Diaz v. Secretary of Health and Human Services, Civ. No. 90-2133 GG.

• Decision Date: 21 April 1992
• Docket Number: Civ. No. 90-2133 GG.
• Citation: 791 F. Supp. 905
• Parties: Tomas Marrero DIAZ, Plaintiff, v. SECRETARY OF HEALTH AND HUMAN SERVICES, Defendant.
• Court: U.S. District Court — District of Puerto Rico

791 F. Supp. 905

Tomas Marrero DIAZ, Plaintiff, v. SECRETARY OF HEALTH AND HUMAN SERVICES, Defendant.

Civ. No. 90-2133 GG.

United States District Court, D. Puerto Rico.

April 21, 1992.

Juan A. Hernandez Rivera, Raymond Rivera Esteves, San Juan, P.R., for plaintiff.

Daniel F. Lopez Romo, U.S. Atty., Jose Vazquez Garcia, Asst. U.S. Atty., Hato Rey, P.R., for defendant.

OPINION AND ORDER

GIERBOLINI, Chief Judge.

Plaintiff is seeking review of the Secretary of Health and Human Services's decision denying his application for disability benefits under the Social Security Act, 42 U.S.C. § 405(g). The Administrative Law Judge (hereafter ALJ) held a hearing, and thereafter affirmed the Social Security Administration's denial of plaintiff's claim. The Appeals Council denied plaintiff's request for review of the ALJ decision, making the ALJ's decision the final decision of the Secretary.

We referred the case to the magistrate for a Report and Recommendation. The magistrate recommended that we affirm the decision of the Secretary on the basis that it was supported by substantial evidence, and that we deny plaintiff's claim for benefits. Upon our de novo review of the evidentiary record as a whole we find that the Secretary's findings of fact are not supported by substantial evidence. We thus REJECT the Report and Recommendation of the magistrate, since we find good cause to REMAND this case to the Secretary to take additional evidence on the points discussed below.

STANDARD OF REVIEW

The scope of judicial review by a district court of a final decision of the Secretary is limited by statute. 42 U.S.C. § 405(g) (1991) provides that, "The findings of the Secretary as to any fact, if supported by substantial evidence, shall be conclusive ..." The Supreme Court has defined "substantial evidence" as "more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Richardson v. Perales, 402 U.S. 389, 91 S.Ct. 1420, 1427, 28 L.Ed.2d 842 (1971), quoting Consolidated Edison Co. v. NLRB, 305 U.S. 197, 59 S.Ct. 206, 217, 83 L.Ed. 126 (1938); Accord Kent v. Schweiker, 710 F.2d 110, 114 (3rd Cir.1983); and Miranda v. Secretary of HEW, 514 F.2d 996, 998 (1st Cir.1975).

Our Circuit has held that the "substantial evidence" standard is a "stringent limitation" on the scope of court review, Reyes-Robles v. Finch, 409 F.2d 84, 86 (1st Cir.1969); and that a district court should defer to the Secretary's "reasonable" findings of fact, even if a district court sitting as the trier of fact might have reached an opposite conclusion. Lizotte v. Secretary of HHS, 654 F.2d 127, 131 (1st Cir.1981), and Velez v. Secretary of HEW, 593 F.2d 157, 160, n. 4 (1st Cir.1979).

Despite the narrow scope of judicial review which governs a district court's review of the agency's final decision as to whether Social Security disability benefits should be granted, the Supreme Court has emphasized the importance of the judicial review process under a "substantial evidence" standard,

Reviewing courts must be influenced by a feeling that they are not to abdicate the conventional judicial function. Congress has imposed on them responsibility for assuring that the ... agency keeps within reasonable grounds. That responsibility is not less real because it is limited to enforcing the requirement that evidence appear substantial when viewed on the record as a whole ...

Universal Camera Corp. v. NLRB, 340 U.S. 474, 71 S.Ct. 456, 466, 95 L.Ed. 456 (1951); See also Consolidated Edison Co., 59 S.Ct. at 217 ("The assurance of a desirable flexibility in administrative procedure does not go so far as to justify orders without a basis in evidence having rational probative force."); Beavers v. Secretary of HEW, 577 F.2d 383, 387 (6th Cir.1978); and Klug v. Weinberger, 514 F.2d 423, 425 (8th Cir.1975).

The Supreme Court has made clear, and other courts agree, that when reviewing a social security decision, a district court must look at the record as a whole to see if based on "substantial evidence".

The substantiality of evidence must take into account whatever in the record fairly detracts from its weight. This is clearly the significance of the requirement ... that courts consider the whole record ... A reviewing court is not barred from setting aside a ... decision of an agency when it cannot conscientiously find that the evidence supporting that decision is substantial, when viewed in the light that the record in its entirety furnishes, including the body of evidence opposed to the ... agency's view.

Universal Camera Corp. v. NLRB, 71 S.Ct. at 464-465; Kent, 710 F.2d at 114. ("The search for substantial evidence is thus a qualitative exercise without which our review of social security disability cases ceases to be merely deferential and becomes instead a sham."); Lynn v. Schweiker, 565 F.Supp. 265, 267 (S.D.Tex. 1983) ("However, it is not the Court's role on judicial review merely to rubber-stamp the decisions of the Secretary. It must scrutinize the record in its entirety to determine the reasonableness of the decision reached. Simmons v. Harris, 602 F.2d 1233, 1236 (5th Cir.1979)."); Accord Simonson v. Schweiker, 699 F.2d 426, 429 (8th Cir.1983); Rodríguez v. Secretary of HHS, 647 F.2d 218, 222 (1st Cir.1981); Money v. Califano, 470 F.Supp. 636, 640 (E.D.Ark.1979), and Beavers, 577 F.2d at 387.

FACTUAL RECORD

After plaintiff's initial application for benefits was denied by the Secretary, administrative hearings were conducted on January 8, 1990 (Tr. 30-47), and February 8, 1990 (Tr. 48-76). Plaintiff was represented by counsel, and the ALJ took testimony of plaintiff; a medical expert who surveyed the medical record without examining the plaintiff; and a vocational expert.

Plaintiff is a 56 year old married individual with one year of college whose past relevant work (PRW) was as a meter reader with an electric company for over twenty years (Tr. 35). This work consisted of walking, reading meters, standing, making notations of the numbers in a log book and driving a vehicle (Tr. 35).

Plaintiff claimed to have been unable to work since December of 1984. The ALJ found that the plaintiff met the Act's disability insured status requirements on the alleged date of onset, December 31, 1984, and continuously through December 31, 1990. (Tr. 12)

Plaintiff has a long history of mental impairments requiring psychiatric evaluation, as well as with other physical medical impairments. Plaintiff had a work accident in June of 1971 where a rock fell on his head, requiring stitches (Tr. 156). After this accident he developed persistent headaches. On December 21, 1971 Dr. Andrés López-Cumpiano diagnosed "anxious depression" and continued to treat claimant with medication and other treatment until May 7, 1979, when the doctor closed the case with a disability finding of Neurosis Class II with a 30% disability (Tr. 143, 156).

A March 26, 1980 evaluation by Dr. Guillermo Santiago, a psychiatrist, yielded a diagnosis of "depressive neurosis" (Tr. 147). Dr. Santiago found that plaintiff works in spite of his interpersonal relations and is at the "border of a psychotic outbreak." (Tr. 147, 148).

Dr. Abelardo Martinez did a psychiatric evaluation on May 1, 1981 and found that plaintiff has crying episodes, entertains ideas of low-self esteem, sadness and desperation, and that suicidal ideas and auditive hallucinations still persist. (Tr. 155). His conclusion was that the plaintiff was a "profoundly depressed person and with great irritability." (Tr. 157).

Plaintiff returned to the SIF on September 22, 1980 for psychiatric treatment, which continued through June 2, 1982. (Tr. 162). A September 10, 1982 psychiatric evaluation by Dr. Angel N. Miranda, found that plaintiff had sleeping problems and nightmares, episodes in which he forgets things, and frequent crying spells. (Tr. 176). Dr. Miranda diagnosed chronic depressive reaction—moderate—severe, and found symptoms of a slight conceptual disorganization, severe tension, severe depressive "mood", and hostile and severe-moderate motor retardation. (Tr. 177)

Dr. Abelardo Martinez did another psychiatric evaluation on November 8, 1982. Plaintiff complained that he doesn't go out alone because he becomes disoriented and does not know how to return home, cannot read because of severe headaches, and has frequent nightmares (bloody). (Tr. 167, 168) Plaintiff has mental blocks, and remembers dates and important events in his life, but forgets other details like the names of psychiatrists or prescriptions. (Tr. 168). Dr. Martinez diagnosed "neurosis of Anxiety with hysteric traits" and remarked that, "At present patient is working. He says that those `mental blocks' prevents him from working efficiently. We recommend major psychiatric tx. to keep the patient in the work force." (Tr. 169)

Plaintiff was treated at SIF from May 21, 1987 to June 30, 1987 and the Final Report by Dr. Oscar Ruiz diagnosed Axis I—Dysthymic Disorder. (Tr. 172). The report notes ongoing dysphoric moods that include "depression, nervousness, forgetfulness irritability, anergia and insomnia of at least 2 years evolution", and Dr. Ruiz commented that intermittent long term psychiatric follow up would be required along with pharmacologic supervision and supportive psychotherapy. (Tr. 172). The last SIF progress notes of May 2, 1988 awarded plaintiff a 40% disability. (Tr. 174).

Dr. Reinaldo E. Kianes did a psychiatric evaluation on May 30, 1989 and diagnosed Adjustment Disorder with depressed mood. (Tr. 183) Dr. Kianes found that plaintiff can take care of his personal needs, watches T.V., sometimes listens to soft music, reads the newspaper, sometimes shops with wife, visits family, goes to church and sometimes drives. (Tr. 181). Dr. Kianes did not find blockings, suicidal ideas, delusions or perceptual disturbances. (Tr. 182). Dr. Kianes found claimant to be alert, in contact with reality,...