## Facts

- Clifford Flatford, a former truck driver and maintenance worker with limited education, had coronary artery disease and underwent coronary artery bypass surgery in 1981.
- A 1982 catheterization showed additional narrowing but normal left ventricular function and functioning grafts.
- Flatford stopped working in March 1983 due to heart-related symptoms and sought disability benefits and SSI.
- An initial 1983 benefits application was denied; a later application led to an administrative finding of disability beginning December 1, 1987, leaving disability for March 1983 through November 30, 1987 in dispute.
- In reopened proceedings addressing the earlier period, the administrative law judge (ALJ) obtained written interrogatory responses from Dr. Donald Saunders, a cardiologist, because no local cardiologist would act as medical adviser.
- Flatford’s attorney declined to submit interrogatories before reviewing Dr. Saunders’s responses, requested the responses, and reserved the right to cross-examine.
- At the hearing, the ALJ introduced Dr. Saunders’s written responses; Flatford received them at the hearing rather than earlier.
- After the hearing, counsel requested a supplemental hearing to cross-examine Dr. Saunders; the ALJ denied the request and relied in part on Dr. Saunders’s written opinions to deny benefits for the pre–December 1987 period.

## Issues

1. Whether Social Security regulations governing post-hearing evidence required the ALJ to provide a supplemental hearing for oral cross-examination of a medical adviser whose written responses were obtained and relied upon.
2. Whether the ALJ’s refusal to allow oral cross-examination of the post-hearing medical adviser violated procedural due process under the Fifth Amendment.

## Decision

- The Sixth Circuit affirmed the district court’s judgment upholding the Commissioner’s denial of benefits for the period before December 1, 1987.
- The court held the regulations did not mandate a supplemental hearing or an absolute right to oral cross-examination of a post-hearing medical adviser.
- The court held due process was satisfied because Flatford had notice of the medical adviser’s written opinions and a meaningful opportunity to respond through written submissions, including proposed interrogatories and rebuttal evidence.
- Applying the Mathews v. Eldridge balancing framework, the court found the likely value of live cross-examination was limited where the adviser’s opinion interpreted existing medical records rather than presenting new factual testimony.
- The court found no showing that the absence of oral cross-examination likely affected the outcome.

## Legal Principles

- Social Security disability proceedings are primarily inquisitorial; procedural protections are measured by what fairness requires in context, not by automatic importation of trial-type rights.
- SSA procedures governing post-hearing evidence generally require disclosure of the evidence and an opportunity to comment, submit written questions, or provide rebuttal material; they do not create an absolute entitlement to oral cross-examination of post-hearing sources.
- Procedural due process in benefits adjudications is evaluated under Mathews v. Eldridge by weighing (1) the private interest, (2) the risk of erroneous deprivation and the probable value of added safeguards, and (3) governmental administrative burdens.
- When a medical adviser’s input is based on the same documentary record available to the claimant, written rebuttal procedures may be sufficient to satisfy due process absent a concrete showing of prejudice.

## Conclusion

The Sixth Circuit held that the ALJ’s reliance on a post-hearing medical adviser’s written interrogatory responses, without granting a supplemental hearing for oral cross-examination, complied with Social Security regulations and did not violate due process where the claimant could review the report and respond in writing.


Flatford v. Chater, 93 F.3d 1296 (6th Cir. 1996)