This section contains the nature of the case and procedural background.

P filed a claim for disability insurance benefits under the Social Security Act. P was seen by a neurosurgeon who recommended conservative treatment. This provided no relief. Eventually, P consented to surgery. No disc protrusion or other definitive pathology was identified at surgery. P was diagnosed with nerve root compression. The pain continued, and two doctors were unable to find a cause. P consulted a third doctor who diagnosed: back sprain, lumbosacral spine. D arranged for another consult. The Doctor's report was devastating to P. P was described as a 'big physical healthy specimen . . . obviously holding back and limiting all of his motions, intentionally. . . . His upper extremities, though they are completely uninvolved by his injury, he holds very rigidly as though he were semi-paralyzed. His reach and grasp are very limited but intentionally so. . . . Neurological examination is entirely normal to detail sensory examination with pinwheel, vibratory sensations, and a light touch. Reflexes are very active, and there is no atrophy anywhere.' D denied the claim. D arranged for a psychiatrist to examine P. The claim was again denied. P requested a hearing before a hearing examiner. P formally objected to the admission of the other reporting physicians as hearsay; the authors were not there, and hence, there was no opportunity for cross-examination. They were admitted, and once again, the claim was denied. P made a request for review by the Appeals Council. Once again, D ruled against P. P filed suit in District Court. The court remanded based on hearsay on hearsay. D appealed, and the Fifth Circuit noted the absence of any subpoenas and that P was not in a position to claim he was denied confrontation and cross-examination. It held that all the evidence was not substantial evidence and affirmed the remand. The Supreme Court granted certiorari.

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