Wettstein v. Califano

478 F. Supp. 838, 1979 U.S. Dist. LEXIS 8912
District Court, E.D. Wisconsin·Decided October 29, 1979·No. No. 78-C-547·Published

Opinion

MEMORANDUM AND ORDER

WARREN, District Judge.

Plaintiff brought this action pursuant to section 205(g) of the Social Security Act, 42 U.S.C. § 405(g) to obtain judicial review of a final decision of the Secretary of Health, Education and Welfare, denying plaintiff’s application for the establishment of a period of disability under section 216(i) of the Social Security Act, 42 U.S.C. § 416(i) and for disability insurance benefits under section 223 of the Act, 42 U.S.C. § 423. The Secretary has filed a motion for summary affirmance pursuant to Rule 56 of the Federal Rules of Civil Procedure.

A review of the record shows that the plaintiff filed an application for disability insurance benefits on November 13, 1974 and was granted a period of disability commencing August 7, 1974. (Transcript, pp. 165 — 67). On March 19, 1977, the Bureau of Disability Insurance of the Social Security Administration terminated the plaintiff’s period of disability and her benefits based thereon. The bureau held that her disability had ceased in August of 1976 (Transcript, p. 185) and that there was an overpayment of benefits of $1,191.60 to the plaintiff and her son.

The plaintiff requested the bureau to reconsider its decision, which it did, but it again denied the plaintiff’s claim. The [840]*840claimant then requested a hearing before an Administrative Law Judge (ALJ). A hearing was held on February 28, 1978 and as a result, the ALJ upheld the determination of the Social Security Administration that the plaintiff was able to do “substantial gainful activity” as of August, 1976, and that a refund of the overpayment was necessary. (Transcript, p. 23). The decision of the AU became the final decision of the Secretary when approved by the appeals council on June 26, 1978.

The plaintiff is a thirty-eight year old woman who was initially found to be disabled in December of 1975 by the decision of an AU. The determination of disability was made on the basis of medical reports indicating the plaintiff was suffering from hypertension, pericarditis and obesity. (Transcript, p. 169). Prior to her disability, the plaintiff was an active school teacher. Since her disability, she has been unable to return to her former position as a teacher.

In February of 1976, after she had been determined disabled, the plaintiff was informed she was being placed on a nine-month trial work period because her file indicated she was doing some kind of work since September of 1975. The plaintiff’s work activity report indicated that the plaintiff and her husband had entered into a contract with Door County to operate a shelter home for children. Under the terms of the contract, the plaintiff and her husband are paid $250 a month for keeping four beds in their home available plus $15 per day for each child placed in the home.

According to the tax returns of the plaintiff and her husband, as well as their testimony at the hearing, it appears the plaintiff received approximately $140 a month as income from the shelter. This sum, however, includes a certain portion of rental income which the plaintiff contends should not have been considered as income by the AU. Absent the rental portion, the plaintiff earned an estimated $120 a month for her work in the shelter home.

The record indicates that the plaintiff is still suffering from residuals of pericarditis and obesity. Furthermore, as a result of pericarditis, the plaintiff has also developed rheumatoid arthritis. The plaintiff’s physician indicates that she is on diaretic therapy for fluid retention as well as Gold therapy for her rheumatoid arthritis. Her doctor also indicates that the plaintiff fatigues easily and requires long periods of rest after any prolonged activity. According to her doctor, the plaintiff’s prognosis is poor, however, the doctor did indicate that the therapy has helped her condition “to the point she has markedly improved to where she is no longer in constant pain with markedly diminished activity level.” (Transcript, p. 217). The AU also considered the conflicting reports of the other doctor which examined the plaintiff prior to the initial determination of her disability. See Miranda v. Secretary of Health, Education and Welfare, 514 F.2d 996 (1st Cir. 1975). At least one of the doctors felt the plaintiff could return to work.

According to the testimony of the plaintiff, her duties at the shelter home included meal planning, twenty-five percent of the cooking, keeping the books and records, informing the county court and social service agencies of the childrens’ progress and setting up parental visits. In addition, the plaintiff provides some guidance for the children, accompanies them to court and entertains them on occasion. (Transcript, pp. 47, 50, 59, 76). The record also indicates that the plaintiff’s husband performs the physical activities in connection with the shelter home.

On the basis of the plaintiff’s activities in running the shelter home, as well as her income, the AU ruled that the plaintiff had demonstrated the ability to do substantial gainful activity because she was, in fact, doing substantial gainful activity in administrating the shelter home. The AU also found that the plaintiff has a rheumatoid arthritis condition, residuals of pericarditis and a weight problem, but has demonstrated by her activity she has had a significant improvement in her condition as a result of the therapy. (Transcript, p. 22).

An individual claiming disability insurance benefits pursuant to 42 U.S.C. § 423 is [841]*841required to be under a “disability.” Disability is defined in section 423(d)(1)(A) as an:

inability to engage in any substantial gainful activity by reason of any medically determinable 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 not less than 12 months.

In further defining disability, 42 U.S.C. § 423(d)(2)(A) provides:

an individual . . . shall be determined to be under a disability only if his physical or mental impairment or impairments are of such severity that he is not only unable to do his previous work but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy, regardless of whether such work exists in the immediate area in which he lives, or whether a specific job vacancy exists for him, or whether he would be hired if he applied for work. For purposes of the preceding sentence (with respect to any individual), “work which exists in the national economy” means work which exists in significant numbers either in the region where such individual lives or in several regions of the country.

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Wettstein v. Califano, 478 F. Supp. 838, 1979 U.S. Dist. LEXIS 8912 (E.D. Wis. 1979).

478 F. Supp. 838 (Wettstein v. Califano) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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