Taylor v. Heckler

Decision Date09 July 1985
Docket NumberNo. 84-1646,84-1646
Citation765 F.2d 872
Parties, Unempl.Ins.Rep. CCH 16,218 Mildred R. TAYLOR, Plaintiff-Appellant, v. Margaret M. HECKLER, Secretary of Health and Human Services, Defendant- Appellee.
CourtU.S. Court of Appeals — Ninth Circuit

A. Keith Lesar, Aptos, Cal., for plaintiff-appellant.

Gary L. Floerchinger, San Francisco, Cal., for defendant-appellee.

Appeal from the United States District Court for the Northern District of California.

Before KENNEDY, ALARCON, and NELSON, Circuit Judges.

ALARCON, Circuit Judge:

Mildred R. Taylor (hereinafter Taylor) appeals from the district court's grant of summary judgment affirming the denial of her application for disability benefits by the Secretary of Health and Human Services (hereinafter the Secretary), 576 F.Supp. 1172. Taylor contends that the Secretary had no grounds for reversing the Administrative Law Judge's (hereinafter ALJ) determination that she was indeed disabled as of May 1974, since that decision was supported by substantial evidence. She argues that the court should have reviewed the ALJ's decision to determine whether it was supported by substantial evidence, rather than reviewing only the Secretary's decision. Taylor also argues that her pain constitutes a recognized form of disability. Finally, she contends that the district court erred in concluding that it lacked jurisdiction to review the Secretary's decision to not reopen Taylor's 1976 application for disability benefits.

We address each of Taylor's contentions and the facts pertinent thereto under separate headings.

1. Secretary's Review of ALJ

Taylor asserts that the Secretary could not reverse the ALJ's determination that Taylor was disabled if the ALJ's finding was supported by substantial evidence.

42 U.S.C. Sec. 405(b) specifically provides that the Secretary is authorized on her own motion to hold such hearings and conduct such investigations as she may deem necessary or proper for the administration of benefits. Further, under the administrative regulations which were promulgated to give effect to the scope and intent of the Social Security Act, the Secretary is authorized to review any decision of an ALJ on her own motion. 20 C.F.R. Sec. 404.969. The regulations also provide for mandatory review where the ALJ's decision is not supported by substantial evidence. 20 C.F.R. Sec. 404.970(a)(3). In so doing, the Secretary may "consider the evidence in the [whole] record and any additional evidence it believes is material to an issue being considered." 20 C.F.R. Sec. 404.976(b). The Secretary thus had unlimited authority to review the merits of the ALJ's determination of disability under the Social Security Act and the applicable regulations. She was not required to adopt the particular findings of the ALJ even if those findings were supported by substantial evidence.

2. District Court's Scope of Review

Taylor contends that the district court erred by limiting its scope of review to determining whether the Secretary's conclusion that Taylor was not disabled was supported by substantial evidence. She argues that the district court should only have reviewed whether the ALJ's decision was supported by substantial evidence since the Secretary derived her authority to review the ALJ from 20 C.F.R. Sec. 404.970(a)(3).

The Secretary is empowered to affirm, modify or reverse the ALJ's decision. Such decision then becomes final and is binding upon the parties unless review is sought in district court. 20 C.F.R. Sec. 404.981.

"The court will set aside a denial of benefits only if the Secretary's findings are based upon legal error or are not supported by substantial evidence in the record as a whole." Kail v. Heckler, 722 F.2d 1496, 1497 (9th Cir.1984) (emphasis added). Judicial review is limited to "final decisions" of the Secretary. 42 U.S.C. Sec. 405(g). The district court properly reviewed only the Secretary's final decision.

3. Substantial Evidence

Taylor's application for benefits in 1976 was denied due to her failure to prove that she was disabled as of December 1976. Since Taylor failed to seek review of that initial determination, the decision became final and binding on all parties to the action. 20 C.F.R. Sec. 404.905. Taylor thus continued to carry the burden of proving disability in her 1981 application because the 1976 findings of non-disability created a presumption of continuing non-disability. Lyle v. Secretary, 700 F.2d 566, 568 (9th Cir.1983). The claimant can overcome this presumption by proving "changed circumstances" indicating a greater disability. Booz v. Secretary, 734 F.2d 1378, 1379-80 (9th Cir.1984). Here, it appears that Taylor's condition had improved rather than deteriorated. The record indicates that between 1976 and 1978 Taylor experienced improvement in the nature of her limitations and pain allegedly suffered. She has therefore failed to show the requisite "changed circumstances."

Even if the presumption were not applied, however, the Secretary's decision must be affirmed. As we have noted, the Secretary's findings are conclusive if supported by substantial evidence. Substantial evidence means "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Richardson v. Perales, 402 U.S. 389, 401, 91 S.Ct. 1420, 1427, 28 L.Ed.2d 842 (1971) (quoting Consolidated Edison Corp. v. N.L.R.B., 305 U.S. 197, 229, 59 S.Ct. 206, 216, 83 L.Ed. 126 (1938) ); Sample v. Schweiker, 694 F.2d 639, 642 (9th Cir.1982). Because substantial evidence supports the Secretary's finding that Taylor was not under a "disability," as defined in the Social Security Act, at any time through the date of the decision, we cannot disturb it.

4. Pain As Disability

Taylor contends that the Secretary failed to give adequate consideration to the evidence of pain in determining that a disability had not been proved. She argues that a claimant's complaints of pain cannot be disregarded solely because there is no objective evidence that proves the truth of the complaints.

A claimant's subjective complaint of pain is by itself insufficient to establish disability. Sorenson v. Weinberger, 514 F.2d 1112, 1118 (9th Cir.1975). In order for pain to be disabling, subjective complaints must be accompanied by medical evidence. See Gonzales v. Harris, 631 F.2d 143, 146 (9th Cir.1980) (despite claimant's testimony on pain, she failed to prove disability, in view of evidence of her activity and lack of medical evidence on her alleged disability); Gallagher v. Schweiker, 697 F.2d 82, 85 (2d Cir.1983) (although alleging severe pain, claimant failed to produce medical evidence indentifying underlying impairment and was therefore denied benefits).

The Secretary made a detailed review of the evidence presented in support of Taylor's contention that her pain rendered her unable to engage in gainful activity. The Secretary found that the record failed to reveal evidence of severe impairment and concluded that it did not find statements made by the claimant and her witnesses that Taylor suffered from severe unremitting pain to be credible due to the lack of medical evidence to explain the nature of her complaints. The record supports the Secretary's conclusion that Taylor's complaints of pain were unsupported by medical evidence. The Secretary can disregard a claimant's self-serving statements if they are unsupported by objective evidence. Maounis v. Heckler, 738 F.2d 1032, 1034 (9th Cir.1984), citing Coats v. Heckler, 733 F.2d 1338, 1340 (9th Cir.1984). In light of Taylor's failure to substantiate her claim by clear medical evidence, we must uphold the Secretary's decision.

5. Administrative res judicata

Taylor contends that the Secretary's 1976...

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