Opinion ID: 556478
Heading Depth: 1
Heading Rank: 2

Heading: The Validity of the Secretary's Methodology

Text: 21 Because the Act expressly grants the Secretary rule-making authority, our review is limited to determining whether the Secretary's rules and regulations are based on a permissible construction of the statute. The Act authorizes the Secretary to 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   . 42 U.S.C. Sec. 405(a). Additionally, as discussed above, Section 423(d)(2)(B) grants the Secretary the power to promulgate the listing which is at issue in this case. In these circumstances, 2 the Secretary's interpretation of the statute will not be disturbed unless it is arbitrary, capricious, or manifestly contrary to the statute. Chevron U.S.A., Inc. v. Natural Resources Defense Council, Inc., 467 U.S. 837, 844, 104 S.Ct. 2778, 2782, 81 L.Ed.2d 694. 22 The Secretary's methodology which forbids a consideration of a spouse's RFC in determining medical equivalence is contrary to Section 423(d)(2)(B), which requires that benefits be awarded to a claimant unable to engage in any gainful activity. In so holding, we concur in the view of the First, Second, Third, Ninth and Tenth Circuits. See Cassas v. Secretary, 893 F.2d 454, 458 (1st Cir.1990) (residual functional capacity cannot be ignored in considering medical equivalence and, ultimately, disability); Kier v. Sullivan, 888 F.2d 244, 247 (2nd Cir.1989) (Social Security Ruling 83-19 conflicts with the language of 42 U.S.C. Sec. 423(d)(1)(A) and (d)(2)(B)); Finkelstein v. Sullivan, 924 F.2d 483, 489 (3rd Cir.1991) (the Secretary must medically evaluate the widow's residual functional capacity to determine whether her condition    equals the level of severity of one of the Secretary's listed impairments); Ruff v. Sullivan, 907 F.2d 915, 916 (9th Cir.1990) ([T]he Secretary is required to consider residual functional capacity in determining whether a wage earner's surviving spouse's disability is medically equivalent to a listed impairment.); Davidson v. Secretary, 912 F.2d at 1253-1254 (If the widow's disability benefits claimant    does not meet or equal a description contained in the listings, the Secretary must necessarily consider the RFC implications of the claimant's medical condition). The Fourth Circuit has required an individualized assessment of a claimant's RFC when the spouse has a combination of ailments, but not when the spouse has a single affliction that fails to meet the Listing. Bennett v. Sullivan, 917 F.2d 157 (4th Cir.1990). 23 The language of Section 423(d)(2)(B) itself indicates that a determination of the individual's impairments and functional capabilities must supplement any mechanical comparison of medical findings with the Listing. The Section specifies that a spouse may not be found disabled unless his or her physical or mental impairment or impairments are of the level of severity the Secretary deems disabling. The Secretary thus must evaluate an individual's impairment, or combination of impairments, before making a comparison to objective standards of impairment established by the Secretary. Moreover, the incorporation of an any gainful activity standard suggests that the level of severity of one's impairment is to be measured with reference to functional requirements of the workplace. 24 This reading of Section 423(d)(2)(B) comports with the Act's overall functional approach to disability. The Supreme Court has recognized that the Act generally defines 'disability' in terms of an individualized, functional inquiry into the effect of medical problems on a person's ability to work. Sullivan v. Zebley, 110 S.Ct. at 890; Heckler v. Campbell, 461 U.S. 458, 459-460, 103 S.Ct. 1952, 1953-1954, 76 L.Ed.2d 66 (The Act defines 'disability' in terms of the effect a physical or mental impairment has on a person's ability to function in the workplace). In the 1984 Amendments, Congress re-emphasized the importance of functional impairment in evaluating disability. Congress directed the Secretary to consider the combined impact of the impairments    throughout the disability determination process for wage earners, spouses and children. 42 U.S.C. Sec. 423(d)(2)(C). It explicitly required that the Secretary perform a realistic assessment of functional limitations for all claimants with combinations of impairments. 25 The legislative history of the Listing and Section 423(d)(2)(B) also reveals that Congress contemplated an individualized inquiry into functional impairment for spouses claiming disability benefits. The district court carefully examined the history of the Listing, beginning with reports on the medical guides first proposed in 1959 as an aid for determining wage earners' benefits. It concluded that because the Listing was never intended to be used as a basis for denial of disability benefits, it would be inconsistent with Congress' intent to construe the Listing as an exhaustive list of the sets of medical findings that qualify a claimant for spouses' benefits. Marcus, 696 F.Supp. at 378. The district court found from its review of the relevant history what is apparent when reading the Listing today: that the Listing was only meant to identify clear-cut cases and to catalog the more common disabling conditions. Nothing in the legislative history suggests that the Listing was to be used to deny benefits to claimants whose level of functional impairment has never been assessed. 26 The Secretary agrees that the Listing, as originally formulated, did not aim to disqualify wage earners from collecting disability benefits. The Secretary argues, however, that Congress meant the Listing to apply more strictly to spouses than to wage earners. The Secretary maintains that when Congress first created the spouses' disability benefits program in 1967, it intended that the same Listing already used to identify wage earners who automatically qualified for benefits should also be used automatically to disqualify spouses applying for benefits. The Secretary believes that the language of Section 423(d)(2)(B), drafted in 1967, and the Congressional commentary thereon, approve his medical equivalence approach. In his opinion, the setting of a higher standard of disability for spouses (the any gainful activity standard) endorses his refusal to perform an RFC analysis for spouses. 27 The 1967 Amendments did not eliminate the Secretary's obligation to conduct individualized functional assessments for disability claimants in cases involving spouses. The higher any gainful activity standard explicitly excused the Secretary only from considering vocational factors. The Senate Report accompanying the 1967 Amendments stated that the test of disability for spouses: 28 is somewhat more restrictive than that for disabled workers and childhood disability beneficiaries. The determination of disability in the case of a widow or widower would be based solely on the level of severity of the impairment. Determinations in disabled widow and widower cases would be made without regard to nonmedical factors such as age, education, and work experience, which are considered in disabled worker cases. Senate Report at 1967 U.S.Code Cong. & Admin.News 2883 (emphasis supplied). 29 By restricting the definition of disability for spouses, Congress intended to eliminate the consideration of the vocational factors of age, education and work experience. 30 Nothing in the 1967 Amendments indicates that Congress meant to restrict the use of an RFC analysis. Indeed, the very exclusion of these factors [age, education and work experience],    strongly suggests that the other factor--residual functional capacity--is to be considered. Kier, 888 F.2d at 247. The primary goal of the 1967 Amendments was to increase reliance on medical evaluations in establishing the claimant's disability. The House Committee desired that more precise guidelines    be used in determining the degree of disability and that statements of the applicant or conclusions by others with respect to the nature or extent of impairment be excluded from the Secretary's consideration. H.Rep. No. 544, 90th Cong., 1st Sess. 28-30 (1967). The Secretary acknowledges that an RFC analysis is a medical assessment, made by medical or psychological professionals, of the claimant's impairment. 20 CFR Sec. 404.1546. Congress' purpose in 1967 was actually to foster the use of medical assessments like an RFC analysis. 31 The 1967 Amendments also did not change Congress' original understanding that the Listing represents a non-exhaustive sampling of impairments. Congress continued to believe that the Listing created a conclusive presumption of disability. In discussing the use of the Listing in wage-earner cases, the Senate noted: 32 In most cases the decision that an individual is disabled can be made solely on the basis of an impairment, or impairments, which are of a level of severity presumed (under administrative rules) to be sufficient so that    it may be presumed that the person is unable to [engage in substantial gainful activity] because of the impairment or impairments. Senate Report at 1967 U.S.Code Cong. & Admin.News 2883 (emphasis supplied). 33 At the time Congress added spouses' benefits to the Act, it continued to believe that the level of severity set by the Secretary in the Listing could not be conclusive in 100% of the cases. 34 The Supreme Court recently has disapproved the practice of using the Listing, which is meant to create a presumption of disability, as a catalog which presumptively can disqualify claimants for disability benefits. Sullivan v. Zebley, 493 U.S. 521, 110 S.Ct. 885, 107 L.Ed.2d 967 (1990), involved the proper interpretation of 42 U.S.C. Sec. 1382c(a)(3)(A), which provides that a child is disabled if he suffers from any ... impairment of comparable severity to one which would make an adult incapable of substantial gainful activity. The Court struck down the Secretary's practice of denying a child benefits if he failed to prove an impairment medically equivalent to the adult Listing. The Court noted four shortcomings of the Listing as applied to child claimants: 35 First, the listings obviously do not cover all illnesses and abnormalities that actually can be disabling. 36