Beasley v. Bowen, Civ. A. No. 85-2934.

Decision Date29 June 1988
Docket NumberCiv. A. No. 85-2934.
Citation693 F. Supp. 1216
PartiesRenee BEASLEY, Plaintiff, v. Otis R. BOWEN, Secretary of Health and Human Services, Defendant.
CourtU.S. District Court — District of Columbia

John S. Olshin, Washington, D.C., for plaintiff.

Daniel Bensing, Asst. U.S. Atty., Washington, D.C., for defendant.

MEMORANDUM OPINION

JOHN H. PRATT, District Judge.

Plaintiff, Renee Beasley, brings this action seeking review of a final decision of the defendant, the Secretary of Health and Human Services, which denied plaintiff's application for child's disability insurance benefits under Title II, Section 202(d) and 223(a) of the Social Security Act ("Act"), as amended, 42 U.S.C. § 402(d) & 423(a) (1982). Jurisdiction lies under Section 205(g) of the Act, 42 U.S.C. 405(g) (1982). Presently before us are plaintiff's motion for summary judgment1 and defendant's motion for judgment of affirmance. For the reasons set forth below, we find that defendant's decision is not supported by substantial evidence. Accordingly, we reverse.

I. Procedural History

Plaintiff filed an application for disability benefits with the Department of Health and Human Services ("the Agency") on November 22, 1983. After her claim was initially denied, she moved for reconsideration. When her application was again rejected, she requested an oral hearing, which was granted.

The Administrative Law Judge ("ALJ") who presided over the hearing concluded that Renee Beasley was not entitled to disability insurance benefits. Request for review by the Appeals Council was denied. The adverse decision of the ALJ then stood as the final decision of the Secretary in the claimant's case.

This litigation was filed on September 17, 1985. After remand to the Agency for redetermination, the Appeals Council subsequently vacated its previous denial of review, and remanded plaintiff's case to an ALJ for further proceedings. On August 22, 1986 the ALJ issued a decision once again finding that plaintiff was not disabled within the meaning of the Act. The ALJ based this determination on his conclusion that the claimant was not disabled as of March 12, 1981, the date on which she attained the age of 22, and that she was capable of performing jobs which exist in significant numbers in the national economy. On February 2, 1987 the Appeals Council issued a decision adopting the findings and conclusions of the ALJ, with one modification. The February 2, 1987 decision constitutes the defendant's final determination, and is presently before us for review.

II. Discussion

It is clear that plaintiff bears the burden of establishing a disability as defined by the Social Security Act in order to be entitled to benefits. Hess v. Secretary of Health, Education and Welfare, 497 F.2d 837, 840 (3rd Cir.1974). The parties agree that the sole issue before us is whether, on the record as a whole, there is substantial evidence to support the Agency's final findings.

A. Plaintiff's burden with respect to the underlying controversy

The child of an individual entitled to oldage or disability insurance benefits, or the child of an individual who dies fully or currently insured, is entitled to child's disability benefits, under Section 202(d)(1)(B) of the Act, 42 U.S.C. 402(d)(1)(B), if at the time of her application, she is "under a disability (as defined in section 423(d) of this title) which began before she attained the age of twenty-two" (emphasis added).2 The Act defines "disability," for purposes of the child's disability insurance benefits, 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. § 423(d)(1)(A); see also 20 C.F.R. § 404.1505.

The Act further provides that an individual will be determined to be disabled

only if her physical or mental impairment or impairments are of such severity that she is not only unable to do her previous work but cannot, considering her age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy.

42 U.S.C. § 423(d)(2)(A).

To carry her burden in the context of this case, plaintiff must establish that she suffered from a severe, medically determinable,3 physical or mental impairment prior to the date on which she turned 22. Once this is established, the Secretary then has the burden of showing that the claimant, "based upon her age, education, work experience, and residual functioning capacity, is capable of performing gainful work."4 Brown v. Bowen, 794 F.2d 703, 706 (D.C. Cir.1986) (citing 20 C.F.R. §§ 404.1520(f), 416.920(f)); Hayes v. Bowen, 643 F.Supp. 770, 771 (D.D.C.1986). In special cases, once the impairment is established, an inability to work need not be found. For instance, if plaintiff can establish in this case that she is mentally retarded within the meaning of Section 12.05 of Appendix 1 of the regulations, 20 C.F.R. Part 404, Subpart P, inability to work need not be proven. In determining whether the claimant is disabled, four elements of proof are considered: 1) medical data and findings; 2) expert medical opinions; 3) subjective complaints; and 4) the claimant's age, education, and work history. Blalock v. Richardson, 483 F.2d 773, 776 (4th Cir.1972); Di Benedetto v. Secretary of the Dep't of Health & Human Services, 518 F.Supp. 786, 787 (D.D.C.1981).

B. The parties' respective positions

Plaintiff asserts two mental impairments. First, she claims that she suffers from paranoid schizophrenia. Second, she claims that her I.Q. scores are such that she should be deemed mentally retarded.5 She argues that she was plagued by both of these impairments prior to March 12, 1981, when she attained the age of 22.

The defendant concedes that "the evidence of record in this case reveals that plaintiff currently suffers from a significant mental impairment involving schizophrenia." Defendant's Memorandum in Support of his Motion for Judgment of Affirmance ("Def.Memo."), at 3. But defendant argues, regarding plaintiff's claim of schizophrenia, that "the sketchy evidence of record concerning plaintiff's condition prior to March 12, 1981 simply does not demonstrate that plaintiff was disabled prior to that date." Defendant's Memorandum in Opposition to Plaintiff's Motion for Summary Judgment, at 2 ("Def. Opp."). Defendant asserts that plaintiff's history "at most" indicates "that plaintiff may have had sporadic psychological problems prior to March 12, 1981." Id. With regard to plaintiff's claim of mental retardation, the defendant argues that this contention fails for the same reason that her overall argument for entitlement fails — i.e., "the evidence does not demonstrate that she had a condition that met all of the requirements of section 12.05C mental retardation prior to March 12, 1981." Id. at 3. The crucial issue is, therefore, whether there is substantial evidence in the record to support defendant's conclusion that plaintiff did not suffer from either of these impairments so as to be disabled within the meaning of the Act prior to March 12, 1981.

C. The Standard of Review

In reviewing the Agency's action, "deference is to be afforded the administrative decision and it is not for the trial court to review de novo the Secretary's final decision as to findings of fact and the reasonable inferences to be drawn therefrom." Reyes v. Secretary of Health, Education and Welfare, 476 F.2d 910, 914 (D.C.Cir. 1973). The court is not, however, to merely act as a "rubberstamp" to the administrative decision. Perli v. Schweiker, 543 F.Supp. 394, 395 (S.D.N.Y.1982); Davis v. Heckler, 566 F.Supp. 1193 (D.D.C.1983). Rather it is for the court to carefully scrutinize the entire record in order to determine whether the Secretary's decision is supported by substantial evidence. Brown v. Bowen, 794 F.2d 703, 705 (D.C.Cir.1986); see also Dorsey v. Heckler, 702 F.2d 597, 602 (5th Cir.1983).

Substantial evidence is considered to be "such relevant evidence which a reasonable mind might accept as sufficient to support a conclusion." Richardson v. Perales, 402 U.S. 389, 401, 91 S.Ct. 1420, 1427, 28 L.Ed. 2d 842 (1971) (quoting Consolidated Edison Co. v. N.L.R.B., 305 U.S. 197, 229, 59 S.Ct. 206, 217, 83 L.Ed. 126 (1938)); Graves v. Heckler, 607 F.Supp. 1186, 1187 n. 2 (D.D.C.1985). The evidence provided clearly must be "more than a mere scintilla." Richardson, 402 U.S. at 401, 91 S.Ct. at 1427. With these principles before us, we proceed.

D. The Record

Several important facts are undisputed. The claimant has no past relevant work experience.6 She completed ten years of formal education, but failed twice to commence with her class. Prior to attaining age 22, she "had a significant medical impairment involving schizophrenia." Administrative Record ("AR"), at 31 (ALJ Finding No. 5). In fact, she was diagnosed as suffering from paranoid schizophrenia by Dr. Ellen Balsley on October 13, 1978, and was prescribed Stelazine and Cogentin. AR, at 213; Def.Memo., at 4.7 Her treatment was discontinued after November 20, 1978, because of her failure to keep appointments. Additional psychiatric help was not sought until July, 1982. Plaintiff has a long history of non-prescription drug use, although the extent of such is unclear. Renee Beasley presently suffers from a significant mental impairment involving schizophrenia.

At the second hearing, the ALJ heard testimony from Renee Beasley; Carol Beasley, plaintiff's mother; Bessie S. Bradley, plaintiff's grandmother; and Emmett E. Molloy, a vocational expert. In addition, the ALJ had before him reports prepared by several doctors and psychologists8 and the transcript of the prior hearing.

E. Findings

This court has carefully examined the briefs filed by the parties, the decisions of the ALJ and the Appeals...

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