Hill v. Sullivan

125 F.R.D. 86, 1989 WL 34917
CourtDistrict Court, S.D. New York
DecidedApril 12, 1989
DocketNo. 87 Civ. 4344 (JMW)
StatusPublished
Cited by22 cases

This text of 125 F.R.D. 86 (Hill v. Sullivan) is published on Counsel Stack Legal Research, covering District Court, S.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hill v. Sullivan, 125 F.R.D. 86, 1989 WL 34917 (S.D.N.Y. 1989).

Opinion

MEMORANDUM AND ORDER

WALKER, District Judge:

I. INTRODUCTION

This is a proposed class action for declaratory and injunctive relief against Louis Sullivan, the Secretary of Health and Human Services (“the Secretary”).1 The named plaintiff, proposed intervenor and proposed class members are widows or widowers 2 who have or will apply for disability benefits under the Old-Age, Survivors, and Disability Insurance program of Title II of the Social Security Act (“the Act”). 42 U.S.C. §§ 402(e), 423(d). The proposed class challenges the methodology used by the Secretary in determining whether or not to grant disability benefits to widows under the Act. Plaintiffs allege that the Secretary has violated the Act, and thus denied widows their disability benefits, because defendant fails to evaluate a widow claimant’s residual functional capacity.3 In addition, plaintiffs allege that the defendant’s system of determining disability benefits fails to properly consider pain and other symptoms when assessing the severity of impairments; permits adjudicators to dismiss claims for widow’s disability benefits without adequate explanation of why impairments do not meet or equal a listed disability4; and violates the Administrative Procedure Act (the “APA”). As a result, [88]*88plaintiffs argue that they are denied “an opportunity to establish that their impairments render them incapable of any gainful activity.” P.Opp. at 7.

The plaintiffs move for class certification pursuant to Rule 23(c) of the Federal Rules of Civil Procedure. The defendant opposes this motion and in turn moves to dismiss the plaintiffs’ action pursuant to Fed.R. Civ.P. 12(b)(6). In addition, proposed plaintiff Rose Roesch moves to intervene. After reviewing the legislative history of the Act and its relevant amendments; recent court opinions that have addressed the same or substantially similar issues; the parties’ submissions in this case; and after hearing oral argument, this Court concludes that the proposed class action cannot be dismissed for failure to state a claim. Accordingly, and for the reasons stated below, this Court denies the defendant’s motion to dismiss, grants the plaintiffs’ motion for class certification, and grants Rose Roesch’s motion to intervene.

II. FACTUAL BACKGROUND

On defendant’s motion to dismiss, the Court, as it must, construes the amended complaint in the light most favorable to the plaintiffs. See, e.g., Jenkins v. McKeithen, 395 U.S. 411, 421, 89 S.Ct. 1843, 1848, 23 L.Ed.2d 404 (1969).

Named plaintiff Marjorie Hill is 52 years old. Her sole source of income remains a monthly Supplemental Security Income (“SSI”) disability grant of $357.24. According to the doctors who have examined her, she has coronary heart disease, pulmonary disease, status post hysterectomy and cholecystectomy, uncontrolled hypertension, and severe pain. In May 1985, she filed concurrent applications for widow’s disability benefits under the Act and disability benefits under the SSI program of Title XVI of the Act. Defendant denied both applications initially and again when reconsidered. Hill then had a de novo hearing before an administrative law judge (“AU”). The AU found that Hill’s impairments prevented her from performing her past relevant work and also limited her residual functional capacity to “less than” sedentary work. See Am.Comp., Ex. A at 4.

The AU then issued two decisions. First, he found Hill disabled and eligible for SSI benefits; second, he found her ineligible for widow’s disability benefits because none of her impairments “singly or in combination meet or equal any of the Listings in Appendix 1 to Subpart P.” Id., Ex. B at 3. Hill’s request for review by the Appeals Council, the third stage of her administrative review, was denied, so she has brought this action under 42 U.S.C. 405(g).5

Proposed intervenor Rose Roesch was injured in recent accidents. She now has several physical impairments. See P.Opp. at 3. Roesch followed a course similar to that of plaintiff Hill. In September of 1986, she applied for both SSI and widow’s disability benefits. At the intial determination stage and upon reconsideration, both applications were denied. In January of 1988, an Administrative Law Judge (“AU”), after a hearing, reversed the denial of Roesch’s SSI application, but affirmed the denial of widow’s benefits. In granting the application for SSI benefits, the AU concluded that

the evidence indicates that the claimant is unable to perform the exertional requirements for sedentary work and is unable to sit up to six hours during an eight hour day, lift up to ten pounds, travel to work or walk normally ... [T]he claimant has complaints of unremitting pain, which is substantiated by the medical evidence ... [Her] depression further restricts] her ability to perform work activity.

See Int.Comp., Ex. A.

In affirming the denial of Roesch’s claim for widow’s benefits, the AU stated that [89]*89“[t]he medical evidence of record does not establish that the claimant has any impairment or combination of impairments which is medically equivalent to an impairment listed in Appendix 1.” Id. Roesch appealed this decision to the Appeals Council, which remanded the matter to an AU for further proceedings. On December 6, 1988, an AU issued a decision in which he concluded, in relevant part, that “the claimant [Rose Roesch] is entitled to widow’s insurance benefits based on disability ...” Roesch nonetheless continues her request to intervene in this class action, based on what she calls the partly unfavorable decision by the AU. While he did determine that Roesch was eligible for widow disability benefits from July 27, 1987, he also determined that she was ineligible for those benefits for the period between August 7, 1985—when Roesch alleges she first became disabled—to July 27, 1987. Roesch argues that, in reaching this decision, the AU relied upon the very policies and practices which are being challenged by this action. Roesch admits that she has not yet exhausted her administrative remedies.

III. STATUTORY BACKGROUND

This case focuses attention on three sources that require interpretation: the Social Security Act itself; regulations promulgated under the Act; and internal Social Security rulings.

Among other groups, the Act provides for benefits to wage earners and' widows. To qualify for disability benefits, a widow claimant must satisfy a more stringent test than that applicable to a wage earner claimant. The Act itself provides that “a widow’s disability must be sufficiently severe to preclude an individual from engaging in ‘any’ gainful activity, whereas a wage earner’s disability need be sufficient to preclude an individual from engaging in any ‘substantial’ gainful activity.” Gallagher v. Schweiker,

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Cite This Page — Counsel Stack

Bluebook (online)
125 F.R.D. 86, 1989 WL 34917, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hill-v-sullivan-nysd-1989.