application of the rule at trial retroactive.
Id. at 275, 114 S.Ct. 1483 (internal citations omitted). The Court warned, however, that “[o]f course, the mere fact that a new rule is procedural does not mean that it applies to every pending case.... Our orders approving amendments to federal procedural rules reflect the commonsense notion that the applicability of such provisions ordinarily depends on the posture of the particular case.” Id. at 275 n. 29, 114 S.Ct. 1483.
The Court offered these final words of guidance:
When a case implicates a federal statute enacted after the events in suit, the court‘s first task is to determine whether Congress has expressly prescribed the statute‘s proper reach. If Congress has done so, of course, there is no need to resort to judicial default rules. When, however, the statute contains no such express command, the court must determine whether the new statute would have retroactive effect, i.e., whether it would impair rights a party possessed when he acted, increase a party‘s liability for past conduct, or impose new duties with respect to transactions already completed. If the statute would operate retroactively, our traditional presumption teaches that it does not govern absent clear congressional intent favoring such a result.
Id. at 280, 114 S.Ct. 1483. Armed with these principles, the Court found that application of the 1991 Act would have an impermissible retroactive effect on the conduct of the defendant. Specifically, the Court found that retroactive application of punitive damages would raise serious constitutional concerns with respect to the Ex Post Facto Clause. Id. at 281, 114 S.Ct. 1483. With respect to compensatory damages, the Court found that “[t]he introduction of a right to compensatory damages is also the type of legal change that would have an impact on private parties’ planning.... [I]f applied here, [compensatory damages] would attach an important new legal burden to that conduct.” Id. at 282-83, 114 S.Ct. 1483. The Court also found that because the 1991 Act increased the scope of actionable conduct, it created a new cause of action that could not be retroactively applied to the defendant. Id. at 283, 114 S.Ct. 1483.
In Martin v. Hadix, 527 U.S. 343, 119 S.Ct. 1998, 144 L.Ed.2d 347 (1999), the Supreme Court held that a provision of the
The Supreme Court answered in the negative. Under the first step of Landgraf, the Court found that Congress had
had a reasonable expectation that work they performed prior to enactment of the PLRA ... would be compensated at the pre-PLRA rates ... [C]ounsel performed a specific task ... and they were told that they would be compensated at a rate of $150 per hour. Thus, when the lawyers ... provided these services before the enactment of the PLRA, they worked in reasonable reliance on this fee schedule. The PLRA, as applied to work performed before its effective date, would alter the fee arrangement post hoc by reducing the rate of compensation. To give effect to the PLRA‘s fees limitations, after the fact, would “attac[h] new legal consequences” to completed conduct.
Id. at 358, 119 S.Ct. 1998 (second alteration in the original) (citation omitted).
The Court rejected the respondent‘s argument that the fee provision of the PLRA was collateral to the main cause of action and therefore was not impermissibly retroactive under Landgraf. Id. at 358-59, 119 S.Ct. 1998. The Court admitted that in Landgraf, the Court stated that the question of attorney‘s fees did not “change the substantive obligations of the parties because they are collateral to the main cause of action.” Id. at 359, 119 S.Ct. 1998 (internal quotation marks and citation omitted). The Court, however, warned about generalizations in the retroactivity analysis:
While it may be possible to generalize about types of rules that ordinarily will not raise retroactivity concerns, ... these generalizations do not end the inquiry. For example, in Landgraf, we acknowledged that procedural rules may often be applied to pending suits with no retroactivity problems, ... but we also cautioned that “the mere fact that a new rule is procedural does not mean that it applies to every pending case ... We took pains to dispel the “sugges[tion] that concerns about retroactivity have no application to procedural rules.” ... When determining whether a new statute operates retroactively, it is not enough to attach a label (e.g., “procedural,” “collateral“) to the statute; we must ask whether the statute operates retroactively.
Id. (alteration in the original) (internal citations omitted). The Court found that though the attorney fees were “collateral,” that label did not preclude a retroactivity analysis. Id.
In Republic of Austria v. Altmann, the Supreme Court held that the
The Supreme Court disagreed and held that the district court had jurisdiction to hear the case. The Court first noted that while there was language in the FSIA suggesting that Congress intended the FSIA to apply to preenactment conduct, that language was not so clear so as to be an “expres[s] prescri[ption of] the statute‘s proper reach.” Id. at 694, 124 S.Ct. 2240 (alterations in the original) (quotation marks omitted). The Court then proceeded to determine whether the statute had an impermissible retroactive effect. The Court found that the FSIA defied categorization as either a substantive or procedural provision. Id. at 694, 124 S.Ct. 2240. The Court, however, ruled that the presumption against retroactivity did not apply to changes in sovereign immunity, inasmuch as the purpose of sovereign immunity was not so that foreign nations could shape their conduct around such immunity. Id. at 696, 124 S.Ct. 2240. Instead, sovereign immunity was a “gesture of comity” based on “current political realities and relationships.” Id. In other words, the underlying rationale for the presumption against retroactivity did not exist in the sovereign immunity context. In bolstering its decision, the Court found that the language of the statute and its structure, while not clear enough to be considered an express command from Congress, strongly suggested that Congress intended the FSIA to reach claims based upon preenactment conduct. Id. at 697-99, 124 S.Ct. 2240.
III.
The lead opinion asserts that the deletion of Listing 9.09 and the subsequent implementation of new obesity rules constituted procedural, as opposed to substantive, changes, so that Plaintiff did not suffer from an impermissible retroactive effect. Nothing could be further from the truth. As Judge Griffin explains in his separate opinion, and as Judge Gilman agrees in his separate opinion, burdens of proof are substantive, not procedural, law. See, e.g., Raleigh v. Illinois Dep‘t of Revenue, 530 U.S. 15, 20-21, 120 S.Ct. 1951, 147 L.Ed.2d 13 (2000) (“Given its importance to the outcome of cases, we have long held the burden of proof to be a ‘substantive’ aspect of a claim.” (emphasis supplied)); Dir., Office of Workers’ Comp. Programs v. Greenwich Collieries, 512 U.S. 267, 271, 114 S.Ct. 2251, 129 L.Ed.2d 221 (1994) (“But the assignment of the burden of proof is a rule of substantive law ....“); Dick v. New York Life Ins. Co., 359 U.S. 437, 446, 79 S.Ct. 921, 3 L.Ed.2d 935 (1959) (“[P]resumptions (and their effects) and burden of proof are ‘substantive’ ....“). In the same vein, presumptions, such as that found in Listing 9.09, are substantive law. See id; see also Allentown Mack Sales and Serv., Inc. v. N.L.R.B., 522 U.S. 359, 378, 118 S.Ct. 818, 139 L.Ed.2d 797 (1998) (explaining that evidentiary presumptions are “substantive rules of law“). No matter what label the lead opinion attaches, the shift from Listing 9.09 to the new obesity rules was a substantive change in the law, so that application of the new rules had an impermissible retroactive effect on Plaintiff.2
Moreover, even without the preceding case law on the substantive nature of burdens of proof and presumptions, the lead opinion‘s assertion that the change in the SSA‘s obesity rules was procedural would still be improper. The Supreme Court has repeatedly warned against mechanically labeling a change in law as procedural and therefore not subject to the presumption against retroactivity. See Martin, 527 U.S. at 359, 119 S.Ct. 1998 (“When determining whether a new statute operates retroactively, it is not enough to attach a label (e.g., ‘procedural,’ ‘collateral‘) to the statute; we must ask whether the statute operates retroactively.“); Landgraf, 511 U.S. at 275 n. 29, 114 S.Ct. 1483. The question then becomes what the proper inquiry should be to determine whether a change in law has an impermissible retroactive effect, without relying on the judicial shortcuts of calling the change “procedural” or “substantive.”
The analysis of the D.C. Circuit is persuasive in this regard. In National Mining Association v. Department of Labor, the court addressed new rules promulgated by the Department of Health and Human Services (“DHHS“) pursuant to the
Rather than rely on “procedural” and “substantive” labels, a court must ask whether the [regulation] operates retroactively.... This inquiry involves a commonsense, functional judgment about whether the new provision attaches new legal consequences to events completed before its enactment. Thus, where a rule changes the law in a way that adversely affects [a party‘s] prospects for success on the merits of the claim, it may operate retroactively even if designated “procedural” by the Secretary.
Id. at 859-60 (alterations in the original) (internal quotation marks and citations omitted). A specific example of a seemingly procedural change that the court struck down as impermissibly retroactive was
a rebuttable presumption that when a miner who is eligible for black lung benefits receives medical treatment for a pulmonary disorder, the disorder is “caused or aggravated by the miner‘s pneumoconiosis.”
20 C.F.R. § 725.701(e) . The employer may rebut the presumption with “credible evidence that the medical service or supply provided was for a pulmonary disorder apart from those previously associated with the miner‘s disability” or was beyond the treatment necessary to treat the covered disorder, or “was not for a pulmonary disorder at all.” Id.
Id. at 865. Before this new regulation, a miner was required to affirmatively prove
The instant case presents almost identical circumstances, except that the burden shift was in the opposite direction. Under Listing 9.09, if Plaintiff met certain criteria, there was an irrebuttable presumption that Plaintiff was disabled and thus entitled to benefits. Under the new obesity rules, Plaintiff must actually prove disability at Step Three, Four, or Five of the SSA‘s process in order to qualify for benefits. In Kokal v. Massanari, a district court viewed the deletion of Listing 9.09 in this manner: “Here, Plaintiff‘s rights would be substantively altered if the [change in obesity rules] was deemed applicable to pending claims, because the revised regulation would raise the bar on proof of disability based on obesity.” 163 F.Supp.2d 1122, 1131 (N.D.Cal.2001). As the facts of this case so aptly demonstrate, the new obesity rules adversely affected Plaintiff‘s prospects for success on the merits. These new rules thus had an impermissible retroactive effect and should not have been applied to Plaintiff‘s pending application for disability benefits.
Judge Gilman‘s position that National Mining Association is directly on point and persuasive therefore clashes and is irreconcilable with his conclusion that the deletion of Listing 9.09 and the application of the new obesity rules to Plaintiff was not impermissibly retroactive. Under National Mining Association, the inquiry is whether “a rule changes the law in a way that adversely affects [a party‘s] prospects for success on the merits of the claim.” Nat‘l Mining Assoc., 292 F.3d at 860 (alteration in the original) (internal quotation marks and citation omitted). This inquiry answers whether the change in law is impermissibly retroactive, not whether the change in law is substantive or procedural. Id. at 859-60. In this case, it is without question that the change in law, from Listing 9.09 to the new obesity rules, adversely affected Plaintiff‘s prospects for success on the merits of her disability claim. The “persuasive and apposite” analysis of National Mining Association invariably leads to the conclusion that the application of the new obesity rules to Plaintiff‘s disability claim had an impermissible retroactive effect.3 Concurring Op., Judge Gilman, at 653.
The D.C. Circuit‘s analysis comports with the Supreme Court‘s guidance in
The lead opinion‘s repeated reliance on Altmann, in deeming that the change in the SSA‘s obesity rules is procedural, is puzzling. Altmann was not a case whose decision hinged upon the Supreme Court‘s determination that the relevant change in law was procedural; indeed, the Supreme Court specifically rejected that argument:
Under Landgraf, ... it is appropriate to ask whether the Act affects substantive rights (and thus would be impermissibly retroactive if applied to preenactment conduct) or addresses only matters of procedure (and thus may be applied to all pending cases regardless of when the underlying conduct occurred). But the FSIA defies such categorization.
541 U.S. at 694, 124 S.Ct. 2240 (emphasis supplied). The Court‘s decision did not rely on the procedural-substantive line in its analysis. Instead, the basis of the decision was that the FSIA defined the boundaries of sovereign immunity, a principle where the presumption against retroactivity was inapplicable in that sui generis context. Id. at 696, 124 S.Ct. 2240. Altmann simply cannot be read to support the notion that the shift in obesity rules was merely procedural.
The lead opinion‘s misapprehension of Altmann is readily apparent when it cites to that case to support the proposition that “a statute that has been held to be substantive in one context is not thereby made substantive for retroactivity purposes.” Lead Op. at 648 n.2. There is absolutely no language in Altmann that says such a thing. As stated above, Altmann explicitly states that the FSIA defied categorization as either substantive or procedural law. 541 U.S. at 694, 124 S.Ct. 2240. The pages to which the lead opinion cites continue and state that, even though the FSIA was not clearly substantive or procedural, the general presumption against retroactivity did not apply to sovereign immunity, as sovereign immunity reflected “current political realities and relationships,” as opposed to a set of laws on which the foreign countries relied “to shape their conduct.” Id. at 695-96, 124 S.Ct. 2240. The Supreme Court did not hold that the FSIA
The lead opinion also states that the “relevant activity” here is adjudicatory conduct, so that the deletion of Listing 9.09 and the application of the new rules did not have a retroactive effect:
Changes to these listings consequently have their effect on benefits applications when claimants reach step three in the process of adjudicating their claims. A rule regulating the evaluation and presentation of proof does not normally operate retroactively if it is applied to pending cases. The SSA may freely change rules that purely govern the conduct of adjudication, without fear of retroactive effect, if those changes apply only to pending cases.
Lead Op. at 649. As an initial note, this is a none-too-subtle repackaging of the lead opinion‘s previous argument labeling the deletion of Listing 9.09 and the promulgation of new rules as a procedural change. The phrase “adjudicatory conduct” is simply another way to describe procedure in the litigation process. This is especially apparent in the lead opinion‘s use of the phrase “evaluation and presentation of proof” and the lead opinion‘s characterization of Listing 9.09 as a “rule of adjudication“; the lead opinion is reasserting its position that changes in procedure do not give rise to an impermissible retroactive effect. Obviously, a change in
IV.
Because the deletion of Listing 9.09 was a substantive change, our analysis should
At the risk of stating the obvious, most if not all of this country‘s disabled did not rely on SSA rules and regulations or even disability benefits in becoming disabled. Inherent in this point is that a person generally does not choose to become disabled; a disability is ordinarily the product of circumstances beyond the control of the person whom it afflicts. But the absence of reliance on law in becoming disabled is not dispositive in determining whether a change in that law has an impermissible retroactive effect. Under the lead opinion‘s
approach would find no retroactive harm in even the most blatant of cases.
It is plain that Plaintiff did not rely on SSA rules and regulations in becoming disabled. This fact, however, is irrelevant as to whether the application of the new rules would work an impermissible retroactive effect. The facts in Landgraf illustrate this point: one could not say that the defendant employer somehow relied on the
The Supreme Court found that the underlying act of the employer in Landgraf was its planning on how to address a hostile work environment claim: “The introduction of a right to compensatory damages is also the type of legal change that would have an impact on private parties’ planning.” 511 U.S. at 282, 114 S.Ct. 1483. Specifically, the Court stated that “[t]he new damages provisions ... can be expected to give managers an added incentive to ward off discriminatory conduct by subordinates before it occurs.” Id. at 282 n. 35, 114 S.Ct. 1483. Under the
Plaintiff‘s case presents a similar issue of planning based on the SSA‘s eligibility requirements for disability benefits. The difficulty of proving eligibility for benefits is certainly a factor considered by an individual in disability planning. For example, suppose that qualifying for Social Security disability benefits is extremely difficult; only 1% of applicants eventually receive benefits, and this is only after a torturous eligibility review process. An individual might look at the difficulty in proving eligibility and plan accordingly, by purchasing a third party disability insurance policy with less exacting requirements, by increasing her level of savings in case of disability in the future, and other such measures. Likewise, if qualifying for Social Security disability benefits were extremely easy, an individual might have a very different portfolio mix in her planning, as she would not invest heavily in instruments that hedge the risk of disability. Thus, in this case, Plaintiff did not become disabled in reliance on the disability benefits scheme available at the time; but rather, she planned for the possibility of becoming disabled in reliance on the disability benefits scheme available at the time. Had Plaintiff known that the SSA‘s requirements for eligibility would have changed so dramatically, she might have been inclined to alter her planning. This is especially true with respect to Plaintiff‘s situation, where her application for disabil-
The lead opinion appears to believe that a reliance theory based on disability planning “proves too much,” as such a theory would “for many, many years” preclude application of newly enacted legislation to those who planned in accordance with the old scheme. Lead Op. at 647 n.1. This is incorrect and contrary to Supreme Court precedent. A simple example will illustrate this point: the Supreme Court did not hold in Landgraf that because the defendant employer, before 1991, relied on the
The effect on Plaintiff‘s disability planning also illustrates why the deletion of Listing 9.09 and the implementation of a new regulation was a substantive, as opposed to a procedural, change. A procedural change usually does not work an impermissible retroactive effect because a party usually does not rely on rules of procedure: “We [have] noted the diminished reliance interests in the matter of procedure.... Because rules of procedure regulate secondary rather than primary conduct, the fact that a new procedural rule was instituted after the conduct giving rise to the suit does not make application of the rule at trial retroactive.” Landgraf, 511 U.S. at 275, 114 S.Ct. 1483 (citations omitted). In short, procedural rules may generally be retroactively applied, because “even if a party had known of a procedural change in advance, it would not have changed its conduct prior to the lawsuit.” United States v. Real Property in Section 9, Town 29 North, Range 1 West Township of Charlton, 241 F.3d 796, 799 (6th Cir.2001) (citing Landgraf, 511 U.S. at 275, 114 S.Ct. 1483). Because a change from one procedure to another generally has an ambiguous and unknown effect on a party, a party usually does not fashion its conduct according to procedural rules. Here, however, had Plaintiff known of the change to the obesity rules in advance, she definitely would have changed her conduct in that her disability planning would have been significantly different.
National Mining Association is a text-
Inherent in National Mining Association is the notion that the employer-coal mine operators and the insurance companies relied on the then-existing rules and regulations in planning how to address BLBA liability. When the DHHS promulgated new rules that made it easier to establish a BLBA claim, the DHHS disrupted this planning such that application of the new rules to pending claims would have had an impermissible retroactive ef-
pectations” with respect to this planning.
V.
Because the deletion of Listing 9.09 and the application of the new obesity rules had an impermissible retroactive effect on Plaintiff‘s pending disability application, I would reverse the order of the district court and remand Plaintiff‘s case to the SSA so that her application for disability benefits could be considered under Listing 9.09.
Notes
9.09 Obesity. Weight equal to or greater than the values specified in Table I for males, Table II for females (100 percent above desired level), and one of the following:
A) History of pain and limitation of motion in any weight-bearing joint or the lumbrosacral spine ... associated with findings on medically acceptable imaging techniques of arthritis in the affected joint or lumbrosacral spine; or
B) Hypertension with diastolic blood pressure persistently in excess of 100 mm. Hg measured with appropriate size cuff; or
C) History of congestive heart failure manifested by past evidence of vascular congestion such as hepatomegaly, peripheral or pulmonary edema; or
D) Chronic venous insufficiency with superficial varicosities in a lower extremity with pain on weight bearing and persistent edema; or
E) Respiratory disease with total forced vital capacity equal to or less than 2.0 L. or a level of hypoxemia at rest equal to or less than the values specified in Table III-A or III-B or III-C.
Judge Griffin attempts to explain away
