Allen v. Califano
| Decision Date | 04 January 1980 |
| Docket Number | No. 77-1486,77-1486 |
| Parties | Doris Jean ALLEN, Plaintiff-Appellant, v. Joseph A. CALIFANO, Jr., Secretary of Health, Education and Welfare,Defendant-Appellee. |
| Court | U.S. Court of Appeals — Sixth Circuit |
Walter K. Crawford, Cookeville, Tenn., for plaintiff-appellant.
Hal D. Hardin, U. S. Atty., William H. Farmer, Margaret Huff, Wm. Gary Blackburn, Nashville, Tenn., for defendant-appellee.
Before EDWARDS, Chief Judge, WEICK, Circuit Judge, and PECK, Senior Circuit Judge.
Appellant Allen seeks reversal of a judgment of the United States District Court for the Middle District of Tennessee affirming denial of Social Security disability benefits previously entered on behalf of the Secretary of Health, Education and Welfare on recommendation of an administrative law judge and the Appeals Council. The case involves an obviously difficult administrative and judicial determination of a Social Security disability claim.
Appellant Allen is a now 45-year-old woman who has a medical record that seems well-nigh impossible to have accumulated in her lifetime. Her problems have included a laminectomy, an appendectomy, tubal ligation, herniography, hysterectomy, mastectomy, urinary tract infection, spastic colon, adhesions of the lower bowel, and persistent low back and abdominal pain. No witness at the administrative hearing disputed any part of the preceding portion of this paragraph. The disputed question is: Nonetheless is Mrs. Allen now suffering from "a physical or mental impairment" which is "medically determinable" and has lasted or can be expected to last for a continuous period of at least 12 months? 1
Mrs. Allen appeared without counsel before the Administrative Law Judge. Accordingly, her testimony in response to his patient questioning was somewhat disorganized. Mrs. Allen testified that her first (and it appears only) job was in a shirt factory in Cookeville, Tennessee where she worked for a total of 20 years. Her first factory operation was trimming and matching shirt collars. On returning to work after the birth of her second child, she was put to work sewing on neck buttons. When her third child was born, she did not go back to work until 1964. Then, as to type of work and reasons she left the job in July of 1975, she testified:
A. Well, I was I started out rolling collars. And, that hurt my back so bad, that I took pick-up.
Q. Now, explain what you mean by, pick-up.
A. Well, as the girls would fold shirts, and put them on a table, I would put tags on them, if they had to be, and travel boards in them.
And, then, I would set them on another table for the boxing girls.
And, then, well, about a week, or 2, before I went to the hospital, they put me on folding. And, I reckon I was gone to, you know, fold and pick-up, too. There wasn't enough work on the pick-up.
And, then,
Q. And, why did you quit your work in July?
A. Well, I got sick in March of last year.
Q. Sick of what? Got sick from what, ma'am?
A. With my stomach.
Q. Well, you say, March of 1975?
A. Uh-huh.
Q. Now, when you say, you got sick with your stomach. Now, tell me a little bit more about that.
A. Well, I had cramps. I almost doubled up with pain, the way I had cramps.
And, I went to Dr. Shipley (phonetic), and he gave me some medicine. And, it didn't go (Sic ) any good. And, I went back, and he gave me some more medicine, and put me on a diet of 5 weeks of milk and crackers.
And, so, then, he put me in the hospital in May.
The ALJ also inquired about her medical history before she left work:
Q. Have you ever had an operation, Mrs. Allen?
A. Yes.
Q. What was that for?
A. Well, I the first one I ever had was appendicitis.
And, then, I had a hernia.
And, I had 2 on my breasts.
And, I had my tubes tied.
And, I had a spinal fusion.
And, I had a hysterectomy, when I was 28.
And, I guess that's all.
Q. Was the hysterectomy the last one?
A. No, sir.
Q. When was the most recent
A. When was the last one?
Q. uh-huh operation?
A. Well, the last one was on my breasts. It's been about 2 years, I guess.
Then, I went to Of course, I had been to Dr. Francis (phonetic) with my stomach.
And Dr. Alper told me to go to a gynecologist, before
Q. Where does Dr. Francis have his office?
A. Up here on Cedar Street (phonetic).
Q. And, what did you see him about?
A. I went with my stomach.
Q. And, what did he tell you?
A. Well, he just give me some medicine.
And, Dr. Alper told me to go to a gynecologist, before I came back to him.
So, I went to Dr. James Sholl (phonetic).
Q. Where does he have his office?
A. He's here in Cookeville.
And, he told me that he thought I had a bowel obstruction.
Mrs. Allen's oldest son John also testified under the ALJ's questioning:
Q. Now, will you tell me what you've observed, in the way of her physical problems?
A. Well, on many occasions, I'd come in from school and she'd be lying in on in bed, and she'll say, "there's not much I've been able to do, today, you know, in the house." And, looks pretty bad, still.
She complains that her back hurts. Her stomach cramping. Numerous headaches.
It seems like I've never known my mother truthfully, I've never know my mother to feel really good, like she could, you know, some thing wasn't bothering her.
Q. Well, she said she attempted to work there in the shirt factory.
You're familiar with the fact that she worked there, haven't you (phonetic)?
A. Yes, sir.
Q. That she quit work there in July of 1975. She's testified.
Now, did you notice her discomfort, or complaints, got greater, or what?
A. Well, we used she would ride home with us from school. Me, my brother, and sister.
And, many times, she'd have to lay down in the back seat, because she just wouldn't feel well enough to sit up and ride.
And, I had always felt that her working there at the shirt factory did intensive her illness, her ailments.
Four qualified physicians, consulted by Mrs. Allen for treatment of her various problems, provided opinions upon her medical problems and/or continued employability.
Dr. Oscar W. Carter of Carter-Spalding Urological Association of Nashville wrote on August 18, 1975:
We have seen this patient at intervals since 1963 with recurrent bouts of urinary tract infection with a urethral stricture and with a stricture in her lower right ureter.
She has required treatment at intervals of about every three months sometimes more often, sometimes not quite that often. In addition to this she has other medical ailments. We feel that this woman is chronically ill and is probably not able to hold a regular job.
On June 22, 1976, Dr. James W. Shaw provided the following "Discharge Summary" after consultation and examination:
This patient is a 42 year old Gravida III, para III who has had numerous surgeries in the past. Her complaint is a long standing pain in the left lower quadrant which is continuous and also has intermittent episodes of cramping and bloating, especially when she becomes constipated or after she eats. The patient has been admitted to numerous hospitals and has been worked up for this. An upper GI series, BE, IVP's have all been negative. The rest of her history is in her old charts. The patient is currently being treated by Dr. Oscar Carter for the past 12 years for recurrent, urinary tract problems. On admission the patient's vital signs were normal. She is a well developed, well nourished, somewhat slender white female who appears to be in chronic distress. The cardiopulmonary system was physiologic. There are masses from previous breast masses. There are multiple abdominal scars present on the patient. Pelvic exam revealed only an irregular mass fixed in the pelvis which is tender to palpation on the left side which appears to be small bowel. The admission diagnosis is chronic abdominal pain, probably small bowel adhesions. The patient's admission lab work revealed normal urinalysis with WBC 8620 with normal differential and PCV 38. Gynogram was performed on this patient which showed a loop of small bowel in the pelvis. The gynogram reveals a piece of small bowel stuck down in the pelvis. The patient was scheduled for an exploratory laparotomy the day after the gynogram, however, after explanation of the difficulty in removing adhesions and the possibility of the adhesions reforming, and being possible to cause complete bowel obstruction, it was decided by the patient that she attempt to treat this conservatively for some time to see if she can tolerate it. The patient was discharged on LA formula one tsp t.i.d. after meals, Gaviscon foam tabs 2 after each meal and h.s., Talwin compound 2 tablets every 3 hours pr.n. for pain, Ellavil starting at 25 mg h.s. and then increasing to 75 mg h.s. Septra tablets 1 daily in the morning and the evening, Pyridium one daily in the morning and one in the evening. She was given a follow up visit to the office in 2 weeks.
On August 28, 1975, Dr. Ben Alper provided the following "Discharge Summary" after full examination and clinical tests at the West Side Hospital, Nashville, where she had been under examination and treatment from July 1, 1975 to July 27, 1975:
DISCHARGE SUMMARY: This 43-year old lady was admitted because of abdominal disorder manifested by a lower abdominal cramping. She has been having the symptoms for 3 weeks when she consulted her physician in Cookeville 4 months ago. A mass in her abdomen was suspected and she was hospitalized, but the mass was never confirmed. Her bowel pattern has varied from having 0-5 stools per day, and no diarrhea or mellena noted. She has had intermittent periods of constipation as well. The details of her history and physical are recorded in the...
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