Stawls v. Califano

• Decision Date: 03 May 1979
• Docket Number: No. 77-2108,77-2108
• Citation: 596 F.2d 1209
• Parties: Marjorie L. STAWLS, Appellant, v. Joseph A. CALIFANO, Jr., Secretary of Health, Education, and Welfare, Appellee.
• Court: U.S. Court of Appeals — Fourth Circuit

Page 1209

596 F.2d 1209

Marjorie L. STAWLS, Appellant, v. Joseph A. CALIFANO, Jr., Secretary of Health, Education, and Welfare, Appellee.

No. 77-2108.

United States Court of Appeals Fourth Circuit.

Argued July 17, 1978.

Decided May 3, 1979.

Ralph Rabinowitz, Norfolk, Va. (O. L. Gilbert, Rabinowitz, Rafal & Swartz, Norfolk, Va., on brief), for appellant.

Thomas A. Dougherty, Jr., Asst. Regional Atty., Dept. of H. E. W., Washington, D. C. (Stephanie W. Naidoff, Regional Atty., Dept. of H. E. W, Washington, D. C., William B. Cummings, U. S. Atty., Alexandria, Va., Michael A. Rhine, Asst. U. S. Atty., Norfolk, Va., on brief), for appellee.

Before BUTZNER, RUSSELL, and WIDENER, Circuit Judges.

WIDENER, Circuit Judge:

Marjorie L. Stawls appeals from the district court's affirmance of the Secretary of Health, Education and Welfare's denial of disability benefits under the Social Security Act. She claims to be disabled within the meaning of 42 U.S.C. § 423(d) due to schizophrenia. The Secretary does not contend that Mrs. Stawls is not presently suffering from a mental disorder; in fact, that is conceded. Rather, the Secretary maintains that plaintiff failed to establish that, beginning on or before the date she was last insured, ¹ she suffered a disability of sufficient severity to preclude her from engaging in substantial gainful activity.

Mrs. Stawls is fifty-two years of age, and a high school graduate. Upon graduating from high school, she went to work for Virginia Electric and Power Company (VEPCO). She worked for VEPCO for thirteen years as an office clerk, and resigned from VEPCO in 1957 because of anxiety, tension, nerves, inability to sleep and to cope with any stress, and upon the recommendation of her doctor. Since that time, she has done some volunteer work and as much housework as she can. She claims that she has been unable to work since June 1956 because of poor mental health and inability to cope with stress. ²

The evidence adduced at the hearing showed the following. Appellant has been under psychiatric care from 1954 through the present. From 1954 to 1967, she was under the care of Dr. Robert Thrasher, and from 1967 to the present she has been under the care of Dr. William Gibbs. Both Doctors Thrasher and Gibbs are practicing psychiatrists. In 1957, an X-ray of appellant's upper gastrointestinal tract was taken and the X-ray was normal. An intravenous cholangiogram was also performed and was considered normal. From November 23, 1963 to December 25, 1963, she was hospitalized at Norfolk General Hospital for what was diagnosed as reactive depression. During this period of hospitalization, she received her first shock therapy. ³ She was again hospitalized from April 28, 1967 to May 5, 1967 for what was finally diagnosed as psychoneurosis and anxiety. ⁴ Between June 21, 1967 and July 27, 1974, Mrs. Stawls was hospitalized on eight separate occasions with diagnoses ranging from psychoneurosis and anxiety to acute schizophrenic state to chronic schizophrenia. An aide to her Congressman (apparently a case worker), and acquaintance of Doctors Thrasher and Gibbs as well as Mrs. Stawls, testified at the hearing. She testified that while appellant was working for VEPCO she had already begun exhibiting emotional problems. She also testified that Dr. Gibbs stated that since 1967, the date from which he has known Mrs. Stawls, he thought she was physically or mentally unable to cope with a job. On February 24, 1976, Dr. Thrasher called the State agency at Norfolk. He stated that he was unable to locate his records on appellant, but, from what he could recall, she was depressed, had a lot of anxiety and a very marked personality. Dr. Thrasher further stated that appellant had to resign from her job with VEPCO "because she could not handle it." In a letter dated April 2, 1976, Dr. Gibbs stated that he hospitalized appellant on nine occasions, with diagnoses ranging from acute anxiety state to acute schizophrenic state to chronic schizophrenic reaction. He stated that during the time of her remissions, between hospitalizations, she remained on tranquilizers or sedatives, or both. Dr. Gibbs also said that during the remissions from the acute phases of her illness appellant did not exhibit serious difficulties. Dr. Gibbs concluded, "It is my opinion that she is unable to work, because of the frequency of her exacerbations of her disorder. In my opinion she has been unable to work steadily at any sort of employment since I have known her. It is my conjectured opinion that she was unable to work for many years before I made her acquaintance."

Based upon the above evidence, the administrative law judge determined that, "The evidence fails to prove that the (appellant) was under a 'disability' within the meaning of the Social Security Act, as amended, that had its onset while she still had insured status and which continued to a time within the retroactive filing date of this application." The administrative law judge stated:

"It is conceded . . . that the evidence available in this case does in fact show that this unfortunate lady has indeed had troublesome emotional problems at least since November of 1963, when she was first hospitalized for same. According to the available records, it was not again necessary for her to be hospitalized for emotional problems until 1967, some three to four years later. However, the available medical evidence does not in fact prove that the claimant had a continuous, incapacitating mental illness dating from sometime before September of 1962 up to a year before she filed her current application, which is what the evidence must show before she could be found to be entitled on this application. To the contrary, her present treating psychiatrist has unequivocally stated that during the periods of remissions from her acute phases of her illness, claimant did not exhibit serious difficulties. Her own testimony as to her activities in public and civic affairs rather conclusively proves that she does not have the types of limitations set forth in the Social Security Regulations dealing with disability as constituting an incapacitating mental illness, that is that quite obviously, she has not had prolonged, marked restriction of her daily activities, constriction of interest and seriously impaired ability to relate to other people."

The administrative law judge concluded by stating that the denial of disability benefits "is . . . based on the lack or deficiency of medical evidence . . . which would actually prove that the claimant has been in fact completely incapacitated or unable to engage in any type of work activity from September of 1962 up until the present time."

Appellant requested and received a review of the administrative law judge's decision by the Appeals Council. Pursuant to her request, in addition to the evidence considered by the administrative law judge, the Council considered two pieces of evidence that were not before the administrative law judge at the time he rendered his decision. The Council considered a letter from Dr. Gibbs dated October 14, 1976. In this letter Dr. Gibbs clarified the statement he made in his letter of April 2, 1976 that Mrs. Stawls does not exhibit serious difficulties during remissions from the acute phases of her illness. Dr. Gibbs stated:

"The nature of her ongoing illness permits her to remain without being hospitalized and without causing a serious problem in her environment for considerable periods of time when she is 'in remission'. It must be evident to anyone, who will accept the diagnosis of Chronic Schizophrenia as a legitimate diagnosis, to recognize that these individuals can not cope with any additional stress and strain in their everyday lives without being subject to an acute phase in this illness.

"In my opinion Mrs. Stawls is not able to work when she is 'in remission,' because seeking a job or actively accepting continuous type of employment would constitute such a stress on her adaptation that it would precipitate her illness."

Additionally, the Council considered a letter from Dr. Thrasher dated October 22, 1976. This letter was written in response to appellant's request for information regarding her employability prior to 1962. Although Dr. Thrasher was...