Hawkins v. Heckler, 83-1845.

• Citation: 600 F. Supp. 832
• Decision Date: 22 January 1985
• Docket Number: No. 83-1845.,83-1845.
• Parties: Bobby J. HAWKINS, Plaintiff, v. Margaret M. HECKLER, Secretary of Health and Human Services of the United States, Defendant.
• Court: U.S. District Court — District of Kansas

600 F. Supp. 832

Bobby J. HAWKINS, Plaintiff, v. Margaret M. HECKLER, Secretary of Health and Human Services of the United States, Defendant.

No. 83-1845.

United States District Court, D. Kan.

January 22, 1985.

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

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

MEMORANDUM AND ORDER

PATRICK F. KELLY, District Judge.

This is an action under 42 U.S.C. § 405(g) for judicial review of the decision of the Secretary of Health and Human Services terminating Plaintiff's entitlement to disability benefits under the Social Security Act. This matter originally came before this Court on Plaintiff's motion for summary judgment and alternative motion for remand, and the Secretary's motion to affirm the Secretary's decision. In a ruling filed September 24, 1984 this Court denied both motions for summary judgment and remanded the case to the Secretary with instructions to effectuate reconsideration by the Administrative Law Judge (ALJ). The Appeals Council submitted a Clarifying Order of Appeals Council dated October 19, 1984 in which it again reaffirmed the termination of Plaintiff's period of disability but failed to obtain reconsideration by the ALJ. This matter is now before the Court again on Plaintiff's renewed motion for summary judgment.

Plaintiff was originally granted a period of disability beginning in June, 1977, because of chronic alcoholism, liver disease, and secondary malnutrition. (R. 14-15) He stopped drinking on January 14, 1980. (R. 49) He failed at a brief work attempt as a janitor. He was forced to stop working in 1980 because his foot disorder caused too much pain, and he could not do the walking. (R. 14, 167-168) The Secretary ruled that Plaintiff's disability ceased in March, 1982, and his entitlement to benefits ceased in May, 1982. He has Pes Planus and planter calluses (R. 78, 146), which limit him to six hours of intermittent standing. (R. 142) It was because of this impairment that the ALJ found Plaintiff's residual functional capacity to be limited to sedentary employment. (R. 16)

In 1978, Plaintiff, according to his doctor,

... reached an irreversible phase in his chronic liver disease. There is already evidences of hepatocellular damage due to the increase in SGOT and LDH and superimposed to it we can see an increase in the alkaline phosphatase. Evidences of severe liver dysfunction are concluded also because of the low albumin and low cholesterol. Probably the patient has Laenec's cirrhosis of the liver with end stage organ damage, due to chronic alcoholism. Since he already has signs of accumulation of ascitic fluid and hepatomegaly I believe he is disabled because of his prognosis is essentially poor at that degree of liver dysfunction.

He was mentally clear but he could develop portal encephalopathy after a high protein meal or as a result of any other metabolic disturbance.

In summary, I believe Mr. Hawkins is disabled.

(R. 130-131)

Plaintiff's liver condition has improved considerably, but he still has an elevated serum magnesium level, which usually indicates renal insufficiency (R. 158), a high globulin level, which could relate to old liver damage (R. 146), diet limitations (R. 116), and the need to urinate frequently. (R. 40, 153)

Also apparently resulting from his alcohol addiction, Plaintiff has lost normal reflexes. (R. 137) A consultative physician also found Achilles reflex to be absent and sensation to be decreased, "both suggesting early sensory and motor neuropathy ... The MCV is increased, suggesting ineffective erythropoiesis." (R. 153) Another Social Security examining physician found no sensation from the feet halfway to the knees. (R. 146)

Plaintiff was committed to Larned State Hospital in 1974 for a ninety day treatment. He was diagnosed as having a passive aggressive personality and alcohol addiction. (R. 124) By 1980, chronic brain syndrome, and chronic desocialization were noted. Low-normal intelligence was also noted, and

His personality profile suggested that he was schizoid and had difficulty in dealing with authority. Recommendations were made for highly structured aftercare program.

(R. 136) At that time he had difficulty comprehending what was expected of him, and he did not accept the recommendation to attend Midtown Halfway House. (R. 136)

Following the onset of Plaintiff's sobriety, the following psychological evaluation was made on January 29, 1980:

Personality test data suggests an individual who might best be classified as a schizoid personality. This type of individual holds a basic, sullen distrust toward other people and finds it difficult to relate interpersonally. His basic outlook on life is one of chronic pessimism and worry and in times of stress there may be evidence of somewhat bizarre and unusual behavior. Bobby demonstrates a resentment toward authority figures and social institutions in general and may be expected to find the task of going along with rules and regulations of a treatment program to be somewhat difficult.

In light of this individual's personality style and low level of intelligence, it is suggested that his treatment program be fairly simple and straight forward, and that interventions be oriented toward behaviors rather than abstract insight. This individual will occasionally need to withdraw from others on an emotional and cogitative level as a result of his defenses being shaken. When this occurs it should be allowed, although he should be encouraged to talk with others about his distrust after he is sufficiently recovered. It is also suggested that a highly structured aftercare program would be helpful for this person.

(R. 138)

To fully explore the possibility of chronic brain syndrome, a neuropsychological evaluation was performed January 1, 1983 by Leslie Ruthven, Ph.D., a clinical psychologist. He found Plaintiff to be functioning in the low average range of intelligence, but his intellectual efficiency was undermined by impulsive or disinhibited reactivity. He was found to act without adequate reflection. His thinking was rigid, and he tended to persist in a fruitless direction even though events would indicate a different course of action. Diagnosed as having minimal brain dysfunction, he was observed to be impaired by disinhibition, which may have led to his previous alcoholism. The psychologist concluded that Plaintiff had some potential for returning to competitive employment with the assistance of therapy. (R. 169-170) Examples of Plaintiff's inappropriate and unrealistic thought processes are found at R. 48-49, where he indicated he could do alcoholic counseling, drafting, and engineering.

Plaintiff heeded this psychologist's recommendation in anticipation that he would be able to work again. His therapy, however, disclosed additional and much more serious problems. An April 20, 1983 report from his psychologist disclosed:

After my initial evaluation of the above individual (see Report dated 1/27/83) I began seeing him in weekly psychotherapy sessions, which I anticipate continuing for a year or so. In my contacts with him I have found that there is much more serious psychopathology — and disability — then I was aware of from my first evaluation, which was directed toward the issue of brain damage because of a previous diagnosis of Organic Brain Syndrome. My current diagnosis is that of a chronic paranoid schizophrenic reaction in a recovering alcoholic with minimal brain dysfunction. Clinically and on psychological tests I have found him to have substantial delusional ideas and I feel that these paranoid beliefs play a dominant role in his social isolation and estrangement from people, including family members. Heretofore I thought he might be able to handle the demands of employment within the next six months but I am not expecting him to be able to handle gainful employment for at least a year or more, but I am fairly hopeful about the long term prognosis for this individual. In addition to the therapy, I am also encouraging him to pursue vocational evaluation and training with the Department of Vocational Rehabilitation.

(R. 176) It is this report which was submitted to the Appeals Council after the hearing and which occasioned the previous remand of this case to the Secretary.

Specific examples of Plaintiff's isolation and other symptoms can also be found in his testimony. He lives in a storage van on a business street. His only amenities are a couch, an old TV and a hot plate. He has no restroom and no running water. (R. 44) He has only one friend around whom his few activities revolve. (R. 45) His only other social contact is his sister. (R. 53) He inarticulately expressed a problem relating to people. (R. 45-46) He has depression "day and night." (R. 46)

This court has previously described the scope of review in Green v. Schweiker, 582 F.Supp. 786 (1984) at 789-790:

The standard of review in this case is established by 42 U.S.C. § 405(g), which provides that `the finding of the Secretary as to any fact, if supported by substantial evidence, shall be conclusive.' Substantial evidence is such evidence as a reasonable person would accept as adequate to support a conclusion. Richardson v. Perales, 402 U.S. 389, 401, 91 S.Ct. 1420, 1427, 28 L.Ed.2d 842 (1971).

In Arie v. Heckler, No. 82-1608 (D.Kan. July 15, 1983), the Court stated:

While it is not the duty of the Court to reweigh the evidence, the Court may not mechanically accept the findings of the Secretary, but must scrutinize the entire record to determine whether the conclusions reached are rational. Martin v. Schweiker, 562 F.Supp. 912 (D.Kan.1982). The 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). 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

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