Source: https://law.justia.com/cases/federal/appellate-courts/F3/94/40/602328/
Timestamp: 2019-02-17 05:16:41
Document Index: 723915066

Matched Legal Cases: ['§ 404', '§ 405', '§ 416', '§ 416', '§ 1382', '§ 423']

51 Soc.sec.rep.ser. 555, Unempl.ins.rep. (cch) P 15542bflorence Bush, Plaintiff-appellee, v. Donna E. Shalala, Secretary of Health and Human Services,defendant-appellant, 94 F.3d 40 (2d Cir. 1996) :: Justia
Justia › US Law › Case Law › Federal Courts › Courts of Appeals › Second Circuit › 1996 › 51 Soc.sec.rep.ser. 555, Unempl.ins.rep. (cch) P 15542bflorence Bush, Plaintiff-appellee, v. Donna E...
51 Soc.sec.rep.ser. 555, Unempl.ins.rep. (cch) P 15542bflorence Bush, Plaintiff-appellee, v. Donna E. Shalala, Secretary of Health and Human Services,defendant-appellant, 94 F.3d 40 (2d Cir. 1996)
US Court of Appeals for the Second Circuit - 94 F.3d 40 (2d Cir. 1996)
Argued May 20, 1996. Decided Aug. 23, 1996
Ms. Bush again sought review by the Appeals Council. And the Council in May of 1991 remanded the case for further administrative inquiry into plaintiff's symptoms. It requested that an ALJ "make specific findings as to the credibility of the claimant's complaints and their effect on her ability to function."
Pursuant to the Appeals Council decision, a fifth administrative hearing was held in May 1993 before ALJ David Nisnewitz. Judge Nisnewitz, after reviewing the medical evidence, found that " [a]lthough the claimant has established that she suffers from a severe respiratory impairment, said impairment fails to meet or equal the level of severity of any disabling condition contained in Appendix 1, Subpart P of Social Security Regulations No. 4." Judge Nisnewitz went on to make the following findings:
. The plaintiff's "impairment did not prevent [her] from performing her past relevant work as a bank teller from her alleged onset of disability on May 24, 1985 through her date last insured on December 31, 1989."
. "In the disability report prepared by the claimant at the time of filing her application ... the claimant indicated that she was placed under no restrictions by any treating physician. Following his examination of the claimant, Dr. Vevaina reported that the claimant's ability to sit, stand, walk and lift was unlimited. However, he recommended that the claimant avoid exposure to a number of environmental irritants.... His assessment corresponds with that of the claimant's treating physician, Dr. Weinstock, who recommended, in July 1990, that the claimant avoid exposure to cigarette smoke and increased amounts of dust, mold and flowers. The Administrative Law Judge notes that a bank environment typically does not require exposure to the allergens identified by Dr. Weinstock...."
. " [T]he Administrative Law Judge has given thoughtful consideration to the claimant's allegations of disabling pain and symptoms as required by Social Security Ruling 88-13 and 20 CFR 404.1529.... The claimant was prescribed Bronkosol, Seldane, Ocean Nasal Spray and Beconase. She reported no adverse side-effects from her use of these medications.... Results of chest x-rays, bronchoscopy and blood studies were within normal limits. These results have been consistent from 1985 through May 1990. On physical examinations, the claimant has displayed normal breath sounds, with no evidence of wheezing, rales or rhonchi. The claimant's treating physician, Dr. Weinstock, reports that the claimant's symptoms had improved and that she experienced a marked response to bronchodilation therapy. Following his examination of the claimant in October 1987 and May 1990, Dr. Vevaina concluded that there was no evidence that the claimant was disabled in any manner."
. " [T]he claimant alleges that her daily activities are extremely constricted due to persistent coughing spells.... However, the claimant noted that, between 1985 and 1989, she was able to shop for clothing and shoes, wore perfume and lipstick and attended church on a weekly basis. She further testified that she taught Sunday School. Her housekeeping chores were limited to making beds, doing laundry, cleaning the bathroom and cooking. Her husband reportedly performs chores such as vacuuming and grocery shopping. The claimant also acknowledges that she has a driver's license and continued to drive through 1989."
. "At hearing, the claimant testified that she traveled to the Middle East in 1989 ... for a period of two weeks. The claimant also travels to South Carolina annually for a two-week trip during the summer months. Presumably, if temperature extremes did, indeed, exacerbate the claimant's symptoms, she would travel to South Carolina during a more temperate time of the year. Despite the claimant's allegations that her coughing and breathing difficulties are disabling, the Administrative Law Judge finds no diagnostic studies of record which can reasonably support the claimant's allegations."
. " [T]he claimant continues to attend church, perform limited housekeeping and travels without limitation. Her activities, in conjunction with de minimus [sic] medical findings, lead the Administrative Law Judge to conclude that the claimant's symptoms are not as severe as alleged.... [H]e does not find that it was of such frequency, intensity and duration ... as to render her incapable of performing substantial gainful activity on a sustained basis."
The claimant's treating physicians have consistently reported that severe exacerbations of her asthma occur only upon exposure to dust, damp weather, and flowers. The clinical records reflect that she did improve after treatment was initiated.... Given the proper environmental limitations as identified in the decision, the claimant is not precluded from performing the demands of her past relevant work.
Finally, last year in May, the district court (Sifton, C.J.) granted the plaintiff's motion and entered judgment in her favor. The district court stated that ALJ Nisnewitz had failed to conduct a hearing over "a number of days" and that he had not provided the reviewing court with "findings of fact and conclusions of law of some complexity." The court went on to say that " [t]he Secretary has had more than enough time and opportunity to pursue those inquiries and make those detailed findings of fact permitting me to review the determination, so in these circumstances the remedy for the failure to explore these matters in the past can only be reversal and a remand for an award." Accordingly, it awarded plaintiff disability insurance benefits retroactive to 1985 through December 31, 1989.
In evaluating disability claims, the Secretary is required to use a five-step sequence, promulgated in 20 C.F.R. §§ 404.1520, 416.920 (1981):
"First, the Secretary considers whether the claimant is currently engaged in substantial gainful activity. If he is not, the Secretary next considers whether the claimant has a "severe impairment" which significantly limits his physical or mental ability to do basic work activities. If the claimant suffers such an impairment, the third inquiry is whether, based solely on medical evidence, the claimant has an impairment which is listed in Appendix 1 of the regulations. If the claimant has such an impairment, the Secretary will consider him disabled without considering vocational factors such as age, education, and work experience; the Secretary presumes that a claimant who is afflicted with a "listed" impairment is unable to perform substantial gainful activity. Assuming the claimant does not have a listed impairment, the fourth inquiry is whether, despite the claimant's severe impairment, he has the residual functional capacity to perform his past work. Finally, if the claimant is unable to perform his past work, the Secretary then determines whether there is other work which the claimant could perform." The burden of proving disability, encompassing the first four of these steps, is on the claimant. The burden of proving the fifth step is on the Secretary.
Rivera v. Schweiker, 717 F.2d 719, 722-23 (2d Cir. 1983) (emphases added) (citations omitted).3 Ms. Bush was not found to have a "listed" impairment, and thus she had the burden of proving that her impairment interfered with her capacity to perform her relevant past work. The government contends that Ms. Bush has not met her burden on this point.
ALJ Nisnewitz found that Ms. Bush had not shown that she was unable to perform her past relevant work. If there is "substantial evidence" to support the Secretary's findings, they are "conclusive" and may not be questioned by the district court. 42 U.S.C. § 405(g). "Substantial evidence," in the social security disability insurance context, means "more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Richardson v. Perales, 402 U.S. 389, 401, 91 S. Ct. 1420, 1427, 28 L. Ed. 2d 842 (1971) (citation and internal quotation marks omitted).
continues to have relatively severe symptom exacerbations with exposure to dust, damp weather, or flowers. She has developed food allergies, which have also increased her allergic rhinitis symptoms. Another new problem has been severe reflux esophagitis with episodes or aspiration of gastric secretions.... Due to her allergic rhinitis and asthma, she should avoid work environments with cigarette smoke, increased amounts of dust or molds spores or flowers.
The district court did not focus on the past relevant work requirement, which remains the key to disability benefits in this case. It voiced outrage at alleged improprieties in the administrative hearing and the ten-year delay since Ms. Bush first filed her petition. While we have sympathy for the district court's reaction, we cannot decorate such sentiments with the force of law. In its decision, the district court repeatedly indicated its yearning for a more detailed inquiry. See, e.g., Jt.App. at 7 ("what we're accustomed to in this court" is "a proceeding and hearing extending over a number of days, following which there would be an opinion and findings of facts and conclusions of law of some complexity"). But administrative hearings are not similar to the hearings to which district courts are typically accustomed. As the Supreme Court has observed, Congress gave the Secretary much discretion to deal with the millions of decisions she must make. See Perales, 402 U.S. at 399-400, 91 S. Ct. at 1426-27. In particular, a full-blown adversarial hearing is not required. Id. at 400-01, 91 S. Ct. at 1427 ("There emerges an emphasis upon the informal rather than the formal. This, we think, is as it should be, for this administrative procedure, and these hearings, should be understandable to the layman claimant, should not necessarily be stiff and comfortable only for the trained attorney, and should be liberal and not strict in tone and operation."). Requirements of due process apply, of course, but what is adequate to meet those requirements is understandably different in such hearings than in judicial trials. See generally JERRY L. MASHAW, DUE PROCESS IN THE ADMINISTRATIVE STATE (1985).
Nor, on these facts, does the ten-year delay justify a finding in Bush's favor. The plaintiff correctly notes that the Third Circuit has held that the Railroad Retirement Board violated an applicant's due process rights by taking almost four years to issue a final decision regarding disability benefits. Kelly v. Railroad Ret. Bd., 625 F.2d 486, 491 (3d Cir. 1980). In Kelly, however, the court found that there was substantial evidence in the record that the claimant was in fact disabled. There is no such evidence here, and absent a finding that the claimant was actually disabled, delay alone is an insufficient basis on which to remand for benefits. See Gilliland v. Heckler, 786 F.2d 178, 184 (3d Cir. 1986) (a decision to reverse and direct an award for benefits "should be made only when ... substantial evidence on the record as a whole indicates that the Claimant is disabled and entitled to benefits").
The abnormality to which plaintiff's lawyer referred was actually in a 1983 x-ray, not the 1985 x-ray taken at Astoria Hospital (where no abnormality was found)
The record does not explain why plaintiff's disability insurance terminated on December 31, 1989. Under the statute, disability insurance coverage can end for a variety of reasons, including eligibility for retirement payments. See 42 U.S.C. § 416(i) (3)
An individual applying for social security disability benefits is considered to have a disability if he or she has 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 has lasted or can be expected to last for a continuous period of not less than 12 months." 42 U.S.C. § 416(i) (1) (A); 42 U.S.C. § 1382c(a) (3) (A). Further, " [a]n individual shall be determined to be under a disability only if his physical or mental impairment or impairments are of such severity that he is not only unable to do his previous work but cannot, considering his age, education, and work experience, 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)
ALJ Nisnewitz also gave substantial consideration to the factors in Social Security Ruling 88-13, and Ms. Bush does not appear to suggest otherwise in her brief to this Court. The Ruling provides that when a claimant's symptoms suggest a greater restriction of function than can be demonstrated by objective evidence alone, consideration will be given to such factors as:
Type, dosage, effectiveness, and side effects of medication that the claimant has taken to alleviate her symptoms;
Present or past treatment, other than medication, for relief of pain or other symptoms;
Any measures the claimant uses or has used to relieve her pain or other symptoms; and
Other factors concerning functional limitations and restrictions due to pain or other symptoms
See 20 CFR 404.1529(c) (3); SSR 88-13. As previously discussed, the ALJ did consider these factors in his decision.