Casey v. Cohen

295 F. Supp. 561, 1968 U.S. Dist. LEXIS 7682
CourtDistrict Court, W.D. Virginia
DecidedDecember 21, 1968
DocketCiv. A. No. 68-C-57-A
StatusPublished
Cited by6 cases

This text of 295 F. Supp. 561 (Casey v. Cohen) is published on Counsel Stack Legal Research, covering District Court, W.D. Virginia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Casey v. Cohen, 295 F. Supp. 561, 1968 U.S. Dist. LEXIS 7682 (W.D. Va. 1968).

Opinion

OPINION and JUDGMENT

DALTON, Chief Judge.

The plaintiff, Estel Casey, has brought this action under the Social Security Act, § 205(g), 42 U.S.C.A. § 405(g), requesting a review and reversal of a decision of the Secretary of Health, Education and Welfare which denied disability insurance benefits to the plaintiff. The Secretary has ruled that the issues raised by the plaintiff in this proceeding are res judicata by reason of previous decisions of the Secretary, and he now moves for summary judgment.

The record discloses that three previous applications have been filed by the plaintiff involving facts and issues similar to those presented by his fourth application. When these previous claims were denied by the Secretary, the plaintiff did not exhaust his administrative remedies nor did he seek judicial review as provided in 42 U.S.C.A. § 405. Under these circumstances, considered more fully below, judicial review by this court of the decision of the Secretary is virtually foreclosed.

Estel Casey, the claimant, who is forty-four years of age, has not worked for any appreciable period of time since 1955. He alleges that he is unable to work because, in his words, “My stomach is all the time soured and my head hurts me and there’s mucus forming in my lungs and I can’t stand on my feet my nerves are so bad.” Medical reports on the claimant’s condition between 1954 and 1960 disclose a variety of physical ailments including sinusitis, arthritis and chronic ethmoiditus. However, the chief cause of the claimant’s distress appears to be a psychogenic nervous disorder, which has been diagnosed in various ways: “Psyehoneurosis; conversion reaction in a passive dependent character,” “dependent, inadequate personality and a tendency to regress with conversion manifestation,” and “anxiety reaction, chronic.” According to the claimant, whenever he attempts to work or perform simple tasks, or even when he comes in contact with strangers, he shakes all over and breaks out into a sweat.

Under the provisions of the Social Security Act, §§ 216(i) and 223, 42 U.S.C.A. §§ 416(i) and 423, as amended, the claimant is not entitled to either disability insurance benefits or the establishment of a period of disability unless he became disabled at a time when he met the insurance coverage requirements of the Act. The pertinent requirement in this case is that the claimant must have earned a minimum amount of wages for twenty calendar quarters out of a period of forty quarters preceding the date of disability. 42 U.S.C.A. §§ 416(i) and 423(c). It is conceded that the claimant’s insured status expired on March 31, 1960. In other words, the claimant must show that he became disabled on or before that date.

At a hearing held in 1962 before a hearing examiner, the foregoing facts were presented in support of the claimant’s second application for disability benefits filed September 26, 1960. In his written opinion dated July 17, 1962, the hearing examiner thoroughly reviewed the evidence and concluded that at no time prior to March 31, 1960, was the claimant under a “disability,” which at that time was defined in the Act as the “inability to engage in any substantial [563]*563gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or to be of long-continued and indefinite duration.” 42 U.S.C.A. §§ 416 (i) (1) (A) and 423(c) (2) (1964). This ruling was based on the finding of the hearing examiner that none of the diagnoses of the claimant’s condition revealed delusions, hallucinations, irrationality, incoherence, or loss of memory or concentration. The hearing examiner considered of cardinal importance the fact that some of the examining physicians had indicated that the claimant might be helped by psychiatric treatment, but the claimant had consistently refused to submit to treatment. Since the burden of proving a disability was on the claimant, the hearing examiner concluded that in the absence of evidence indicating that treatment would not help the claimant, his condition must be regarded as a remedial condition. Relying on the authority of Thompson v. Flemming, 188 F. Supp. 123 (D.C.Or.1960), the hearing examiner concluded that a remedial condition did not constitute a disability under the Act.

We would be inclined to disagree with the reasoning and conclusions of the hearing examiner if his ruling were the subject of review in this proceeding. See Beggs v. Celebrezze, 356 F.2d 234 (4th Cir. 1966). However, such is not the case. This ruling became the final decision of the Secretary when the claimant failed to pursue his administrative remedies by appealing the decision of the hearing examiner to the Appeals Council of the Social Security Administration.

The claimant’s third application for disability insurance benefits was filed on November 16, 1965. The additional evidence submitted by the claimant in support of this application consisted primarily of a report from a Virginia state hospital where the claimant had been under examination for a period of four weeks late in 1965. The report of the examining physician did not help the claimant’s cause:

On admission he appeared rather restless and apprehensive. He was well oriented, speech coherent and believed that his first wife’s family are against him. He denied hallucinatory experiences and seemed to be somewhat evasive about his mental episode. Physical examination shows chonic bronchitis. Chest x-ray negative. Blood serology and routine laboratory studies within normal limits. During hospitalization patient complained of his stomach and his back and had some tremors of his hands. His judgment was not very good and his insight was incomplete. He improved greatly, gained good insight and good judgment. He was well oriented, had good memory and talked freely.
DIAGNOSIS: Personality Trait Disturbance, Emotionally unstable personality.
PROGNOSIS: Prognosis guarded. Patient discharged 12-16-65 as not mentally ill.

The claimant’s third application was denied both initially and upon reconsideration requested by the claimant. In denying this application the Secretary noted that the definition of “disability” had been amended by the Social Security Amendments of 1965, § 303(a), 42 U.S. C.A. §§ 416(i) (1) and 423(c) (2), as amended, (Supp. I, 1967), to mean an “inability to engage in any substantial gainful activity by reason of any 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 12 months.” After reviewing the claimant’s record, including the evidence submitted with previous application, the Secretary concluded, “We find that your condition was not disabling within the meaning of the previous or present provisions of law on August 8, 1954 (the date you state you became unable to work), or on any later date through March 31,1960. This is the last day on which you still met the earnings requirement [of the Act].” This [564]*564ruling became the final decision of the Secretary when the claimant failed to request a hearing before a hearing examiner. We agree that the amended definition of “disability” would not require a reversal of the Secretary’s previous decisions.

Claimant’s fourth application, filed December 5, 1966, was again thoroughly considered by a hearing examiner.

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Bluebook (online)
295 F. Supp. 561, 1968 U.S. Dist. LEXIS 7682, Counsel Stack Legal Research, https://law.counselstack.com/opinion/casey-v-cohen-vawd-1968.