Paul v. Shalala

Decision Date18 August 1994
Docket NumberNo. 93-3621,93-3621
Citation29 F.3d 208
Parties, Unempl.Ins.Rep. (CCH) P 14074B Ethel PAUL, Plaintiff-Appellant, v. Donna E. SHALALA, Secretary of Health and Human Services, Defendant-Appellee. Summary Calendar.
CourtU.S. Court of Appeals — Fifth Circuit

Paul Brian Spurlock, New Orleans, for appellant.

Joanna Tate, U.S. Dept. of Health & Human Services, Dallas, TX, Glenn K. Schreiber, Asst. U.S. Atty., Robert J. Boitmann, U.S. Atty., New Orleans, LA, for appellee.

Appeal from the United States District Court for the Eastern District of Louisiana.

Before GARWOOD, SMITH and DeMOSS, Circuit Judges.

JERRY E. SMITH, Circuit Judge:

Ethel Paul was denied disability and Supplemental Security Income ("SSI") benefits by the Secretary, Department of Health and Human Services. Concluding that the district court correctly awarded summary judgment in favor of the Secretary, we affirm.

I.

Paul applied for disability and SSI benefits on January 6, 1990, alleging disability because of back injury, diabetes, and hypertension. The Secretary denied her application initially and then again upon reconsideration.

At Paul's request, the claim was heard before an administrative law judge ("ALJ") on December 21, 1990. Paul's personal physician, Michael Hunter, attested to Paul's physical disabilities. In response, the Secretary presented a vocational expert, who opined that Paul had sufficient residual functional capacity to perform certain work, and Donald Faust, an orthopedic surgeon, who examined Paul and testified that her disabilities were less pronounced than had been alleged. The ALJ concluded that Paul's disabilities were insufficient to meet the SSA requirements and thus denied her relief.

The Appeals Council rejected Paul's request for review. Pursuant to 42 U.S.C. Sec. 405(g), Paul appealed to the district court, which adopted the magistrate judge's recommendation and dismissed Paul's complaint.

II.

Paul raises two issues on appeal. First, she contends that the ALJ failed to comply with 20 C.F.R. Sec. 404.1512(e)(1), which she reads to require that a claimant's treating physician be given an opportunity to supplement his initial report with more detailed information, should the ALJ find the information to be inadequate. Paul alleges, and the Secretary acknowledges, that despite the ALJ's finding that Hunter's medical conclusions were unsubstantiated by supporting clinical data, Hunter was never solicited by the ALJ to present additional information. Rather, the ALJ merely substituted Faust's medical opinions for Hunter's. Paul also asserts, as error, the ALJ's decision to give more weight to Faust's testimony, alleging that the opinion of Hunter, as treating physician, should be accorded more deference.

III.

Our review of the Secretary's final decision is limited to two inquiries: (1) whether substantial evidence of record supports the Secretary's decision; and (2) whether the decision comports with relevant legal standards. Muse v. Sullivan, 925 F.2d 785, 789 (5th Cir.1991) (per curiam); Villa v. Sullivan, 895 F.2d 1019, 1021 (5th Cir.1990). "Substantial evidence is more than a scintilla and less than a preponderance. It is such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Muse, 925 F.2d at 789. If supported by substantial evidence, the decision of the Secretary is conclusive and must be affirmed. Richardson v. Perales, 402 U.S. 389, 390, 91 S.Ct. 1420, 1422, 28 L.Ed.2d 842 (1971).

IV.
A.

This court has jurisdiction to review the Secretary's final decision only where a claimant has exhausted her administrative remedies. Muse, 925 F.2d at 791; Dominick v. Bowen, 861 F.2d 1330, 1332 (5th Cir.1988). Paul's failure to raise her Sec. 404.1512(e)(1) claim in the Appeals Council, see 20 C.F.R. Sec. 404.900(b), deprives us of jurisdiction to review the claim. As such, we dismiss Paul's first issue on appeal for want of jurisdiction.

Paul's arguments to the contrary are inapposite. First, the new claim that the ALJ failed to comply with Sec. 404.1512(e)(1) is not an expansion of the general rationale proffered in support of the appeal. Prior to raising the treating physician supplementation argument in the district court, Paul centered her appeal to the Appeals Council on the allegedly disproportionate weight ascribed to the consulting physician's opinion and on the alleged misapplication of Social Security Ruling 88-13. These foci are distinct from Paul's additional contention that Hunter should have been contacted to supplement his original testimony.

The two "assignment[s] of errors" that Paul presented to the Appeals Council were "[w]hether the [ALJ] erred in discounting the findings and opinions of the treating physicians" and "[w]hether the [ALJ] erred in failing to properly apply Social Security Rule 88-13." The closest Paul comes to a Sec. 404.1512(e)(1) issue in her Appeals Council brief is the statement that "[f]or the [ALJ] to assume that Dr. Hunter did not have the totality of the records in his possession is an unsubstantiated assumption." This assertion falls well short of an argument that Sec. 404.1512(e)(1) (which Paul did not cite) requires that the doctor be recontacted.

Second, the caselaw supports our decision to dismiss for want of jurisdiction. We disagree with Paul that the situation in this case is markedly different from those in Dominick and Muse. The plaintiff in Dominick asserted, for the first time on appeal to the circuit court, an error in the determination of her insured status, id. at 1332, while the Muse plaintiff similarly failed to challenge the alleged bias of the ALJ in front of the Appeals Council. Id. at 791. Paul, similarly, did not raise the treating physician claim at the Appeals Council; the issue surfaced for the first time in the district court.

Furthermore, while equitable grounds may support this court's decision to consider issues not previously presented, In re Corrugated Container Antitrust Litig., 647 F.2d 460, 461 (5th Cir. Unit A May 1981) (per curiam) ("This rule, however, is not inflexible and it gives way when necessary to prevent a...

To continue reading

Request your trial
364 cases
  • Hector v. Barnhart
    • United States
    • U.S. District Court — Southern District of Texas
    • 1 mars 2004
    ...opinion of a specialist generally is accorded greater weight than that of a non-specialist. See Newton, 209 F.3d at 455; Paul v. Shalala, 29 F.3d 208, 211 (5th Cir.1994), overruled on other grounds by Sims v. Apfel, 530 U.S. 103, 108, 120 S.Ct. 2080, 147 L.Ed.2d 80 (2000). Medical opinions ......
  • Puente v. Astrue
    • United States
    • U.S. District Court — Southern District of Texas
    • 22 septembre 2008
    ...opinion of a specialist generally is accorded greater weight than that of a non-specialist. See Newton, 209 F.3d at 455; Paul v. Shalala, 29 F.3d 208, 211 (5th Cir.1994), overruled on other grounds by Sims v. Apfel, 530 U.S. 103, 108, 120 S.Ct. 2080, 147 L.Ed.2d 80 (2000). Medical opinions ......
  • Hawthorne v. Astrue
    • United States
    • U.S. District Court — Southern District of Texas
    • 19 mars 2007
    ...opinion of a specialist generally is accorded greater weight than that of a non-specialist. See Newton, 209 F.3d at 455; Paul v. Shalala, 29 F.3d 208, 211 (5th Cir.1994), overruled on other grounds by Sims v. Apfel, 530 U.S. 103, 108, 120 S.Ct. 2080, 147 L.Ed.2d 80 (2000). Medical opinions ......
  • Mulet-Rivera v. Barnhart
    • United States
    • U.S. District Court — Southern District of Texas
    • 22 juin 2006
    ...opinion of a specialist generally is accorded greater weight than that of a non-specialist. See Newton, 209 F.3d at 455; Paul v. Shalala, 29 F.3d 208, 211 (5th Cir.1994), overruled on other grounds by Sims v. Apfel, 530 U.S. 103, 108, 120 S.Ct. 2080, 147 L.Ed.2d 80 (2000). Medical opinions ......
  • Request a trial to view additional results
9 books & journal articles
  • Issue Topics
    • United States
    • James Publishing Practical Law Books Social Security Disability Collection - James' Best Materials. Volume 2
    • 5 mai 2015
    ...to bar claimants from raising issues in federal court that were not raised administratively. Id. at 2083, comparing Paul v. Shalala , 29 F.3d 208, 210 (5th Cir. 1994), and James v. Chater , 96 F.3d 1341, 1343-1344 (10th Cir. 1996), with Harwood v. Apfel , 186 F.3d 1039, 1042-1043 (8th Cir. ......
  • Assessment of disability issues
    • United States
    • James Publishing Practical Law Books Archive Social Security Issues Annotated. Vol. I - 2014 Contents
    • 2 août 2014
    ...by the evidence.” Id. at 456, citing Brown v. Apfel , 192 F.3d 492, 500 (5 th Cir. 1999); Greenspan , 38 F.3d at 237; Paul v. Shalala , 29 F.3d 208, 211 (5 th Cir. 1994). In Newton , the Fifth Circuit held that the ALJ erred in discrediting the claimant’s treating specialist’s opinion where......
  • Issue topics
    • United States
    • James Publishing Practical Law Books Bohr's Social Security Issues Annotated - Volume II
    • 4 mai 2015
    ...to bar claimants from raising issues in federal court that were not raised administratively. Id. at 2083, comparing Paul v. Shalala , 29 F.3d 208, 210 (5th Cir. 1994), and James v. Chater , 96 F.3d 1341, 1343-1344 (10th Cir. 1996), with Harwood v. Apfel , 186 F.3d 1039, 1042-1043 (8th Cir. ......
  • Table of Cases
    • United States
    • James Publishing Practical Law Books Bohr's Social Security Issues Annotated - Volume II
    • 4 mai 2015
    ...§§ 106.3, 106.7, 204.7, 607.1 Patterson v. Chater , 983 F. Supp. 1410, 1414 (M.D. Fla. 1997), §§ 202.2, 203.4, 205.16 Paul v. Shalala , 29 F.3d 208 (5th Cir. 1994), 5th-01, 5th-00, 5th-99, §§ 202.8, 203.8, 601.1, 702.5, 1601.2 Paxton v. Shalala , 52 F.3d 321 (Table), No. 94-2461 (4th Cir. M......
  • Request a trial to view additional results

VLEX uses login cookies to provide you with a better browsing experience. If you click on 'Accept' or continue browsing this site we consider that you accept our cookie policy. ACCEPT