Opinion ID: 439104
Heading Depth: 1
Heading Rank: 2

Heading: Burden of Proof and Burden of Coming Forward in Termination Cases

Text: 5 It is well settled that the claimant has the burden of proving her disability and must show that she is unable 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 twelve months. 42 U.S.C. Secs. 423(d)(1)(A); Kane v. Heckler, 731 F.2d 1216 (5th Cir.1984). She bears a continuing burden of proving her disability, Mathews v. Eldridge, 424 U.S. 319, 336, 96 S.Ct. 893, 903, 47 L.Ed.2d 18 (1976), and must carry this burden of proof in termination cases as well as in initial disability determination cases. Ransom v. Heckler, 715 F.2d 989, 992-993 (5th Cir.1983); Crosby v. Schweiker, 650 F.2d 777, 778 (5th Cir.1981); Smith v. Schweiker, 646 F.2d 1075, 1077 n. 2 (5th Cir.1981). 6 Nevertheless, a prior determination of disability is not without effect; it is binding on all parties to the hearing, 20 C.F.R. 416.1455 (1983); Patti v. Schweiker, 669 F.2d 582, 587 (9th Cir.1982), and has a res judicata effect as to that record. If the Secretary reassessed a claimant's eligibility for benefits 2 and no new evidence was submitted after the prior decision, termination would not be justified. The Secretary may not overrule an earlier finding of disability merely on a reappraisal of earlier evidence. Miranda v. Secretary of Health, Education, and Welfare, 514 F.2d 996, 998 n. (1st Cir.1975). To hold otherwise would allow eligibility to turn on the whim of the reviewing ALJ rather than on evidence of the claimant's condition. Simpson v. Schweiker, 691 F.2d 966, 969 (5th Cir.1982). 3 Accordingly, once evidence has been presented which supports a finding that a given condition exists it is presumed in the absence of proof to the contrary that the condition has remained unchanged. Weinberger v. Rivas, 475 F.2d 255, 258 (5th Cir.1973); accord Patti v. Schweiker, 669 F.2d at 586 (9th Cir.1982). 7 In requiring the Secretary to provide evidence of a changed condition, we do not shift the burden of proof which, by statute, remains with the claimant. We adopt the Thayer rule of presumptions which shifts only the burden of coming forward. See J. Weinstein, M. Berger, Weinstein's Evidence, p 300 at 300-2 (1982). The Secretary is not required to prove by substantial evidence that the claimant's disability has ceased; 4 she need only offer additional evidence tending to rebut the presumption of continued disability. 5 Id. This evidence may suggest that the condition has improved or that it was not as serious as originally thought. Cassiday v. Schweiker, 663 F.2d 745, 747 (7th Cir.1981). The claimant is then given another opportunity to submit additional evidence of continued disability. The facts upon which the prior determination of disability was made must be weighed by the trier of fact along with new evidence submitted by both parties. See J. Weinstein, supra, p 300 at 300-5--300-6. After a new determination of eligibility is made, the entire record must be reviewed to determine if the ALJ's decision is supported by substantial evidence. Crosby v. Schweiker, 650 F.2d at 778; Smith v. Schweiker, 646 F.2d at 1076; Miranda, 514 F.2d at 998 n.. 8 Applying this standard of review to the case before us, we hold that Buckley was entitled to a presumption of continuing disability based upon the 1980 determination by Charles Collins. The Secretary came forward with new evidence regarding Buckley's physical condition. Evaluations were made of Buckley's cervical spine, bilateral knees, and arthritis. The ALJ concluded that these ailments were not incapacitating and that conclusion was supported by substantial evidence. Buckley's prior determination of disability, however, had been due to her psychological condition and no additional evidence regarding that condition was presented. 9 A psychiatrist, Dr. Alvin Cohen, reviewed Buckley's mental status on January 25, 1982, and found that she had no gross abnormalities, such as delusions or hallucinations. He noted that her activities were somewhat restricted and that her social relationships were limited to one close girlfriend and members of her immediate family. He diagnosed her condition as a [s]chizophrenic [d]isorder, in remission, stated her prognosis to be guarded, and recommended the continuation of therapy. On August 16, 1978, Dr. Cohen made an almost identical report. He stated that Buckley had no gross abnormalities such as delusions or hallucinations, but that she was restricted in her activities. He diagnosed her condition as an [u]ndifferentiated psychotic reaction, in remission with use of medication. This 1978 report was before Charles Collins when he determined that Buckley was disabled; the almost identical 1982 evaluation added no new information to the record on Buckley's mental condition. That being so, the prior determination of disability stands. 10 REVERSED.