Sullivan v. Zebley: Supreme Court Strikes Down Regulations Limiting Disabled Children’s Benefits

On February 20, 1990, the United States Supreme Court handed down a landmark decision for disabled, low-income children, in Sullivan v. Zebley.  NCYL, along with the Youth Law Center and Protection and Advocacy, Inc., represented amici curiae in the case, on the side of the children who argued that Social Security regulations discriminated against them.

The Zebley decision centered around eligibility criteria for children seeking disability benefits through the Supplemental Security Income (“SSI”) program.  At the time Zebley was decided, SSI was the only federal source of direct cash assistance for disabled children and their families. 

When it created the SSI program, Congress broadly outlined the eligibility requirements.  The Social Security Administration then passed regulations to implement the program.  Over time, it became clear that the agency applied stricter criteria to children’s SSI applications than to adults’ applications.  An adult could show he was disabled by either: (1) meeting the medical criteria for one of the “listings” of various conditions that the agency had enumerated, or (2) making an individualized showing that he lacked the functional capacity to perform “substantial gainful activity.”  About 25% of adult applicants qualified for SSI using the latter route. 

Under the regulations, however, this latter route did not exist for children.  Social Security regulations limited children’s eligibility to the specific medical criteria contained in the “listings,” despite statutory language that children were eligible for SSI if they had an impairment of “comparable severity” to one that would make an adult unable to work. 

The result was the denial or termination of SSI benefits for children like the lead plaintiffs in Zebley v. Sullivan.  Brian Zebley, for instance, was born with partial paralysis of his brain and was found eligible for SSI benefits at age two.  Less than two years later, however, the agency stopped paying his benefits when it decided that Brian’s impairments did not meet or equal each and every specific finding in the relevant listing.  Plaintiff Joseph Love, Jr. suffered from organic brain syndrome and failed first grade three times.  At the hearing on his SSI application, a psychiatrist for the Social Security Administration testified that an adult with Joseph’s symptoms would meet the disability standard.  Even so, Joseph’s application was denied because he did not meet the childhood listings.

In 1983, Brian sued the Secretary of Health and Human Services.  The United States District Court certified the case as a class action but ruled that the Social Security regulations were valid.  Brian and the class appealed, and the Third Circuit Court of Appeals ruled in their favor.  The Secretary then appealed to the United States Supreme Court.

The Supreme Court agreed with the Third Circuit that the Social Security regulations were unlawful.  The Supreme Court found that the Social Security Administration’s criteria for determining childhood disability contradicted the standard set by Congress, and so the agency had exceeded its statutory authority. 

In its decision, the Supreme Court found that expanding the listings without also allowing for individualized functional assessments would not fix the legal deficiency, thus implicitly agreeing with the NCYL amicus brief.  The Court adopted the position forwarded in NCYL’s brief when the Court explained that “the listings-only approach disregards factors such as pain, side effects of medication, feeding problems, dependence on medical equipment, confinement at home, and frequent hospitalization, that vary with each individual case.”  The Court rejected the Secretary’s argument that it was not feasible for the agency to conduct an individualized inquiry of a child’s functional abilities because children do not work.  

Following the Supreme Court’s ruling, the Social Security Administration ordered its staff not to deny or terminate any child’s SSI disability claim using the old standards.  The agency published an interim standard for children’s disability applications in May 1990 and published final revised rules in February 1991.  In December 1990, the agency also expanded the list of mental impairments that would qualify a child for SSI.

Post-Zebley, NCYL participated in a coalition to conduct outreach in targeted areas of the country.  In California, NCYL widely publicized the new SSI disability standards for children, consulted with the Social Security Administration and with state agencies, and provided trainings and technical assistance to advocates and government personnel.  This outreach was critical to reaching the hundreds of thousands of potential class members who had been denied SSI benefits between 1980 and 1991 and who could now request review of their applications as part of the Zebley settlement.

In Zebley’s wake, the number of disabled children receiving SSI nearly tripled, and the percentage of successful SSI applications increased from one-third to over one-half.

The Zebley plaintiffs were represented by Community Legal Services of Philadelphia and Delaware County Legal Assistance.  At the Supreme Court, NCYL and its co-counsel represented amici curiae The Children’s Defense Fund; The Cystic Fibrosis Foundation; SKIP National, Inc.; The Spina Bifida Association of Greater Los Angeles; The Tourette Syndrome Association, Inc.; The Rehabilitation Presidents Council of California; and 19 individual disabled children and youth across the country—ranging in ages from 10 months to 19 years old—who had all been denied SSI benefits.