Ruiz v. Secretary of Health & Human Services
Ruiz v. Secretary of Health & Human Services
Opinion of the Court
OPINION AND ORDER
This is an action brought pursuant to section 205(g) of the Social Security Act, as amended, 42 U.S.C. Sec. 405(g), to review a final determination of the Secretary of Health and Human Services which denied in part plaintiff’s application for a period of disability and disability insurance benefits. Claimant was thirty-five years of age when he filed the current application, the third of its kind,
It appears from the evidence on record that plaintiff was admitted to the Ponce District General Hospital on August 12, 1974 for a cranial operation as a result of a fracture in his skull, that he was discharged from the hospital on August 22, 1974 with a temporary disability and that he received outpatient treatment until September 11, 1974. Thereafter, plaintiff apparently moved to the United States; the next medical evidence consisting of a neurological examination performed in New Jersey on September 10, 1975 and an electroencephalogram report dated August 25, 1975. The neurologist who examined him on that date did not find any neurological deficits due to his status post craniotomy. The report of the electroencephalogram was normal. Nevertheless, the examining doctor recommended a repeat skull series and an EMI scan. Based on this evidence, on September 30, 1975 the Secretary denied plaintiff’s request for supplemental security income.
Based on this evaluation, on March 15, 1978 plaintiffs application was denied as it was determined that he could meet the basic demands of unskilled work and was able to engage in his customary job as a dishwasher in the hotel and restaurant business. On March 9, 1978 he requested reconsideration of this denial and claimed that “no one ha[d] examined [him] properly [and that] no one can know what [he is] feeling unless a proper examination is carried out.” On August 21, 1981 reconsideration was denied. At a hearing he presented additional evidence consisting of a medical report of a Dr. Ramón Ferreris who informed that he had been seeing plaintiff monthly since December 21, 1977 until July 23, 1981 and was treating him with anticonvulsives and tranquilizers for what he diagnosed -as grand-mal seizures due to a head injury suffered in 1974. In addition, he presented a clinical abstract from the Ponce District General Hospital which confirms that plaintiff did in fact suffer a fractured skull and was operated in August 1974.
At the hearing plaintiff and his wife testified that he was hit on the head by an assailant in August of 1974 and was operated at the Ponce District Hospital at which time plates were placed in his skull. Ever since, plaintiff testified, he had suffered from attacks and dizzy spells which were alleviated when he took medication. Plaintiffs wife testified that he had changed considerably since the accident and that he had become nervous and aggressive towards her. According to their testimony plaintiff does nothing but sit or sleep all day.
Prior to the hearing it appears that plaintiffs attorneys had requested that he be referred to a psychologist for an evaluation, including a Wechsler Adult Intelligence Scale test (WAIS). This request was renewed at the January 1982 hearing and the administrative law judge ruled that plaintiff would be referred for further evaluations, including a psychiatric, a neurological and a psychological examination. He stated that this was necessary because plaintiff had been very sick in 1978 and there was no available medical evidence since then. The administrative law judge, however, issued his decision on March 24, 1982 and, based on the lack of medical evidence since April 1, 1977 to the date of his decision, held that plaintiff was not disabled as of April 1,1977. For the period prior to April 1977 the administrative law judge applied collateral estoppel to the Secretary and found that plaintiff was under a disability from July 10, 1977 through March 31, 1977, period during which he had been receiving supplemental security income under Title XVI of the Act based on a
On May 11, 1982 review of the hearing decision was requested and additional evidence consisting of a psychological evaluation made on April 7, 1982 by psychologist Rafaela Franco. It appears from that report that two psychological tests and an intelligence test were made and the results are of concern. It appears from the report that plaintiff obtained an intelligence quotient (I.Q.) of 68 in the Wechsler Adult Intelligence Scale, Puerto Rican adaptation, having obtained a 72 in the Verbal Scale and a 67 in the Performance Scale for a classification of mildly mentally retarded, borderline and mentally retarded in the Full, Verbal and Performance Scales respectively. Severe impairments were observed in the performance part of the test; clumsiness, slowness and insecurity having been observed in his work style. According to the report the results of the Bender Gestalt test revealed deviations from the standards for adults. Plaintiffs work was characterized by severe rotations, simplifications, distortions and difficulty integrating characteristics which are compatible for individuals with organic disorders. Difficulty following a sequence could be observed. These results were consistent with those obtained in the Wechsler test. The Rorschach Personality Projective test was also administered revealing disorganization of mental processes with manifestations pertaining to a conduct typical of a schizophrenic condition. In the psychologist's opinion plaintiff’s intellectual and psychosocial functioning have been deteriorated and at present are severely impaired. According to her, “areas which are essential to a person of limited social and intellectual resources in order to function, such as attention, memory and viso-motor skills, have been affected by organic damage.” This, together with his emotional condition which “interferes and creates an obstacle for using the' resources which are already scarce” led her to conclude that little accomplishment can be obtained from treatment or vocational rehabilitation.
The Appeals Council considered this additional evidence and concluded that reconsideration was not warranted. We disagree. The determination of whether a person is disabled within the meaning of the Social Security Act is the responsibility of the Secretary, 20 CFR Sec. 404.1527 (1983); Griffin v. Weinberger, 407 F.Supp. 1388, 1395 (N.D.Ill. 1975) aff d. 539 F.2d 712 (7th Cir. 1976); and judicial review of such a determination is limited to whether the Secretary’s findings are supported by substantial evidence in the record as a whole. 42 U.S.C. Sec. 405(g). Richardson v. Perales, 402 U.S. 389, 91 S.Ct. 1420, 28 L.Ed.2d 842 (1971); Rodriguez v. Secretary of Health and Human Services, 647 F.2d 218, 222 (1st Cir. 1981). “Substantial evidence” has been defined as “more than a mere scintilla” or “such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Consolidated Edison Co. v. N.L.R.B., 305 U.S. 197, 229, 59 S.Ct. 206, 217, 83 L.Ed. 126 (1938). In other words, the Secretary’s findings must be upheld “if a reasonable mind, reviewing the evidence in the record as a whole, could accept it as adequate to support [her] conclusion.” Rodriguez, 647 F.2d 222. Although it is the Secretary’s duty as the ultimate finder of facts to resolve all conflicts in the evidence, Lizotte v. Secretary
SO ORDERED.
. Plaintiff's previous applications in 1974 and 1975 were denied for failure to meet the earnings requirements of the Act. The Secretary considered the current application as a request for revision and reopening. After reconsideration of plaintiff's earning records he concluded that due to some administrative error certain earnings had not been credited and that plaintiff met the insured status requirement. Accordingly, the application was reopened and the
. The onset date of plaintiff's impairment was amended during the hearing from 1975, which appeared on the application, to August 12, 1974, date which appeared on the previous applications.
. Plaintiff apparently had filed concurrent applications for disability benefits and supplemental security income. Apparently because the earnings requirements differ under titles II and XVI of the Act, the applications are considered separately.
. The term “disability" has the same meaning under both Title II and Title XVI of the Act. See: 42 U.S.C. Sec. 423(d); 42 U.S.C. Sec. 1382c(a)(3).
. As for the period from August 22, 1974 to July 9, 1975, collateral estoppel applies to the plaintiff as well as to the Secretary and plaintiff was not disabled for purposes of disability insurance benefits as well as for purposes of receiving supplemental security income.
Reference
- Full Case Name
- Manuel Ramirez RUIZ v. SECRETARY OF HEALTH AND HUMAN SERVICES
- Status
- Published