Schoolcraft v. Sullivan

753 F. Supp. 1478, 1991 U.S. Dist. LEXIS 128, 1991 WL 181
CourtDistrict Court, D. Minnesota
DecidedJanuary 3, 1991
DocketCiv. 4-90-53
StatusPublished
Cited by3 cases

This text of 753 F. Supp. 1478 (Schoolcraft v. Sullivan) is published on Counsel Stack Legal Research, covering District Court, D. Minnesota primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Schoolcraft v. Sullivan, 753 F. Supp. 1478, 1991 U.S. Dist. LEXIS 128, 1991 WL 181 (mnd 1991).

Opinion

ORDER

DOTY, District Judge.

This matter is before the court on plaintiffs' motion for class certification and defendants’ motion to dismiss for either lack of subject matter jurisdiction or failure to state a claim upon which relief may be *1479 granted, or in the alternative, for summary judgment. Based on the file, record and proceedings herein, the court grants defendants’ motion for summary judgment.

BACKGROUND

The plaintiffs bring this action to challenge the administrative process for evaluating social security disability claims in which the claimants allege alcoholism or other substance abuse as the basis for their disability.

Titles II and XVI of the Social Security Act provide monthly disability benefits to persons who are unable “to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment.” 1 42 U.S.C. § 428(d)(1)(A); 42 U.S.C. § 1382c(a)(3)(A). The definition of disability is stringent because the Act does not permit benefits for partial disabilities. Stephens v. Heckler, 766 F.2d 284, 285 (7th Cir.1985). The Act further imposes a durational requirement: an impairment must be disabling for a continuous period of not less than' twelve months. 42 U.S.C. § 423(d)(1)(A); Timmerman v. Weinberger, 510 F.2d 439, 443 (8th Cir.1975). Thus, medical conditions which are episodic and do not last for a continuous 12-month period cannot constitute a disability within the meaning of the Social Security Act, even if they are disabling for recurrent periods of less than twelve months. See, e.g., Maher v. Secretary of Health & Human Servs., 898 F.2d 1106, 1109 (6th Cir.1989) (citing Schaffer v. Califano, 433 F.Supp. 1218, 1224 (D.Md.1977)). In order to obtain benefits under Titles II or XVI, a person must file a claim with the Secretary alleging, among other things, the condition or impairment which disables, and the date on which the disability began. Once a claimant is deemed “disabled”, benefits will continue as long as other nondisability related criteria are met unless the claimant’s medical.condition has improved to the point where substantial gainful activity can be performed. 2

The Secretary has established a four-tier administrative appeals process to resolve disputed disability claims. The “initial determination” of a claim is made by a state agency pursuant to regulations, guidelines, and performance standards established by the Secretary (Initial Stage). 42 U.S.C. §§ 421(a), 1383b(a). If the initial determination is adverse, the individual may request within 60 days a de novo reconsideration by the same state agency. (Reconsideration Stage). Failure to seek further review-renders the initial determination binding. After an adverse reconsideration decision, the claimant becomes “entitled to a hearing thereon by the Secretary”, 42 U.S.C. §§ 421(d), 1383(c)(1). The claimant may request a de novo hearing before an administrative law judge (ALJ) within 60 days after the adverse reconsideration determination. 42 U.S.C.' §§ 405(b)(1), 1383(c)(1). Failure to request an ALJ hearing renders the reconsideration determination binding. At the fourth stage, the claimant may appeal an adverse AU decision, within 60 days, to the Appeals Council, the highest appellate tribunal within the Social Security Administration. If the claimant fails to make a timely request for such review, the AU decision becomes binding. For purposes of judicial review, a determination, of an individual’s claim for benefits becomes a “final decision” only after the Appeals Council has either denied review or granted review and issued its own decision. This final decision then is subject to judicial review pursuant to 42 U.S.C. § 405(g). See 42 U.S.C. §§ 421(d), 1383(c)(3).

In Minnesota, a state agency called the Disability Determination Services of the Minnesota Department of Jobs and Training *1480 (DDS) has been designated by the Secretary to handle the first two stages of the administrative process. Thus, the DDS determines whether the claimant is disabled at the Initial Stage. If unsuccessful at the Initial Stage, the claimant may ask the DDS for a reconsideration. If unsuccessful at the Reconsideration Stage, the claimant may request a hearing before an administrative law judge who is employed by the Social Security Administration.

Throughout the four-tier administrative appeals process, a five-step analysis is used to determine whether a claimant is “disabled” for purposes of the Act. In the first step, the Secretary determines if the claimant is working or engaged in “substantial gainful activity” at the time of the determination. If yes, the claim for benefits is automatically denied. 20 C.F.R. §§ 404.1520(a) & (b), 416.920(a) & (b) (1989). If the claimant is not engaged in substantial gainful activity, the Secretary moves to the second step of the process and determines whether the claimant has a physical or mental impairment which is “severe”. An impairment is considered severe if it significantly limits a claimant’s physical or mental ability to perform basic work activity. If an impairment is not severe, the claimant is not considered to be disabled and the claim is denied. 20 C.F.R. §§ 404.-1520(c), 416.920(c) (1989). If the claimant is determined to have a severe impairment, the Secretary moves to the third step to determine whether the claimant’s impairment meets or equals the severity of an appropriate listed impairment. A listed impairment is one which is included, with its symptoms, in the regulations governing the Title II and Title XVI programs. If the Secretary determines that the claimant has an impairment which meets or equals the characteristics of a listed impairment the claimant is conclusively presumed disabled. 20 C.F.R. §§ 404.1520(d), 416.920(d) (1989). If the claimant’s impairment does not meet or equal a listing, the Secretary goes to the fourth step to determine whether the claimant is able to do work formerly done. If the claimant is able to do the former work the claimant is not considered disabled and the claim is denied. 20 C.F.R.

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Related

Goodnight v. Shalala
837 F. Supp. 1564 (D. Utah, 1993)
Schoolcraft v. Sullivan
971 F.2d 81 (Eighth Circuit, 1992)

Cite This Page — Counsel Stack

Bluebook (online)
753 F. Supp. 1478, 1991 U.S. Dist. LEXIS 128, 1991 WL 181, Counsel Stack Legal Research, https://law.counselstack.com/opinion/schoolcraft-v-sullivan-mnd-1991.