Jeffrey F. RYAN, Plaintiff-Appellant, v. Margaret M. HECKLER, Secretary of Health and Human Services, Defendant-Appellee

762 F.2d 939, 1985 U.S. App. LEXIS 30169, 9 Soc. Serv. Rev. 427
CourtCourt of Appeals for the Eleventh Circuit
DecidedJune 11, 1985
Docket84-7138
StatusPublished
Cited by61 cases

This text of 762 F.2d 939 (Jeffrey F. RYAN, Plaintiff-Appellant, v. Margaret M. HECKLER, Secretary of Health and Human Services, Defendant-Appellee) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eleventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Jeffrey F. RYAN, Plaintiff-Appellant, v. Margaret M. HECKLER, Secretary of Health and Human Services, Defendant-Appellee, 762 F.2d 939, 1985 U.S. App. LEXIS 30169, 9 Soc. Serv. Rev. 427 (11th Cir. 1985).

Opinion

GODBOLD, Chief Judge:

The Secretary denied child insurance benefits and SSI benefits to á 25 year-old man who is brain damaged and suffers from *940 seizures and emotional problems. The district court found substantial evidence to support the Secretary’s decision. Because the Secretary failed to follow her own regulations, we vacate and remand for further consideration under proper legal standards.

FACTS

Appellant Jeffrey Ryan was seriously hurt in an automobile accident in 1972, suffering severe injury to his brain and skull. Subsequently he began to experience seizures and to suffer from emotional difficulties. He has been, and is being, treated for his problems and takes medication for his seizures. Appellant has never been employed and has the equivalent of a high school education. He currently lives with his mother and a younger sister; his father is deceased.

The AU’s detailed and comprehensive summary of the medical evidence shows the following. In 1972 Ryan underwent extensive surgery to repair severe injury to his skull and brain caused by an automobile accident. Appellant’s treating physician, Dr. Nofzinger, reported that his post-operative recovery was relatively uneventful, although protracted and marked by appellant’s “extreme fear-type of reactions.”

In 1973 it was felt that Ryan would benefit from academic tutoring and that he might need counseling in connection with a possible behavioral problem caused by his prolonged illness.

In 1974 appellant was evaluated by a psychologist, Dr. Miller, at the request of Dr. Nofzinger. Dr. Miller found that Ryan was moderately to severely depressed and also suffered from a moderate to severe adolescent reaction. The doctor concluded that the source of his emotional problems was not organic but resulted from his home environment.

Appellant’s seizures increased in 1975, and Dr. Nofzinger increased his daily Dilantin dosage to 300 milligrams. Appellant was hospitalized in August, 1976, for evaluation after emergency referral by the Mental Health Center. He was found to be suffering from grand mal seizures and a probable anti-social personality disorder. Dr. Nofzinger also noted that he thought that Ryan was homicidal and needed to see a psychiatrist.

In 1977 Dr. Wicks, a psychiatrist, interviewed and evaluated appellant at the request of the Alabama Disability Determination Unit. Dr. Wicks found Ryan to be a rather ordinary young man who did not suffer from any psychiatric disorder and who was competent to manage his own affairs.

In 1978 Dr. Nofzinger reported that appellant’s neurological condition was stable but that his psychological status had deteriorated sharply. His emotional condition and personality problems were far beyond the control of physicians. County authorities agreed that Ryan needed to be committed for his own safety. Dr. Nofzinger also noted that he believed that Ryan was not taking his medication regularly and also that it was difficult to determine the exact cause and source of his emotional problems.

During this same period Ryan was examined once by another neurologist, Dr. Pearson. She noted deformities in his hand, foot, skull, and face caused by the automobile accident. She reported that he was suffering grand mal seizures every month or less. She also suggested that he could manage his financial affairs.

Records from University Hospital in Birmingham, Alabama, revealed that claimant was admitted to the psychiatric unit in March, 1979. Psychological testing indicated immaturity and impulsiveness but no other abnormalities. His diagnoses at discharge were developmental delay, major motor seizures and temporal lobe seizures, and non-psychotic organic brain syndrome with brain trauma. He was subsequently enrolled in the Day Treatment Center and received counseling until 1980 when counselors reported that, while he had made progress, they were uncertain whether he could function in an unstructured environment.

*941 Dr. Halsey reported in November, 1981, that Ryan had been examined on two occasions. Appellant had significant brain damage and a seizure disorder that was currently under adequate control. He averaged a few to several seizures per month despite sizable doses of Dilantin and Tegrotol. In addition, Dr. Halsey suggested that Ryan was apparently mentally retarded and essentially incapable of fully caring for himself or managing financial benefits in his own best interest. Dr. Halsey recommended that if there was any question about his disability status based on his seizure disorder alone, quantitative psychometric tests should be done to document his degree of mental incapacity.

Appellant subsequently underwent consultative psychological evaluation on January 7, 1982, by clinical psychologist, Dr. Saxon. He noted that appellant had a rather awkward gait and appeared rather flat in affect throughout most of the session but was able to show some humorous responses to comments. He obtained a verbal IQ of 96, a performance IQ of 85, and a full scale IQ of 90, placing his level of intellectual functioning in the low end of the average range. Dr. Saxon stated that the evidence suggested that a rather concerted effort to reeducate had been made, given the severity of appellant’s injury and especially since he had a frontal lobe injury in which brain tissue had to be removed. The examiner concluded that given the nature of his apparent injury, appellant would not appear to be particularly employable unless great pain were taken to put him in an appropriate job placement.

Claimant also underwent consultative neurological evaluation in January 1982. Dr. Schottland reported his impression as generalized post traumatic seizure disorder of moderate severity which with difficulty was controlled on medication, some bilateral motor abnormalities, particularly on the right side, and a mild aphasiac speech disturbance which he estimated probably constituted a 60 percent total body impairment.

In a brief, conclusory report dated March 9, 1982, submitted by appellant at the hearing, Dr. Wilson certified that he had seen Ryan just after his automobile accident. He had a compound fracture of the skull with some brain tissue missing. Dr. Wilson concluded that the loss of the brain tissue caused a severe personality change rendering appellant unable to care for himself. Dr. Wilson also stated that Ryan was unemployable.

At the hearing appellant testified that he suffered from severe headaches, dizziness, depression, leg and foot pain, and occasional and irregular seizures. He claimed that the seizures occurred without warning and caused him to lose consciousness. He experienced no bladder or bowel incontinence during those attacks. Seizures left him exhausted and unable to talk. Appellant stated that he did take his medication as prescribed. He testified that he saw his treating physician Dr. Halsey every five or six months and has had his medication levels adjusted. According to Ryan, Dr. Halsey told him that medication could not completely eliminate the seizures. Ryan further testified that although restricted somewhat by his pain and physical problems, he did help out around the house. Shirley Burnette, appellant’s mother, also testified. She essentially corroborated her son’s testimony.

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762 F.2d 939, 1985 U.S. App. LEXIS 30169, 9 Soc. Serv. Rev. 427, Counsel Stack Legal Research, https://law.counselstack.com/opinion/jeffrey-f-ryan-plaintiff-appellant-v-margaret-m-heckler-secretary-of-ca11-1985.