SIMS v. APFEL, COMMISSIONER OF SOCIAL SECURITY
No. 98-9537
Supreme Court of the United States
Argued March 28, 2000—Decided June 5, 2000
530 U.S. 103
Sarah H. Bohr argued the cause for petitioner. With her on the briefs were Chantal J. Harrington, Gary R. Parvin, and Jon C. Dubin.
Malcolm L. Stewart argued the cause for respondent. With him on the brief were Solicitor General Waxman, Acting Assistant Attorney General Ogden, Deputy Solicitor General Kneedler, William Kanter, and Robert D. Kamenshine.*
A person whose claim for Social Security benefits is denied by an administrative law judge (ALJ) must in most cases,
I
In 1994, petitioner Juatassa Sims filed applications for disability benefits under Title II of the Social Security Act,
Petitioner then requested that the Social Security Appeals Council review her claims. A claimant may request such review by completing a one-page form provided by the Social Security Administration (SSA)—Form HA-520—or “by any other writing specifically requesting review.”
Next, petitioner filed suit in the District Court for the Northern District of Mississippi. She contended that (1) the ALJ had made selective use of the record; (2) the questions the ALJ had posed to a vocational expert to determine petitioner‘s ability to work were defective because they omitted
The Court of Appeals for the Fifth Circuit affirmed. 200 F. 3d 229 (1998). That court affirmed on the merits with regard to petitioner‘s first contention. With regard to the second and third contentions, it concluded that, under its decision in Paul v. Shalala, 29 F. 3d 208, 210 (1994), it lacked jurisdiction because petitioner had not raised those contentions in her request for review by the Appeals Council. We granted certiorari, 528 U. S. 1018 (1999), to resolve a conflict among the Courts of Appeals over whether a Social Security claimant waives judicial review of an issue if he fails to exhaust that issue by presenting it to the Appeals Council in his request for review. Compare Paul, supra, at 210; James v. Chater, 96 F. 3d 1341, 1343-1344 (CA10 1996), with Harwood v. Apfel, 186 F. 3d 1039, 1042-1043 (CA8 1999); Johnson v. Apfel, 189 F. 3d 561, 563-564 (CA7 1999).1
II
A
The Social Security Act provides that “[a]ny individual, after any final decision of the Commissioner of Social Security made after a hearing to which he was a party, ... may obtain a review of such decision by a civil action” in federal district court.
The Commissioner rightly concedes that petitioner exhausted administrative remedies by requesting review by the Council. Petitioner thus obtained a final decision, and nothing in
Nevertheless, the Commissioner contends that we should require issue exhaustion in addition to exhaustion of remedies. That is, he contends that a Social Security claimant, to obtain judicial review of an issue, not only must obtain a final decision on his claim for benefits, but also must specify that issue in his request for review by the Council. (Whether a claimant must exhaust issues before the ALJ is not before us.) The Commissioner argues, in particular, that an issue-exhaustion requirement is “an important corollary” of any requirement of exhaustion of remedies. Brief for Respondent 13. We think that this is not necessarily so and that the corollary is particularly unwarranted in this case.
Initially, we note that requirements of administrative issue exhaustion are largely creatures of statute. Marine Mammal Conservancy, Inc. v. Department of Agriculture, 134 F. 3d 409, 412 (CADC 1998). Our cases addressing issue
Similarly, it is common for an agency‘s regulations to require issue exhaustion in administrative appeals. See, e. g.,
It is true that we have imposed an issue-exhaustion requirement even in the absence of a statute or regulation. But the reason we have done so does not apply here. The basis for a judicially imposed issue-exhaustion requirement is an analogy to the rule that appellate courts will not consider
“Ordinarily an appellate court does not give consideration to issues not raised below. For our procedural scheme contemplates that parties shall come to issue in the trial forum vested with authority to determine questions of fact. This is essential in order that parties may have the opportunity to offer all the evidence they believe relevant to the issues which the trial tribunal is alone competent to decide; it is equally essential in order that litigants may not be surprised on appeal by final decision there of issues upon which they have had no opportunity to introduce evidence. And the basic reasons which support this general principle applicable to trial courts make it equally desirable that parties should have an opportunity to offer evidence on the general issues involved in the less formal proceedings before administrative agencies entrusted with the responsibility of fact finding.” Id., at 556.
As we further explained in L. A. Tucker Truck Lines, courts require administrative issue exhaustion “as a general rule” because it is usually “appropriate under [an agency‘s] practice” for “contestants in an adversary proceeding” before it to develop fully all issues there. 344 U. S., at 36-37. (We also spoke favorably of issue exhaustion in Unemployment Compensation Comm‘n of Alaska v. Aragon, 329 U. S. 143, 154-155 (1946), without relying on any statute or regulation, but in that case the waived issue had not been raised before the District Court, see id., at 149, 155.)
But, as Hormel and L. A. Tucker Truck Lines suggest, the desirability of a court imposing a requirement of issue exhaustion depends on the degree to which the analogy to normal adversarial litigation applies in a particular administrative proceeding. Cf. McKart v. United States, 395 U. S. 185, 193 (1969) (application of doctrine of exhaustion of ad-
B
The differences between courts and agencies are nowhere more pronounced than in Social Security proceedings. Although “[m]any agency systems of adjudication are based to a significant extent on the judicial model of decisionmaking,” 2 K. Davis & R. Pierce, Administrative Law Treatise § 9.10, p. 103 (3d ed. 1994), the SSA is “[p]erhaps the best example of an agency” that is not, B. Schwartz, Administrative Law 469-470 (4th ed. 1994). See id., at 470 (“The most important of [the SSA‘s modifications of the judicial model] is the replacement of normal adversary procedure by ... the ‘investigatory model‘” (quoting Friendly, Some Kind of Hearing, 123 U. Pa. L. Rev. 1267, 1290 (1975))). Social Security proceed-
The regulations make this nature of SSA proceedings quite clear. They expressly provide that the SSA “conduct[s] the administrative review process in an informal, nonadversary manner.”
Thus, the Hormel analogy to judicial proceedings is at its weakest in this area. The adversarial development of issues by the parties—the “com[ing] to issue,” 312 U. S., at 556—on which that analogy depends simply does not exist. The Council, not the claimant, has primary responsibility for identifying and developing the issues. We therefore agree with the Eighth Circuit that “the general rule [of issue exhaustion] makes little sense in this particular context.” Harwood, 186 F. 3d, at 1042.
Accordingly, we hold that a judicially created issue-exhaustion requirement is inappropriate. Claimants who exhaust administrative remedies need not also exhaust issues in a request for review by the Appeals Council in order to preserve judicial review of those issues. The judgment of the Fifth Circuit is reversed, and the case is remanded for further proceedings.
It is so ordered.
JUSTICE O‘CONNOR, concurring in part and concurring in the judgment.
In most cases, an issue not presented to an administrative decisionmaker cannot be argued for the first time in federal court. On this underlying principle of administrative law, the Court is unanimous. See ante, at 108; post, at 114-115
Although the SSA‘s regulations warn claimants that completely failing to request Appeals Council review will forfeit the right to seek judicial review, see
JUSTICE BREYER concedes that these factors “might mislead the Social Security claimant” to believe that issue exhaustion is not required. Post, at 118 (dissenting opinion). He nonetheless contends that this is not a problem because the SSA has assured the Court that it “has not invoked [issue exhaustion] in suits brought by claimants who were unrepresented during the Appeals Council proceedings.” Brief for Respondent 41-42. As a matter of past practice, the agency‘s statement appears to be inaccurate. See Owens v. Apfel, No. 1:98CV1442 (ND Ohio, Aug. 3, 1999), vacated on other grounds, 205 F. 3d 1341 (CA6 2000). But even if this stated policy were uniformly followed, I think it would be unwise to adopt a rule that imposes different issue exhaustion obligations depending on whether claimants are represented by counsel.
In this case, the SSA told petitioner (1) that she could request review by sending a letter or filling out a 1-page form that should take 10 minutes to complete, (2) only that failing to request Appeals Council review would preclude judicial review, and (3) that the Appeals Council would review her entire case for issues. She did everything that the agency asked of her. I would not impose any additional requirements, and would reverse the judgment and remand for further proceedings consistent with this opinion.
JUSTICE BREYER, with whom THE CHIEF JUSTICE, JUSTICE SCALIA, and JUSTICE KENNEDY join, dissenting.
Under ordinary principles of administrative law a reviewing court will not consider arguments that a party failed to raise in timely fashion before an administrative agency. See
“[O]rderly procedure and good administration require that objections to the proceedings of an administrative agency be made while it has opportunity for correction in order to raise issues reviewable by the courts. ... [C]ourts should not topple over administrative decisions unless the administrative body not only has erred but has erred against objection made at the time appropriate under its practice.” L. A. Tucker Truck Lines, supra, at 37.
Although the rule has exceptions, it applies with particular force where resolution of the claim significantly depends upon specialized agency knowledge or practice. In this case, petitioner asked the reviewing court to consider arguments of the kind that clearly fall within the general rule, namely, whether an administrative law judge should have ordered a further medical examination or asked different questions of a vocational expert. No one claims that any established exception to this ordinary “exhaustion” or “waiver” rule applies. See, e. g., Bethesda Hospital Assn. v. Bowen, 485 U. S. 399, 406-407 (1988) (futility); Mathews v. Eldridge, 424 U. S. 319, 329, n. 10 (1976) (constitutional claims).
The Court nonetheless concludes that the law requires a new exception. It points out that the ordinary waiver rule as applied to administrative agencies “is an analogy to the rule that appellate courts will not consider arguments not raised before trial courts.” Ante, at 108-109. And the plurality argues that the agency proceedings here at issue, unlike those before trial courts, are not adversarial proceedings. Ante, at 110-112. Although I agree with both
There are, of course, important differences between a court and an administrative agency, but those differences argue in favor of, not against, applying the waiver principle here. Cf. SEC v. Chenery Corp., 318 U. S. 80, 88-95 (1943). As this Court has explained, the law ordinarily insists that a party invoke administrative processes before coming to court in order to avoid premature interruption of the administrative process and to enable the expert agency to develop the necessary facts. McKart v. United States, 395 U. S. 185, 193-194 (1969). In addition, exhaustion is required because a
“complaining party may be successful in vindicating his rights in the administrative process. If he is required to pursue his administrative remedies, the courts may never have to intervene. And notions of administrative autonomy require that the agency be given a chance to discover and correct its own errors. Finally, it is possible that frequent and deliberate flouting of administrative processes could weaken the effectiveness of an agency by encouraging people to ignore its procedures.” Id., at 195.
Certain of these reasons apply with equal force to courts and to administrative agencies. Others, such as the notion of “administrative autonomy,” apply with special force to agencies. None of them applies only to courts. Practical considerations arising out of the agency‘s familiarity with the subject matter as well as institutional considerations caution strongly against courts’ deciding ordinary, circumstance-specific matters that the parties have not raised before the agency—at least where there is no good reason excusing that failure. These considerations apply where a party fails to give an agency an opportunity to correct its own mistake, i. e., to a failure to raise a matter on an internal agency ap-
I would add that these ordinary “exhaustion of remedies” rules are particularly important in Social Security cases, where the Appeals Council is asked to process over 100,000 claims each year, Social Security Administration Office of Hearings and Appeals, Key Workload Indicators—Fiscal Year 1999, p. 21 (115,151 requests for Appeals Council review), where many of those cases ultimately find their way to federal court, Administrative Office of the United States Courts, L. Mecham, Judicial Business of the United States Courts: 1998 Report of the Director 144 (Table C-2) (over 14,000 cases in fiscal year 1998), and where the Social Security Act itself stresses their applicability,
Nor, with one exception, do I see why the nonadversarial nature of the Social Security Administration internal appellate process makes a difference. An initial ALJ proceeding is, after all, itself nonadversarial. Ante, at 111 (although claimant may be represented by counsel, the agency itself has no representative present and relies upon the ALJ to “investigate the facts and develop the arguments both for and against granting benefits“). Yet I assume the plurality would not forgive the requirement that a party ordinarily must raise all relevant issues before the ALJ. Cf. Shalala, supra, at 15 (noting statute‘s “nonwaivable and nonexcusable requirement that an individual present a claim to the agency before raising it in court“).
Neither does the law in this area disfavor informal proceedings. See Hormel, 312 U. S., at 556 (“And the basic reasons which support th[e] general principle [of waiver] appli-
There is, however, one exception, i. e., one way in which the informality of the proceedings may matter. Administrative lawyers are normally aware of the basic “exhaustion of remedies” rules, including the specific waiver principle here at issue. But the internal appellate review proceeding‘s informality; the absence of a clear statement in the rules or on the Appeals Council instructional form insisting upon the raising of all, not just some, issues; the presence on the instructional form of just a few lines for the listing of issues; and an attached estimate that on average an appellant can “read the instructions, gather the necessary facts and fill out the form” in 10 minutes, see Form HA-520—taken together—might mislead the Social Security claimant. That is, it might make the claimant believe he need not raise every issue before the Appeals Council. Ante, at 113-114 (O‘CONNOR, J., concurring in part and concurring in judgment).
But the Social Security Administration says that it does not apply its waiver rule where the claimant is not represented. Brief for Respondent 41-42. And I cannot say it is “arbitrary, capricious, [or] an abuse of discretion,”
For these reasons, I would affirm the judgment of the Court of Appeals.