Source: https://openjurist.org/712/f2d/795/mcbrayer-v-secretary-of-health-and-human-services
Timestamp: 2019-01-22 10:41:36
Document Index: 701258207

Matched Legal Cases: ['§ 922', '§ 423', '§ 423', '§ 423', '§ 423', '§ 416', '§ 423', '§ 423', '§ 423']

712 F2d 795 McBrayer v. Secretary of Health and Human Services | OpenJurist
712 F. 2d 795 - McBrayer v. Secretary of Health and Human Services
712 F2d 795 McBrayer v. Secretary of Health and Human Services
712 F.2d 795
2 Soc.Sec.Rep.Ser. 343
No. 1022, Docket 82-6150.
Argued March 25, 1983.
McBrayer applied for these benefits based on his status as the surviving child of a coal miner who died of black lung disease. See 30 U.S.C. § 922(a)(3) (Supp. V 1981). Section 922(a)(3) refers to the definition of "child" contained in section 902(g). Section 902(g), as amended in 1972, defines "child" as a child or stepchild who is unmarried and either a student, under 18, or "under a disability as defined in section 423(d) of Title 42." 42 U.S.C. § 423(d) defines "disability" as "inability to engage in any substantial gainful activity by reason of any ... physical or mental impairment." 42 U.S.C. § 423(d)(1)(A). Section 423(d)(4), however, "establishes a different test of [substantial gainful activity] for blind persons than is applied administratively for persons with other disabilities." H.Rep.No. 95-702 Part II, 95th Cong., 1st Sess. 73, reprinted in 1977 U.S.Code Cong. & Ad.News 4155, 4291, 4319. It provides that "[n]o individual who is blind shall be regarded as having demonstrated an ability to engage in substantial gainful activity on the basis of earnings that do not exceed the exempt amount [for retired persons]." 42 U.S.C. § 423(d)(4). Even though the opening line of section 416(i)(1) states that its definition of disability applies "[e]xcept for purposes of ... [section] 423 ... of this title," section 423(d)(4) by its own terms requires us to refer to the section 416(i)(1) definition of blindness before we can apply the section 423(d)(4) definition of substantial gainful activity. See also § 423(d)(1)(B) ("in the case of an individual who ... is blind (within the meaning of "blindness" as defined in section 416(i)(1) of this title)"). "Blindness" means "central visual acuity of 20/200 or less in the better eye with the use of a correcting lens," 42 U.S.C. § 416(i)(1)(B), though limitation in the fields of vision so that the visual field at its widest diameter is no more than 20? also constitutes blindness, id.1 Thus, the Secretary is required to decide if McBrayer was blind before he turned twenty-two and, if so, whether this prevented him from engaging in substantial gainful activity as defined in sections 423(d)(1)(A) and 423(d)(4). We reverse the Secretary as to the finding of blindness and remand the issue of substantial gainful activity.
The administrative record clearly establishes that McBrayer suffered from congenital cataracts and nystagmus since his birth in November of 1929 and that his vision has always been impaired as a result. It is also clear, however, that his eye condition has deteriorated over his lifetime and, while his current condition is disabling, the ALJ found that it was not disabling prior to November, 1951, when McBrayer was twenty-two years old.2 Section 423(d)(3) further provides that physical impairment must be demonstrable by medically acceptable clinical and laboratory diagnostic techniques. The only expert evidence bearing on the question whether McBrayer was blind before he was twenty-two is the medical report of Dr. Jacob J. Stam in September 1974. Dr. Stam, an ophthalmological consultant of the Secretary and a board-qualified specialist, found McBrayer's vision, with correction, to consist of only "light perception" in his right eye and to be 20/400 in his left eye. The doctor concluded that "at age 18 it is most probable that the best vision with lenses was approximately the same as on this exam today. This patient has been legally blind since birth."
Substantial evidence is that quantum of "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), quoting Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229, 59 S.Ct. 206, 217, 83 L.Ed. 126 (1938); Dousewicz v. Harris, 646 F.2d 771, 773 (2d Cir.1981). Though we must credit an ALJ's findings if supported by substantial evidence, we retain a responsibility to conduct a searching inquiry and to scrutinize the entire record, having in mind that the Social Security Act (as well as the Coal Mine Health and Safety Act) is remedial in purpose. Id. Under these standards, the ALJ simply had no evidence to find that appellant did not meet criteria for statutory blindness in 1951 even though his vision continued to deteriorate into the 1960s, after he became twenty-two. Dr. Stam's report, as substantiated by the Columbia Presbyterian records, stands unchallenged except by the ALJ's own inference to the contrary. But the ALJ cannot arbitrarily substitute his own judgment for competent medical opinion. Grable v. Secretary of HEW, 442 F.Supp. 465, 470 (W.D.N.Y.1977). As stated by the Third Circuit, "[w]hile an administrative law judge is free to resolve issues of credibility as to lay testimony or to choose between properly submitted medical opinions, he is not free to set his own expertise against that of a physician who testified before him." Gober v. Matthews, 574 F.2d 772, 777 (3d Cir.1978); see also Dousewicz v. Harris, 646 F.2d at 774 (diagnosis proper though made several years after actual onset of impairment).
Having established that McBrayer was blind does not establish that he was disabled unless as a result of his impairment he was unable to engage in substantial gainful activity, 42 U.S.C. § 423(d)(1)(A), which permitted him to earn in excess of the exempt amount specified by 42 U.S.C. § 423(d)(4). Unfortunately, the exempt amount referred to by section 423(d)(4), set out in 403(f)(8)(D), only covers earnings in years as early as 1977, while McBrayer's relevant earnings could start as early as 1929 and he had no recorded actual earnings until 1951. We have no difficulty in finding that McBrayer is included in the groups covered by the exempt amount provision: even though the 1977 amendment begins to apply only in taxable year 1977, McBrayer's putative entitlement to Black Lung Benefits did not begin until May, 1978, when his mother died, even though his disability may have commenced in 1929, when he was born. Because Congress intended to extend special aid to blind persons eligible for benefits in 1977 and thereafter, it is proper to apply the modified substantial gainful activity standard to those blind persons who became eligible after 1977 no matter when they became blind or "disabled." Though it is easy for us to say that McBrayer is entitled to benefits if his earnings were less than the exempt amount under 423(d)(4), it is another matter--an entirely factual one--to determine whether McBrayer's earnings exceeded the section 423(d)(4) amount. Three factors in particular confound a simple comparison of McBrayer's reported earnings with the § 423(d)(4) amount. First, the exempt amounts are monthly, and McBrayer's earnings reported in the record on appeal are annual. Second, section 423(d)(4) requires to be excluded from the individual's earnings amounts equal to the cost of attendant services, drugs, equipment, etc., which were necessary for the applicant's employment and no attempt has been made to estimate these. Third, we cannot, within the reasonable confines of judicial notice, calculate the value of McBrayer's earnings in any year after 1950. Each of these three factors should be considered by the Secretary on remand.