OCTOBER TERM, 1999
Syllabus
SIMS
v. APFEL, COMMISSIONER OF SOCIAL SECURITY
CERTIORARI TO THE UNITED STATES COURT OF APPEALS FOR THE FIFTH
CIRCUIT
No. 98-9537. Argued March 28, 2000-Decided June 5,2000
Petitioner applied for Social Security disability and
Supplemental Security Income benefits. After a state agency denied
her claims, she obtained a hearing before a Social Security
Administrative Law Judge (ALJ), who also denied her claims.
Petitioner then requested review by the Social Security Appeals
Council, which denied review. She next filed suit in the Federal
District Court, contending that the ALJ erred in three ways. The
District Court rejected her contentions, and the Fifth Circuit
affirmed, concluding that it lacked jurisdiction over two of the
contentions because they were not included in petitioner's request
for review by the Appeals Council.
Held: The judgment is reversed, and the case is remanded.
200 F.3d
229, reversed and remanded.
JUSTICE THOMAS delivered the opinion of the Court with respect
to Parts I and II-A, concluding that Social Security 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. Although administrative
issue-exhaustion requirements are largely creatures of statute,
there is no contention that any statute requires such exhaustion
here. It is also common for an agency's regulations to require
issue exhaustion in administrative appeals, but Social Security
Administration (SSA) regulations do not. This Court has required
issue exhaustion even in the absence of a statute or regulation,
but the reason for doing so does not apply here. The desirability
of a judicially imposed issue-exhaustion requirement depends on the
degree to which the analogy to normal adversarial litigation
applies in a particular administrative proceeding. See
Hormel v.
Helvering, 312 U. S. 552, 556. Where
that proceeding is not adversarial, the reasons for a court to
require issue exhaustion are much weaker than where the parties are
expected to develop the issues themselves. Pp. 106-110.
JUSTICE THOMAS, joined by JUSTICE STEVENS, JUSTICE SOUTER, and
JUSTICE GINSBURG, concluded in Part II-B that the differences
between courts and agencies are nowhere more pronounced than in
Social Security proceedings, which are inquisitorial rather than
adversarial. The ALJ's duty is to investigate the facts and develop
the arguments
104
both for and against granting benefits, and the Council's review
is similarly broad. The regulations expressly provide that the SSA
conducts the administrative review process in an informal,
nonadversary manner. As the Council, not the claimant, has primary
responsibility for identifying and developing the issues, the
general issue-exhaustion rule makes little sense in this context.
Pp. 110-112.
JUSTICE O'CONNOR concluded that the SSA's failure to notify
claimants of an issue exhaustion requirement is a sufficient basis
for holding that such exhaustion is not required in this context.
Requiring issue exhaustion is inappropriate here, where the SSA's
regulations and procedures affirmatively suggest that specific
issues need not be raised before the Appeals Council. pp.
112-114.
THOMAS, J., announced the judgment of the Court and delivered
the opinion of the Court with respect to Parts I and II -A, in
which STEVENS, O'CONNOR, SOUTER, and GINSBURG, JJ., joined, and an
opinion with respect to Part II-B, in which STEVENS, SOUTER, and
GINSBURG, JJ., joined. O'CONNOR, J., filed an opinion concurring in
part and concurring in the judgment,
post, p. 112. BREYER,
J., filed a dissenting opinion, in which REHNQUIST, C. J., and
SCALIA and KENNEDY, JJ., joined,
post, p. 114.
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.
*
JUSTICE THOMAS announced the judgment of the Court and delivered
the opinion of the Court with respect to Parts I and II-A, and an
opinion with respect to Part II-B, in which JUSTICE STEVENS,
JUSTICE SOUTER, and JUSTICE GINSBURG join.
A person whose claim for Social Security benefits is denied by
an administrative law judge (ALJ) must in most cases,
* Rochelle Bobroff, Michael Schuster, and
Robert E. Rains filed a brief for the American Association
of Retired Persons et al. as
amici curiae urging
reversal.
105
before seeking judicial review of that denial, request that the
Social Security Appeals Council review his claim. The question is
whether a claimant pursuing judicial review has waived any issues
that he did not include in that request. We hold that he has
not.
I
In 1994, petitioner Juatassa Sims filed applications for
disability benefits under Title II of the Social Security Act, 49
Stat. 622, 42 U. S. C. § 401
et seq., and for supplemental
security income benefits under Title XVI of that Act, 86 Stat.
1465,42 U. S. C. § 1381
et seq. She alleged disability from
a variety of ailments, including degenerative joint diseases and
carpal tunnel syndrome. After a state agency denied her claims, she
obtained a hearing before a Social Security ALJ. See generally
Heckler v.
Day, 467 U. S. 104, 106-107
(1984) (describing stages of review of claims for Social Security
benefits). The ALJ, in 1996, also denied her claims, concluding
that, although she did have some medical impairments, she had not
been and was not under a "disability," as defined in the Act. See
42 U. S. C. §§ 423(d) (1994 ed. and Supp. III) and 1382c(a)(3)
(1994 ed., Supp. III);
Sullivan v.
Zebley, 493 U. S.
521, 524-526 (1990).
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." 20 CFR § 422.205(a) (1999).
Petitioner, through counsel, chose the latter option, submitting to
the Council a letter arguing that the ALJ had erred in several ways
in analyzing the evidence. The Council denied 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
106
several of petitioner's ailments; and (3) in light of certain
peculiarities in the medical evidence, the ALJ should have ordered
a consultative examination. The District Court rejected all of
these contentions. App. 74-84.
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 (CAlO 1996), with
Harwood v.
Apfel, 186 F.3d
1039,1042-1043
(CA81999); 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. 42 U.
S. C. § 405(g). But the Act does not define "final decision,"
instead leaving it to the SSA to give meaning to that term through
regulations. See § 405(a);
Weinberger v.
Salfi,
422 U. S. 749,
766 (1975). SSA regulations provide that, if the Appeals Council
grants review of a claim, then the decision that the Council issues
is the Com-
1 We agree with the parties that, even were a court-imposed
issueexhaustion requirement proper, the Fifth Circuit erred in
treating it as jurisdictional. Cf.
Mathews v.
Eldridge, 424
U. S. 319, 328 (1976).
107
missioner's final decision. But if, as here, the Council denies
the request for review, the ALJ's opinion becomes the final
decision. See 20 CFR §§ 404.900(a)(4)-(5), 404.955, 404.981,
422.210(a) (1999).2 If a claimant fails to request review from the
Council, there is no final decision and, as a result, no judicial
review in most cases. See § 404.900(b);
Bowen v.
City of
New York, 476 U.
S. 467, 482-483 (1986). In administrative-law parlance, such a
claimant may not obtain judicial review because he has failed to
exhaust administrative remedies. See
Salfi, supra, at
765-766.
The Commissioner rightly concedes that petitioner exhausted
administrative remedies by requesting review by the Council.
Petitioner thus obtained a final decision, and nothing in § 405(g)
or the regulations implementing it bars judicial review of her
claims.
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
2 Part 404 of 20 CFR (1999) applies to Title II of the Act. The
regulations governing Title XVI, which can be found at 20 CFR pt.
416 (1999), are, as relevant here, not materially different. We
will therefore omit references to the latter regulations.
108
exhaustion reflect this fact. For example, in
Woelke
&
Romero Framing, Inc. v.
NLRB, 456 U. S. 645 (1982), we
held that the Court of Appeals lacked jurisdiction to review
objections not raised before the National Labor Relations Board. We
so held because a statute provided that" '[n]o objection that has
not been urged before the Board ... shall be considered by the
court.'"
Id., at 665 (quoting 29 U. S. C. § 160(e) (1982
ed.)). Our decision in
FPC v.
Colorado Interstate Gas
Co., 348 U. S.
492, 497-498 (1955), followed similar reasoning. See also
United States v.
L. A. Tucker Truck Lines, Inc.,
344 U. S. 33, 36,
n. 6 (1952) (collecting statutes);
Washington Assn. for
Television and Children v.
FCC, 712
F.2d 677, 681-682, and n. 6
(CADC 1983) (interpreting
issueexhaustion requirement in 47 U. S. C. §405 (1982 ed.) and
collecting statutes). Here, the Commissioner does not contend that
any statute requires issue exhaustion in the request for
review.
Similarly, it is common for an agency's regulations to require
issue exhaustion in administrative appeals. See,
e.
g., 20 CFR § 802.211(a) (1999) (petition for review to
Benefits Review Board must "lis[t] the specific issues to be
considered on appeal"). And when regulations do so, courts
reviewing agency action regularly ensure against the bypassing of
that requirement by refusing to consider unexhausted issues. See,
e. g., South Carolina v.
United States Dept. of
Labor, 795 F.2d
375, 378
(CA4 1986);
Sears, Roebuck and Co. v.
FTC, 676 F.2d
385, 398, n. 26
(CA9 1982). Yet, SSA regulations do not
require issue exhaustion. (Although the question is not before us,
we think it likely that the Commissioner could adopt a regulation
that did require issue exhaustion.)
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
109
arguments not raised before trial courts. As the Court explained
in
Hormel v.
Helvering, 312 U. S. 552 (1941):
"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 adversariallitigation applies in a particular administrative
proceeding. Cf.
McKart v.
United States, 395 U. S. 185, 193 (1969)
(application of doctrine of exhaustion of ad-
110
Opinion of THOMAS, J.
ministrative remedies "requires an understanding of its purposes
and of the particular administrative scheme involved");
Salfi, 422 U. S., at 765 (same). Where the parties are
expected to develop the issues in an adversarial administrative
proceeding, it seems to us that the rationale for requiring issue
exhaustion is at its greatest.
Hormel, L. A. Tucker Truck
Lines, and
Aragon each involved an adversarial
proceeding. See
Hormel, supra, at 554, 556;
L. A. Tucker
Truck Lines, supra, at 36;
Aragon v.
Unemployment
Compensation Comm'n of Alaska, 149 F.2d 447, 449-452
(CA9 1945), aff'd in part and rev'd in part,
329 U. S. 143 (1946). (In
Hormel, we allowed an exception to the issue-exhaustion
requirement. 312 U. S., at 560.) Where, by contrast, an
administrative proceeding is not adversarial, we think the reasons
for a court to require issue exhaustion are much weaker. More
generally, we have observed that "it is well settled that there are
wide differences between administrative agencies and courts,"
Shepard v.
NLRB, 459 U. S. 344, 351
(1983), and we have thus warned against reflexively "assimilat[ing]
the relation of ... administrative bodies and the courts to the
relationship between lower and upper courts,"
FCC v.
Pottsville Broadcasting Co., 309 U. S. 134, 144
(1940).
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-
111
ings are inquisitorial rather than adversarial. It is the ALJ's
duty to investigate the facts and develop the arguments both for
and against granting benefits, see
Richardson v.
Perales, 402
U. S. 389, 400-401 (1971), and the Council's review is
similarly broad. The Commissioner has no representative before the
ALJ to oppose the claim for benefits, and we have found no
indication that he opposes claimants before the Council. See
generally Dubin, Torquemada Meets Kafka: The Misapplication of the
Issue Exhaustion Doctrine to Inquisitorial Administrative
Proceedings, 97 Colum. L. Rev. 1289, 1301-1305, 1325-1329
(1997).
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." 20 CFR §
404.900(b) (1999). They permit-but do not require-the filing of a
brief with the Council (even when the Council grants review), §
404.975, and the Council's review is plenary unless it states
otherwise, § 404.976(a). See also § 404.900(b) ("[W]e will consider
at each step of the review process any information you present as
well as all the information in our records"). The Commissioner's
involvement in the Appeals Council's decision whether to grant
review appears to be not as a litigant opposing the claimant, but
rather just as an adviser to the Council regarding which cases are
good candidates for the Council to review pursuant to its authority
to review a case
sua sponte. See §§ 404.969(b)-(c);
Perales, supra, at 403. The regulations further make clear
that the Council will "evaluate the entire record," including "new
and material evidence," in determining whether to grant review. §
404.970(b). Similarly, the notice of decision that ALJ's provide
unsuccessful claimants informs them that if they request review,
the Council will "consider all of [the ALJ's] decision, even the
parts with which you may agree," and that the Council might review
the decision "even if you do not ask it to do so." App.25-27.
Finally, Form HA-520, which
112
Opinion of O'CONNOR, J.
the Commissioner considers adequate for the Council's purposes
in determining whether to review a case, see § 422.205(a), provides
only three lines for the request for review, and a notice
accompanying the form estimates that it will take only 10 minutes
to "read the instructions, gather the necessary facts and fill out
the form." The form therefore strongly suggests that the Council
does not depend much, if at all, on claimants to identify issues
for review. Given that a large portion of Social Security claimants
either have no representation at all or are represented by
nonattorneys, see Dubin,
supra, at 1294, n. 29, the lack of
such dependence is entirely understandable.
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 556on 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 issueexhaustion
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
113
(BREYER, J., dissenting). In the absence of a specific statute
or regulation requiring issue exhaustion, however, such a rule is
not always appropriate. The inquiry requires careful examination of
"the characteristics of the particular administrative procedure
provided."
McCarthy v.
Madigan, 503 U. S. 140, 146
(1992). The Court's opinion provides such an examination, and
reaches the correct result. Accordingly, I join Parts I and II -A
of the Court's opinion, as well as its judgment. I write separately
because, in my view, the agency's failure to notify claimants of an
issue exhaustion requirement in this context is a sufficient basis
for our decision. Requiring issue exhaustion is particularly
inappropriate here, where the regulations and procedures of the
Social Security Administration (SSA) affirmatively suggest that
specific issues need not be raised before the Appeals Council.
Although the SSA's regulations warn claimants that completely
failing to request Appeals Council review will forfeit the right to
seek judicial review, see 20 CFR § 404.900(b) (1999), the
regulations provide no notice that claimants must also raise
specific issues before the Appeals Council to preserve them for
review in federal court, see
ante, at 108 (SSA regulations
do not require issue exhaustion). To the contrary, the relevant
regulations and procedures indicate that issue exhaustion before
the Appeals Council is
not required. To request Appeals
Council review, a claimant need not file a brief. See § 404.975.
Rather, he can file either Form HA-520, "Request for Review of
Hearing Decision/Order," or "any other writing specifically
requesting review." § 422.205(a). Form HA-520, the suggested means
of requesting review, provides only three lines (roughly two
inches) for the statement of issues and grounds for appeal, and the
SSA estimates that it should take a total of 10 minutes to read the
instructions, collect the relevant information, and complete the
form, see 58 Fed. Reg. 28596 (1993);
ante, at 111-112.
Moreover, Appeals Council review is plenary unless the Council
informs the claimant otherwise in
114
writing, see § 404.976(a); as the notice of decision of the
Administrative Law Judge (ALJ) to petitioner stated, if she
requested review before the Appeals Council, "the Council will
consider all of [the ALJ's] decision .... Requesting review places
the entire record of your case before the Council." See App.
26-27.
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 i-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
115
United States v.
L. A. Tucker Truck Lines, Inc.,
344 U. S. 33,
36-37 (1952);
Unemployment Compensation Comm'n of Alaska v.
Aragon, 329 U.
S. 143, 155 (1946);
Hormel v.
Helvering, 312 U. S. 552, 556-557
(1941); see also 2 K. Davis & R. Pierce, Administrative Law
Treatise § 15.8, pp. 341-344 (3d ed. 1994). As this Court explained
long ago:
"[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
116
propositions, I do not see how they lead to the plurality's
conclusion.
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, circumstancespecific
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-
117
peal, just as they apply to a failure ever to raise the matter
at all. See
id., at 194 (exhaustion principles apply equally
where "administrative process is at an end and a party seeks
judicial review of a decision that was not appealed through the
administrative process").
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, 42 U. S. C. §§ 405(g),
(h). See generally
Shalala v.
Illinois Council on Long
Term Care, Inc., 529 U. S. 1, 12-13 (2000);
Weinberger
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 thee] general principle [of waiver] appli-
118
cable 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" (emphasis added)). Considerations of time and expense can
favor such proceedings. And, since a Social Security claimant is
permitted his own counselor other representative if he wishes, the
informality does not necessarily work to his disadvantage. Indeed,
the plurality's rule, by interfering with the ordinary ALJ/Appeals
Council/District Court order for presenting agency-specific
arguments, threatens to complicate judicial review, thereby
producing increased delay without any benefit to the agency or to
the claimants themselves.
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," 5 U. S. C. § 706(2)(A),
to apply the waiver rule when a claimant was represented before the
Appeals Council, as was petitioner,
119
by an
attorney. Petitioner's lawyer should have known the
basic legal principle: namely, that, with important exceptions, a
claimant must raise his objections in an internal agency appellate
proceeding or forgo the opportunity later to raise them in court.
The Fifth Circuit, moreover, had precedent applying the general
rule in this specific context.
Paul v.
Shalala,
29 F.3d
208, 210-211 (1994). And far from being misled by the agency's
form, petitioner's lawyer followed an alternative procedure, see 20
CFR §§ 422.205(a), 404.968(a) (1999), and filed 19 pages of
detailed legal and factual arguments challenging the ALJ's
decision. App.51-69. In these circumstances, petitioner is
accountable for her lawyer's decision-whether neglectful or by
design-to reserve some of her objections for federal court.
For these reasons, I would affirm the judgment of the Court of
Appeals.
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