Rodriguez v. Califano

431 F. Supp. 421, 1977 U.S. Dist. LEXIS 15880
CourtDistrict Court, S.D. New York
DecidedMay 16, 1977
Docket76 Civ. 3833(MP)
StatusPublished
Cited by75 cases

This text of 431 F. Supp. 421 (Rodriguez v. Califano) 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
Rodriguez v. Califano, 431 F. Supp. 421, 1977 U.S. Dist. LEXIS 15880 (S.D.N.Y. 1977).

Opinion

POLLACK, District Judge.

This is a petition for judicial review of a decision denying plaintiff Social Security disability benefits. Both parties have moved for summary judgment. The issue is whether there is substantial evidence supporting HEW’s decision that plaintiff was not disabled, i. e., unable to engage in substantial gainful activity by reason of a physical or mental impairment. The plaintiff had insured status no later than March 31, 1969 and has the burden of establishing that an impairment had reached disabling severity by that date.

Plaintiff contends on these motions that the evidence given by Dr. Polivio Cueva showed that he had become disabled by 1965 because of osteo-arthritis, osteo-porosis and other various conditions.

However, Dr. Cueva first examined plaintiff five years later, in 1970. He testified that after viewing various X-rays and a physical examination, he felt that plaintiff’s impairment was only “moderate.” It was not until Dr. Cueva examined the plaintiff on June 8, 1973 that the doctor changed his mind and expressed the belief that plaintiff’s problem had become severe. Dr. Cueva testified that in 1970 plaintiff had a 20-30% limitation of motion of his shoulder.

The HEW hearing examiner held that although plaintiff had complained of pain in his right shoulder as early as February 3, 1969, Dr. Cueva’s testimony and the fact *423 that the impairment did not require followup treatment or occasion continuing complaints by plaintiff before 1970 showed that plaintiff had not proved that he was “disabled” before 1970.

In order to establish entitlement to a period of disability and disability insurance benefits plaintiff has the burden of establishing that he was unable to engage in substantial gainful activity by reason of a 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 at least 12 months and the existence of which is demonstrated by evidence supported by data obtained by medically acceptable clinical and laboratory techniques, at a time when he met the insured status requirements of the Act. 42 U.S.C. § 423(d). Franklin v. Secretary of HEW, 393 F.2d 640 (2d Cir. 1968).

The mere presence of a disease or impairment is not disabling within the meaning of the Social Security Act. It must be shown that the disease or impairment causes functional limitations which preclude plaintiff from engaging in any substantial gainful activity. E. g., Blalock v. Richardson, 483 F.2d 773, 775 (4th Cir. 1972); Waters v. Gardner, 452 F.2d 855, 857 (9th Cir. 1971); Mann v. Richardson, 323 F.Supp. 175, 179 (S.D.N.Y.1971).

When making a finding as to plaintiff’s ability or inability to engage in any substantial gainful activity, there are four elements of proof to be considered: (1) objective medical facts and clinical findings; (2) diagnoses and medical opinions of examining physicians; (3) subjective evidence of pain and disability as testified to by plaintiff and corroborated by others who have observed him; and (4) plaintiff’s age, educational background, and work history. All of these elements of proof must be considered together and in combination with each other. Gold v. Secretary of HEW, 463 F.2d 38, 41 (2d Cir. 1972): De-Paepe v. Richardson, 464 F.2d 92, 94 (5th Cir. 1972); Underwood v. Ribicoff, 298 F.2d 850 (4th Cir. 1962).

Section 205(g) of the Act, 42 U.S.C. § 405(g), provides that the findings of the Secretary as to any fact, if supported by substantial evidence, 1 shall be conclusive. Accordingly, the Secretary’s findings, if reasonable, should not be disturbed by the Court on review. Richardson v. Perales, 402 U.S. 389, 91 S.Ct. 1420, 28 L.Ed.2d 842 (1971); Levine v. Gardner, 360 F.2d 727 (2d Cir. 1966). The conclusive effect of the substantial evidence rule applies not only with respect to the Secretary’s findings as to basic evidentiary facts, but also to inferences and conclusions drawn therefrom. Beane v. Richardson, 457 F.2d 758, 759 (9th Cir.), cert. denied, 409 U.S. 859, 93 S.Ct. 144, 34 L.Ed.2d 105 (1972); Vineyard v. Gardner, 376 F.2d 1012, 1014 (8th Cir. 1967); McHale v. Mathews, 416 F.Supp. 1191, 1192 (S.D.N.Y.1976).

It is settled law that plaintiff bears the ultimate burden of persuasion to establish inability to engage in any substantial gainful activity and thus entitlement to disability benefits. Gold v. Secretary of HEW, supra, 463 F.2d at 41; Franklin v. Secretary of HEW, supra, 393 F.2d at 642; Gardner v. Richardson, 383 F.Supp. 1, 4 (E.D.Pa.1974).

It is well established that evidence of an impairment which reached disabling severity after the expiration of plaintiff’s insured status, or exacerbation of existing impairment after expiration, cannot be the basis for the determination of entitlement to a period of disability and disability insurance benefits, even though the impairment itself may have existed before plaintiff’s insured status expired. DeNafo v. Finch, 436 F.2d 737, 739 (3d Cir. 1971); Henry v. Gardner, 381 F.2d 191, 195 (6th Cir.), cert. *424 denied, 389 U.S. 993, 88 S.Ct. 492, 19 L.Ed.2d 487 (1967), rehearing denied, 389 U.S. 1060, 88 S.Ct. 797, 19 L.Ed.2d 864 (1968); Mann v. Richardson, supra, 323 F.Supp. at 177. See Selig v. Richardson, 379 F.Supp. 594 (E.D.N.Y.1974).

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Bluebook (online)
431 F. Supp. 421, 1977 U.S. Dist. LEXIS 15880, Counsel Stack Legal Research, https://law.counselstack.com/opinion/rodriguez-v-califano-nysd-1977.