Gwendolyn GUADAMUZ; Mary Baham; Raymond Holm; Plaintiffs-Appellees, v. Otis R. BOWEN, Secretary of Human Services; Nicholas Brady, in his official capacity as Managing Trustee of the Federal Disability and Insurance Trust Fund, Defendants-Appellants.
No. 86-2857
United States Court of Appeals, Ninth Circuit
Argued and Submitted July 11, 1988. Decided Oct. 18, 1988.
859 F.2d 762 | 23 Soc.Sec.Rep.Ser. 360 | Unempl.Ins.Rep. CCH 14220A
David W. Calvert and Glenn M. Clark, Withy, Miller, Clark, Levin & Calvert, Berkeley, Cal., for plaintiffs-appellees.
Appeal from the United States District Court for the Northern District of California.
Before FARRIS, WIGGINS and TROTT, Circuit Judges.
WIGGINS, Circuit Judge:
The Secretary of Health and Human Services appeals from an injunction issued by the district court. The plaintiffs brought a class action challenging the Secretary‘s procedure for computing attorneys’ fees in Social Security cases. The plaintiffs moved for partial summary judgment and an injunction. The district court granted the motions for partial summary judgment and an injunction in part and denied them in part. The court held that the Secretary‘s application of
FACTS
Title II (SSDI) of the Social Security Act,
In order to remedy the “windfall” problem, Congress enacted in 1980 a “windfall offset” provision.
Title II provides for payment of attorneys’ fees. Under
A particular attorney‘s fee is calculated both by the court and by the Secretary as a percentage of the past-due benefits. If the retroactive Title II benefits awarded to the claimant are reduced by the prior award of Title XVI benefits, the attorney‘s fee will be much smaller. This is so because, by regulation, the Secretary defines “past-due” benefits as the “total amount of benefits payable under Title II of the Act....”
[A]ssume a claimant is entitled to $10,000 in Title II benefits and $9,000 in Title XVI benefits, each entitlement calculated independently of the other. If Title II benefits are paid first, the court can authorize up to $2,500 (25% of $10,000) in attorneys’ fees under Sec. 406(b) and the Secretary can withhold and pay directly to the attorney up to $2500 under either Sec. 406(a) or (b). However, assume the $9,000 in Title XVI benefits are paid first. Under Sec. 1320a-6, the $10,000 Title II entitlement must be offset by the $9,000 Title XVI award, leaving only $1,000 in Title II benefits. The result is that the court could authorize only $250 in attorneys’ fees under Sec. 406(b) and the Secretary could withhold and pay directly to the attorney only $250 under either subsection (a) or (b).
Guadamuz v. Heckler, 662 F.Supp. 1060, 1063 n. 2 (N.D.Cal.1986).4
Without ever certifying a class, the district court granted the appellees’ motion for an injunction and partial summary judgment.6 The court held that “for purposes of applying Sec. 406 in concurrent claims cases, ‘past-due benefits’ means the actual Title II benefits payable before offset for Title XVI benefits.” Guadamuz, 662 F.Supp. at 1067. The court found that the Secretary‘s interpretation of
STANDARD OF REVIEW
Questions of law are reviewed de novo. United States v. McConney, 728 F.2d 1195, 1201 (9th Cir.) (en banc), cert. denied, 469 U.S. 824, 105 S.Ct. 101, 83 L.Ed.2d 46 (1984). The district court‘s grant of permanent injunctive relief is reviewed for an application of erroneous legal principles. SEC v. Goldfield Deep Mines Co. of Nevada, 758 F.2d 459, 465 (9th Cir.1985).
ANALYSIS
I. Jurisdiction.
Both below, and on appeal, the Secretary challenged the subject matter jurisdiction of the district court. Nowhere in its order did the district court address this issue. The plaintiffs alleged jurisdiction under
Salfi would seem to preclude subject matter jurisdiction over the appellees’ class action. The appellees’ complaint alleged federal-question jurisdiction under section 1331 and 1343(a)(3).8 Under Salfi, 405(h) would preclude general federal question jurisdiction or any other means of judicial review except as provided for in the Act. Also, the unnamed class members here cannot meet the administrative exhaustion requirements of 405(g). However, the two named attorney members of the class alleged facts in their complaint showing that they made application for fees with the Secretary after having successfully represented the named beneficiary plaintiffs before the Secretary or in the district court and pursued all means of administrative review of the Secretary‘s fee award.9
At least the named attorneys in this putative class action are not jurisdictionally barred from asserting their claims. First, subsections 405(g) and (h) do not apply to them or their claims. See Humana of South Carolina, Inc. v. Califano, 590 F.2d 1070, 1081 n. 77 (D.C.Cir.1978). These subsections refer to the right of judicial review after any final decision of the Secretary “made after a hearing.” Attorneys have no right to a “hearing” before the Secretary concerning attorneys’ fees. Thomason v. Schweiker, 692 F.2d 333, 335 (4th Cir.1982). The setting of fees is committed to the Secretary‘s discretion. Id. at 335-36. Where an action is committed to absolute agency discretion by law, however, courts have assumed the power to review allegations that an agency exceeded its legal authority, acted unconstitutionally, or failed to follow its own regulations. Ness Inv. Corp. v. United States Dep‘t of Agric., 512 F.2d 706, 713-14 (9th Cir.1975); see also Thomason, 692 F.2d at 336, Garcia v. Neagle, 660 F.2d 983, 988 (4th Cir.1981) (citing Ness ), cert. denied, 454 U.S. 1153, 102 S.Ct. 1023, 71 L.Ed.2d 309 (1982); Scanwell Laboratories, Inc. v. Shaffer, 424 F.2d 859, 874 (D.C.Cir.1970) (“[w]hen the bounds of discretion give way to the stricter boundaries of law, administrative discretion gives way to judicial review“). The plaintiffs’ complaint alleged that the Secretary‘s interpretation and application of section 406 exceeded her legal authority. We hold, under Ness, that the district court and this court have jurisdiction over the named attorneys’ claims.
II. Secretary‘s Interpretation of Section 406.
The complexity of this issue and many other issues in the Social Security area has prompted Congress to confer on the Secretary exceptionally broad authority to prescribe standards for applying sections of the Act. Schweiker v. Gray Panthers, 453 U.S. 34, 43, 101 S.Ct. 2633, 2640, 69 L.Ed.2d 460 (1981); Batterton v. Francis, 432 U.S. 416, 425, 97 S.Ct. 2399, 2405, 53 L.Ed.2d 448 (1977); Cubanski v. Heckler, 781 F.2d 1421, 1424 (9th Cir.1986). Congress has done so in regard to both Title II and Title XVI benefits.
The district court found that section 406 has two purposes: first, to protect claimants from exorbitant attorneys’ fees; and second, to encourage effective legal representation of claimants by insuring the maintenance of a Social Security bar by insuring an attorney a reasonable fee. Id. at 1063-64.
The court found that the first purpose was accomplished under section 406 by the Secretary or court authorizing “a reasonable fee,” and by prohibiting attorneys from charging more than that fee. Id. at 1064. The court also found that the Secretary‘s interpretation of “past-due benefits” did little to protect claimants in 406(a) cases where the case has not gone to court. The court noted that under 406(a) the Secretary‘s interpretation will not affect the amount the attorney may charge the client because under (a) the amount “authorized” to the attorney is determined independently of the offset. Id.11 The claimant will still be responsible to his attorney for fees up to the authorized amount and the Secretary‘s interpretation of “past-due benefits” has no effect on what the attorney may collect. Id.
As to the second purpose—the attorney “incentive” factor—the court found that the reduction of attorneys’ fees operated as a direct disincentive to attorneys taking Social Security cases. Especially in 406(b), court award cases, the fee awardable and collectible by an attorney may be severely reduced. Id. The court also found that the present procedure for figuring Title II and Title XVI benefits produced an arbitrary and capricious result. Id. Under today‘s procedures, whether Title II or Title XVI benefits are paid first is purely a matter of chance depending on which monthly benefit check is processed first. The district court stated: “[T]wo attorneys who do the same work and achieve the same results for their respective clients may receive significantly different attorneys’ fees simply because one client‘s Title II benefits are processed first while the other‘s Title XVI benefits are processed first.” Id. at 1064-65.
In Burnett v. Heckler, 756 F.2d 621 (8th Cir.1985), an attorney challenged the reduction of his fee due to the Secretary‘s application of the “windfall offset” provision. The attorney made the exact same claim as here—that his attorney‘s fees should be computed pre-offset. The Eighth Circuit found that the Secretary‘s procedure was consistent with the congressional goal of protecting claimants from exorbitant attorneys’ fees. The court stated that under the Secretary‘s approach the claimant will receive more in benefits. Id. at 625-26.12 The court also found that the “direct payment” feature of section 406 was the primary incentive to attorneys rather than the actual amount received. That is, the court believed that attorneys are more interested in being insured payment of some fee and avoiding collection problems than receiving the highest possible fee. The court noted that the Secretary‘s procedure did not affect this aspect of section 406. Id. at 626. Given these determinations, the court found that the Secretary‘s interpretation was not arbitrary or capricious nor did it exceed the Secretary‘s authority. Id. at 625; see also McKenzie v. Bowen, 787 F.2d 1216, 1219 (8th Cir.1986) (“Although the statute is not altogether explicit in its offset of benefits formula, it certainly does not prohibit the calculation of [Title XVI] benefits first in concurrent applications.“); Lindsay v. Secretary, 612 F.Supp. 366, 368 (D.N.J.1985) (same); Gallo v. Heckler, 600 F.Supp. 1513, 1519-20 (E.D.N.Y.1985) (same).
In a closely related case, White v. Bowen, 835 F.2d 974 (2d Cir.1987), claimants brought a class action challenging the Secretary‘s procedure for reimbursing the states for their interim assistance payments. By statute, only Title XVI benefits are reimbursable to states for interim assistance payments. The Secretary, therefore, in order to insure maximum reimbursement to the states, adopted a procedure of figuring Title XVI benefits first so they would not be offset by Title II benefits if they were paid first. The Second Circuit noted that “there simply is no clear statutory guidance on how to decide which retroactive benefits are to be calculated first.” Id. at 978. The court found that the Secretary‘s procedural mechanism insured a source of reimbursement to state welfare agencies, and denied claimants a “windfall” due to the overpayment created by receipt of state interim assistance benefits, and by unreduced Title XVI and Title II monies. “Therefore, the Secretary‘s approach in eliminating this windfall constitute[d] a proper exercise of his discretion and represents a reasonable means of coordinating [Title II benefits], [Title XVI benefits], and state interim assistance programs.” Id. at 979.
All the other circuit courts that have addressed the issue have similarly concluded that the Secretary‘s interpretation of section 406 and associated procedures for calculating Title II and Title XVI benefits in “concurrent claims” cases is entitled to deference. See Baker v. Bowen, 839 F.2d 1197, 1198-1201 (6th Cir.1988); Detson v. Schweiker, 788 F.2d 372, 376 (6th Cir.1986) (primary incentive to attorneys is 406‘s “direct payment” feature not maximum attorneys’ fees); Wheeler v. Heckler, 787 F.2d 101, 106 (3d Cir.1986) (“if [Title XVI] is not calculated first when concurrent, retroactive awards of [Title XVI and Title II] benefits are made, the state may never be reimbursed“); Cuthbert v. Secretary, 784 F.2d 1157, 1160 (4th Cir.1985) (affirmed lower court‘s dismissal of attorneys’ fees petition for lack of subject matter jurisdiction; agreed with Secretary‘s definition of “past-due benefits” as those “payable“). As one court summarized, the Secretary‘s decision is a balancing of all the various interests: (1) the policy of reducing windfalls where retroactive awards are made, (2) the encouragement of legal representation, (3) the decision to protect 75 percent of past-due Title II benefits, and (4) the need to reimburse the states for welfare assistance. Wheeler, 787 F.2d at 108. All of these courts, focusing on either the protection of clients from high attorneys’ fees or the need to reimburse state welfare agencies, have found the Secretary‘s balancing of these interests to be properly within the Secretary‘s discretion and entitled to deference.
III. Administrative Procedure Act.
On appeal, the appellees also argue that the procedure and interpretation adopted by the Secretary violated the notice, comment and publication requirements of the Administrative Procedure Act (APA).
From the record, it is difficult for this court to address this issue. The Secretary‘s regulation defining “payable” benefits under Title II as net post-offset benefits seems to have been promulgated pursuant to the notice, comment and publication procedures of the APA. See
Under the APA, only “substantive” agency rules must meet the Act‘s notice, comment and publication requirements before final implementation.
One court has held that calculating Title XVI benefits prior to calculating Title II benefits constitutes an interpretive rule not subject to the requirements of the APA. McKenzie, 787 F.2d at 1222. The court noted that an interpretive rule only clarifies or explains existing law or regulations, and may include an administrative construction of a statute. Id. We agree with the McKenzie court, especially given that the Secretary‘s present random order of calculation of Title II and Title XVI benefits is hardly a “procedure” at all. The “procedure” does not change any existing law or policy, nor does it remove any previously existing right of claimants or their attorneys. It has never been the policy of the Secretary to determine attorneys’ awards based on gross, pre-offset Title II benefits. The “procedure” simply fills in some gaps created by Congress’ creation of the windfall offset provision. See Powderly v. Schweiker, 704 F.2d 1092, 1098 (9th Cir.1983). We hold that failure to follow the APA‘s formal rule-making requirements in adopting this procedure is not fatal to the Secretary‘s approach.
CONCLUSION
The district court should have deferred to the Secretary‘s interpretation of 406 and its associated procedures. The Secretary‘s approach also does not violate the notice and comment requirements for substantive rule-making under the APA. We REVERSE the district court‘s grant of the injunction ordering the Secretary to calculate and withhold attorneys’ fees based on pre-offset Title II benefits.
REVERSED.
Notes
(a) Notwithstanding any other provision of this Act, in any case where an individual--
(1) is entitled to benefits under title II [
then any benefits under title II [
The original version of Sec. 1320a-6 did not provide for the application of the “windfall offset” when Title II benefits were paid first. In response, the Secretary administratively applied the offset in such cases by always determining Title XVI benefits first. Section 1320a-6 was amended in 1984 so as to allow for the offset regardless whether Title II or XVI benefits were calculated and paid first. Therefore, the order in which the benefits are calculated and paid is no longer material for the purposes of the offset. The amendment became effective on February 1, 1985.
Whenever the Secretary, in any claim before him for benefits under this title, makes a determination favorable to the claimant, he shall, if the claimant was represented by an attorney in connection with such claim, fix ... a reasonable fee to compensate such attorney for the services performed by him in connection with such claim. If as a result of such determination, such claimant is entitled to past-due benefits under this title, the Secretary shall ... certify for payment (out of such past-due benefits) to such attorney in an amount equal to whichever of the following is the smaller: (A) 25 per centum of the total amount of such past-due benefits, (B) the amount of the attorney‘s fee so fixed, or (C) the amount agreed upon between the claimant and such attorney as the fee for such attorney‘s services.
Whenever a court renders a judgment favorable to a claimant under this title who was represented before the court by an attorney, the court may determine and allow as part of its judgment a reasonable fee for such representation, not in excess of 25 percent of the total of the past-due benefits to which the claimant is entitled by reason of such judgment, and the Secretary may ... certify the amount of such fee for payment to such attorney out of, and not in addition to, the amount of such past-due benefits.
(emphasis added).
Any individual, after any final decision of the Secretary made after a hearing to which he was a party ... may obtain a review of such decision by a civil action....
Section 405(h) (Finality of administrative determinations) provides:
The findings and decisions of the Secretary after a hearing shall be binding upon all individuals who were parties to such hearing. No findings of fact or decision of the Secretary shall be reviewed by any person, tribunal, or governmental agency except as herein provided. No action against the United States, the Secretary, or any officer or employee thereof shall be brought under section 1331 or 1346 of Title 28, United States Code, to recover on any claim arising under this title.
(a) The district court shall have original jurisdiction of any civil action authorized by law to be commenced by any person:
....
(3) To redress the deprivation, under color of any State law, statute, ordinance, regulation, custom or usage, with any right, privilege or immunity secured by the Constitution of the United States or by any Act of Congress providing for equal rights of citizens or of all persons within the jurisdiction of the United States.
When a challenge to an agency construction of a statutory provision, fairly conceptualized, really centers on the wisdom of the agency‘s policy, rather than whether it is a reasonable choice within a gap left open by Congress, the challenge must fail. In such a case, federal judges—who have no constituency—have a duty to respect legitimate policy choices made by those who do. The responsibilities for assessing the wisdom of such policy choices and resolving the struggle between competing views of the public interest are not judicial ones: “Our Constitution vests such responsibilities in the political branches.”
Chevron, 467 U.S. at 866, 104 S.Ct. at 2793 (quoting TVA v. Hill, 437 U.S. 153, 195, 98 S.Ct. 2279, 2302, 57 L.Ed.2d 117 (1978)).
