Opinion ID: 529294
Heading Depth: 1
Heading Rank: 5

Heading: The Combination Policy

Text: 37 The Secretary has cross-appealed from the district court's invalidation of the combination policy formerly applied pursuant to 20 C.F.R. Secs. 404.1522, 416.922 and SSR 82-55. The policy, established in 20 C.F.R. Secs. 404.1522 and 416.922, provided that the Secretary would consider the combined effects of unrelated impairments only if all are severe and expected to last twelve months. 20 C.F.R. Secs. 404.1522, 416.922 (1983). SSR 82-55 stated, [i]nasmuch as a nonsevere impairment is one which does not significantly limit basic work-related functions, neither will a combination of two or more such impairments significantly restrict the basic work-related functions needed to do most jobs. 4 The Secretary's theory was that nonsevere impairments are unlikely to have any sort of cumulative effect which would limit a claimant's ability to perform basic work functions. 38 In its 1985 order, the district court enjoined the Secretary from applying the challenged regulations and ruling to claims by class members, and ordered the Secretary to readjudicate the claims of any class member who had been denied benefits under any of the invalidated provisions. The district court, on reconsideration after our remand, concluded that Yuckert did not address the combination policy and stated that plaintiffs' claim that the combination policy violated the Social Security Act remains an issue in this case. 699 F.Supp. at 54. In a later order directing entry of a judgment in favor of the plaintiff class, nunc pro tunc to September 13, 1988, the district court clarified that its decision was final and that the original order vis-a-vis the combination policy was reinstated. 39 The SSA was amended by the Social Security Disability Benefits Reform Act of 1984, Pub.L. No. 98-460, Sec. 4(a)(1), 98 Stat. 1794, 1800 (1984) (DBRA), in such a way as to explicitly repudiate the combination policy. Section 223(d)(2)(C) provides that in determining an individual's eligibility for benefits, the Secretary shall consider the combined effect of all of the individual's impairments without regard to whether any such impairment, if considered separately, would be of such severity. See 42 U.S.C. Sec. 423(d)(2)(C)(Supp.III 1985); see also 20 C.F.R. Secs. 404.1523, 416.923 (1989). Thus, the district court's order only applied to class members whose claims were denied prior to December 1, 1984, the effective date of the amendment. 40 The district court's invalidation of the combination policy was based largely on the rationale of Johnson v. Heckler, 769 F.2d 1202, 1213-15 (7th Cir.1985), in which the court determined that the fact that 42 U.S.C. Sec. 423(d)(2)(A)(Supp.III 1985) referred to severity in terms of physical or mental impairment or impairments  mandated the consideration of the combined effect of all impairments. 42 U.S.C. Sec. 423(d)(2)(A) (emphasis added). The Secretary argues that the fact that the statute also defines disability as the 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 which has lasted or can be expected to last for a continuous period of not less than 12 months, 42 U.S.C. Sec. 423(d)(1)(A)(Supp.III 1985) (emphasis added), requires the presence of at least one impairment which by itself could render the claimant disabled. 41 The Johnson court treated the fact that Congress had amended the statute specifically to require consideration of the combined effect of impairments as a correction of the Secretary's erroneous interpretation rather than as a substantive change. That court also noted that at the time the amendments to the statutory definition of disability were passed in 1968, the Secretary's own regulations defined disability in terms of impairment or impairments. Johnson, 769 F.2d at 1214 (citing 33 Fed.Reg. 11749, 11750 (1968), codified at 20 C.F.R. Sec. 404.1501(a)(1) (1969)); see also McDonald v. Secretary of Health and Human Services, 795 F.2d 1118, 1127 (1st Cir.1986) (the Secretary's policy of not considering the combined effect of nonsevere impairments dates only from 1980). 42 The mere fact that the singular impairment is used in 42 U.S.C. Sec. 423(d)(1)(A) cannot bear the weight the Secretary ascribes to it. Although the word impairment can be read as medical condition, it also has a functional connotation, and a single impairment may well be the product of multiple medical conditions. For example, the claim of Bailey, the named plaintiff, was that he suffered from blindness in one eye, arthritis of the spine, chronic obstructive pulmonary disease, heart disease, leg cramps, headaches, bad nerves, depression and status post mouth cancer. Given that the definition of disability in the SSA is functional, based on the claimant's inability to perform certain tasks, it would be illogical to read the Act as precluding the Secretary from considering the combined functional effect of nonsevere impairments. We note that all the circuits which have considered the issue have concluded that the combination regulations were invalid. In addition to the First and Seventh Circuits, which invalidated the combination policy in McDonald and Johnson respectively, two other circuits have read the SSA as requiring the Secretary to consider the combined effects of nonsevere impairments in individual cases. See Bowen v. Heckler, 748 F.2d 629, 634-35 (11th Cir.1984); Felshina v. Schweiker, 707 F.2d 71, 73 (2d Cir.1983). 43 The Secretary argues on appeal that the legislative history of the DBRA indicates that the provision dealing with the combination of impairments was viewed as a change in the law. The Secretary relies primarily on the statement in Senate Report No. 466, 98th Cong., 2d Sess. at 22, referring to section 223(d)(2)(C) as a new rule. The Secretary also notes that House Conference Report No. 1039 describes the law prior to enactment of the DBRA as having no statutory provision concerning the consideration of the combined effects of a number of different impairments. H.R.Conf.Rep. No. 1039, 98th Cong., 2d Sess. 29, reprinted in 1984 U.S.Code Cong. & Admin.News 3038, 3080, 3087. Furthermore, the Secretary argues that Congress, in enacting the combined impairment provision, chose not to make it retroactive while at the same time making other provisions of the DBRA retroactive. 44 The fact that the Senate Report describes section 223(d)(2)(C) as a new rule does not preclude us from treating it as a mere clarification of the existing law. While it is true that section 223(d)(2)(C) added new language to the statute, that does not mean that the earlier version of section 223(d) was not intended to be interpreted so as to require consideration of multiple impairments. In fact, the most persuasive legislative history indicates that section 223(d)(2)(C) was intended only as a clarification. House Report No. 618 states that the DBRA was generally intended to clarify existing law, and that the provision concerning the combination of impairments was part of that clarification. See H.R.Rep. No. 618, 98th Cong., 2d Sess. 6-8, reprinted in 1984 U.S.Code Cong. & Admin.News 3038, 3043-46 (DBRA does not constitute any change in the current definition of disability). Since it was the House bill that eventually passed, we find this language the best evidence of legislative intent. 45 The Secretary urges, however, that the Senate Report must be given equal weight in light of the fact that the Supreme Court in Yuckert relied on both the Senate Report and the House Report in concluding that the Secretary was free to ignore vocational factors at the second stage of the sequential inquiry. Although the Supreme Court in Yuckert did look to both the Senate and House reports, nothing in that opinion requires us to assign any particular weight to either of those sources in ascertaining the legislative intent behind a regulatory policy that was not before the Court in that case. 5 If anything, Yuckert reinforced the notion that the SSA concept of disability is functional, rather than technical, thus supporting the common-sense realization that the combined effect of nonsevere medical conditions can cause a functional impairment that meets the statutory definition of disability. This suggests that the statute should have been read to require consideration of such combinations even before the DBRA. We thus reject the Secretary's cramped interpretation of the statutory language and legislative history, and we will affirm the district court's order invalidating 20 C.F.R. Secs. 404.1522, 416.922 and SSR 82-55, and requiring the Secretary to afford claimants who were denied benefits on the basis of these provisions an opportunity to have their claims reconsidered.