Champion v. Califano

• Decision Date: 30 November 1977
• Docket Number: Civ. A. No. 77-0796.
• Citation: 440 F. Supp. 1014
• Parties: Harold E. CHAMPION, Plaintiff, v. Joseph CALIFANO, Jr., Defendant.
• Court: U.S. District Court — District of Columbia

440 F. Supp. 1014

Harold E. CHAMPION, Plaintiff, v. Joseph CALIFANO, Jr., Defendant.

Civ. A. No. 77-0796.

United States District Court, District of Columbia.

November 30, 1977.

Michael Gilbert, Washington, D. C., for plaintiff.

William Briggs, Asst. U. S. Atty., Washington, D. C., for defendant.

MEMORANDUM

GASCH, District Judge.

This action was brought to review a decision of the Appeals Council of the Social Security Administration affirming a decision of a Hearing Examiner that denied plaintiff disability benefits under the Social Security Act. Plaintiff is a 31-year-old male who suffers from multiple sclerosis. He was first afflicted with the disease in 1966 while on active duty in the Air Force at which time he began to suffer loss of eyesight. He was later discharged from active duty. He states that he has since suffered pain, further loss of eyesight, loss of coordination in certain extremities, nervousness, and extreme mental and emotional depression.

On February 8, 1973, plaintiff filed for disability insurance benefits pursuant to applicable provisions of the Social Security Act. This application was lost, and on November 13, 1973, plaintiff filed again. After a review of his case by a disability examiner and a physician, the application was denied on April 2, 1974, because it was determined that his impairments were not of such severity as to preclude him from performing his regular work. Plaintiff requested reconsideration, and on November 12, 1974, after further review, the application was again denied.

Pursuant to plaintiff's request, a hearing was held on April 5, 1976, before an Examiner of the Social Security Administration's Bureau of Hearings and Appeals. On September 28, 1976, the administrative law judge rendered his decision denying plaintiff's claim. This decision became the final decision of the Secretary of Health, Education and Welfare when the Appeals Council approved it on March 9, 1977.

After the Appeals Council's action, plaintiff filed this suit wherein he alleges that the agency decision was not supported by substantial evidence in the record. Plaintiff also alleges that there exists additional evidence not previously submitted which, if considered by the Hearing Examiner, would require a decision in plaintiff's favor. Therefore, plaintiff asks this Court to find the Secretary's decision to be improper and to order payment of his disability claim, or, in the alternative, to remand the case to the agency for the submission of this additional evidence.

The limited role of judicial review in these cases is set out in the Social Security Act itself, which states: "The findings of the Secretary as to any fact, if supported by substantial evidence, shall be conclusive . . .." 42 U.S.C. § 405(g) (1970). The Supreme Court interpreted this statutory provision in Richardson v. Perales, 402 U.S. 389, 91 S.Ct. 1420, 28 L.Ed.2d 842 (1971), wherein the Court said that substantial evidence means

"more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion."

Id. at 401, 91 S.Ct. at 1427 (citation omitted). It is thus not this Court's function to reweigh the evidence or substitute its judgment for that of the Secretary; instead, it must defer to the administrative decision as long as it meets the requisite evidentiary standard. Reyes v. Secretary of Health, Education & Welfare, 155 U.S.App.D.C. 154, 158, 476 F.2d 910, 914 (1973); accord, Wesley v. Secretary of Health, Education & Welfare, 385 F.Supp. 863, 865 (D.D.C.1974).

To qualify for disability insurance benefits, the applicant must meet the insured status requirements of the Act and then establish a disability as defined by the Act. The Social Security Administration determined that the last month during which plaintiff satisfied the insured status criteria was June, 1974.¹ Therefore, plaintiff must show that he had a disability on or before that date. To satisfy this burden, plaintiff must prove that he suffers from a medically determinable physical or mental impairment that is likely to cause death or that has persisted or will likely persist for twelve months and that prevents him from engaging in any substantial gainful employment.²E.g., Blalock v. Richardson, 483 F.2d 773, 775 (4th Cir. 1972).

The afflictions that plaintiff claims to suffer from are multiple sclerosis and its residual effects,³ nervousness, and mental depression. In his decision denying plaintiff's application for benefits, the administrative law judge first found that "this claimant is . . . not . . . precluded from returning to his prior types of employment by his physical impairments." Administrative Record at 8. In reaching this conclusion, the ALJ emphasized the following medical evidence:

(1) the June 1976 evaluation of Dr. Gordon who found no evidence of orthopedic disability at that time and noted that if the plaintiff had multiple sclerosis it appeared at that time to be in a state of remission;

(2) the May 1976 ophthalmological evaluation by Dr. Nes who found that plaintiff was blind in his right eye but still had good visual acuity in his left eye and therefore was not totally visually disabled; and

(3) the June 1970 neurological evaluation of Dr. Green who found minimal impairments of the left limbs and some hip pain possibly due to multiple sclerosis but concluded that plaintiff could engage in sustained light work.

Id. at 7-8. The ALJ then turned to an evaluation of the psychiatric evidence and found that "this claimant is . . . not . . . precluded from returning to his former types of employment by his psychological impairments." Id. at 9. As support for this conclusion, he references only the July 1976 psychiatric evaluation of Dr. White and quotes that doctor's conclusion that plaintiff was "unable to work presently because of the severity of his depression." Id. at 8. Thereafter, the ALJ simply states the final conclusion that based on the entire record the claimant was not found to be disabled within the meaning of the Social Security Act. Id. at 9.

Although the evidence cited to support the conclusion of no physical impairment arguably constitutes substantial evidence for that conclusion,⁴ this Court finds the ALJ's decision to be erroneous in two other respects: There is no substantial evidence in the record to support the conclusion that plaintiff had no psychological impairment, and the ALJ failed to consider whether the combined effects of plaintiff's physical and mental conditions rendered him disabled within the meaning of the Act.

The definition of disability clearly states that a mental impairment may in itself be sufficient to entitle the claimant to benefits.⁵ The Social Security Administration has promulgated criteria for determining the severity of psychological impairments,⁶ and the ALJ referenced these criteria in finding no disability in the plaintiff. They divide mental disorders into three categories for purposes of the Social Security program, one of which, "functional mental disorders," is clearly applicable here.⁷ Among its various subclasses are "Psychoneurotic disorders" including "neurotic-depressive reaction." Psychoneuroses are described as being characterized by reactions to deep-seated conflicts and are classified by the defense mechanisms the individual employs to stave off the threat of emotional decompensation (e.g., anxiety, depression . .)." 20 C.F.R. § 404, Subpt. P, App. Sec. 12.00(B) (1977).

The report of Dr. White strongly indicates that plaintiff's condition falls squarely within the above description. She stated that it was her impression that plaintiff suffered from "Severe Depressive Neurosis." Administrative Record at 86 (emphasis in original). Based on this impression, Dr. White's recommendation was that plaintiff was unable to work. Id. Although the ALJ acknowledged this recommendation, he chose to ignore it, yet he offered no other evidence to support that decision.

Not only does the very evidence the ALJ cited support the conclusion that plaintiff suffers from a mental disability, but other evidence in the record also strengthens that conclusion. Plaintiff's own testimony states that he has lost jobs or quit them because of his nerves,⁸ and Valium has been prescribed for him because of his nervousness. Id. at 21-23, 27, 90. Based on this record it is clear that the decision of the ALJ concerning plaintiff's mental condition lacked substantial evidence and that to the contrary there exists substantial evidence that plaintiff in fact is disabled because of his depression and nervousness.

The Court, however, need not rest its decision in this case solely on that basis. Even if the mental condition alone were not sufficient to cause plaintiff to be disabled, when one considers the combined effect of this depression and nervousness with the undeniable physical manifestations of his multiple sclerosis, plaintiff clearly is disabled within the meaning of this Act and entitled to benefits. These combined effects must be considered for the Act seeks to administer relief to the whole man and not simply to serve as a vehicle for the separate clinical analysis of individual ailments. E.g., Bittel v. Richardson, 441 F.2d 1193, 1195 (3d Cir. 1971); Dillon v. Celebrezze, 345 F.2d 753, 755-57 (5th Cir. 1965). The record shows that plaintiff is blind in the right eye, that he occasionally suffers temporary blindness in the left eye, that he encounters periods of pain in the abdomen or hip, that he has coordination problems and occasional numbness in some of his extremities, and that he suffers from depression and nervousness. Disability necessarily means the combination and interrelation of the various individual ailments. It takes only elementary common sense to look at the record of this man's physical and mental condition to see that the sum of the evidence here equals total disability. There is no substantial evidence in...