Mathews v. Eldridge

The secretary of health, education, and welfare contended that the district court should not have heard the case because district courts do not have jurisdiction over an action seeking the review of the secretary. District courts can only review a final decision of the secretary. The secretary based his claim on Weinberger v. Salfi (1975). In that case, the Supreme Court decided that judicial review in an action challenging the denial of claimed benefits was possible only after exhausting all of the administrative remedies, including a final decision by the secretary. When Mathews v. Eldridge was brought before the Supreme Court, however, it held that in the instant case, Eldridge satisfied the requirement that a claim must be presented to the secretary by filling out the questionnaire and writing a letter to the state agency. Although Eldridge did not exhaust the secretary's internal review procedures, the denial of his claim was enough of a "final decision" to satisfy the exhaustion requirement. Thus Eldridge had the right to present the case to the district court.

The Fifth Amendment states that no person shall "be deprived of life, liberty, or property without due process of law." The secretary contended that the existing administrative procedures provided all the process that is constitutionally due before someone can be deprived of benefits. Eldridge contended that the existing review procedures would be adequate if the disability benefits were terminated after the evidentiary hearing, not before it. Justice Powell, writing for the majority, quoted Cafeteria Workers v. McElroy (1961) "Due process, unlike some legal rules, is not a technical conception with a fixed content unrelated to time, place and circumstances." Powell also quoted Morrissey v. Brewer (1972), "Due process is flexible, and calls for such procedural protections as the particular situation demands." Powell listed the three factors that must be considered when looking into the specific dictates of due process: 1) the private interest that the official action will affect; 2) the risk of mistakenly depriving someone of benefits, and the probable value of additional procedural safeguards; 3) the Government's interest, including the financial and administrative costs that additional procedures would bring about.

Powell described the procedures in place for terminating Social Security disability benefits. The disability insurance program is jointly administered by state and federal agencies. State agencies determine if a person has a disability, when it began, and when it ceased. The worker must show, using medical tests, that he cannot work. The main reason for terminating someone's benefits is that the worker is no longer disabled or has returned to work. A team determines if a person continues to be eligible for benefits. The team consists of a doctor and a nonmedical person trained in disability evaluation. The agency asks the worker, through questionnaires, about his current condition, treatments, and restrictions. The agency also gets information from the worker's doctor. If the agency and the beneficiary disagree about his condition, the agency informs him that his benefits may be terminated, provides a summary of the evidence, and offers the opportunity to review the medical reports and other evidence in his file. He may also respond in writing and send in additional evidence. At that point, the state agency makes its final decision, which is reviewed by an examiner from the SSA Bureau of Disability Insurance. The SSA then notifies the recipient of the decision and the reasons for it and tells him that he has the right to seek reconsideration from the state agency. The benefits end two months after the person's recovery has taken place. If the person seeks reconsideration from the state agency, and the determination goes against him, the SSA reviews the decision. The person then has a right to an evidentiary hearing in front of an SSA administrative law judge. After that, the claimant is entitled to request discretionary review by the SSA Appeals Council. Finally, he may obtain a judicial review.

Powell noted that despite the elaborate procedures provided, the district court and court of appeals considered them to be constitutionally inadequate. Those courts concluded that due process required an evidentiary hearing before the benefits were terminated. Powell disagreed with that conclusion, believing that a hearing after termination of benefits was sufficient. Powell reasoned that disability benefits were not based on financial need. "Indeed, it is wholly unrelated to the worker's income or support from many other sources."

The Court recognized that the length of time a person is wrongfully deprived of benefits is important in assessing the impact of the government's action on the person's interests. The secretary conceded that the delay between the cutoff of benefits and the final decision after a hearing is over one year. Powell noted that "the hardship imposed upon the erroneously terminated disability recipient may be significant. Still the disabled worker's need is likely to be less than that of a welfare recipient. In addition to the possibility of access to private resources, other forms of government assistance will become available" if the worker falls below the subsistence level. Something less than an evidentiary hearing is sufficient prior to terminating disability benefits.

Powell pointed out that a medical assessment is a more sharply focused and easily documented decision than one involving the termination of welfare benefits. It is based on routine, standard, and unbiased medical reports by specialists. The disability benefits entitlement assessment provides an effective means for the recipient to communicate to the decision-maker, mainly by way of the questionnaire. Also, before the termination of benefits, the person is given full access to the information relied on by the state agency.

Powell noted that the administrative burden must be weighed against requiring, as a constitutional right, an evidentiary hearing upon demand in all cases prior to the termination of disability benefits. "The ultimate additional cost in terms of money and administrative burden would not be insubstantial." He also noted that the judicial model of an evidentiary hearing is neither a required, nor even the most effective, method of decision making in every circumstance. The essence of due process is that a person facing a serious loss be given notice of the case and the opportunity to present his side of it. The procedures must be tailored to the capacities and circumstances of the person to make sure he or she has a meaningful opportunity to present his case. In determining what process is due in this case, substantial weight must be given to the good faith judgments of the people who work in the administration of social welfare programs. The prescribed procedures provide the claimant with an effective process for asserting his or her claim prior to any administrative action. The claimant is also assured a right to an evidentiary hearing and subsequent judicial review before the denial of his claim becomes final.

Powell summed up his opinion by stating that an evidentiary hearing is not required before disability benefits are ended. The current administrative procedures "fully comport with due process."