Roman v. Secretary of Health, Education and Welfare, Civ. No. 633-69.

• Decision Date: 15 November 1972
• Docket Number: Civ. No. 633-69.
• Citation: 355 F. Supp. 646
• Parties: Gumersinda ROMAN, Plaintiff, v. SECRETARY OF HEALTH, EDUCATION AND WELFARE, Defendant.
• Court: U.S. District Court — District of Puerto Rico

355 F. Supp. 646

Gumersinda ROMAN, Plaintiff, v. SECRETARY OF HEALTH, EDUCATION AND WELFARE, Defendant.

Civ. No. 633-69.

United States District Court, D. Puerto Rico.

November 15, 1972.

José A. Rivera Mercado, Hato Rey, P. R., for plaintiff.

Julio Morales-Sanchez, U. S. Atty., for defendant.

MEMORANDUM OPINION AND ORDER

TOLEDO, District Judge.

This civil action is brought by Gumersinda Román pursuant to Section 205(g) of the Social Security Act (hereinafter called the Act), Title 42, United States Code, Section 405(g), seeking judicial review of a final decision of the Secretary of Health, Education and Welfare (hereinafter named the Secretary), rendered on August 14, 1969, holding that she is not entitled to any period of disability under Section 216(i) of the Act, Title 42, United States Code, Section 416 (i) and disability insurance benefits under Section 223 of the Act, Title 42, United States Code, Section 423.

Plaintiff, born on January 7, 1918, alleged that she became unable to work on February 1963, because of headaches accompanied by dizziness and stiffening of the extremities.

The administrative record before the Court reflects that plaintiff filed with the Social Security Administration applications to establish a period of disability and for disability benefits on October 19, 1965¹ and April 10, 1968, claiming that she first became unable to work because of her impairment in February 1963. The Administration disallowed both of her applications, on the ground that her impairments were not of sufficient severity to prevent her from engaging in any substantial gainful activity. Notice of the last disallowance was given to the plaintiff by letter dated July 15, 1968. Plaintiff requested a reconsideration on August 28, 1968. The Administration reconsidered her last application and affirmed its disallowance. Notice of the disallowance was given to the plaintiff by letter of February 7, 1969. She disagreed with the Administration's reconsidered determination and requested a hearing. The hearing was held on June 4, 1969 and the hearing examiner entered its decision on July 23, 1969.

Plaintiff meets the insured status requirements through the quarter ending December 31, 1967. Therefore, on the basis of her application of April 10, 1968, plaintiff must establish that she was under a disability which commenced prior to December 31, 1967, when she last met the special insured status requirements.

The statutory scheme of judicial review being limited in nature, this Court is bound to ascertain only whether the record contains substantial evidence to support the Secretary's findings. Rosario v. Secretary of Health, Education & Welfare (D.C.P.R.1971), 324 F.Supp. 1321.

As a result of the claims made by the plaintiff, she has been examined by ophthalmologists, neurologists, radiologists and general practitioners, all of whom have performed various tests and analyses and have been unable to determine precisely the cause of plaintiff's sickness. The only physical impairments found were headaches (migraine) and visual limitations.

Plaintiff on its brief in reply to defendant's brief in support of answer to the complaint states that at no time was she examined by a psychiatrist to determine if she was suffering from a psychosomatic affliction or from some other emotional or psychiatric condition such as a conversion reaction.² A review of the transcript of the entire record of proceedings related to the application of the plaintiff before the Social Security Administration reflects that mention was made to plaintiff's mental condition. The hearing examiner on the date of the hearing before him, mentioned he was to be sent by plaintiff, after said hearing, a report on her from a Mental Health Clinic (Tr. 29). The mentioned report which is included in the transcript of record before the Social Security Administration, consists of a certification from Dr. José A. Román Toledo, a clinical physician at the Mental Health Center in Arecibo, Puerto Rico. Said certification signed on July 7, 1969, states that plaintiff is receiving treatment in the Center since September 30, 1968; that on the last mentioned date she showed nervousness, headaches, muscle contractures in left side of body, dizziness, insomnia and in some occasions — she states — blindness; and that the diagnostic impression was that plaintiff suffers from conversion reaction with anxiety (Tr. 99-100). The hearing examiner's decision of July 23, 1969, refers to the report of Dr. José A. Román Toledo and its contents (Tr. 10): and on its findings the hearing examiner's decision states the following:

"2. The claimant's principal impairment on December 31, 1967, was that of migraine headaches which responded to medication; since September 1968, she has been treated for conversion reaction with anxiety".

No further inquiry, at the administrative level, on plaintiff's mental condition is found in the transcript of proceedings before this Court.

Defendant submits that plaintiff failed to establish that she had physical or mental impairments, or a combination of impairments that would prevent her from engaging in substantial gainful activity, thus failing to prove that she is entitled to benefits. We cannot agree with said assertion.

Defendant also submits that the burden of proof is not on the Secretary to make an initial showing of nondisability to perform a job: Justice v. Gardner (6 Cir. 1966), 360 F.2d 998; de la Cruz v. Secretary of Health, Education & Welfare (D.C.P.R.1971), 331 F.Supp. 522, 524; de Jesus Faria v. Finch (D.C.P.R. 1971), 336 F.Supp. 1069; but that the burden is upon plaintiff to prove she is entitled to the benefits of the Act. Whitt v. Gardner (6 Cir. 1968), 389 F.2d 906; Torres v. Secretary of Health, Education & Welfare (D.C.P.R.1971), 333 F.Supp. 676.

We are of the opinion that the above stated rule, even though being very convenient for the expediency of process on the administrative level, should be applied with caution in cases like the one before us. We have before us an indigent plaintiff (the record reflects her sole income is $12.50 a month which she receives from Welfare), who lacks adequate schooling (plaintiff has third grade grammar school), who seems to suffer from a mental condition (diagnosed on September 30, 1968 as conversion reaction with anxiety) and who was not represented or assisted by counsel at the Administrative proceedings. In Leon v. Secretary of Health, Education & Welfare (D.C.P.R.1971), 337 F.Supp. 905, we dealt with a situation similar to the present one. In said...