Graham v. Celebrezze

• Decision Date: 23 June 1964
• Docket Number: Civ. A. No. 744.
• Citation: 230 F. Supp. 936
• Court: U.S. District Court — Southern District of West Virginia
• Parties: Bert GRAHAM, Plaintiff, v. Anthony J. CELEBREZZE, Secretary of Health, Education and Welfare, Defendant.

230 F. Supp. 936

Bert GRAHAM, Plaintiff, v. Anthony J. CELEBREZZE, Secretary of Health, Education and Welfare, Defendant.

Civ. A. No. 744.

United States District Court S. D. West Virginia.

June 23, 1964.

J. N. Harman, III, Welch, W. Va., for plaintiff.

Percy H. Brown, Asst. U. S. Atty., Charleston, W. Va., for defendant.

CHRISTIE, District Judge:

The plaintiff filed application for disability insurance benefits and to establish a period of disability on August 29, 1961, alleging that he became disabled during the summer of 1959, at age 48, because of back trouble, stomach pains, and pains in his legs. The application was denied initially by the Bureau of Old-Age Survivors Insurance, the functions of which are now incorporated within the Social Security Administration, after the West Virginia Vocational Rehabilitation Division, upon evaluation of the evidence by a physician and counselor, had found that plaintiff was not under a disability. He then requested a hearing. The hearing examiner, before whom plaintiff appeared, considered the case de novo on the basis of the testimony and documents admitted in evidence, and on December 28, 1962, found that plaintiff was not under a disability. The hearing examiner's decision became the final decision of the Secretary of Health, Education, and Welfare when the Appeals council denied plaintiff's request for review on February 8, 1963. This decision is now before this court for judicial review, pursuant to Section 205(g) of the Social Security Act, 42 U.S.C.A. § 405(g) upon a certified transcript of the record, the complaint of the plaintiff, the answer thereto of the Secretary, and a motion of the Secretary for summary judgment under Rule 56(b) of the Federal Rules of Civil Procedure, 28 U.S.C.A. In its review, however, the court is circumscribed by this provision in the Act referred to:

"The findings of the Secretary as to any fact, if supported by substantial evidence, shall be conclusive. * * *"

The issues before the Secretary were whether the plaintiff had established a period of disability under Section 216(i) of the Act, as amended, and if so, the beginning date of such disability, and whether he was entitled to disability insurance benefits under Section 223 of such Act, 42 U.S.C.A. §§ 416(i) and 423. These issues were dependent upon specific findings as to whether, during the effective period of the application, filed August 29, 1961, and while the special earnings requirement were met, the plaintiff was under a disability, as defined by said Section 223, sub-section(c) (2), of the Act, providing that:

"The term `disability' means 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 to be of long-continued and indefinite duration."

Section 223(a) (1) (D) of the Act requires that a claimant to receive benefits must establish that he was under a "disability", as above defined, at the time of the filing of his application therefor, and the last sentence of said Section 223, subsection (c) (2), of the Act, puts upon the claimant the ultimate burden of establishing his claim in these words:

"An individual shall not be considered to be under a disability unless he furnishes such proof of the existence thereof as may be required."

The courts have given general recognition to this requirement by holding that the burden of proof is on the claimant to establish his claim with creditable evidence. Underwood v. Ribicoff, 298 F.2d 850, (4th Cir. 1962); Maynard v. Celebrezze, 209 F.Supp. 523, 524 (S.D.W.Va.1962); Taylor v. Ribicoff, 204 F.Supp. 144 (S.D.W.Va.1962); Kerner v. Flemming, 283 F.2d 916, 921 (2nd Cir. 1960); Thurston v. Hobbs, 133 F.Supp. 205 (W.D.Mo.1955).

The Secretary found that the special earnings requirements were met during the effective period of the application, but that the plaintiff had not carried the burden of establishing a period of disability and an entitlement to disability insurance benefits.

The rule is well established and generally recognized that, under its authority to review the administrative findings of the Secretary, the court may not hear the case de novo nor substitute its own conclusions for those of the administrative agency. Its true function is to uphold the administrative finding if there is found substantial evidence to support it. United States v. Certain Interests in Property, et al., 296 F.2d 264 (4th Cir. 1961); Underwood v. Ribicoff, supra; Laird v. Ribicoff, 207 F.Supp. 668 (W.D. S.C.1962); McPherson v. Ribicoff, 209 F.Supp. 341 (D.Md.1962). However, as pointed out in Pruitt v. Flemming, 182 F.Supp. 159, 161 (S.D.W.Va.1960), this rule does not mean that courts should surrender their traditional "judicial function", but instead, that they will see to it that the administrative agency does not act arbitrarily or capriciously in denying just and worthy claims.

Thus, it is seen that in its review of the decision of the administrative agency, the ascertainment of the meaning of the statutory term "substantial evidence", as it relates to cases of this sort, is all-important. For guidance in this regard, we find that a similar provision appears in the National Labor Relations Act, and in construing its meaning there, the Supreme Court, in National Labor Relations Board v. Columbian, 306 U.S. 292, 59 S. Ct. 501, 83 L.Ed. 660, Point 4 of the Syllabus, defined it thusly:

"Substantial evidence is more than a scintilla, and must do more than create a suspicion of the existence of the fact to be established. It is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion, and it must be enough to justify, if the trial were to a jury, a refusal to direct a verdict when the conclusion sought to be drawn from it is one of fact for the jury."

It is fundamental that in considering a motion to strike the plaintiff's evidence, and direct a verdict for the defendant, the court is guided by what its action would be if a verdict were returned for the plaintiff, and a motion made for a new trial on the ground of insufficient evidence. It is axiomatic that if more than one reasonable inference can be drawn from the evidence, the case should be submitted to the jury.

Thus viewed, the rule given in Utica Mut. Ins. Co. v. Rolloson, 246 F.2d 105, 4th Cir., on a motion to set aside a verdict, is pertinent to the inquiry:

"Our inquiry is not whether there was evidence to support a result contrary to the jury's verdict, but whether there was evidence legally sufficient to support the verdict that was found."

So it is here. The inquiry is not whether there is evidence to support a conclusion different from that reached by the Secretary, but whether there is substantial evidence to support the conclusion he did reach. We are not here concerned with whether his decision is logical or illogical, or whether we might have drawn a different conclusion from the evidence before him, for such is not properly within our sphere of authority under the limitation imposed upon us by the statute. Under this limited authority, we are confined to an ascertainment from an impartial examination of the record of whether or not the decision of the Secretary is supported by substantial evidence.

In making this determination, however, it must be borne in mind that the Congress, in amending the law to provide benefits to those covered by it who become disabled from engaging in gainful activity, recognized that existing social and economic needs gave rise to such legislation. Its obvious purpose was the attainment of an humanitarian end; and, like all remedial legislation, it should be liberally construed, interpreted, and administered that it may accomplish the beneficent result intended. Pruitt v. Flemming, supra; Carqueville v. Folsom, D.C., 170 F.Supp. 777; Willard v. Hobby, D.C., 134 F.Supp. 66.

But, however, wholesome the purpose and intent of the legislation may be, still the burden of establishing a claim under it is left to rest upon the one who asserts it, and no rule of liberality will take the place of required proof. The award of benefits cannot, therefore, rest upon imagination, speculation, conjecture, or sympathy—only creditable proof will suffice.

Viewed in this context, does the evidence in this case support in a persuasive or substantial way the decision of the Secretary denying plaintiff's claim? This necessarily calls for a review of the evidence, but before doing so, it will be well to examine the pertinent rules of law that must be applied to it.

The courts appear to be in general accord that where there is a conflict in the evidence, or conflicting inferences may be drawn from established facts, it is the proper function of the administrative agency to resolve the same, and his decision will be upheld by the courts. Butler v. Folsom, 167 F.Supp. 684 (W.D. Ark. 1958); Taylor v. Ribicoff, 204 F. Supp. 144, 147 (W.D.W.Va.1962); Gotshaw v. Ribicoff, 307 F.2d 840, 845 (4th Cir. 1962). And this is true even though there is but a "slight preponderance of the evidence on one side or the other." Underwood v. Ribicoff, supra; United States v. Certain Interests in Property, et al., supra.

Reverting here to Section 223(c) (2) of the Act, defining "disability", it is clear that for a claim to be established thereunder, the evidence must disclose:

(1) A physical or mental impairment medically determinable as such;

(2) The impairment thus found must be of such severity as to preclude engaging in any gainful activity;

(3) It must reasonably be expected to either result in death in the foreseeable future; or

(4) Be of such permanent nature as to reasonably be expected to continue for a long and indefinite (unforeseeable) duration.

This definition, as it is seen, comprehends a medical finding that the impairment is of such severity and permanency as to preclude the claimant from engaging in any...