Sikes v. Flemming

187 F. Supp. 872, 1960 U.S. Dist. LEXIS 3401
District Court, W.D. Missouri·Decided June 2, 1960·No. No. 12480·Published·Cited by 3 cases

Opinion

RIDGE, Chief Judge.

By the instant action plaintiff seeks review of the final decision of the Appeals Council, Social Security Administration, Department of Health, Education and Welfare, denying a “freeze” period of disability asserted by plaintiff under Section 216 (i) of the Social Security Act, 42 U.S.C.A. § 416 (i).

A Referee heard the evidence adduced in support of plaintiff’s contention that he is eligible for monthly insurance benefits under the Social Security Act, based on his application filed June 3, 1957, because of a “disability” beginning not later than December 31, 1953. The Referee’s finding and conclusion that petitioner did not sustain the burden of proof cast upon him under the act and, therefore, was not entitled to any monthly insurance benefits was affirmed by the Appeals Council. The Secretary of Health, Education and Welfare adopted such findings as his decision on plaintiff’s application.

The issue here is whether there is substantial evidence in the record to support the decision of the Secretary that the plaintiff (having the burden of proof thereof) failed to establish that he is entitled to a period of disability (a so-called “disability freeze”) under Section 216 (i) of the Social Security Act (42 U.S.C.A. § 416 (i)) or to disability insurance benefits under Section 223 of the Act, (42 U.S.C.A. § 423.)

Plaintiff’s applications to establish disability and for disability insurance benefits were denied initially and on reconsideration by the Bureau of Old-Age and Survivors Insurance, after the Missouri State Department of Education, Section of Vocational Rehabilitation. Thereafter, the plaintiff requested and was granted a personal hearing before a Hearing Examiner, who found that plaintiff is not entitled to the establishment of a period of disability and/or to monthly benefits” under the Social Security Act. Thereafter, plaintiff requested a review by the Appeals Council. The same was; denied on the ground that “after careful examination of this matter, we are of the opinion that a formal review of the Referee’s decision would result in no advantage to the claimant.” Hence the decision of the Hearing Examiner became the “final decision of the Secretary” on plaintiff’s case, within the meaning of Section 205(g) of the Social Security Act (42 U.S.C.A. § 405(g)).

The main issue in this case was whether, by reason of a medically determinable impairment, or combination of impairments, expected to be of long-continued and indefinite duration, plaintiff has established that he was continuously unable to engage in any substantial gainful activity from a time not later than December 31, 1953, and continuing to the time of the filing of his application, (June 3, 1957) and whether during that time plaintiff was suffering from such an impairment as to render him unable to engage in any substantial gainful activity.

The medical evidence in this case consists of written reports of doctors. From such reports it is reasonable to conclude that plaintiff does not have a physical, determinable impairment which precludes him from the performance of any substantial gainful work as claimed. In his application to establish disability, plaintiff traces his claim of disability to a back injury received in the year 1941, which in 1949 caused a laminectomy operation to be performed on his back. Thereafter, plaintiff was gainfully employed until the year 1953, after which time plaintiff claims that he could not do any work because his back “became progressively worse.” There is no medical evidence in the instant record tending to establish the progressive nature of any injury to plaintiff’s back subsequent to the time he had a spinal fusion in his lumbar spine in 1949. The only disabili[874] ty established to plaintiff’s back was at least of six years’ duration at the time of his appearance before the Referee.

Substantially, the record shows that from plaintiff’s eligibility date he has had residuals of an old ruptured inter-vertebral disk, for which he was operated and a bone graft done in 1949, and that he had some recurrence of pain symptoms therefrom in 1954 and the years following. The evidence is, however, that in 1954 plaintiff weighed 229 pounds and was 71 inches tall. The doctor who examined plaintiff at that time did not “advise (him to) lay off, (but) only (do) light work.” (Tr. 82) There is no evidence of any medical treatment to plaintiff in the years 1955 and 1956. So far as the record shows, plaintiff was not again seen by any physician until February 7, 1957, at which time plaintiff weighed 241 pounds. The physician who then examined plaintiff “felt sure that (plaintiff’s) back would not hurt him so much if he would lose 50 pounds.” Another physician examined plaintiff on October 11, 1957. Because of plaintiff’s marked obesity and unstable back, that physician could not evaluate the injury to his back or the measure of his pain. Plaintiff was again examined in August, 1958, at which time he weighed 248 pounds. That physician noted that he considered plaintiff presently “incapacitated for any manual labor because of the pain in his back”; but it was his further “impression that the loss of about 75 pounds of weight would be very helpful to him.” Aside from the clinical findings of a laminectomy made by the above examining physician, no X-ray films or clinical findings established any present disability, other than the laminectomy above mentioned, existing in plaintiff's back. Without undertaking a more detailed statement of the contents of the medical reports, all of which were considered by the Referee, we think it sufficient to say that there is substantial evidence in the instant record from which the Referee could conclude, as he apparently did, that plaintiff’s obesity is a concurring cause of any disability which he presently claims to his back; that the same is not due to any pathological condition and that plaintiff would be greatly benefited by a substantial weight reduction so that the over-all picture concerning plaintiff’s work record and claimed disability is that “his impairment is remediable to a degree which would permit him to engage in substantial gainful activity within the meaning of the Act, and regulations of the Secretary issued pursuant thereto, and therefore, plaintiff has not established his claim of disability by a greater weight of the credible evidence in the record, and that such claim should be rejected.

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