Czubala v. Heckler

574 F. Supp. 890, 1983 U.S. Dist. LEXIS 11934
CourtDistrict Court, N.D. Indiana
DecidedNovember 7, 1983
DocketCiv. H 77-371
StatusPublished
Cited by11 cases

This text of 574 F. Supp. 890 (Czubala v. Heckler) is published on Counsel Stack Legal Research, covering District Court, N.D. Indiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Czubala v. Heckler, 574 F. Supp. 890, 1983 U.S. Dist. LEXIS 11934 (N.D. Ind. 1983).

Opinion

MEMORANDUM OF DECISION ' and ORDER

MOODY, District Judge.

Claimant-plaintiff, Darrell Czubala, brought this action pursuant to Section 205(g) of the Social Security Act (“Act”), 42 U.S.C. § 405(g), to obtain judicial review of a final decision of the Secretary of Health and Human Services (“Secretary”), granting a closed period of disability and for disability insurance benefits under Title II of the Act, and denying supplemental security income benefits based on disability under Title XVI of the Act.

PROCEDURAL HISTORY

Claimant filed applications on September 4, 1975 seeking benefits under Title II and Title XVI of the Act alleging he became unable to work on May 30, 1975, at age twenty. (R. 82, 85). The applications were denied initially and on reconsideration. (R. 86, 90-91). Subsequently, the Administrative Law Judge, (“AU”) before whom claimant, his attorney, his parents, and a vocational expert appeared, considered the claims de novo, and on June 23, 1977 found that claimant was entitled to a closed period of disability and disability insurance benefits from May 30, 1975 to April, 1977. No decision was made as to claimant’s entitlement to Title XVI benefits. (R. 7-14). The AU’s decision became the final decision of the Secretary when the Appeals Council approved it on September 27, 1977 (R. 3).

STATEMENT OF FACTS

Claimant was born May 9, 1955 and has completed the twelfth grade (R. 28-29). He alleges disability as of May 30, 1975 due to paralysis of the left arm resulting from a stab wound (R. 82-85). Prior to receiving the wound, claimant worked as a grocery clerk and bagger, a laborer, a ditch digger, and a sewer cleaner (R. 30-32). The Secretary has concluded claimant was under a disability from May 30, 1975 to April, 1977, but not thereafter.

Claimant was hospitalized on May 23, 1975 for stab wound treatment. He complained of severe pain in the arm and hand with obvious cyanosis and some questionable swelling of the left hand. Exploration by a vascular surgeon, Dr. Gasior, showed transsection of the ulnar and medial nerves and the brachial artery. Re-anastomosis of the brachial artery was performed. After the operation, claimant complained of severe pain which required heavy narcotic and tranquilizer dosages. An attempt at secondary closure of the injured area was impossible, but a skin graft was applied. Claimant progressed normally; however, some diminution of pulsation of the radial artery was found, and claimant was transferred to another hospital.

Examinations conducted during claimant’s first hospitalization showed normal, except for the left upper extremity. Claimant had a two inch laceration on the posterior aspect of the left arm. There was marked swelling and ecchymosis of the entire upper arm, especially the anterior aspect. Claimant had cyanosis of the arm distal to the site of the injury and definite limitations of motion in flexion and dorsiflexion, but he was able to dorsiflex fingers weakly. Pulses were absent in the wrist. The impression was that there was hematoma formation, possibly interrupting the venous drainage from the area distal to the stab wound. Also, there was probable severance of the brachial artery and the ulner and median nerves and questionable partial severance of the radial nerve (R. 111-112). Claimant took physical therapy during his hospital stay and briefly thereafter. He *893 had a normal range of active motion in his left shoulder, lacked 25 degrees from complete elbow extension, and had a slight problem with forearm supination. Hand function was poor; the muscle around the MP joint was weak and he complained of mild to moderate sensation loss in the left hand below the wrist. Claimant was given active assistance and resuscitative exercises to the left shoulder, elbow, wrist and hand (R. 107).

Hospitalization continued from June 13, 1975 to June 18, 1975. A subclavian angiogram showed occlusion in the left brachial artery with collateral circulation providing the blood supply to the forearm. The radial recurrent and anterior and posterior ulner recurrent arteries were seen around the elbow joint. The impression was complete occlusion of the brachial artery (R. 164). EKG studies showed a terminal conduction variant which may be consistent with a person of claimant’s age (R. 165-167). EMG of the upper extremities and back showed A-l plus fibrillation and/or positive sharp waves in the brachiordialis. There was diminished motor unit recruitment in several muscles, but none showed complete denervation (R. 168). NCV studies showed that no evoked muscle potentials could be illicited (R. 169). No surgical procedures were performed during this hospitalization (R. 161).

Claimant’s physician during his second hospitalization, Dr. Robert Gasior, a general and thorasic surgeon, sent two letters to Dr. Joseph Tyrrell. The first, dated June 8, 1975, reported claimant had palpable radial pulse, but indicated that changes in claimant’s hand were a result of neuromuscular dystrophy. There was expected atrophy of the lumbricals and the interossii. EMG demonstrated activity in the previously repaired nerves (R. 154). The second letter, dated June 19, 1975, reported claimant had a patent profunda brachii artery which, via the ulner recurrent artery, supplies the distill branchial radial ulner complex. Claimant had a warm hand and a pulsate radial artery. EMG nerve velocities studies were recommended; to be followed by secondary repairs (R. 155).

Claimant was hospitalized again from August 18, 1975 to August 30, 1975. Since claimant’s previous hospitalization he experienced gradual improvement in motor strength and sensation of his forearms and fingers; however, causalgic pain had gotten progressively worse in the fingers (R. 121). Physical examinations showed heart, lungs, and abdomen normal. There was atrophy of the arm, forearm, and other small muscles of the hand. Wrist and finger flexion were weak, and deep tendon reflexes were good except for the left upper triceps. Neurological exam showed claimant’s mental status, cranial nerves, and cerebellum intact. Sensory exam revealed analgesia in the ulner nerve distribution on the left, with some median nerve involvement on the hand and a positive Tinel’s sign below the injury (R. 121). Nurses noted that the left arm was weaker, and that he was not able to grasp, but able to partially close his hand. Sensation was intact in the upper half of the arm. Claimant could not distinguish pin pricks and felt prickling pain in the left fingertips (R. 123). The pulse at the wrist was decreased on the left and the flexors were weak, but the extensors were normal (R. 127). Claimant had a left cervical sympathetic block performed on August 29, 1975, and he appeared to have the return of some ulner and median use. X-rays taken during this hospitalization showed a normal chest and multiple surgical clips were noted in the soft tissues.

Dr. Joseph Tyrrell, a general surgeon, filed a consultive report on October 24, 1975. He reported that as of July 18,1975, claimant had no pulsation in the left wrist, but general circulation seemed adequate, although his hand was cool and dry. Claimant took pain and nerve medications at that time, and physiotherapy was prescribed. The left hand shows signs of lumbrical and interossii atrophy. Claimant’s prognosis for complete return of the function of the left hand was guarded to poor.

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Bluebook (online)
574 F. Supp. 890, 1983 U.S. Dist. LEXIS 11934, Counsel Stack Legal Research, https://law.counselstack.com/opinion/czubala-v-heckler-innd-1983.