Robinson v. Sullivan, Civ. A. No. 87-8019.
| Citation | 733 F. Supp. 989 |
| Decision Date | 04 April 1990 |
| Docket Number | Civ. A. No. 87-8019. |
| Parties | Dorothy E. ROBINSON v. Louis W. SULLIVAN, M.D., Secretary of Health and Human Services. |
| Court | U.S. District Court — Eastern District of Pennsylvania |
Robert A. Wilson, Philadelphia, Pa., for plaintiff.
Richard Mentzinger, Jr., Asst. U.S. Atty., Philadelphia, Pa., for defendant.
Plaintiff brought this action pursuant to 42 U.S.C. § 405(g) seeking judicial review of a final decision of the Secretary of Health and Human Services denying her claim for Disabled Widow's Benefits under Title II of the Social Security Act, 42 U.S.C. § 423 et seq. (1982).2 On March 17th, 1989, I referred this action to United States Magistrate William F. Hall, Jr., pursuant to 28 U.S.C. § 636(b). The parties subsequently filed cross motions for summary judgment.
After review of the record and the parties' contentions,3 the Magistrate submitted a report and recommendation which recommended denial of the parties' cross-motions for summary judgment and remand to the Secretary for further development of the record. The Magistrate concluded that the Secretary must consider the claimant's "residual functional capacity" ("RFC")4 in determining whether she is entitled to benefits.
Pursuant to 28 U.S.C. § 636(b)(1), I conducted a de novo review of the Magistrate's findings, and approved and adopted the Report on February 14, 1990. The Secretary has filed a motion to alter or amend judgment, arguing that I should consider the effect of the Supreme Court's recent decision in Sullivan v. Zebley, ___ U.S. ___, 110 S.Ct. 885, 107 L.Ed.2d 967 (1990), on whether the Secretary must consider a claimant's RFC in widows' disability cases.
For the reasons that follow, I conclude that the Secretary's widow disability regulations cannot be reconciled with the statute they purport to implement.5 I hold that the Secretary must consider RFC in widows' cases. Since he did not do so in this case, I will decline to vacate or amend my February 14, 1990 Order.
The Social Security Act provides social security insurance benefits to, among others, disabled wage earners and disabled widows, widowers, or surviving divorced spouses of deceased wage earners.6 Different substantive standards distinguish the disability determination for widows from the disability determination for wage earners. In order to obtain benefits under the statute, a wage earner must demonstrate an inability to engage in substantial gainful activity. In contrast, a widow must demonstrate that she is incapable of any gainful activity. Compare 42 U.S.C. § 423(d)(2)(A) (1983 & Supp.1989) with 42 U.S.C. 423(d)(2)(B) (1983 & Supp.1989).7
Pursuant to 42 U.S.C. § 405(a), the Secretary has promulgated a five step sequential disability evaluation procedure applicable to wage earners. 20 C.F.R. § 404.1520 et seq. (1989). See Bowen v. Yuckert, 482 U.S. 137, 140-142, 107 S.Ct. 2287, 2290-2291, 96 L.Ed.2d 119 (1987). The first two steps involve threshold determinations that the claimant is not presently working and has an impairment which is of the required duration and which significantly limits his ability to work. 20 C.F.R. §§ 404.1520(a), (b), (c). In the third step, the medical evidence of the claimant's impairment is compared to a list of impairments. See 20 C.F.R. Part 404, Subpart P, Appendix 1. If a claimant's impairment meets or equals a listed impairment, he or she is conclusively presumed to be disabled and entitled to benefits. 20 C.F.R. § 404.1525(a).
If a wage earner claimant's impairment does not meet or equal a listed impairment, the analysis proceeds to the fourth and fifth steps. The fourth step is an assessment of the claimant's RFC and a decision whether it permits him to engage in his prior work. 20 C.F.R. § 404.1520(e). If the claimant's RFC is consistent with prior employment, benefits are denied. 20 C.F.R. § 416.920(e). If the claimant's RFC is not consistent with his prior employment, the fifth and final step is a decision as to whether the claimant, in light of his RFC, age, education and work experience, has the capacity to perform "alternative occupations available in the national economy." 20 C.F.R. § 404.1520(f). If not, benefits are awarded. 20 C.F.R. § 416.920(f).
The Secretary's test for determining whether a widow claimant is disabled is an abbreviated version of the wage earner test. A widow qualifies for benefits only if she qualifies through Step 3 of the evaluation procedure. 20 C.F.R. §§ 404.1576-404.1578. In order to obtain benefits under the regulations, a widow must establish that she has a physical or mental impairment which has the "specific clinical findings that are the same as those for any impairment in the Listing of Impairments or are medically equivalent to those for any impairment shown there." 20 C.F.R. § 404.1578(a).8 If a widow cannot qualify under the Listing, benefits are denied. There is no inquiry corresponding to the fourth and fifth steps of the procedure applicable to wage earners and therefore no assessment of the claimant's RFC.
The Listing of Impairment is a description of various physical and mental illnesses and abnormalities, most of which are categorized by the body system they affect.9 Each impairment is defined in terms of several specific medical signs, symptoms, or laboratory test results. For a claimant to show that his impairment matches a listing, the impairment must meet all of the specified medical criteria. An impairment that manifests only some of those criteria, no matter how severely, does not qualify. See Social Security Ruling (SSR) 83-19,10 West's Social Security Reporting Service (Rulings Supp. Pamph. 1988) 90, 91-92 ( ) (emphasis in original).
SSR 83-19 further holds that a claimant cannot qualify for benefits under the "equivalence" step by showing that the overall functional impact of his unlisted impairments, or combination of impairments is as severe as that of a listed impairment. SSR 83-19, at 92-93 ( ) (emphases in original).
In sum, under the regulations and SSR 83-19, the Secretary does not afford widows' disability claimants with an RFC analysis comparable to Step 4 of the wage earner's procedure or an opportunity to demonstrate that the overall impact of her impairment(s) is as severe as that of a listed impairment. The issue in this case is whether the Secretary's failure to provide an individualized assessment of a widow's RFC is consistent with the language of 42 U.S.C. § 423(d)(2)(B).
This case involves a facial challenge to the Secretary's Social Security regulations.11 In assessing such a challenge, a reviewing court must defer to an agency's interpretation of a statute which the agency administers so long as the interpretation is reasonable. Zebley v. Bowen, 855 F.2d 67, 72 (3d Cir.1988) aff'd, ___ U.S. ___, 110 S.Ct. 885, 107 L.Ed.2d 967 (1990). The Act provides that the "Secretary shall have full power and authority to make rules and regulations and to establish procedures, not inconsistent with the provisions of this subchapter, which are necessary or appropriate to carry out such provisions." 42 U.S.C. § 405(a). Because Congress did not describe explicitly a method for determining whether a claimant is disabled, my review is limited to determining if the regulations in question, 20 C.F.R. §§ 404.1577 and 404.1578, exceed the Secretary's authority or are arbitrary or capricious. Yuckert, supra; Heckler v. Campbell, 461 U.S. 458, 466, 103 S.Ct. 1952, 1956, 76 L.Ed.2d 66 (1983); Zebley, 855 F.2d at 72.12 The judiciary is the final authority on issues of statutory construction and must reject administrative constructions which are contrary to clear legislative intent. Id. The agency's regulations must give effect to the unambiguously expressed intent of Congress. Id.
The claimant argues that the Secretary's regulations governing widows' disability are inconsistent with the language of § 423(d)(2)(B). She contends that, taken separately, her impairments do not meet or equal any listed impairment, but in combination they prevent her from engaging in any gainful activity. She asserts that she has met the statutory standard, but has been denied benefits because she does not qualify under the regulations. She therefore contends that the regulations are inconsistent with § 423(d)(2)(B).13
After review of claimant's arguments, the Magistrate held that the Secretary must review a claimant's functional limitations in widows' disability cases. Report, at 8-9. In arriving at this conclusion, the Magistrate relied in part on the Court of Appeals for the Third Circuit's decision in Zebley v. Bowen, supra. At the time the Magistrate issued the Report, the Supreme Court had granted certiorari in Zebley. See ___ U.S. ___, 109 S.Ct. 2062, 104 L.Ed.2d 627 (1989). On February 20, 1990, the Supreme Court affirmed the Zebley decision. Sullivan v. Zebley, supra.
In his motion to vacate or amend judgment, the Secretary contends that the Supreme Court's decision in Zebley supports the position that RFC is not a proper consideration in widows' disability cases. In Zebley, the Court considered the Secretary's regulations concerning child disability benefits.14 The Court concluded that under the...
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Pizarro ex rel. A.P. v. Colvin
..."only when it manifests the specific findings described in the set of medical criteria for that listed impairment." Robinson v. Sullivan, 733 F.Supp. 989, 992 (E.D.Pa.1990) (internal citations omitted). A medical equivalence can be found where a claimant has: (1) a listed impairment with me......