Underwood v. Ribicoff

Decision Date04 January 1962
Docket NumberNo. 8458.,8458.
Citation298 F.2d 850
PartiesCarl G. UNDERWOOD, Claimant (Social Security Account Number XXX-XX-XXXX), Appellee, v. Abraham A. RIBICOFF, Secretary of Health, Education and Welfare, Appellant.
CourtU.S. Court of Appeals — Fourth Circuit

David L. Rose, Atty., Dept. of Justice, Washington, D. C. (William H. Orrick, Jr., Asst. Atty. Gen., Terrell L. Glenn, U. S. Atty., Columbia, S. C., and Alan S. Rosenthal and Jerome I. Levinson, Attys., Dept. of Justice, Washington, D. C., on the brief), for appellant.

Henry T. Chance, Augusta, Ga. (Harris, Chance, McCracken & Harrison, Augusta, Ga., Dorcey Lybrand, and Lybrand, Simons & Rich, Aiken, S. C., on the brief), for appellee.

Before SOBELOFF, Chief Judge, and BRYAN and BELL, Circuit Judges.

J. SPENCER BELL, Circuit Judge.

This is an appeal from the decision of the District Court for the Eastern District of South Carolina, holding that there was no substantial evidence in the Record to support a final determination by the Secretary of Health, Education and Welfare that the Claimant has failed to establish satisfactorily his inability to engage in "any substantial gainful activity" within the meaning of Sections 216(i) and 223 of the Social Security Act, 42 U.S.C.A. §§ 416(i), 423 and, therefore, that Claimant was not entitled to a period of disability or disability insurance under the Act. After overruling the Secretary's finding, the District Court substituted therefor its own finding that on the substantial evidence in the Administrative Record, Claimant was unable to engage in "any substantial gainful activity" and that he was, therefore, entitled to (1) have a period of disability under Section 216(i), and (2) receive disability insurance benefits under § 223 of the Act.

The narrow issue presented by this case is whether or not the District Judge erred in rejecting the finding of the Secretary that Claimant was not precluded by his physical condition from holding any substantial gainful employment. If we find the District Court not to be in error on this point, we must then determine whether the findings substituted therefor by the District Court are properly supported by the evidence. United States v. Certain Interests in Property et al., 296 F.2d 264, Civil No. 8280, C.A., 4 Cir., Nov. 6, 1961. If there is substantial evidence in the record to support the finding of the Secretary, the District Court cannot set it aside. 42 U. S.C.A. § 405(g). If there is only a slight preponderance of the evidence on one side or the other, the Secretary's finding must be affirmed. United States v. Certain Interests in Property et al., supra.

In this case, there are four elements of proof to be considered in making a finding of Claimant's ability or inability to engage in any substantial gainful activity. These are: (1) the objective medical facts, which are the clinical findings of treating or examining physicians divorced from their expert judgments or opinion as to the significance of these clinical findings, (2) the diagnoses, and expert medical opinions of the treating and examining physicians on subsidiary questions of fact, (3) the subjective evidence of pain and disability testified to by Claimant, and corroborated by his wife and his neighbors, (4) Claimant's educational background, work history, and present age.

For the purpose of making a finding of fact on this issue, the fact finder must recognize the obvious interrelation of these elements of proof. The objective medical findings may show more or less clearly the existence of certain clinically determinable physical or mental impairments. However, a recitation of objective, clinical findings will seldom show, without more, the over-all effect of these impairments on a particular individual. This is a matter of medical judgment to be decided with reference to the individual's general physical condition and the state of development of each of the defects. The expert medical opinion of treating or examining physicians on these subsidiary questions of fact will in most cases be essential in determining with respect to a particular individual the severity of an objectively determinable physical impairment. This subsidiary question of fact is distinguishable from the ultimate question of fact in issue in the case.

The ultimate fact in issue; that is, Claimant's ability or inability to engage in any substantial gainful activity, is not to be resolved, however, solely on the basis of medical opinion evidence as to this ultimate fact. Opinion evidence on this issue is without weight. United States v. Spaulding, 293 U.S. 498, at 506, 55 S.Ct. 273, 79 L.Ed. 617 (1934). This is a matter for administrative determination. Though Spaulding is distinguishable on the facts from the instant case, we deem it clear that the principle there laid down is equally applicable in actions for judicial review of an administrative finding made pursuant to 42 U.S.C.A. § 416(i) (1) (A).

However, expert medical diagnostic opinion and evidence, alone, may not enable a fact finder properly to determine whether or not such limitation of capacity amounts to disability within the terms of the Act. Where it is not possible to reach a determination on such evidence it then becomes necessary to consider subjective testimony to determine accurately the effect of these impairments upon the Claimant. Such evidence may be entitled to great weight on the matter of disability, especially where such evidence is uncontradicted in the record. Even where medical opinion is very strong in favor of disability, this subjective evidence will always be a significant source of corroboration.

Yet these first three elements will not conclusively determine whether Claimant is disabled within the meaning of the Act. Thus, even though severe physical limitation be established, it is still necessary in applying the legal standard to relate this limitation to the Claimant's work history and educational background. Butler v. Flemming, 288 F.2d 591 (5 Cir. 1961). Indeed, the Secretary's regulations, after setting forth examples of impairments which would ordinarily be considered as preventing substantial gainful activity, expressly provide: "Conditions which fall short of the levels of severity indicated must also be evaluated in terms of whether they do in fact prevent the individual from engaging in any substantial gainful activity." Subpart P, ¶ 404.1501 (d).

We pass now to a consideration of the facts of this particular case. This Record contains the reports of seven physicians who examined Claimant between December 21, 1953, and May 20, 1959. Each report contains a statement of the objective medical findings made by the examining physician.

Claimant was treated weekly by Dr. Thomas J. Howard during the period between February 25, 1958, and April 7, 1958. Prior to February 25, 1958, Claimant's medical record shows a history of hypertensive cardio-vascular disease, chronic bronchitis and emphysema, a myocardial injury, coronary heart disease, and of a disc condition in the lumbar region. Dr. Howard diagnosed severe emphysema. He noted acute respiratory attacks and dyspnea on slight exertion and that Claimant's vital respiratory capacity was 75% below normal. He also found many ronchi and rales in the chest. As to Claimant's heart, he found mild cardiac decompensation, a left cardiac enlargement, and he gave Claimant a cardiac functional capacity of Class III (marked limitation of physical activity). With respect to Claimant's back, Dr. Howard found osteoarthritis of the sacroiliac spine, and a possible disc condition. He also found general arteriosclerosis. He diagnosed a possible aortic aneurism, a most serious condition, if it does, indeed, exist.

Dr. Howard classified Claimant's condition as progressive rather than static and noted that only slight improvement is possible, if any is possible at all. He stated that he had advised Claimant not to work and noted, "not able to do any type of work".

The results of an examination of Claimant conducted at Government request by Doctors Reeves and Levy on May 5, 1959, far from negating Dr. Howard's findings, add additional weight to them. These later findings are by any reasonable comparison consistent with those of Dr. Howard. Reeves and Levy both reported pulmonary emphysema, confirming Howard's diagnosis of lung disease. Reeves, like Howard, found generalized arteriosclerosis, the only difference being that Reeves classified it as "mild to moderate". He also confirmed Howard's finding of osteoarthritis of the sacroiliac spine, and noted a 20% limitation of flexion. He gave Claimant a cardiac functional capacity of Class I (no marked...

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    ...Cir.1962). If the Commissioner's findings are supported by substantial evidence, the courts are bound to accept them. Underwood v. Ribicoff, 298 F.2d 850 (4th Cir.1962). However, despite this deference to the Commissioner's finding of fact, "[a] factual finding by the ALJ is not binding if ......
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4 books & journal articles
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    ...v. Apfel , 14 F. Supp.2d 839, 841 (W.D. Va. 1998), citing Vitek v. Finch , 438 F.2d 1157, 1159-60 (4th Cir. 1962); Underwood v. Ribicoff , 298 F.2d 850, 851 (4th Cir. 1962). c. Fifth Circuit The following four elements of proof are to be weighed in determining whether there is substantial e......
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    • James Publishing Practical Law Books Archive Social Security Issues Annotated. Vol. II - 2014 Contents
    • August 3, 2014
    ...143 (8th Cir. 1986), § 602.3 Underwood v. Bowen , 828 F.2d 1081, 1083 (5th Cir. 1987), §§ 107.4, 1107.4, 1207.1 Underwood v. Ribicoff , 298 F.2d 850, 851 (4th Cir. 1962), § 101.4 Underwood v. Shalala , 985 F. Supp. 970, 976, 978 (D. Colo. 1997), §§ 201.1, 205.2, 207.1, 210.2, 210.3, 210.5, ......
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    ...Apfel , 14 F. Supp.2d 839, 841 (W.D. Va. 1998), citing Vitek v. Finch , 438 F.2d 1157, 1159-60 (4 th Cir. 1962); Underwood v. Ribicoff , 298 F.2d 850, 851 (4 th Cir. 1962). c. Fifth Circuit The following four elements of proof are to be weighed in determining whether there is substantial ev......
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    • James Publishing Practical Law Books Bohr's Social Security Issues Annotated - Volume II
    • May 4, 2015
    ...143 (8th Cir. 1986), § 602.3 Underwood v. Bowen , 828 F.2d 1081, 1083 (5th Cir. 1987), §§ 107.4, 1107.4, 1207.1 Underwood v. Ribicoff , 298 F.2d 850, 851 (4th Cir. 1962), § 101.4 Underwood v. Shalala , 985 F. Supp. 970, 976, 978 (D. Colo. 1997), §§ 201.1, 205.2, 207.1, 210.2, 210.3, 210.5, ......

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