## Facts

- Juatassa Sims applied for Social Security disability insurance benefits (Title II) and Supplemental Security Income (Title XVI), alleging disability from multiple conditions, including degenerative joint disease and carpal tunnel syndrome.
- A state agency denied the claims, and an Administrative Law Judge (ALJ) later denied benefits, finding Sims was not disabled under the Social Security Act.
- Sims sought Appeals Council review by submitting a letter (rather than a standard form) that asserted certain ALJ errors; the Appeals Council denied review.
- Sims sued in federal district court, arguing the ALJ (1) selectively used the record, (2) posed defective vocational-expert questions that omitted ailments, and (3) failed to order a consultative examination despite irregularities in the medical evidence.
- The district court rejected her arguments and upheld the denial of benefits.
- The Fifth Circuit affirmed, holding it lacked jurisdiction over two claims because Sims did not specifically raise them in her request for Appeals Council review, effectively requiring issue exhaustion at that stage.

## Issues

1. Whether a Social Security claimant who exhausts the administrative remedies required by statute and regulations must also raise specific issues to the Appeals Council to preserve those issues for judicial review.

## Decision

- The Supreme Court reversed and remanded.
- The Court held that Social Security claimants who exhaust administrative remedies are not required to exhaust specific issues in a request for Appeals Council review to preserve judicial review of those issues.
- A plurality reasoned that neither the Social Security Act nor SSA regulations impose an issue-exhaustion requirement at the Appeals Council stage, and that judicially imposed issue exhaustion is ill-suited to SSA’s informal, nonadversarial review process.
- Justice O’Connor concurred in the judgment on narrower grounds, emphasizing that SSA procedures did not give claimants clear notice that failure to list issues before the Appeals Council would result in waiver.
- The dissent would have required issue exhaustion to advance efficiency and respect agency decisionmaking.

## Legal Principles

- Issue-exhaustion requirements in administrative review ordinarily come from statutes or agency regulations; absent such authority, courts consider whether imposing issue exhaustion is appropriate for the specific administrative scheme.
- Judicially imposed issue exhaustion is less justified in proceedings that are informal and nonadversarial, where the agency bears primary responsibility for developing issues.
- In Social Security Appeals Council review, a claimant’s failure to specify an issue in the request for review does not, by itself, bar later judicial review when governing law and agency practice do not clearly impose and communicate such a requirement.

## Conclusion

Because the Social Security Act and SSA regulations did not require claimants to identify each issue for Appeals Council review—and SSA procedures did not clearly notify claimants of any waiver rule—the Court held that Sims could seek judicial review of issues not specifically raised to the Appeals Council and remanded for further proceedings.


Sims v. Apfel, 530 U.S. 103 (2000)