Williams v. Bowen, Civ. No. H 86-668.
Decision Date | 04 June 1987 |
Docket Number | Civ. No. H 86-668. |
Citation | 663 F. Supp. 45 |
Parties | Shirley I. WILLIAMS, Plaintiff, v. Otis R. BOWEN, M.D., Secretary of Health and Human Services, Defendant. |
Court | U.S. District Court — Northern District of Indiana |
Charles F. Marlowe, Hammond, Ind., for plaintiff.
Gwenn R. Rinkenberger, Asst. U.S. Atty., Hammond, Ind., for defendant.
ORDER
Plaintiff Shirley I. Williams brings this action pursuant to Sections 205(g) and 1631(c)(3) of the Social Security Act (Act), 42 U.S.C. §§ 405(g) and 1383(c)(3), for judicial review of the Secretary of Health and Human Services' (Secretary) final decision denying her benefits under Title II and Title XVI of the Act. The plaintiff filed a Motion for Summary Judgment on March 23, 1987. The Secretary filed a Motion for Summary Judgment on April 13, 1987.
The plaintiff filed applications for disability insurance benefits on March 9, 1987 and on March 7, 1980 and an application for Supplemental Security Income (SSI) on April 17, 1978. These applications were denied through the administrative law judge (ALJ) level and were not further appealed.
The plaintiff filed another application for disability insurance benefits on June 9, 1982 which was denied initially and on reconsideration. On June 20, 1983, an ALJ found that the plaintiff was not disabled at any time prior to the expiration of her insured status on June 30, 1982. She did not appeal this decision further.
On July 9, 1983, the plaintiff filed applications for disability and SSI benefits. The disability application was denied on the ground that the ALJ's decision of June 20, 1983 had already found the plaintiff "not disabled" as of the date she was last insured and that the facts had not changed in the interim. The application for SSI was denied initially and upon reconsideration and on May 21, 1985, the plaintiff requested a hearing on the SSI denial.
The plaintiff filed another disability application on March 22, 1985 which was again denied because of the previous finding by the ALJ that the plaintiff was "not disabled" as of the date she was last insured.
On April 22, 1985, the plaintiff requested a hearing on the denial of SSI and disability benefits. The ALJ conducted the hearing on June 18, 1985 and considered the case de novo. The ALJ declined to reopen the disability benefits applications of July 9, 1984 and March 22, 1985 on the ground that the prior ALJ decision finding her "not disabled" was res judicata. The ALJ further decided that the plaintiff was not eligible for SSI and denied her application of July 9, 1984 because he found that she was not disabled and did not otherwise qualify for SSI. The ALJ's decision became the final decision of the Secretary on August 6, 1986 when the Appeals Council declined further review. The plaintiff's appeal raises three issues: (1) whether the ALJ's conclusion that the plaintiff's heart disease is not disabling is supported by substantial evidence; (2) whether the ALJ placed proper weight on the plaintiff's treating physician's conclusion that the plaintiff was disabled; and (3) whether the ALJ properly found that the previous finding of "not disabled" was res judicata on the issue in this case.
To qualify for supplemental security income benefits under Section 1602 of the Social Security Act, 42 U.S.C. § 1381a, an individual must meet the income restrictions of the Act, file an application for benefits and be an "aged, blind, or disabled individual" as defined in the Act. 42 U.S.C. § 1381a.
Thus, to establish that she is disabled and entitled to benefits, a plaintiff must first present evidence of a medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than twelve months and, second, the impairment must render the plaintiff unable to engage in any substantial gainful work. 42 U.S.C. § 1382c(a)(3)(A) & (B); Lieberman v. Califano, 592 F.2d 986 (7th Cir.1979).
To qualify for a period of disability and disability insurance benefits under Sections 216(i) and 223 of the Social Security Act, an individual must meet the insured status requirements of these sections, be under age 65, file an application for disability insurance benefits and a period of disability, and be under a "disability" as defined in the Act. 42 U.S.C. § 416(i); 42 U.S.C. § 423. The term "disability" in Section 223 has the same meaning as in Section 1602 described above.
Under both Title II and Title XVI, the burden of proof rests upon the plaintiff to establish entitlement to benefits under the Social Security Act. Johnson v. Weinberger, 525 F.2d 403 (7th Cir.1975). This court must review the evidence in the record to determine whether the opinion of the Secretary is supported by substantial evidence on the record as a whole. Whitney v. Schweiker, 695 F.2d 784, 786 (7th Cir.1982). The court's review is limited and this court may not "decide the facts anew, reweigh the evidence, or substitute its judgment for that of the Secretary." Garfield v. Schweiker, 732 F.2d 605, 610 (7th Cir.1984). Substantial evidence is evidence that "a reasonable mind might accept as adequate to support the conclusion." Richardson v. Perales, 402 U.S. 389, 401, 91 S.Ct. 1420, 1427, 28 L.Ed.2d 842 (1971); Garfield v. Schweiker, 732 F.2d at 607.
The plaintiff was forty-four years old at the time of the hearing and had the equivalent of a high school education. She testified that she has taken courses in bookkeeping and nursing. She has worked as a nurse's aid, a switchboard receptionist, and a cashier. She alleged that she became unable to work on February 9, 1978 because of heart trouble, stomach problems, and irritated bowel syndrome.
The plaintiff contends that the ALJ's conclusion that her heart disease is not disabling is not supported by substantial evidence. The plaintiff contends that the ALJ erred in concluding that she does not have congestive heart failure. Congestive failure qualifies as an impairment if accompanied by persistent left ventrical enlargement and hypertrophy documented by both:
Dr. Bruce A. Guberman, M.D., examined the plaintiff and reported on August 14, 1984 that he found no clinical evidence of congestive heart failure. He reported an absence of distension in her neck veins, no S3 gallop, no heptajugular reflex, and no pedal edema.
On August 23, 1984, Dr. Henry J. Merciniak, M.D., reported that the EKG showed premature ventricular contractions, first degree atrioventricular block, left ventricular hypertrophy and nonspecific ST and T wave changes. He concluded that the objective medical...
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