Matias Rivera v. Gardner, 455-67.

• Citation: 286 F. Supp. 305
• Decision Date: 28 June 1968
• Docket Number: No. 455-67.,455-67.
• Court: U.S. District Court — District of Puerto Rico
• Parties: Claudino MATIAS RIVERA v. John W. GARDNER, Secretary of Health, Education & Welfare.

286 F. Supp. 305

Claudino MATIAS RIVERA v. John W. GARDNER, Secretary of Health, Education & Welfare.

No. 455-67.

United States District Court D. Puerto Rico.

June 28, 1968.

Juan G. Riera Toro, Mayaguez, P. R., for plaintiff.

Candita R. Orlandi, San Juan, P. R., for defendant.

MEMORANDUM OPINION

FERNANDEZ-BADILLO, District Judge.

This action confronts the Court with determining whether the Secretary's decision of May 4, 1967 denying Claudino Matias Rivera disability insurance benefits under 42 U.S.C. §§ 416(i) and 423 is supported by substantial evidence. Claimant has been unsuccessful in his three attempts to receive disability benefits. His first application, dated June 20, 1958, was denied because his earnings record did not satisfy the requirements for a period of disability as set forth in 42 U.S.C. § 416(i), paragraph (3). On January 10, 1964 claimant filed a second application seeking a disability determination. Although this request was disallowed by the hearing examiner and by the Appeals Council, plaintiff did not obtain a court review within the statutory time. On June 30, 1965, approximately three months after the Secretary's decision had become final by lapse of time, Matias filed his third and last application claiming a disabling heart condition and nervousness. He had last met the earnings requirement on June 30, 1964.

The statutory definition of disability was modified by the Social Security Amendments of 1965. Under the present law disability insurance benefits are payable to an insured worker if his disabling impairment is expected to result in death or has lasted or can be expected to last for a continuous period of not less than 12 months. In the instant case the administrative decision which is now on review was based on the disability definition as modified by the 1965 Amendments of Section 423(c) (2) (A) and Section 416(i) (1) (A) of Title 42. These amendments are effective with respect to applications for disability insurance benefits filed before July 1965 if the applicant has not died before then and if notice of the final decision of the Secretary has not been given to the applicant before such month. This is such a case.

The Court is now faced with a change of law which brings it to decide the problem raised by the government in its brief. The government contends that since claimant's applications are all based on essentially the same complaints and his prior applications were denied on the administrative level without judicial review being sought, the prior findings and decisions of the administrative body are res judicata in this proceeding.

It has been held that res judicata principles apply to administrative proceedings. As the Supreme Court said in United States v. Utah Constr. Co. (1966) 384 U.S. 394, 422, 86 S.Ct. 1545, 1560, 16 L.Ed.2d 642,

"When an administrative agency is acting in a judicial capacity and resolves disputed issues of fact properly before it which the parties have had an adequate opportunity to litigate, the courts have not hesitated to apply res judicata to enforce repose."

An example of this position was given by the Court of Appeals, Tenth Circuit, in Hobby v. Hodges (1954) 215 F.2d 754, 759, in an action for review of an order entered by the Appeals Council dismissing plaintiff's request for a hearing on the determination of benefits under the Social Security Act.¹

Nonetheless, when circumstances have so required, the courts have adopted a more flexible approach to res judicata thus avoiding a rigid application of the doctrine.²

Res judicata has also been qualified by a material change of circumstances.³ Changes of law by remedial legislation often create new rights or remedies placing subsequent proceedings beyond the conclusive effect of prior judgments. The rights and remedies granted by a newly enacted statute are not prejudiced by the res judicata effect and any prior judgment loses force in subsequent litigation.

It is the Court's opinion that the legislative intent of the 1965 Amendments, liberalizing the statutory definition of disability by eliminating the long continued and indefinite requirement, abrogated the conclusive effect of the prior administrative decision in the present action. Applicant was granted a hearing on the merits of the claim which gave rise to his third application despite the fact that a prior administrative decision on the disability issue had become final. The hearing on his third application was conducted in accordance with the liberalized, amended standard of what constitutes disability. From the decision of the Appeals Council affirming the hearing examiner he now seeks timely review. It would indeed be a harsh and mechanical application of the rule of res judicata if it were here imposed. Principles of equity and considerations of changed circumstances override res judicata in this case. I believe the new legislation serves as a valid basis to the litigation of Matias' last claim, a claim which would have otherwise been barred.

Having disposed of this preliminary problem, the remaining issue is whether there is substantial evidence to support the Secretary's decision. The language contained in the findings of the Hearing Examiner demonstrates that he does not feel that claimant suffers from impairments severe enough to preclude him from engaging in any substantial gainful activity.

The facts in this case are not disputed. The application for disability insurance benefits reveals that plaintiff was born on August 10, 1905. At the time of the hearing he was nearly 61 years old. He alleges that he became unable to work on August 20, 1963. This is an illiterate farm hand having a very restricted work history and training. He signs all papers by making an X and refers to himself as an animal. (Tr. p. 41)

Matias started working since the early age of 10 (Tr. p. 52) and was about 15 years old at the time he was given his first paid job of cutting and harvesting sugar. He testifies that he didn't know any other occupation except for part-time work cleaning ditches. His life time employment has been as a sugar cane cutter. (Tr. p. 52-54)

The social security interviewer who contacted claimant on January 21, 1964 reported that he could hardly keep his hands still (Tr. p. 87). A second report of contact of August 28, 1964 informed that Matias did not appear to be in any serious distress and that apparently the cause for seeking benefits was financial need. The interviewer noticed "that he shakes a bit but only when pressed for details apparently because he had trouble remembering exact information." (Tr. p. 101) The last contact made was on July 17, 1965 where it was observed that "during interview his hands trembled almost constantly even though they rested on top of the desk most of the time. No other signs of impairment were seen or discussed during interview". (Tr. p. 125)

The earliest medical evidence is a report from Dr. José Montalvo, a pediatrician whose subspecialty is internal medicine, who reported on November 13, 1963 that Matias had a very marked tremor of both hands, blood pressure of 200/100, an enlarged heart and a callus old ankle fracture. His diagnosis was: "Hypertensive cardiovascular heart disease. (2) Tremor of unknown etiology. (3) Callus old fracture left ankle. Restrictions on patient's activity: Patient is unable to do the usual work of a laborer in farm work he has done all his life." (Tr. p. 88)

On request of Vocational Rehabilitation Matias was examined on February 17, 1964 and on August 19, 1965 by Dr. Juan Acevedo, a cardiologist, whose diagnoses were "general good health." (Tr. pp. 93, 144) Blood pressure readings were of 150/96 and 150/90 on both occasions. The 1964 report describes claimant as "jittery". (Tr. p. 91) Radiographic examination revealed the heart was within normal limits (Tr. p. 96) and an electrocardiogram revealed a normal tracing in 1964 and sinus biodicardia in 1965.

Claimant submitted two other reports from Dr. Montalvo, dated December 16, 1964, and August 30, 1966 (Tr. pp. 115, 137) in which he reported that claimant had been under his care since January 8, 1963. The impressions recorded are as follows: 1964 Report: (1) "Hypertensive Cardiovascular Heart Disease: B.P. 190/100; (2) Paralysis Agitans affecting both hands. 1966 Report: (1) Arterial hypertension with present episodes of angina pectoris; (2) Epigastric disease; (3) Coronary sclerosis.

Five additional medical reports reveal the same diagnosis: arterial hypertension. (See Tr. pp. 100, 104, 139, 148, 166) Dr. González, medical director of the Afiasco Health Center, confirmed the final diagnosis reported by the cardiologist of their out patient department. Said diagnosis was hypertensive cardiovascular disease, diabetes mellitus and Parkinson's Syndrome. (Tr. pp. 148-151) The consultative medical report of Dr. Charles A. Payne, neurologist, dated January 11, 1967, in its pertinent part reads as follows: (Tr. pp. 165-166)

"Neurological Examination: Blood pressure 180/100; pulse 76. The patient was moderately alert and partially cooperative but denied orientation and general information was nil. He was edentulous and his facies was masked. Cranial nerve examination revealed Grade II (K.W) fundi and early arcus senilis. Motor examination revealed gross rhythmic 6-9/sec. tremor of the right upper extremity, maximal in the hand at rest. Cog-wheel rigidity was palpable in the right arm and the patient could not accommodate to tapping of the bridge of the nose. He claimed diminished appreciation of pin prick in the right face, arm and leg. Generalized muscle weakness was claimed but full effort was not exerted. The deep tendon reflexes were hypoactive but symmetrical throughout and both plantors were flexor. Coordination was not impaired although a tremor was present at rest in the right upper extremety. The gait was slow and hesitant but not propulsive or circumductive.

"Impression: 1.

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