Professional Documents
Culture Documents
United States Court of Appeals, Tenth Circuit
United States Court of Appeals, Tenth Circuit
2d 1059
3 Soc.Sec.Rep.Ser. 162
and regulations as required by New Mexico law. See N.M.Stat.Ann. Sec. 14-4-5
(1978). They contended that the DDU was without authority to make any
disability determinations, and therefore could not form a valid agreement with
the Social Security Administration (SSA) under 42 U.S.C. Sec. 421(b). Thus,
they argued that any actions by the Secretary of the Department of Health and
Human Services (Secretary) in reviewing the DDU's determinations were void.
The district court did not reach the merits of plaintiffs' complaint but dismissed
for failure to exhaust administrative remedies. We affirm.
2
In Mathews v. Eldridge, 424 U.S. 319, 328, 96 S.Ct. 893, 899, 47 L.Ed.2d 18
(1976), the Supreme Court explained that there are two components to the final
decision requirement of Sec. 405(g):[The final decision requirement] consists of
two elements, only one of which is purely "jurisdictional" in the sense that it
cannot be "waived" by the Secretary in a particular case. The waivable element
is the requirement that the administrative remedies prescribed by the Secretary
be exhausted. The nonwaivable element is the requirement that a claim for
benefits shall have been presented to the Secretary. Absent such a claim there
can be no "decision" of any type. And some decision by the Secretary is clearly
required by the statute.
The only issue presented here is whether the exhaustion requirement should be
waived.2 This requirement can be waived in two ways. First, the Secretary may
waive it if he is satisfied that no further review is warranted either because the
internal needs of the agency are fulfilled or because the relief sought is beyond
his power to confer. Eldridge, 424 U.S. at 330, 96 S.Ct. at 900; Salfi, 422 U.S.
at 765-67, 95 S.Ct. at 2466-2467. Second, a reviewing court may find a waiver
if a constitutional claim is wholly collateral to the substantive claim of
entitlement, and there is a showing of irreparable injury not recompensable
through retroactive payments. Eldridge, 424 U.S. at 330-31 & n. 11, 96 S.Ct. at
900-901 & n. 11; see also Franks v. Nimmo, 683 F.2d 1290, 1295 (10th
Cir.1982); New Mexico Ass'n for Retarded Citizens v. New Mexico, 678 F.2d
847, 851 (10th Cir.1982); Martinez v. Richardson, 472 F.2d 1121, 1125 (10th
Cir.1973).
There is no claim by plaintiffs that the Secretary has waived the exhaustion
requirement. In his motion to dismiss, the Secretary challenged the complaint
on the ground that plaintiffs have failed to exhaust their administrative
remedies. Thus, for plaintiffs to prevail, we must find that a collateral
constitutional claim with the threat of irreparable injury has been presented.
8 addition to the financial hardship, these plaintiffs have had medical benefits
in
terminated, and have become unable to treat the physical and mental conditions that
caused their disabilities. They will clearly be harmed by the anguish and uncertainty
of lengthy, futile administrative reviews. Further, each of these plaintiffs will be
required to hire a lawyer to espouse a simple constitutional issue, and to reinstate
those benefits which were illegally ceased.
9
10
Despite this claim on appeal, in the district court there were no allegations as to
such elements of irreparable harm in plaintiffs' complaint and no such showing
was made in their response to the defendant's motion to dismiss and supporting
affidavit. Thus, we cannot agree that in the district court the plaintiffs alleged
or made a showing of the degree of irreparable harm required under Eldridge.3
They failed to show below that retroactive payments would not recompense for
their injury.
11
In Eldridge, the Supreme Court faced the issue whether an evidentiary hearing
is required before disability payments are terminated. The Court noted that
termination of disability payments is less likely to cause irreparable injury than
would termination of welfare benefits. The Court reasoned that eligibility for
disability benefits is not based upon financial need:
Indeed, it is wholly unrelated to the worker's income or support from many other
12
14
15
AFFIRMED.
The jurisdictional element is satisfied in this case. This is apparent with respect
to at least six of the seven plaintiffs. The record demonstrates that six plaintiffs,
by presenting the Secretary with a claim for benefits, have met the nonwaivable
"jurisdictional" element. I R. 24-30. Although the record is incomplete
concerning the seventh plaintiff, Virginia Kelch, we need not decide whether
she satisfies this element because of our conclusion that plaintiffs must exhaust
their administrative remedies
The record shows the following with regard to each of the plaintiffs:
Richard R. Bartlett
Bartlett requested a reconsideration of his disability determination by the DDU,
and the SSA affirmed. Bartlett appealed, and an Administrative Law Judge
(ALJ) decided that Bartlett continued to be disabled. SSA currently is
processing this case for payment. I R. 24.
Jesus Ontiveros
SSA agreed with DDU's determination that Ontiveros was disabled. DDU and
SSA affirmed. I R. 25.
Michael Duran and Gerald D. Schneberger
DDU and SSA determined that Duran's and Schneberger's disabilities are
continuing. I R. 26, 27.
Lawrence L. Montoya
DDU determined that Montoya's disability had ceased. On appeal, an ALJ
decided for Montoya. SSA reinstated Montoya's benefits, and he is in "current
pay" status. I R. 28.
Richard M. Gonzales
DDU, SSA, and an ALJ determined that Gonzales's disability had ceased. The
Appeals Council denied the request for appeal. After Gonzales filed a new
application for benefits, DDU and SSA determined that Gonzales was not
disabled. I R. 30.
Virginia Kelch
Harris Factor, Acting Director of SSA's Office of Regulations, states in his
affidavit that the file relating to Virginia Kelch had not been located by
members of his staff. I R. 23.
Plaintiffs allege that in accordance with the determination of the DDU, the
Secretary has ceased all benefits due each of the plaintiffs. Complaint at 4, p
18. Plaintiffs concede, however, that none of the plaintiffs has had a hearing
before an ALJ to review the DDU's determinations. Id., p 19.
4
The Supreme Court in Eldridge was not faced with the issue of the applicability
of the exhaustion requirement of Sec. 405(g) to a challenge to an agency's
jurisdiction. The Court has discussed the application of the exhaustion
requirement in other contexts where the requirement is not statutorily imposed
when faced with challenges to an agency's jurisdiction before administrative
proceedings have been completed. Professor Davis has noted that "the Supreme
Court, when administrative jurisdiction is challenged, sometimes imposes the
exhaustion requirement and sometimes refuses to do so ...." 3 K.C. Davis,
Administrative Law Treatise Sec. 20.02, at 60 (1958); see also 4 id. Sec. 26:5,
at 431 (2d ed. 1983) ("[T]wentieth century [cases challenging lack of agency