Source: https://casetext.com/case/flake-v-gardner
Timestamp: 2019-03-23 23:05:14
Document Index: 283105254

Matched Legal Cases: ['§ 416', '§ 205', '§ 405', '§ 423', '§ 303', '§ 423', '§ 423', '§ 405', '§ 404', '§ 404', '§ 404', '§ 404', '§ 223']

Flake v. Gardner, 399 F.2d 532 | Casetext
Flake v. Gardner
399 F.2d 532 (9th Cir. 1968)
Flakev.Gardner
United States Court of Appeals, Ninth CircuitAug 14, 1968
Robert G. Carter, of Wild, Christensen, Carter Blank, Fresno, Cal., for appellant.
Wm. Byrne, U.S. Atty., Frederick M. Brosio, Jr., Asst. U.S. Atty., Chief Civil Division, Dzintra I. Janavs, Asst. U.S. Atty., Los Angeles, Cal., for appellee.
Before BARNES and DUNIWAY, Circuit Judges, and HILL, District Judge.
Honorable Irving Hill, United States District Judge for the Central District of California, sitting by designation.
This is an action to review a decision of the Secretary of Health, Education and Welfare denying an application for a period of disability and for disability insurance benefits under sections 216(i) and 223 of the Social Security Act as amended ( 42 U.S.C. § 416(i) and 423). The District Court entered summary judgment for the Secretary and the applicant (Flake) appeals. His arguments are, in essence, (1) that the decision of the Secretary is not supported by substantial evidence (§ 205(g)); and (2) that the Secretary applied an improper legal standard in finding the facts.
The action survives although Secretary Gardner is no longer in office. Section 205(g), ( 42 U.S.C. § 405(g)).
When Flake filed his application, and when the hearing was had and the decision was rendered, including that of the Appeals Board, section 223(c)(2) of the Act, as amended, defined "disability" as: "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 to be of long-continued and indefinite duration. An individual shall not be considered to be under a disability unless he furnishes such proof of the existence thereof as may be required." (See 42 U.S.C. § 423(c)(2) (1964).)
On July 20, 1965, this language was amended by Pub.L. 89-97, § 303(a)(2) (79 Stat. 286, at 367) by substituting for the phrase "to be of long-continued and indefinite duration" the phrase "which has lasted or can be expected to last for a continuous period of not less than 12 months." This amendment is applicable to this case under section 303(f)(1) of Pub.L. 89-97 (79 Stat. at 368). Dean v. Gardner, 9 Cir., 1968, 393 F.2d 327, 328 n. 2. But it is by no means clear that such applicability can do Flake any good.
The second sentence, relating to the proof to be furnished, was not changed. 42 U.S.C.A. 1968, pocket part, § 423, makes it appear that the sentence was eliminated. This is not correct. See U.S.C. 1964 Ed., supplement II, title 42, § 423(c)(2) (p. 1606).
The pertinent language of section 303(f)(1), excerpted from a 23 line sentence embodying subparagraphs and sub-subparagraphs, reads: "The amendments made by subsection (a) * * * shall be effective with respect to applications for disability insurance benefits under section 223, and for disability determinations under section 216(i), of the Social Security Act filed —
The Act was again amended by Pub.L. 90-248, Jan. 2, 1968, 81 Stat. 821. See 1 U.S.Code Cong. and Ad. News, 1967, pp. 923ff. The pertinent section is section 158. It shifts the definition of disability that we have quoted, without change, from section 223(c) to 223(d)(1)(A) and adds a new subdivision (3) to the new section 223(d) reading as follows:
It also shifts the second sentence of former section 223(c), quoted above in the body of this opinion, to section 223(d)(5), with only minor changes. Subsection (e) of section 158 of the amending Act makes these amendments also applicable to this case. Dean v. Gardner, supra.
Throughout the pendency of these proceedings, there were two other provisions of the Act that appear to be applicable. One is section 205(a) ( 42 U.S.C. § 405 (a)), which reads:
Pursuant to the authority thus conferred by section 205(a) the Secretary has adopted rather elaborate regulations relating to proof of disability. Those in effect during these proceedings appear at 20 C.F.R. § 404.1501-404.1539 (revised as of January 1, 1967). Particularly pertinent are sections 404.1502(a), 404.1510(a) as well as the remaining subdivisions of that section, 404.1511(a) and (c) relating to arthritis, and 404.1514 relating to impairment of the cardiovascular system. These sections specify in considerable detail the proof required. They are buttressed by section 404.1530. Several of these sections were amended in late 1967 (33 Fed.Reg. 15-18). In general the changes tighten the former requirements.
"Also, medical considerations alone (including the physiological and psychological manifestations of aging) may justify a finding that the individual is under a disability where his impairment is one, as shown by the following examples, which would ordinarily be considered as preventing substantial gainful activity, except where other evidence rebuts a finding of `disability,' e.g., the individual is actually engaging in substantial gainful activity. Examples of such impairments are:
"(a) In order to establish that a medically determinable physical or mental impairment (see § 404.1501(a) or (b)(1)) is present there should be evidence that medically discernible anatomical, physiological, biochemical or psychological aberrations exist. Allegations of inability to work as a result of impairment such as dyspnea (shortness of breath), pain, lack of musculoskeletal function, decreased vision or hearing, decreased memory, etc., should be shown to result from structural, physiological or psychological changes which can be identified by the use of clinical and laboratory diagnostic techniques. An alleged impairment is medically determinable only if it can be verified by the use of clinical and laboratory diagnostic techniques."
"(c) Impairments due to arthritis. In the case of impairments due to arthritis the medical evidence should describe the arthritic condition in sufficient detail to permit an accurate assessment of the limitation of function. The clinical evidence should include history, physical findings and laboratory data, treatment and response. It is important that history and clinical findings be completely reported and that laboratory tests be competently done and results be reported rather than diagnostic interpretations only. The remaining ranges of motion in affected joints and any deformities that may exist should also be measured and described. Any joint changes, loss of muscle mass, pain or other abnormality should be carefully described so that limitation of motion and remaining capacity can be objectively assessed. In the evaluation of the impairment consideration is given to the etiologic type of arthritis; whether the disease is chronic and of long duration; the joints affected; the degree of interference with standing, walking, or hand and finger manipulation and whether there are other constitutional or systemic changes."
We find it difficult to understand why neither Flake nor the Secretary nor the Hearing Examiner referred to any of these regulations except § 404.1526 which the Examiner mentioned in his decision. It reads: "The function of deciding whether or not an individual is under a disability is the responsibility of the Secretary. A statement by a physician that an individual is, or is not, `disabled,' `permanently disabled,' `totally disabled,' `totally and permanently disabled,' `unable to work,' or a statement of similar import, being a conclusion upon the ultimate issue to be decided by the Secretary, shall not be determinative of the question of whether or not an individual is under a disability. The weight to be given such physician's statement depends on the extent to which it is supported by specific and complete clinical findings and is consistent with other evidence as to the severity and probable duration of the individual's impairment or impairments." The Secretary does not here refer to the portion of section 205(g) that we have quoted, nor, except passim in his brief, to the regulations. We therefore express no opinion as to the meaning or effect of either that section of the statute or the regulations. One would expect that, having been authorized to adopt, and having adopted, elaborate regulations as to the proofs required to establish the fact of disability, the Secretary would apply them. However, so far as appears, he did not do so in this case. Perhaps experience has shown that the average applicant cannot afford to procure the very detailed type of medical evidence that the regulations require.
There is legislative history of new subsection 223(d)(3), quoted above, indicating that the Congress was concerned that the Secretary and the courts, particularly the latter, were being too liberal in finding disability, thereby jeopardizing the financial stability of the system. The Senate Report (Finance Committee) No. 744, Nov. 14, 1967, to accompany H.R. 12,080 (2 U.S.Code Cong. Admin. News, 1967, pp. 2834ff) discusses the problem (id. at 2880-2883). We find it significant that, in adopting section 223(d)(3) the Congress used the language that the Secretary had long had in his regulations, 20 C.F.R. § 404.1510, note 5, supra. It would appear that Congress felt that neither the Secretary nor the courts were following the regulations.
We venture to suggest that there may be people who are really disabled, and can be found so by medically acceptable clinical diagnostic techniques, even though laboratory techniques do not support the diagnosis. See Mark v. Celebrezze, 9 Cir., 1965, 348 F.2d 289, and cases there cited; Page v. Celebrezze, 5 Cir., 1963, 311 F.2d 757. Not all subjective complaints of a patient are accepted by a doctor. But one skilled in the art may well be able, by medically acceptable clinical techniques, to sort them out, to decide which to believe, and to make a diagnosis accordingly. In this case, several doctors, in spite of a lack of "objective" symptoms, believed Flake's complaints and came to a diagnosis on that basis. See particularly the report of Dr. Downing, quoted supra. It is arguable that the Hearing Examiner felt bound to reject those diagnoses. We are not at all sure that the amended statute or the regulations require this. It may be, however, that Page v. Celebrezze, supra, and cases like it, are those to which the Senate Committee was referring. See note 9, supra.
We recall that it is said to be harder to be a horse doctor than a people doctor, because the horse can't tell you how he feels or where he hurts.
The Hearing Examiner may also have applied an incorrect standard to the correlative burdens of the claimant and the Secretary in establishing disability. He said, "at least * * * [the claimant] could certainly engage in some more sedentary occupation [than clerking in a liquor store]", implying that the burden was upon Flake to establish both that he was unable to return to the liquor store and that he was unable to engage in any more sedentary occupation. Such a standard would conflict with our decision in Rosin v. Secretary, 1967, 379 F.2d 189. Whether that decision survives the 1968 amendments (see § 223(d) (5) of the Act; S. Rep. No. 744, supra, at 2881-2883; Dean v. Gardner, supra) and what the proper burden of proof should be under those amendments are questions we think should be decided by the Secretary on remand.