Adams v. Flemming

• Decision Date: 08 April 1960
• Docket Number: Docket 25902.,No. 189,189
• Citation: 276 F.2d 901
• Parties: Arthur S. ADAMS, Plaintiff-Appellee, v. Arthur FLEMMING, Secretary of Health, Education and Welfare, Defendant-Appellant.
• Court: U.S. Court of Appeals — Second Circuit

276 F.2d 901 (1960)

Arthur S. ADAMS, Plaintiff-Appellee, v. Arthur FLEMMING, Secretary of Health, Education and Welfare, Defendant-Appellant.

No. 189, Docket 25902.

United States Court of Appeals Second Circuit.

Argued February 8, 1960.

Decided April 8, 1960.

Herbert E. Mooris, Atty., Dept. of Justice, Washington, D. C. (George Cochran Doub, Asst. Atty. Gen., Louis G. Whitcomb, U. S. Atty., District of Vermont, Rutland, Vt., Morton Hollander, Atty., Dept. of Justice, Washington, D. C., on the brief), for defendant-appellant.

Arthur S. Adams, pro se.

Before MOORE, Circuit Judge, and SMITH and HERLANDS, District Judges.

MOORE, Circuit Judge.

Arthur Flemming, Secretary of Health, Education and Welfare (the Secretary) appeals from a decision of the district court granting summary judgment in favor of plaintiff in a civil action for judicial review of the determination by the Social Security Administration that plaintiff was not entitled to a period of disability or disability insurance benefits, provided for in sections 416(i) and 423(c) (2), 42 U.S.C.A. The equities as well as the more technical construction and application of the statute depend upon the facts.

From 1918 to 1946 Arthur S. Adams (plaintiff), born in 1899 and a resident of Middlebury, Vermont, after completing high school, worked steadily for the Insurance Company of North America (the Company). He had done well. In 1946 he was the manager of the Marine Service Department and Inland Claims, his salary was $9,000 a year and he had twenty-four employees under his supervision. His work was "executive type, desk work." For some years prior to 1946 he had been troubled by a sinus condition. Hopeful of obtaining relief, in 1946 plaintiff submitted to an operation which was not successful.

In May 1946 the Company "reluctantly arranged" for plaintiff's retirement, relying upon his judgment as to his physical condition and upon the opinion of the Company's medical consultant. The Company paid plaintiff $3,000 a year as a disability allowance, effective until 1964 when he becomes eligible for a Company pension. From 1946 on plaintiff did not engage in work and by his answer "no" indicated an unwillingness to have his name referred to the appropriate State Rehabilitation Agency with information about his disability and work history. He lived in Middlebury where he did light work at his home and took short walks.

In 1957 plaintiff filed with the Bureau of Old-Age and Survivors Insurance applications (1) to establish a period of disability and (2) to obtain disability insurance benefits. In support thereof plaintiff submitted his affidavit outlining his medical history since 1946 and various medical reports. The applications were denied by the Bureau and plaintiff thereupon requested a hearing. However, he waived his right to appear and to present evidence and elected to rest his case on the documents filed with the Bureau.¹ The Referee analyzed the evidence with particularity and found in substance that plaintiff "had a rather severe sinus condition over a period of years," which caused certain distress and discomfort restricting his activities for temporary periods in certain types of weather but that plaintiff's "impairment and resulting limitation of activities seems to fall far below the level of severity of an impairment contemplated by the Act as being totally disabling." Accordingly, the Referee decided that plaintiff "is not entitled to a period of disability or disability insurance benefits * * *."

Plaintiff then requested a review of the Referee's decision by the Appeals Council, which after receiving two more medical reports and considering the entire record adopted "All of the inferences, findings and conclusions of the referee based upon the evidentiary facts" and affirmed his decision.

Plaintiff thereupon sought judicial review by way of a motion for summary judgment in the district court. The controlling principles of law upon such a review are well established and were recognized by the Court, namely, "the burden of sustaining the claim for benefits is on the claimant" and "The findings of the Social Security Agency are final and binding if there is a substantial basis for them. Such finality extends to inferences and conclusions drawn from the evidence" (D.Vt., 173 F.Supp. 873, 877).

Two fundamental questions are presented: (1) did plaintiff sustain his burden of showing that he came within the class of persons contemplated by the statute (42 U.S.C.A. § 423(c) (2)) as having an "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"; (2) is there any substantial basis for the Agency's determination that plaintiff was not entitled to the claimed disability benefits.

The district court in its opinion injected into the case an element not found either in the statute or in the referee's decision, namely, total disability. It then assumed that total disability means that "one must be bedridden, completely paralyzed, or unable to lift a finger." Obviously there is no such requirement in the law and the referee did not even imply that there is. He simply found that the impairment did not preclude plaintiff from engaging in any substantial work. This finding seems well supported by the evidence, viz., that the sinus condition antedated plaintiff's retirement by many years, that the medical reports he submitted indicated that antihistamine treatment would control and somewhat alleviate the condition, and that none of the doctors stated that plaintiff was unable to engage in any substantial gainful activity.

There are other aspects of this case which bear upon the decision. Plaintiff had worked for 28 years...