Taylor v. Heckler, 84-1254
| Decision Date | 24 September 1984 |
| Docket Number | No. 84-1254,84-1254 |
| Citation | 742 F.2d 253 |
| Parties | , Unempl.Ins.Rep. CCH 15,552 Clarence TAYLOR, SS # 465-58-9132, Plaintiff-Appellant, v. Margaret M. HECKLER, Secretary of Health and Human Services, Defendant-Appellee. Summary Calendar. |
| Court | U.S. Court of Appeals — Fifth Circuit |
Law Offices of O'Shea, Hall & Hart, Kevin C. Hart, Bruce E. MacGregor, Lubbock, Tex., for plaintiff-appellant.
James A. Rolfe, U.S. Atty., Paulina M. Jacobo, Asst. U.S. Atty., Lubbock, Tex., for defendant-appellee.
Appeal from the United States District Court for the Northern District of Texas.
Before RUBIN, RANDALL, and TATE, Circuit Judges.
The claimant Taylor appeals from a judgment of the district court that affirmed the Secretary's termination of his disability benefits under the Social Security Act. 42 U.S.C. Sec. 405(g). He contends that the district court erred in dismissing his complaint and in thus affirming the administrative law judge's finding that Taylor had failed to prove a continuing impairment of disabling severity, so that thus his disability ceased in December 1981.
On appeal, Taylor argues, inter alia, that the ALJ's finding is not supported by substantial evidence, in part because the ALJ failed to afford the claimant, previously determined by the Secretary to be disabled, a presumption that the given disability continued, in the absence of proof to the contrary that the condition has changed or was not as serious as originally found. Rivas v. Weinberger, 475 F.2d 255, 258 (5th Cir.1973), as recently reiterated and explained in Buckley v. Heckler, 739 F.2d 1047 (5th Cir.1984). Finding this contention well taken, we reverse.
Taylor, now 46 years of age, a manual laborer, was originally awarded disability benefits beginning in June, 1973. The disability determination was based upon a herniated-disc back injury, which involved surgery in 1973 and a recommendation for further surgery in 1979. Disability payments were continued without event until January, 1982, when the Secretary on periodic review administratively determined that Taylor was no longer functionally limited by his impairments and was able to engage in substantial gainful employment. The claimant, unrepresented by counsel, obtained a hearing before the ALJ, at which he and his wife testified and at which 19 exhibits were introduced.
The hearing, as well as all the medical reports introduced, indicated that the claimant Taylor has consistently complained of severe back and leg pains that prevent him from doing household chores, let alone working. The hearing lasted 22 minutes (14 pages), of which approximately one-third (4 pages), was involved in questioning about admission of the 19 exhibits into the evidence. 1
In the present instance, the claimant previously had been determined in 1973 by the Secretary to be disabled and unable to perform substantial gainful employment by reason of the herniated-disc back injury and the residual of the surgery. However, in 1982, the ALJ found that the claimant's impairment had improved and his disability had ceased, so that he had the functional capacity to engage in substantial gainful activity following December 1981.
In doing so, as will be detailed more fully in III and IV, infra, the ALJ rejected the testimony of the claimant Taylor and the medical reports of two orthopedists who had treated Taylor over an extended period of time. The ALJ, instead, apparently relied upon the report of a single examination of the claimant by an internist (who had examined Taylor at the request of the Secretary), who, in effect, found no objective symptoms of present disability on the occasion of his examination (except for the absence of the left Achilles jerk, and tenderness at the healed operation scar of the surgery at the lumbar spine), who expressed no opinion as to Taylor's complaints of pain or his ability to perform gainful employment, and who concluded: "Prognosis: Good."
In Buckley v. Heckler, 739 F.2d 1047 (5th Cir.1984), this court has recently clarified and enunciated the principles applicable to a termination of disability benefits that had been previously awarded on the basis of a medically determinable physical or mental impairment, which had previously been determined to disable the claimant from engaging in substantial gainful activity. There, we summarized, with citation of authority, the applicable principles as to the burden of proof and the burden of producing evidence as follows 739 F.2d at 1048-49:
(1) The ultimate burden of proving continuing disability remains with the claimant.
(2) However, the prior determination of disability is not without effect:
(a) It has a res judicata effect as to the record on which the determination was made, so that the Secretary may not find a cessation of previously found disability by a reappraisal of earlier evidence or without producing new evidence;
(b) The prior determination creates a presumption of continuing disability that requires the Secretary to provide evidence of a change in the claimant's disabling condition, either that it has improved, or that it was not as serious as originally determined; and
(c) The facts upon which the prior determination was made must be weighed by the trier of fact along with the Secretary's new evidence and any additional evidence submitted by the claimant of continuing disability.
(3) On judicial review, after a new determination of eligibility is made on these principles, the entire record is reviewed to determine whether the Secretary's decision of cessation of disability is supported by substantial evidence. Id.
Under these principles, the ALJ erred in concluding that Taylor's previously found disability had ceased. For reasons to be elaborated, the evidence before him showed no essential change in the disabling back condition initially determined as the basis for the award for disability benefits.
The evidence before the ALJ consisted of the testimony of the claimant and his wife and 19 exhibits. The exhibits included an initial disability determination of March 19, 1974 (based on a diagnosis of "herniation of nucleus pulposus due to Trauma, L-5, S-1"), the prior administrative papers of 1981 and 1982 leading to the Secretary's determination of cessation of disability of February 2, 1982, and the claimant's response thereto, and the reports of four doctors.
The claimant Taylor and his wife testified to his severe back and leg pains upon exertion, that prevented him from doing even household chores. (Although Taylor testified that he drove his pickup truck to and from a particular place when he needed to, he testified that his back hurt when he did so, and he would return immediately home to bed.) This testimony is consistent with that of the reports of three doctors in the record (and, actually, not inconsistent with that of the fourth, as will be seen).
The report of an examination on January 11, 1982 by Dr. Santos, an orthopedic surgeon who had treated Taylor over the years found low grade muscle spasm, considerable pain and discomfort on extension, x-ray evidence of disc generative disease, and other symptoms of residual back injury. He concluded: The doctor also stated that he had recommended further surgery in 1979, but that Taylor was unwilling, and that the doctor felt that conservative treatment was the choice--and that at that time, he "did not feel that this man, because of the degenerative arthritis of his low back, was going to be able to do anything that required any excessive use of his back in the...
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