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807 F.2d 1502

Docket No. 86-3770.

W.C. v. Bowen

Ninth Circuit Court of Appeals

Argued and Submitted Dec. 2, 1986.

Decided Jan. 13, 1987.

Ninth Circuit Court of Appeals · decided 1987-01-13

2 counsel of record

Key passage — most relied on by later courts

“The Secretary, not Congress, formulated the program to select individual cases for own-motion review. Congress specifically omitted any basis for such review in the final amendment.... In exercising [his] discretion, the Secretary enacted in substantive rule.”

quoted by 1 later decision, including American Hospital Ass'n v. Bowen

“would not have been reviewed. They would have become final decisions binding both the Secretary and claimant. The program [thus] affects individual rights.”

quoted by 1 later decision, including American Hospital Ass'n v. Bowen

Applies 42 U.S.C. § 1382C (§ 1614 of the Social Security Act of 1935) · 5 U.S.C. § 551 (Administrative Procedure Act of 1946) · 5 U.S.C. § 552 (Freedom of Information Act)

Relies on Chrysler Corporation v. Brown · Bowen v. City of New York · Alcaraz v. Block

Good law ✅— No negative treatment on recordhow we know

Opinion by Eugene Allen Wright · Decided 1987-01-13

How this case has been cited

Cited by 25 later decisions — most recently June 2005 · most notably American Hospital Ass'n v. Bowen (1987), George L. Barry v. Otis R. Bowen (1987)

17 federal appellate ·

150198719902000decided

Later decisions citing this case, by decade. The current decade is in progress, and our corpus holds fewer opinions from the most recent years, so the latest bars are undercounted — not a real decline.

View the full empirical analysis of this case →

¶1William Rutzick, Schroeter, Goldmark & Bender, Seattle, Wash., for plaintiff-appel-lee.

¶2Howard S. Scher, Dept, of Justice, Washington, D.C., for defendant-appellant.

¶3*1503Before BROWNING, WRIGHT and BEEZER, Circuit Judges.

¶4EUGENE A. WRIGHT, Circuit Judge.

¶5W.C. is a class plaintiff. He represents a class of social security claimants who were denied disability benefits. These denials occurred after favorable AU decisions when, pursuant to the Bellmon Review Program, the Appeals Council reviewed and reversed the AU decisions. The district court found that the Bellmon Review Program was a substantive rule which required notice and comment rulemaking. Because the rulemaking procedure was not followed, the Appeals Council’s decisions were voided and the court ordered that benefits be restored to the class members. BACKGROUND

¶6The facts are well stated in the district court’s opinion. W.C. v. Heckler, 629 F.Supp. 791 (W.D.Wash.1985). Briefly, the Social Security Administration terminated W.C.’s disability and SSI benefits on February 17, 1982. Plaintiff requested and received a hearing before an Administrative Law Judge. The AU reversed the termination of plaintiff’s benefits. The SSA Appeals Council, a body which issues final decisions on behalf of the Secretary of Health and Human Services, reversed the AU and terminated plaintiff’s benefits.

¶7The AU decision was reviewed under the Bellmon Review Program.1 This was enacted by the Secretary in response to the Bellmon Amendment to the Social Security Act.2 The Amendment was a response to the increasing number of appeals to AUs, the high number of allowance decisions by them, and the policy that only AU decisions denying claims were subject to review. H.R.Rep. No. 944, 96th Cong., 2d Sess. 57, reprinted in 1980 U.S.Code Cong. & Admin.News 1392, 1405; S.Rep. No. 408, 96th Cong., 2d Sess. 53, reprinted in 1980 U.S.Code Cong. & Admin.News 1277, 1331.

¶8The Bellmon Review Program provides for own-motion review of AU decisions allowing disability benefits. The district court found that:

¶9AUs with individual allowance rates3 of 70 percent or higher and AUs in hearing offices with aggregate allowance rates of 74 percent or higher were targeted for review. Half of the allowance decisions issued by targeted AUs were evaluated by the Office of Hearings and Appeals for possible review, and iVz percent of the allowance decisions issued by these AUs were formally reviewed by the Appeals Council. On April 1, 1982, the targeted AUs were divided into four groups based on own-motion rates.4 Each and every allowance decision by AUs in the group with the highest own-motion rates was evaluated for possible review. In the group with the second-highest rates, 75 percent of the AUs allowance decisions were thus evaluated; in the group with the third-highest rates, 50 percent; and in the group with the lowest rates, 25 percent. In addition, the program was expanded so that 15 per*1504cent of all allowance decisions by targeted AUs were formally reviewed by the Appeals Council. Finally, the program was expanded to provide review of a national random sample of AU allowance decisions, AU decisions referred from the SSA Office of Disability Operations, and decisions of all new AUs. W.C., 629 F.Supp. 791, 793-94 (W.D.Wash. 1985) (footnotes renumbered).

¶10The plaintiff’s action in federal district court alleged that the Program5 was adopted improperly because of noncompliance with APA notice and comment procedures. The court entered summary judgment in favor of the class6 on this claim. The Secretary appeals.

¶11ANALYSIS

¶12A. Merits

¶13It is undisputed that the Bellmon Review Program was adopted without notice and comment rulemaking. It is also undisputed that the program is a rule under the Administrative Procedures Act and presumptively requires notice and comment rule-making. 5 U.S.C. §§ 551(4), 553(b) & (c) (1982). Unless it is exempt from such rule-making, the program is invalid. See Busehmann v. Schweiker, 676 F.2d 352, 355-56 (9th Cir.1982).

¶14The Secretary contends that the program merely interprets his long-standing authority to review AU decisions on his own motion. The Secretary has the authority, under 20 C.F.R. §§ 404.969 and 404.970 (1986), to review AU decisions. Razey v. Heckler, 785 F.2d 1426, 1428, amended by 794 F.2d 1348 (9th Cir.1986); Taylor v. Heckler, 765 F.2d 872, 874-75 (9th Cir. 1985). The Secretary argues that the program enforces this existing authority without altering the class of persons subject to own-motion review. As such, according to the Secretary, the program was an interpretive rule not requiring notice and comment rulemaking.

¶15In determining whether a rule is interpretive or substantive, two factors must be considered. The first factor is whether the rule modifies existing rights, law, or policy. If the rule “effect[s] a change in existing law or policy,” Powderly v. Schweiker, 704 F.2d 1092, 1098 (9th Cir. 1983), or “ ‘affect[s] individual rights and obligations,’ ” Chrysler Cory. v. Brown, 441 U.S. 281, 302, 99 S.Ct. 1705, 1718, 60 L.Ed.2d 208 (1979), the rule is substantive. Cubanski v. Heckler, 781 F.2d 1421, 1426 (9th Cir.1986). If the rule is only indicative of the agency’s interpretation of existing law or policy, it is interpretive. Alcaraz v. Block, 746 F.2d 593, 611 (9th Cir.1984); Louisiana-Pacific Corp. v. Block, 694 F.2d 1205, 1210 (9th Cir.1982).

¶16Second, the source of the rule must be considered. If it is promulgated pursuant to statutory direction or under statutory authority, it is a substantive rule. Cubanski, 781 F.2d at 1426. If the agency does not exercise delegated legislative power to promulgate the rule, it is interpretive.

¶17Under these principles, the Bellmon Review Program was a substantive rule. It changed existing policy. The Secretary's existing own-motion review is codified in 20 C.F.R. §§ 404.969 and 404.970. Under those regulations, decisions from one AU were no more likely to be reviewed than those of another. Nor was any class of claimants more likely to be reviewed. Before the review program was implemented, virtually no decisions granting disability benefits were reviewed on the Secretary’s own motion. During 1981, no favorable *1505AU decision was subject to own-motion review. W.C., 629 F.Supp. at 809.

¶18The Bellmon Amendment was specifically designed to change this policy. Congress concluded that the Secretary’s own-motion review authority was insufficiently exercised and directed him to change this policy. As a result, in 1982, 12,000 favorable decisions were considered for own-motion review under the review program. Of these decisions, 2,200 were actually reviewed. Id.

¶19The review program affects existing rights in two ways. First, the district court found that it was designed to alter AU decisions. It caused those judges to deny benefits in close cases where benefits might previously have been granted. Id. at 799-800. Other courts have reached similar conclusions. See, e.g., Barry v. Heckler, 620 F.Supp. 779, 782 (N.D.Cal.1985) (Bellmon Review Program affects impartiality of administrative law judges); Association of Administrative Law Judges, Inc. v. Heckler, 594 F.Supp. 1132, 1143 (D.D.C.1984). This conclusion is not clearly erroneous.

¶20Second, the program limits the Secretary’s discretion not to review an AU decision. Prior to the Bellmon Amendment, the Secretary could review any such determination. Under the program, all decisions from certain “targeted” AUs must be screened for own-motion review. The Secretary no longer has discretion not to consider those for own-motion review. Rules which substantially limit an agency’s discretion are generally substantive rules. See Guardian Federal Savings & Loan Association v. Federal Savings and Loan Insurance Corp., 589 F.2d 658, 666-67 (D.C.Cir.1978).

¶21Here, claimants receiving favorable decisions from targeted AUs faced mandatory screening for own-motion review. Under prior practice, these decisions would not have been reviewed. They would have become final decisions binding both the Secretary and claimant. See Taylor v. Heckler, 765 F.2d 872, 875 (9th Cir.1985). The program affects individual rights.

¶22Turning to the source of the rule, we find that it was issued pursuant to statutory direction. The Bellmon Amendment clearly directs the Secretary to formulate a new policy. It provides “The Secretary of Health and Human Services shall implement a program of reviewing, on his own motion, decisions rendered by administrative law judges____” Social Security Disability Amendments of 1980, Pub.L. No. 96-265, § 304(g), 94 Stat. 441, 456. The Secretary, not Congress, formulated the program to select individual cases for own-motion review. Congress specifically omitted any basis for such review in the final amendment. H.R.Rep. No. 944, 96th Cong., 2d Sess. 57, reprinted in 1980 U.S. Code Cong. & Admin.News 1392, 1405. It clearly intended that the Secretary use his discretion to enact a review program. In exercising that discretion, the Secretary enacted a substantive rule.

¶23The review program is a substantive rule and, as such, required notice and comment rulemaking. The Secretary’s failure to use that procedure, renders the program invalid under the APA.7

¶24B. Remedy

¶25The district court concluded that the Appeals Council decisions were void since they were made under an invalid review program. W.C., 629 F.Supp. at 801. The only valid decisions issued were the favorable ones of the ALJs. The Secretary was ordered to reinstate these favorable decisions and pay retroactive disability benefits to the class members. Id. at 801-02.

¶26An agency rule which violates the APA is void. See Buschmann, 676 F.2d at 355-56. Agency action taken under a void rule has no legal effect. Id.But for the review program, it is highly unlikely that the Appeals Council would have reviewed the plaintiffs’ favorable decisions. An AU *1506decision is binding on the parties unless one of the specified avenues of review is properly exercised. 20 C.F.R. § 416.1455. Since no valid review of the ALJ decisions was taken, they became binding. We agree with the district court that those decisions must be reinstated and the claimants provided disability benefits.8

¶27This remedy does not encroach on the Secretary’s fact-finding role. It does not determine, as a matter of fact, whether a claimant is entitled to disability benefits but merely vacates an invalid agency action. Compare Bowen v. City of New York, — U.S.-, 106 S.Ct. 2022, 2031, 90 L.Ed.2d 462 (1986).

¶28Appellee has indicated that it intends to seek attorneys fees presumably for both the appeal and the action in district court. The request should be made to the district court.

¶29AFFIRMED.

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