Source: https://m.openjurist.org/402/us/389/richardson-v-perales
Timestamp: 2019-11-21 21:34:35
Document Index: 271484388

Matched Legal Cases: ['§ 205', '§ 405', '§ 404', '§ 1732', '§ 556', '§ 556', '§ 405', '§ 405', '§ 556', '§ 405', '§ 404']

402 US 389 Richardson v. Perales | OpenJurist
402 U.S. 389 - Richardson v. Perales
Elliott L. RICHARDSON, Secretary of Health, Education and Welfare, Petitioner,
The Social Security Act has been with us since 1935. Act of August 14, 1935, 49 Stat. 620. It affects nearly all of us. The system's administrative structure and procedures, with essential determinations numbering into the millions, are of a size and extent difficult to comprehend. But, as the Government's brief here accurately pronounces, 'Such a system must be fair—and it must work.'5
'shall have full power and authority to make rules and regulations and to establish procedures * * * necessary or appropriate to carry out such provisions, and shall adopt reasonable and proper rules and regulations to regulate and provide for the nature and extent of the proofs and evidence and the method of taking and furnishing the same in order to establish the right to benefits hereunder.' § 205(a), 42 U.S.C. § 405(a).
The Court has adhered to that definition in varying statutory situations. See NLRB v. Columbian Enameling & Stamping Co., 306 U.S. 292, 300, 59 S.Ct. 501, 505, 83 L.Ed. 660 (1939); Universal Camera Corp. v. NLRB, 340 U.S. 474, 477—487, 71 S.Ct. 456, 459 464, 95 L.Ed. 456 (1951); Consolo v. Federal Maritime Comm'n, 383 U.S. 607, 619—620, 86 S.Ct. 1018, 1026—1027, 16 L.Ed.2d 131 (1966).
'extent to which procedural due process must be afforded the recipient is influenced by the extent to which he may be 'condemned to suffer grievous loss'. * * * Accordingly * * * 'consideration of what procedures due process may require under any given set of circumstances must begin with a determination of the precise nature of the government function involved as well as of the private interest that has been affected by governmental action." Goldberg v. Kelly, 397 U.S. 254, 262—263, 90 S.Ct. 1011, 1018, 25 L.Ed.2d 287 (1970).
1. The identity of the five reporting physicians is significant. Each report presented here was prepared by a practicing physician who had examined the claimant.6 A majority (Drs. Langston, Bailey, and Mattson) were called into the case by the state agency. Although each received a fee, that fee is recompense for his time and talent otherwise devoted to private practice or other professional assignment. We cannot, and do not, ascribe bias to the work of these independent physicians, or any interest on their part in the outcome of the administrative proceeding beyond the professional curiosity a dedicated medical man possesses.
2. The vast workings of the social security administrative system make for reliability and impartiality in the consultant reports. We bear in mind that the agency operates essentially, and is intended so to do, as an adjudicator and not as an advocate or adversary. This is the congressional plan. We do not presume on this record to say that it works unfairly.7
6. Although the claimant complains of the lack of opportunity to cross-examine the reporting physicians, he did not take advantage of the opportunity afforded him under 20 CFR § 404.926 to request subpoenas for the physicians. The five-day period specified by the regulation for the issuance of the subpoenas surely afforded no real obstacle to this, for he was notified that the documentary evidence on file was available for examination before the hearing and, further, a supplemental hearing could be requested. In fact, in this very case there was a supplemental hearing more than two and a half months after the initial hearings. This inaction on the claimant's part supports the Court of Appeals' view, 412 F.2d, at 50—51, that the claimant as a consequence is to be precluded from now complaining that he was denied the rights of confrontation and cross-examination.
7. Courts have recognized the reliability and probative worth of written medical reports even in formal trials and, while acknowledging their hearsay character, have admitted them as an exception to the hearsay rule. Notable is Judge Parker's well-known ruling in the war-risk insurance case of Long v. United States, 59 F.2d 602, 603—604 (CA4 1932), which deserves quotation here, but which, because of its length, we do not reproduce. The Second Circuit has made a like ruling in White v. Zutell, 263 F.2d 613, 615 (1959), and in so doing, relied on the Business Records Act, 28 U.S.C. § 1732.
8. Past treatment by reviewing courts of written medical reports in social security disability cases is revealing. Until the decision in this case, the courts of appeals, including the Fifth Circuit, with only an occasional criticism of the medical report practice,8 uniformly recognized reliability and probative value in such reports. The courts have reviewed administrative determinations, and upheld many adverse ones, where the only supporting evidence has been reports of this kind, buttressed sometimes, but often not, by testimony of a medical adviser such as Dr. Leavitt.9 In these cases admissibility was not contested, but the decisions do demonstrate traditional and ready acceptance of the written medical report in social security disability cases.
1. Perales relies heavily on the Court's holding and statements in Goldberg v. Kelly, supra, particularly the comment that due process requires notice 'and an effective opportunity to defend by confronting any adverse witnesses * * *.' 397 U.S., at 267—268, 90 S.Ct., at 1020. Kelly, however, had to do with termination of AFDC benefits without prior notice. It also concerned a situation, the Court said, 'where credibility and veracity are at issue, as they must be in many termination proceedings.' 397 U.S., at 269, 90 S.Ct., at 1021.
3. The claimant, the District Court, and the Court of Appeals also criticize the use of Dr. Leavitt as a medical adviser. 288 F.Supp., at 314; 142 F.2d, at 53—54. See also Mefford v. Gardner, 383 F.2d 748, 759—761 (CA6 1967). Inasmuch as medical advisers are used in approximately 13% of disability claim hearings, comment as to this practice is indicated. We see nothing 'reprehensible' in the practice, as the claimant would describe it. The trial examiner is a layman; the medical adviser is a board-certified specialist. He is used primarily in complex cases for explanation of medical problems in terms understandable to the layman-examiner. He is a neutral adviser. This particular record discloses that Dr. Leavitt explained the technique and significance of electromyography. He did offer his own opinion on the claimant's condition. That opinion, however, did not differ from the medical reports. Dr. Leavitt did not vouch for the accuracy of the facts assumed in the reports. No one understood otherwise. See Doe v. Department of Transportation, 412 F.2d 674, 678—680 (CA8 1969). We see nothing unconstitutional or improper in the medical adviser concept and in the presence of Dr. Leavitt in this administrative hearing.
4. Finally, the claimant complains of the system of processing disability claims. He suggests, and is joined in this by the briefs of amici, that the Administrative Procedure Act, rather than the Social Security Act, governs the processing of claims and specifically provides for cross-examination, 5 U.S.C. § 556(d). (1964 ed., Supp. V). The claimant goes on to assert that in any event the hearing procedure is invalid on due process grounds. He says that the hearing examiner has the responsibility for gathering the evidence and 'to make the Government's case as strong as possible'; that naturally he leans toward a decision in favor of the evidence he has gathered; that justice must satisfy the appearance of justice, citing Offutt v. United States, 348 U.S. 11, 14, 75 S.Ct. 11, 13, 99 L.Ed. 11 (1954), and In re Murchison, 349 U.S. 133, 136, 75 S.Ct. 623, 99 L.Ed. 942 (1955); and that an 'independent hearing examiner such as in the' Longshoremen's and Harbor Workers' Compensation Act should be provided.
This claimant for social security disability benefits had a serious back injury. The doctor who examined him testified that he was permanently disabled. His case is defeated, however, by hearsay evidence of doctors and their medical reports about this claimant. Only one doctor who examined him testified at the hearing. Five other doctors who had once examined the claimant did not testify and were not subject to cross-examination. But their reports were admitted in evidence. Still another doctor testified on the hearsay in the documents of the other doctors. All of this hearsay may be received, as the Administrative Procedure Act (5 U.S.C. § 556(d) (1964 ed., Supp. V)) provides that '(a)ny oral or documentary evidence may be received.' But this hearsay evidence cannot by itself be the basis for an adverse ruling. The same section of the Act states that '(a) party is entitled * * * to conduct such cross-examination as may be required for a full and true disclosure of the facts.'1
Cross-examination of doctors in these physical injury cases is, I think, essential to a full and fair disclosure of the facts.2
The conclusion reached by the Court of Appeals that hearsay evidence alone is not 'substantial' enough to sustain a judgment adverse to the claimant is supported not only by the Administrative Procedure Act but also by the Social Security Act itself. Although Congress provided in the Social Security Act that '(e)vidence may be received at any hearing before the Secretary even though inadmissible under rules of evidence applicable to court procedure,' see 42 U.S.C. § 405(b), Congress also provided that findings of the Secretary were to be conclusive only 'if supported by substantial evidence.' 42 U.S.C. § 405(g). (Emphasis added.) Uncorroborated hearsay untested by cross-examination does not by itself constitute 'substantial evidence.' See Consolidated Edison Co. v. NLRB, 305 U.S. 197, 230, 59 S.Ct. 206, 217, 83 L.Ed. 126 (1938). Particularly where, as in this case, a disability claimant appears and testifies as to the nature and extent of his injury and his family doctor testifies in his behalf supporting the fact of his disability, the Secretary should not be able to support an adverse determination on the basis of medical reports from doctors who did not testify or the testimony of an HEW employee who never even examined the claimant as a patient.
'Then, when you pyramid hearsay from a so-called medical advisor, who, himself, has never examined the man who claims benefits, then you just compound it—compound a situation that I simply cannot tolerate in my own mind, and I can't see why a hearing examiner wants to abrogate his duty and his responsibility and turn it over to some medical advisor.'
The use by HEW of its stable of defense doctors without submitting them to cross-examination is the cutting of corners—a practice in which certainly the Government should not indulge. The practice is barred by the rules which Congress has provided; and we should enforce them in the spirit in which they were written.
'Midline incision is made in upper border of the spine of L4 downward in the midline to the upper sacrum. Dissection is carried down and in the subperiosteal space exposing the interspaces at L4—5 and L5 S1. At each interspace, partial laminectomy is carried out on the left and of the bone adjacent to the interspace followed by resection of the intervening ligament in order that the interspace could be thoroughly explored both by inspection as well as by palpation. In each instance, there was no protrusion of the disc identified. Further resection downward over the sacrum is carried out in order that we do not overlook the fragment of disc that may have extruded extra-durally in this space but none is found.
'There seems to be more tightness of structures particularly of the roots in the dural sac and the lumbar area than one usually encountered. It is felt that this is the situation representing the root compression syndrome, the exact mechanics of which is not apparent. It is felt that for this reason that hemilaminectomy of the left L—5 would afford the patient additional decompression and this is carried out. After this had been done the dural sac bulges upward in a more normal position. Repeat inspection through the intact dura reveals no evidence of an intradural mass. Likewise the anterior aspect of the canal appears normal. * * *'
'IMPRESSION: He may have a very mild chronic back sprain associated with the congenital anomalies as seen on x-ray, but it has been a long time since I have been so impressed with the obvious attempt of a patient to exaggerate his difficulties by simply just standing there and not moving—not even the uninvolved upper extremities. Thus, he has a tremendous psychological overlay to this illness, and I sincerely suggest that he be seen by a psychiatrist.
Ratliff v. Celebrezze, 338 F.2d 978, 982 (CA6 1964); but see Miracle v. Celebrezze, 351 F.2d 361, 365, 382—383 (CA6 1965).
Ber v. Celebrezze, 332 F.2d 293, 296—298 (CA2 1964); Stancavage v. Celebrezze, 323 F.2d 373, 374 (CA3 1963); Dupkunis v. Celebrezze, 323 F.2d 380, 382 (CA3 1963); Cochran v. Celebrezze, 325 F.2d 137, 138 (CA4 1963); Cuthrell v. Celebrezze, 330 F.2d 48, 50—51 (CA4 1964); Aldridge v. Celebrezze, 339 F.2d 190, 191 (CA5 1964); Dodsworth v. Celebrezze, 349 F.2d 312, 313 314 (CA5 1965); Bridges v. Gardner, 368 F.2d 86, 89 (CA5 1966); Green v. Gardner, 391 F.2d 606 (CA5 1968); Martin v. Finch, 415 F.2d 793, 794 (CA5 1969); Breaux v. Finch, 421 F.2d 687, 689 (CA5 1970); Phillips v. Celebrezze, 330 F.2d 687, 689 (CA6 1964); Justice v. Gardner, 360 F.2d 998, 1000—1001 (CA6 1966); Moon v. Celebrezze, 340 F.2d 926, 928 (CA7 1965); Pierce v. Gardner, 388 F.2d 846, 847 (CA7 1967), cert. denied, 393 U.S. 885, 89 S.Ct. 197, 21 L.Ed.2d 162; Celebrezze v. Sutton, 338 F.2d 417, 419—420 (CA8 1964); Brasher v. Celebrezze, 340 F.2d 413, 414 (CA8 1965); McMullen v. Celebrezze, 335 F.2d 811, 815 (CA9 1964), cert. denied, 382 U.S. 854, 86 S.Ct. 106, 15 L.Ed.2d 92; Flake v. Gardner, 399 F.2d 532, 534 (CA9 1968); Celebrezze v. Warren, 339 F.2d 833, 836 (CA10 1964); McMillin v. Gardner, 384 F.2d 596, 597 (CA10 1967).
S.Rep.No.752, 79th Cong., 1st Sess., 22—23.
'The provision on its face does not confer a right of so-called 'unlimited' cross-examination. Presiding officers will have to make the necessary initial determination whether the cross-examination is pressed to unreasonable lengths by a party or whether it is required for the 'full and true disclosure of the facts' stated in the provision. Nor is it the intention to eliminate the authority of agencies to confer sound discretion upon presiding officers in the matter of its extent. The test is as the section states—whether it is required 'for a full and true disclosure of the facts. * * *' The right of cross-examination extends, in a proper case, to written evidence submitted pursuant to the last sentence of the section as well as to cases in which oral or documentary evidence is received in open hearing. * * * To the extent that cross-examination is necessary to bring out the truth, the party must have it. * * *' H.R.Rep.No.1980, 79th Cong., 2d Sess., 37.
While the Administrative Procedure Act allows statutory exceptions of procedures different from those in the Act, 5 U.S.C. § 556 (1964 ed., Supp. V), there is no explicit ban in the Social Security Act (42 U.S.C. § 405) against the right of cross-examination. And the Regulations of the Secretary provide that there must be 'a reasonable opportunity for a fair hearing.' 20 CFR § 404.927.