Caldwell v. Sullivan, Civ. A. No. 88-1256-T.

• Court: U.S. District Court — District of Kansas
• Writing for the Court: THEIS
• Citation: Caldwell v. Sullivan, 736 F.Supp. 1076 (D. Kan. 1990)
• Decision Date: 26 April 1990
• Docket Number: Civ. A. No. 88-1256-T.
• Parties: Babe Doris CALDWELL, Plaintiff, v. Louis W. SULLIVAN, Secretary of Health and Human Services, Defendant.

736 F. Supp. 1076

Babe Doris CALDWELL, Plaintiff, v. Louis W. SULLIVAN, Secretary of Health and Human Services, Defendant.

Civ. A. No. 88-1256-T.

United States District Court, D. Kansas.

April 26, 1990.

David H.M. Gray, Wichita, Kan., for plaintiff.

Stephen K. Lester, Asst. U.S. Atty., Wichita, Kan., for defendant.

MEMORANDUM AND ORDER

THEIS, District Judge.

This matter is before the court on the Secretary's motion to affirm and the plaintiff's motion for summary judgment. This action involves two applications made under the Social Security Act. Plaintiff filed an application for disability insurance benefits under Title II of the Act, 42 U.S.C. § 401 et seq. and an application for supplemental security income (SSI) benefits based on disability under Title XVI of the Act, 42 U.S.C. § 1381 et seq. Plaintiff's applications were denied initially (Tr. 91-98) and on reconsideration. Tr. 107-15. On October 30, 1987, following a hearing, an administrative law judge (ALJ) rendered a decision finding that plaintiff was not under a disability as defined in the Social Security Act. Tr. 15-23. On March 7, 1988, the Appeals Council of the Social Security Administration denied plaintiff's request for review. Tr. 3-4. Thus, the decision of the ALJ stands as the final decision of the Secretary. Judicial review is available under 42 U.S.C. §§ 405(g), 1383(c)(3).

The standard of review in this case is established by 42 U.S.C. § 405(g), which provides that "the findings of the Secretary as to any fact, if supported by substantial evidence, shall be conclusive, ..." Substantial evidence is that evidence which a reasonable mind might accept as adequate to support a conclusion. Richardson v. Perales, 402 U.S. 389, 402, 91 S.Ct. 1420, 1427, 28 L.Ed.2d 842 (1971). It is not the duty of the court to reweigh the evidence. Garrett v. Califano, 460 F.Supp. 888, 890 (D.Kan.1978); Manigan v. Califano, 453 F.Supp. 1080, 1086 (D.Kan.1978). Substantial evidence, however, must be more than a mere scintilla. Perales, 402 U.S. at 403, 91 S.Ct. at 1428. This court cannot affirm the Secretary's decision by isolating a few facts and calling them "substantial evidence." Cline v. Califano, No. 78-4166 (D.Kan., August 31, 1979). It is the court's duty to scrutinize the entire record to determine whether the Secretary's conclusions are rational. Keef v. Weinberger, 404 F.Supp. 1193, 1196 (D.Kan.1975). In applying these standards, the court must keep in mind that the purpose of the Social Security Act is to ameliorate some of the rigors of life for those who are disabled or impoverished. Dvorak v. Celebrezze, 345 F.2d 894, 897 (10th Cir.1965).

In a Title II application filed on January 22, 1987, plaintiff alleged disability beginning January 28, 1983, as a result of diabetes, fatigue, arthritis in her hands, and bad feet. Tr. 69-72. The Title XVI application does not appear in the record. Plaintiff died on June 23, 1988, shortly after this action was filed. Her children have been substituted as plaintiffs. In this opinion, the court will refer to the original claimant, Babe Doris Caldwell, as plaintiff.

E.R. Schlachter, M.D., admitted plaintiff to St. Francis Hospital on February 20, 1983, for regulation of her diabetes, treatment of high blood pressure, and treatment of a mass in her breast. Tr. 125. Chest x-rays taken on February 23, 1983, revealed a "minimally enlarged" heart and an EKG revealed some abnormalities. Tr. 131-32. Lamont Bloom, M.D., began treating plaintiff's diabetes with insulin during her hospitalization. Tr. 175. Dr. Schlachter's diagnosis was left breast mass abscess, essential hypertension, diabetes mellitus, and hypokalemia. Tr. 125.

When Lewis A. Smith, O.D., examined plaintiff on February 30, 1984, her vision could be corrected to 20/25 + on the right and 20/20 on the left for distance vision, and 20/25 - on the right and 20/25 on the left for near vision. Visual fields were normal and her eyes appeared healthy. Dr. Smith found no indication of visual disability at the time of the examination. Tr. 142-43.

From January 29, 1986 through February 3, 1986, plaintiff was hospitalized because of uncontrolled diabetes. Tr. 139. The admission physical revealed mild background diabetic retinopathy and obesity. Tr. 141. Dr. Bloom indicated that plaintiff's admitted noncompliance with diet and medication contributed to the difficulty in controlling her condition. Dr. Bloom increased plaintiff's insulin dosage and her "blood sugars came into good control." Tr. 139-40.

In a report dated February 4, 1987, Dr. Bloom indicated that when he saw plaintiff on December 19, 1986, she complained of arthritis in her arms and shoulders but had not been taking Motrin as prescribed. He further indicated that plaintiff had "insulin requiring diabetes mellitus and not insulin dependent." He concluded that plaintiff's blood sugars were usually under very good control if she complied with diet, exercise, and activity. Dr. Bloom had no evidence of disability from the standpoint of her diabetes or arthritis. Tr. 145.

Daniel A. Shea, O.D., examined plaintiff's eyes on March 23, 1987. Ophthalmoscopic examination revealed no diabetic retinopathy. Although plaintiff did not exhibit glaucoma, the doctor recommended frequent examinations because of increased risk of glaucoma due to diabetes and ocular hypertension. Tr. 146.

Office notes from Dr. Bloom cover plaintiff's treatment from approximately March 1983 through August 1987. Tr. 151-69. During the course of treatment, Dr. Bloom made a number of notes about plaintiff's failure to take insulin as prescribed (Tr. 153, 164) and failure to follow the prescribed diabetic diet. Tr. 152, 154, 157, 159, 160, 162, 164, 167, 168. Dr. Bloom commented that when plaintiff complied with prescribed treatment her condition was much better. Tr. 156, 157, 158.

Plaintiff underwent a psychological evaluation by Kerin L. Schell, Ph.D., during September 1987. Tr. 176-236. Psychological testing included the Wechsler Adult Intelligence Scale-Revised (WAIS-R), which revealed a verbal IQ of 82, a performance IQ of 87, and a full scale IQ of 83 (Tr. 184); the Luria-Nebraska Neuropsychological Battery, which indicated that plaintiff suffered brain damage, resulting in difficulty thinking, memory problems, and hand coordination deficits (Tr. 185); and the Minnesota Multiphasic Personality Inventory (MMPI), which suggested that plaintiff exhibited hysterical and hypochondriacal tendencies, in addition to suggesting the possibility of neurological problems. Tr. 185-86.

Dr. Schell stated that the results on the Luria test corroborated the plaintiff's actual deficits, lending validity to the test results. Dr. Schell stated that the test results from the MMPI were valid. Plaintiff completed the test carefully and relevantly. There were no indications on the MMPI of "faking bad." Dr. Schell opined that plaintiff appeared to have answered the questions carefully and truthfully. Tr. 185. An optional research scale of the MMPI suggested the possibility of exaggerating psychopathology. Dr. Schell found this not to be unexpected in an individual with brain damage who had regressed into previously latent hysterical tendencies. Dr. Schell believed plaintiff was denying more pathology than what little she may have been exaggerating. Tr. 185.

Dr. Schell's primary diagnosis was organic personality syndrome. Depression and anxiety were a part of this syndrome. The plaintiff's depression symptoms included depressed mood, loss of interest and pleasure, psychomotor retardation, fatigue, loss of energy, feelings of worthlessness, diminished ability to think or concentrate, and indecisiveness. Her anxiety symptoms included motor tension; aches, soreness, and easy fatigability; autonomic hyperactivity; shortness of breath, accelerated heart rate, sweating, dizziness and lightheadedness, nausea, abdominal pain; vigilance and scanning; exaggerated startle response, difficulty concentrating, and irritability. Tr. 188-89.

Dr. Schell stated that plaintiff's problems in tolerating pain were partially due to her existing medical disorders, partially stress-induced (psychological factors affecting physical condition; somatoform disorders), and partially due to brain damage. Tr. 189. Plaintiff's symptoms of psychological factors affecting physical condition included her gradual physical deterioration during the previous two years. Symptoms of conversion disorder included coordination disturbance, paresthesia, and vomiting. Symptoms of somatization disorder included pseudoneurologic symptoms, gastrointestinal discomfort, female reproductive difficulties, psychosexual problems, and cardiopulmonary symptoms. Tr. 189. Symptoms relating to avoidant personality included being easily hurt by criticism, avoidance of people and social contact, fear of saying something inappropriate, fear of being embarrassed, and exaggeration of difficulties. Tr. 191.

Kermit E. White, M.D., a psychiatrist, evaluated plaintiff; however, the date of this evaluation is not reflected in the record. The doctor stated in a report dated January 4, 1988 that plaintiff reported symptoms associated with organic brain syndrome, such as memory loss, thinking and concentration difficulties, apathy, weakness, fatigue, and other psychometric impairments. Dr. White concluded that the plaintiff demonstrated "organic impairment on her psychometric tests and a diagnosis of organic brain syndrome secondary to hypertension induced cerebral arteriosclerosis should be entertained." Dr. White's conclusions were based on the combination of hypertension, diabetes, and chronic obstructive pulmonary disease, which could impair brain functioning and contribute to the inability to think clearly, act responsibly, or function with adequate judgment. Tr. 11-12.

At a hearing held on September 23, 1987, plaintiff testified that she was 62 years old and had completed the 12th grade. She last worked in...