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DAVIS v. HECKLER

June 24, 1983

GEORGE W. DAVIS, Plaintiff,
v.
MARGARET M. HECKLER, SECRETARY, HEALTH AND HUMAN SERVICES, * Defendant



The opinion of the court was delivered by: GREEN

 This action is brought pursuant to 42 U.S.C. § 405(g) whereby plaintiff seeks Social Security disability payments which he alleges were improperly denied to him by the defendant, through her Administrative Law Judge, whose decision became final as the Secretary's decision when subsequently upheld by the Appeals Council of the Social Security Administration of the Department of Health and Human Services (HHS). In his motion for judgment to reverse the defendant's decision, plaintiff asserts that defendant's determination, unsupported by substantial evidence, constituted an abuse of discretion. In response, defendant denies that plaintiff is entitled to the benefits and has moved for judgment affirming the decision. For the reasons set forth below in this Memorandum Opinion, and in light of the remand of this case to the agency for further consideration and both motions are denied.

 Plaintiff filed with the Social Security Administration an application for disability insurance benefits on May 13, 1981, claiming he was disabled due to certain enumerated impairments. Basing the decision on hospital records and physicians' reports, and concluding that Davis' condition did not prevent him from working, HHS disapproved his claim. *fn1" Denied reconsideration on September 24, 1981, plaintiff was granted a hearing before an Administrative Law Judge (ALJ) on March 9, 1982. The ALJ denied plaintiff's claim on March 25, 1982, finding that although plaintiff's impairments caused him to experience "abdominal discomfort and infrequent episodes of acute pain", his allegations of continual, disabling pain were not credible. Accordingly, the ALJ held that plaintiff's impairment did not preclude "performance of his previous work as a custodian or porter." Record at 12. On March 31, 1982, plaintiff sought review with the Appeals Council. The Council, pursuant to Social Security Regulation No. 4, 20 C.F.R. § 404.970 (1982), concluded on May 13, 1982 that plaintiff's case did not qualify for review.

 Born in May, 1930, plaintiff has completed nine years of formal education. At the time he sought disability benefits, he had a background of nine hospital admissions within the prior five years. All of the admissions involved, at least in part, recurrent pancreatitis. Since his claim for benefits he has had at least one additional admission. In 1975, plaintiff underwent an exploratory laparotomy and, because his pancreas was inflamed, no surgery resulted. In 1981, he was successfully operated on to remove blockage present in the distal common bile duct. Physician reports from 1974 to 1981 indicate that plaintiff's ailments include chronic hepatitis alcoholic in origin, chronic recurrent pancreatitis alcoholic in nature, diabetes mellitus, essential hypertension, chronic gastritis, and rheumatoid arthritis. Record at 124-62. Plaintiff has been prescribed medication to relieve his pain and overall discomfort, in addition to having been given dietary instructions which at times he admittedly failed to follow. Record at 125. He testified that while his enlarged liver produces almost constant pain for which he takes daily medication, he suffers no discomfort from the hepatitis. The chronic pancreatitis and gastritis cause decreased appetite, require daily medications which lessen but do not relieve constant pain, Record at 52-56, and are, if considered severally from the other ailments, the most disabling factors, according to plaintiff and the documentation. The diabetes has for several years been well controlled by daily injections of insulin but promotes drowsiness, lessened appetite, blurred vision and pain due to the swelling of his hands. Record at 40-41. The hypertension and associated headaches are controlled by medication. His rheumatoid arthritis, reflected primarily in his right shoulder and arm, produces constant pain and, in his estimation, severe limitations on his ability to lift, carry, or sweep. He takes medication with a codeine base to relieve, in part, this problem. Record at 49-52. Cardiac arrythmia produces occasional but acute pain, Record at 65-67, but Davis contends he is "short-winded" and can only climb two or three steps. Record at 67-69.

 Prior to surgery in 1981, plaintiff had been employed as a waiter, school custodian, a porter and attendant in a supermarket, a furniture handler, and a railroad car cleaner. From 1976 to 1979, he was not employed. Subsequent to the 1981 surgery, the record indicates that plaintiff has not resumed working.

 A federal court may not reweigh the evidence presented to it when reviewing a disability claim decision made by the Social Security Administration, nor may it replace the Secretary's judgment concerning the weight and validity of the evidence with its own. DiBenedetto v. Secretary of the Department of Health and Human Services, 518 F. Supp. 786, 787 (D.D.C. 1981), Wesley v. Secretary of Health, Education and Welfare, 385 F. Supp. 863, 865 (D.D.C. 1974). "In these matters deference is to be afforded the administrative decision and it is not for the trial court to review de novo the Secretary's final decisions as to findings of fact and the reasonable inferences to be drawn therefrom." Reyes v. Secretary of Health, Education and Welfare, 155 U.S. App. D.C. 154, 476 F.2d 910, 914 (D.C. Cir. 1973). Nor, however, may the Court merely act as a "rubberstamp" to administrative decisions. Perli v. Schweiker, 543 F. Supp. 394, 395 (S.D.N.Y. 1982). Rather, it is the duty of the Court to "carefully scrutinize the entire record," Klug v. Weinberger, 514 F.2d 423, 425 (8th Cir. 1975), in order to determine whether the Secretary's decision is supported by "substantial evidence," as provided in 42 U.S.C. § 405(g). Parker v. Harris, 626 F.2d 225 (2d Cir. 1980); Champion v. Califano, 440 F. Supp. 1014, 1015 (D.D.C. 1977). In Richardson v. Perales, 402 U.S. 389, 28 L. Ed. 2d 842, 91 S. Ct. 1420 (1971), the Supreme Court defined this requisite standard to be "more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Id. at 401, citing Consolidated Edison Co. v. N.L.R.B., 305 U.S. 197, 229, 83 L. Ed. 126, 59 S. Ct. 206 (1938).

 "Substantial evidence" does not merely refer to the requisite quantitative evidence necessary to uphold an ALJ decision. It is a qualitative standard as well, as the evidence must address the necessary statutory test for disability benefits eligibility provided in 42 U.S.C. § 423(d)(1)(A). The Social Security Act defines "disability" as an "inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." Id. Inability to engage in substantial gainful activity not only includes inability to do his previous work but requires as well an inability, ". . . considering his age, education, and work experience, [to] engage in any other kind of substantial gainful work which exists in the national economy, regardless of whether such work exists in the immediate area in which he lives, or whether a specific job vacancy exists for him, or whether he would be hired if he applied for work." 42 U.S.C. § 423(d)(2)(A).

 Regulations have been promulgated as an assistance in evaluating whether a claimant has satisfied statutory requirements. Under 20 C.F.R. § 404.1520(a)-(f) (1982) a sequential step process is considered; a finding of no disability at any one of these sequential steps, dictates an end to the inquiry. Under the first step in the evaluation, the claim will be denied if the claimant is presently engaged in substantial gainful activity. 20 C.F.R. § 404.1520(b). Similarly, if a severe impairment is not proved, disability has not been satisfied. 20 C.F.R. § 404.1520(c). *fn2" If the claimant suffers from a less severe impairment and therefore does not meet the criteria of Appendix 1 (Listing of Impairments), the Secretary must determine whether he retains the ability to perform either his former work or less onerous employment. If he can pursue his former work, he is not entitled to disability benefits. See 20 C.F.R. § 404.1520(e). Lastly, if there exists an inability to return to past employment or a less demanding occupation, one's "residual functional capacity[,] . . . age, education, and past work experience" are evaluated to determine, by an individual assessment of each of the claimant's job qualifications (abilities and limitations) measured against each of those factors, whether he is able to engage in other work. 20 C.F.R. § 404.1520(f).

 The Secretary must also consider the existence, if any, of jobs in the national economy that could be performed by a person having claimant's qualifications. Id.; 20 C.F.R. §§ 404.1566-404.1569. See, Heckler v. Campbell, 461 U.S. 458, , 103 S. Ct. 1952, 76 L. Ed. 2d 66, 51 U.S.L.W. 4561, 4563 (1983).

 It should be noted that an individual must adhere to prescribed treatment in order to be eligible to receive benefits, "if this treatment can restore [one's] ability to work." 20 C.F.R. § 404.1530 (1982).

 Since the Secretary determined here that Davis was able to pursue his former work, and therefore held him ineligible for disability benefits, she did not assess whether his abilities, limitations, and overall qualifications would allow his engagement in other work and, if so, whether there were jobs existing in the national economy that this claimant could perform.

 Accordingly, if in light of the above, the Secretary's determination in accepting the decision of the Appeals Council (which upheld the ALJ's decision) is supported by substantial evidence, the Court must affirm the Secretary's decision. If the Secretary's decision cannot be affirmed, the matter would have to be remanded to the agency for further consideration.

 Mindful that it is within the province of the ALJ, and not the Court, to evaluate conflicting evidence, DiBenedetto, 518 F. Supp. at 788, this Court's obligation nonetheless, to scrutinize the record, cannot be minimized: "if, for example, reliance has been placed upon one portion of the record to the disregard of overwhelming evidence to the contrary, the courts are . . . bound to decide against the Secretary." Ainsworth v. Finch, 437 F.2d 446, 447 (9th Cir. 1971), quoting Thomas v. Celebrezze, 331 F.2d 541, 543 (4th Cir. 1964).

 At the hearing, the ALJ heard extensive testimony from Davis concerning his age, lifestyle, work history, ailments, complaints of pain and was able also to personally observe plaintiff's physical demeanor. In addition, the ALJ had before him hospital records dated from 1974 to the ...


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