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April 27, 1960

Louise SISIA, Plaintiff,
Arthur S. FLEMMING, Secretary of Health, Education and Welfare of the United States of America, Defendant

The opinion of the court was delivered by: ZAVATT

This is a civil action brought pursuant to 42 U.S.C.A. ยง 405(g) to review the decision of the Secretary of Health, Education, and Welfare, denying 'child's (disability) insurance benefits' *fn1" to the claimant, plaintiff herein. The Secretary's decision is embodied in the opinion of the Appeals Council of the Social Security Administration (hereinafter referred to as the 'Administration') which reversed a decision of the referee that had awarded the benefits sought. The matter is before this court on cross motions for summary judgment. The only issue is whether the claimant is 'disabled,' it being conceded that the claimant has met the other requirements of the statute.

The scope of review and the powers of this court are all set out in section 405(g):

 'The court shall have power to enter, upon the pleadings and transscript of the record, a judgment affirming, modifying, or reversing the decision of the Secretary, with or without remanding the cause for a rehearing. The findings of the Secretary as to any fact, if supported by substantial evidence, shall be conclusive, and where a claim has been denied * * * because of failure of the claimant * * * to submit proof in conformity with any regulation prescribed (by the Secretary pursuant to law), the court shall review only the question of conformity with such regulations and the validity of such regulations. The court * * * may * * * on good cause shown, order additional evidence to be taken before the Secretary * * *.'

 Besides the formal applications and the decisions of the several Administration officials, the certified record consists primarily of testimony of the claimant, her mother, father, and brother, and two long-time family friends, all taken at the hearing before the referee and supplemented by answers to written interrogatories concerning the claimant's employment and home life directed to the claimant and her parents. In addition there are the claimant's wage and employment records; several medical reports from various institutions and doctors, the earliest dating from 1950; a letter from the New York City Board of Education setting forth the claimant's school record; and a 'report of contact' based on a personal interview with the claimant by a social worker employed by the Administration, that rehashes and evaluates much of the evidence already mentioned.

 The 'objective' facts that the record tends to establish are these:

 The claimant, Louise Sisia, was born December 19, 1913. It is undisputed that she was mentally retarded since childhood. Louise left school at age fifteen on a doctor's certificate, being unable to cope with, or adjust to, school life. Her chief complaints or symptoms were headaches and nausea. She was then in the fourth grade.

 In the latter part of 1944, Louise secured a job with the Conti Shampoo Company at their Brooklyn plant. This was her first job, one previous effort having ended the day it began because Louise 'got sick.' Louise's duties on this new job were to pack shampoo bottles in cartons, and the cartons in cases. In addition, she folded and stapled cardboard to make the cartons. Louise held this job until the middle of 1948 when she left voluntarily. She was paid $ 32 for a five or six day week. However, she was frequently absent from work. This absenteeism was reflected in her wage record which shows that the claimant was never once paid a full quarter's wages in the fifteen calendar quarters that she worked there. During the years 1945 and 1946, her absences averaged about one day per week.

 Besides the job at Conti, the claimant had nine other positions. Three of these jobs appear to have begun and ended during the third quarter of 1947, a quarter in which Louise earned $ 89.25 from Conti. *fn2" In these three jobs she was paid $ 12.60, $ 4.95 and $ 3.90, respectively. In the other six jobs, she earned from a low of $ 4.20 to a high of $ 200.04. Her last job ended in mid-1950. From the time in late 1944 when Louise took the job at Conti to mid-1950 when she left her last job, Louise earned a grand total of $ 4,533.39. Aside from the jobs mentioned, Louise had no other employment, either before or after her eighteenth birthday, up to and including the present.

 In May, 1950, Louise contracted pneumonia and spent ten days in Queens General Hospital. She was re-admitted to that hospital in September of that year for the same disease. She was discharged after 18 days. It was at this time that she was diagnosed as having had rheumatic heart disease, then inactive. This diagnosis was confirmed *fn3" in January, 1954, when she was again readmitted because of 'chest pain.' After a week she was transferred to Goldwater Memorial Hospital where she stayed for an indeterminate time.

 Between the second and third hospitalizations just detailed, around March, 1952, Louise suffered a 'psychotic episode' involving 'paranoid delusions and hallucinations which were accompanied by irritable, excitable outbursts,' in the words of the medical report, or a 'mental breakdown' as described by her brother. She was thereupon sent to Creedmoor State Hospital for seventeen months at which time she was released on convalescent leave and finally discharged one year later, September, 1954.

 While Louise's prior conduct gives rise to an inference of mental deficiency, the medical report from this institution is the first official recognition and diagnosis of that fact. The condition was described as originating 'from birth,' 'idiopathic, moderate, with psychotic reaction.' In answer to the question on a form provided by the Administration 'Please comment on the patient's ability to * * * (3) adjust to a competitive employment situation,' the hospital wrote, 'Would be unable to adjust to a competitive employment situation.' That evaluation dates from November, 1957 and is based on the hospital's observation of Louise between 1952 and 1954.

 The record includes two other medical reports. *fn4" These are on forms supplied by the Administration to the claimant's family doctors. *fn5" Both reports deal primarily with the claimant's physical ailments, and are in agreement that Louise developed rheumatic heart disease during adolescence. Both doctors attended Louise only after 1950 and both advised her not to work at that time. In answer to a question concerning Louise's I.Q. or mental age, one doctor answered 'Not available.' The other, Doctor Kittell, answered, 'It is my impression * * * not based on test * * * that pts. I.Q. is about 65%.' This converts to a mental age of about nine to ten years, which is in the range classified mentally defective or feeble-minded by the recognized I.Q. tests.

 When Louise was not either working or hospitalized she remained at home with her family. The uncontradicted testimony shows that Louise was always sickly *fn6" and was either never able, or allowed, to engage in any strenuous pursuits. Only the lighter household chores were given to her; Mrs. Sisia even considered shopping too strenuous for Louise. Although most of Louise's life was spent at home, she never learned to cook. In answer to the question, 'Are you required to assist your daughter in bathing, dressing and feeding herself?', Louise's mother checked 'No.' The question continued: 'Do you perform any other services for her because of her disability?', to which Mrs. Sisia checked 'Yes.' and described the services thus: 'Cooking, washing and pressing of clothes. I must be with her at all times, she cannot be left alone.'

 Louise can read with fair comprehension and can do simple arithmetic. At the hearing, and in her interview with the Administration social worker, Louise showed a fair ability to remember names and dates, *fn7" and her answers were generally responsive. She was able to travel by ...

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