Source: http://ny.findacase.com/research/wfrmDocViewer.aspx/xq/fac.19830411_0040360.C02.htm/qx
Timestamp: 2016-10-25 08:53:39
Document Index: 518271960

Matched Legal Cases: ['§ 205', '§ 405', '§ 205', '§ 405', '§ 423', '§ 423', '§ 404', '§ 404', '§ 405', '§ 307', '§ 405', '§ 405', '§ 404', '§ 405', '§ 405']

| Carroll v. Secretary of Health and Human Services
Carroll v. Secretary of Health and Human Services
HERBERT CARROLL, PLAINTIFF-APPELLANT,v.SECRETARY OF HEALTH AND HUMAN SERVICES, DEFENDANT-APPELLEE
Appeal from a judgment of the Southern District of New York, John M. Cannella, Judge, dismissing a complaint filed under § 205(g) of the Social Security Act, 42 U.S.C. § 405(g), alleging that the Secretary of Health and Human Services improperly denied plaintiff social security disability insurance benefits.
Herbert Carroll appeals from an order and judgment of the Southern District of New York entered by Judge John M. Cannella dismissing his complaint under § 205(g) of the Social Security Act, 42 U.S.C. § 405(g) (the "Act"), alleging that the Secretary of Health and Human Services ("HHS") improperly denied him social security disability insurance benefits. The district court upheld the Secretary's denial as supported by substantial evidence. The Secretary found that Carroll's impairments were not of such severity as to render him disabled within the meaning of the Act, concluding that he was capable of performing "sedentary" work. The Secretary has moved for a stay of the appeal pending a decision by the Supreme Court in Campbell v. Secretary of Health & Human Services, 665 F.2d 48 (2d Cir. 1981), cert. granted, 457 U.S. 1131, 102 S. Ct. 2956, 73 L. Ed. 2d 1348 (1982).*fn1 We reverse and remand for calculation of benefits.
The physician who treated Carroll most frequently and over the longest period of time (once every three or four weeks, beginning in February 1979) was Dr. Howard Hertzberg, an orthopedic surgeon. In confirming the foregoing findings he testified as follows before the Workers' Compensation Board regarding Carroll's ability to function:
A. I would evaluate [Carroll] as having a permanent partial disability . . . because of his persistent restrictions involving the back and the lower extremities and the persistent complaints of pain and limitation [of movement]." (A. 113-14, 117, emphasis added).
After Carroll's application to the Secretary for Social Security disability benefits was initially denied, a de novo disability hearing, at which Carroll was unrepresented, was held on December 21, 1979 before an Administrative Law Judge. At this hearing Carroll testified and the ALJ received in evidence the medical testimony and records that had been introduced before the Workers' Compensation Board. In a decision dated January 31, 1980, the ALJ concluded that Carroll was not entitled to disability insurance benefits under the Act. The ALJ substantially confirmed the foregoing medical diagnoses and found that Carroll could not "perform his former job as security guard due to resultant difficulty in standing, walking, lifting, and bending." (A. 26). However, he further found that the "medical evidence does not support claimant's allegation that his pain is of such severity that it precludes him from engaging in substantial gainful activity," that he (Carroll) "has the residual functional capacity to perform work-related functions except for work involving prolonged walking and standing, or frequent bending and lifting," and that he "has the residual functional capacity for at least sedentary work."*fn2 (A. 27). Accordingly the ALJ held that Carroll was not entitled to benefits under the Act. No medical evidence had been received as to Carroll's ability to perform "sedentary" functions other than the foregoing testimony of Dr. Hertzberg that he would have only limited ability to sit for any period of time. On March 10, 1980, the Appeals Council of the Social Security Administration denied Carroll's request for review.
If the claimant can perform gainful work existing in the national economy, it is immaterial for purposes of the Act that such work may not exist in the immediate area where he lives or that a specific job vacancy may not exist. 42 U.S.C. § 423(d)(2)(A).
In determining whether a claimant is disabled the Secretary must consider (1) objective medical facts and clinical findings, (2) diagnoses and medical opinions of examining physicians, (3) the claimant's subjective evidence of pain and physical incapacity as testified to by himself and others who observed him, and (4) the claimant's age, educational background, and work history. Parker v. Harris, 626 F.2d 225, 231 (2d Cir. 1980); Marcus v. Califano, 615 F.2d 23, 26 n.2 (2d Cir. 1979); Gold v. Secretary of Health, Education & Welfare, 463 F.2d 38, 41 n.2 (2d Cir. 1972). The opinion of a treating physician is entitled to considerable weight, Parker v. Harris, supra, 626 F.2d at 231; Rivera v. Harris, 623 F.2d 212, 216 (2d Cir. 1980), and in the absence of contradictory evidence is binding on the Secretary. Singletary v. Secretary of Health, Education and Welfare, 623 F.2d 217, 219 (2d Cir. 1980); Eiden v. Secretary of Health, Education and Welfare, 616 F.2d 63, 64 (2d Cir. 1980); Alvarado v. Califano, 605 F.2d 34, 35 (2d Cir. 1979); Bastien v. Califano, 572 F.2d 908, 912 (2d Cir. 1978).
The burden is on the claimant to prove that he is disabled within the meaning of the Act. 42 U.S.C. § 423(d)(5); 20 C.F.R. § 404.1520 (1982); Decker v. Harris, 647 F.2d 291, 293 (2d Cir. 1981). However, if the claimant shows that his impairment renders him unable to perform his past work, the burden then shifts to the Secretary to show there is other gainful work in the national economy which the claimant could perform. Berry v. Schweiker, 675 F.2d 464, 467 (2d Cir. 1982); Campbell v. Secretary of Health and Human Services, 665 F.2d 48, 51 (2d Cir. 1981), cert. granted, 457 U.S. 1131, 102 S. Ct. 2956, 73 L. Ed. 2d 1348 (1982); Parker v. Harris, supra, 626 F.2d at 231. More specifically,
The scope of judicial review of the Secretary's factual determinations and his application of legal principles to the facts has likewise been fairly well defined. "The findings of the Secretary as to any fact, if supported by substantial evidence, shall be conclusive . . . ." 42 U.S.C. 405(g); Richardson v. Perales, 402 U.S. 389, 401, 28 L. Ed. 2d 842, 91 S. Ct. 1420 (1971); Parker v. Harris, supra, 626 F.2d at 231. It is the function of the Secretary, not ourselves, to resolve evidentiary conflicts and to appraise the credibility of witnesses, including the claimant. Richardson v. Perales, supra, 402 U.S. at 399; McLaughlin v. Secretary of Health, Education & Welfare, 612 F.2d 701, 705 (2d Cir. 1980); Marcus v. Califano, supra, 615 F.2d at 27.
The ALJ found that this medical evidence does not support Carroll's claim that his pain is of such severity as to preclude him from engaging in substantial gainful activity and that he has "the residual functional capacity for at least sedentary work as defined in Regulation 404.1510," precluding him from entitlement to disability benefits under the Act. This finding is not supported by substantial record evidence. The Secretary, who had the burden on this issue, failed to introduce any medical or other evidence, such as the testimony of a vocational expert or a consulting physician, that Carroll could hold a sedentary job. By its very nature "sedentary" work requires a person to sit for long periods of time even though standing and walking are occasionally required. 20 C.F.R. § 404.1567(a), (b) (1982). Three of the four doctors who examined Carroll (Drs. Waltier, Bernard and Goldstein) were never asked what work or activity, such as sedentary employment, Carroll could perform and hence expressed no opinion on that subject. However, Dr. Howard Hertzberg, the treating physician who examined Carroll many times over a period of more than a year, expressed the opinion that Carroll had a limited ability to stand for any period of time, to sit for any period, to lift or to bend, and that he could sit, walk or stand for only "short periods."
Nor has the Secretary sustained his burden on the basis of (1) Carroll's testimony that he sometimes reads, watches television, listens to the radio, rides buses and subways, and (2) the ALJ's notation that Carroll "sat still for the duration of the hearing and was in no evident pain or distress." There was no proof that Carroll engaged in any of these activities for sustained periods comparable to those required to hold a sedentary job. On the contrary, as far as the record is concerned he did these things only for short periods. Moreover he testified to various types of pain and limitations of movement that would have precluded his being capable of sedentary employment. His testimony regarding pain was also corroborated to some extent by the doctors who examined him, none of whom indicated any doubts about his credibility. Although the ALJ was not required to credit Carroll's testimony, he would normally be expected to note his rejection of it in whole or part. Yet he failed to indicate any such disbelief, resting his finding of capability of sedentary work on "the medical evidence." The ALJ's observation that Carroll sat through the hearing without apparent pain, being that of a lay person, is entitled to but limited weight, see Freeman v. Schweiker, 681 F.2d 727, 731 (11th Cir. 1982), and since only a 40-minute period was involved it is not inconsistent with the medical evidence and Carroll's own testimony.
We therefore conclude that the Secretary has failed to sustain his burden and that the ALJ's finding that Carroll can engage in sedentary work is not supported by substantial evidence. The judgment dismissing Carroll's complaint must therefore be reversed. There remains the question of whether we should direct that the case be (1) remanded for reconsideration by the Secretary upon the existing record or upon a record to be amplified or (2) remanded for calculation of benefits. This issue requires us to consider Congress' June 9, 1980 amendment of 42 U.S.C. § 405(g), P.L. 96-265, § 307, 94 Stat. 458, which limits our remand power. Prior to the amendment, the section provided in pertinent part:
"The court shall have power to enter, upon the pleadings and transcript of the record, a judgment affirming, modifying, or reversing the decision of the Secretary, with or without remanding the cause for a rehearing. . . . The court shall, on motion of the Secretary made before he files his answer, remand the case to the Secretary for further action by the Secretary, and may, at any time, on good cause shown, order additional evidence to be taken before the Secretary. . . ."
"The court may, on motion of the Secretary made for good cause shown before he files his answer, remand the case to the Secretary for further action by the Secretary, and it may at any time order additional evidence to be taken before the Secretary, but only upon a showing that there is new evidence which is material and that there is good cause for the failure to incorporate such evidence into the record in a prior proceeding; . . . ."
"As we have recently noted, the amendment 'was at least in part designed to limit federal court remands to the Secretary,'" Carter v. Schweiker, 649 F.2d 937, 942 (2d Cir. 1981) (quoting Aubeuf v. Schweiker, 649 F.2d 107, 115 (2d Cir. 1981)). See also S. Rep. No. 96-408, 96th Cong., 2d Sess. 58 (1979), reprinted in [1980] U.S. Code Cong. & Ad. News 1277, 1336. Although the amendment became effective after the close of administrative proceedings in the present case, we must, in the absence of a contrary Congressional directive or of evidence that retroactive application would be manifestly unjust, treat the amendment as applicable. Ward v. Schweiker, 686 F.2d 762, 764 (9th Cir. 1982); Chaney v. Schweiker, 659 F.2d 676, 678 (5th Cir. 1981); see Bradley v. School Board of Richmond, 416 U.S. 696, 711, 40 L. Ed. 2d 476, 94 S. Ct. 2006 (1974); Berry v. Schweiker, supra, 675 F.2d at 467 n.1.
The amendment does not preclude remand when the Secretary has misapplied the law or failed to provide a fair hearing, see, e.g., Carter v. Schweiker, supra, 649 F.2d at 942; Aubeuf v. Schweiker, supra, 649 F.2d at 116. However, when, as here, the reversal is based solely on the Secretary's failure to sustain his burden of adducing evidence of the claimant's capability of gainful employment and the Secretary's finding that the claimant can engage in "sedentary" work is not supported by substantial evidence, no purpose would be served by our remanding the case for rehearing unless the Secretary could offer additional evidence. The Secretary has not yet requested such a remand, and it appears unlikely that the Secretary could show good cause "for failure to incorporate such [additional] evidence into the record in [the] prior proceeding." 42 U.S.C. § 405(g). Nothing appears to have prevented the ALJ in the present case from calling as live witnesses the four doctors who gave evidence before the Workers' Compensation Board and inquiring further into Carroll's capability of employment or from offering other evidence, such as the testimony of vocational experts. See 42 U.S.C. § 405(d) (ALJ's subpoena power); 20 C.F.R. § 404.950(d) (same). Moreover, absent a showing by the Secretary of good cause for a remand, the present case would be an appropriate one in which to carry out Congress' mandate to foreshorten the often painfully slow process by which disability determinations are made. It has now been four years since Carroll applied to HHS for disability benefits. A remand, potentially followed by another appeal, could well delay the payment of benefits to which Carroll appears to be entitled for still further years. However, on the record before us we cannot now determine whether the Secretary would ask to reopen the record for the purpose of introducing additional evidence and, if so, whether he would be able to meet the requirements of § 405(g), i.e. (1) that the evidence be (a) new and (b) material, and (2) that good cause be shown for his failure to produce the evidence in earlier proceedings. See Carter v. Schweiker, supra, 649 F.2d at 942-43. Should the Secretary move for a remand to present new evidence, the application of these standards would present "primarily factual issues [which] must be determined by the district court in the first instance." Id. at 943.
Accordingly, we reverse the order and judgment of the district court with directions to remand the case to the Secretary for the calculation of benefits, subject to the district court's disposition according to the foregoing standards fixed by § 405(g) of any motion by the Secretary for a remand to the ALJ for the consideration of additional evidence, provided the motion is made promptly upon our remand of the case to the district court.