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December 21, 1977

SUSIE M. GRABLE 906 Eagle Street Buffalo, New York 14210 Plaintiff

This action was initiated by Mrs. Susie M. Grable, pursuant to § 205(g) of the Social Security Act, 42 U.S.C. § 405(g), to review the final decision of the Secretary of Health, Education and Welfare denying her disability insurance benefits under §§ 216(i) and 223.

Plaintiff filed an application for a period of disability and for disability insurance benefits on February 7, 1974, alleging that she became unable to work on November 8, 1972 as a result of an on-the-job accident in which she lost the use of her right hand. She claimed that this loss of use, coupled with attendant emotional problems and arthritis, rendered her disabled under the Social Security Act. The application was denied initially and on reconsideration by the Social Security Administration. On appeal, the Administrative Law Judge [ALJ] held a de novo hearing. On December 30, 1975, he found that the plaintiff was not disabled within the meaning of §§ 216(i) and 223 of the Act. The ALJ's decision became the final decision of the Secretary of Health, Education and Welfare when it was affirmed by the Appeals Council on March 18, 1976. The plaintiff then appealed the Secretary's decision to this court. The case is now before the court on motions of both plaintiff and defendant for summary judgment pursuant to Rule 56 of the Federal Rules of Civil Procedure.

To qualify for disability benefits under the Social Security Act, a claimant must establish that he or she has insured status, has not attained the age of 65, has filed an application for benefits, and is under a disability as defined by the Act. Under § 223(d)(1)(A), a person is considered disabled if he or she is unable to engage in any substantial gainful activity by reason of a medically determinable physical or mental impairment which can be expected to result in death or last for at least twelve months. Section 223(d)(2)(A) of the Act defines "substantial gainful activity" to include not only the claimant's previous work but, considering the claimant's age, education, and work experience, any other substantial gainful work which exists in the national economy in significant numbers, regardless of whether such work exists in the immediate area in which the claimant lives, whether a specific job vacancy exists, or whether the claimant would be hired if he or she applied for work. The burden of establishing disability is on the claimant, and the impairments must be demonstrable by medically acceptable clinical and laboratory diagnostic techniques. 42 U.S.C. §§ 423(d)(3), (d)(5).

The scope of judicial review of the Secretary's decision is limited. Section 205(g) provides that "[the] findings of the Secretary as to any fact, if supported by substantial evidence, shall be conclusive." Under this standard, the reviewing court may not try the case de novo or substitute its findings for those of the Secretary. Richardson v. Perales, 402 U.S. 389, 401, 28 L. Ed. 2d 842, 91 S. Ct. 1420 (1971). Where there is conflicting evidence, it is the Secretary, and not the reviewing court, who must resolve the conflict. Id. The single issue before the court is whether the Secretary's decision is supported by substantial evidence.

 The record in this case reveals the following facts, which are not in dispute. Mrs. Grable is a 46-year-old married woman with five children. On November 8, 1972, while working for American Allsafe Company, she accidently crushed her right hand in a molding press. On the basis of this hand injury, which eventually required amputation of most of the hand, her resulting emotional problems and her arthritis, plaintiff claims entitlement to disability insurance benefits. The insured status of plaintiff at all times was determined in her favor and is not in dispute.

 The medical evidence of record is as follows:

 Plaintiff submitted into evidence a letter dated December 20, 1972 from Dr. George Reading, written to the Workmen's Compensation Board. Dr. Reading is the plastic surgeon who has treated plaintiff since the accident. The letter describes in detail plaintiff's injuries and the medical procedures performed on her hand.In essence, a debridement was performed which involved the amputation of the little and ring fingers through the distal metacarpals, amputation of the index finger at the proximal metacarpal level, and amputation of the mid finger at the level of the PIP joint. The thumb was not amputated. In the same letter Dr. Reading states that he felt plaintiff would have permanent loss of the entire use of her hand, but that an attempt to give her a thumb and something to oppose the thumb would be made.

 In a telephone conversation with the State Department of Social Services on July 12, 1974, Dr. Reading stated that although Mrs. Grable had been fitted with a prosthesis, she would never regain the use of her right hand in a practical sense. He also stated that she was learning to write with her left hand, having previously been right-handed, and that she could perform the functions of daily living adequately with her left hand.He noted that there were no conditions significant to her recovery other than obesity.

 In a letter dated December 18, 1974 and addressed to plaintiff's attorneys, Dr. Reading suggested that a tendon transfer might improve the strength of the pinch in Mrs. Grable's right thumb, but that any improvement would be minimal and that she should be considered to have 100% loss of the use of her right hand.

 On November 8, 1973, plaintiff was examined by Blase E. Heckman, M.D., a general practitioner for the Workmen's Compensation Board. He stated that "from a medical point of view, the condition of the right hand represents a total disability," and that different gainful employment might be obtained through a referral to the Rehabilitation Unit.

 On February 28, 1975, plaintiff was examined by Henry C. Everett, M.D., a general surgeon. In his report he stated that Mrs. Grable had complained of pain in both knees and the left shoulder due to arthritis and that "she is totally disabled at present."

 Finally, plaintiff was referred by her attorney to Dr. Emanuel Amato, a psychiatrist.In his report of March 18, 1975, Dr. Amato observed that "Mrs. Grable appeared quiet [and] somewhat withdrawn." He noted that she continuously held her right hand with her left hand as if she were trying to hide it. Dr. Amato reported that Mrs. Grable was very concerned because she could not return to American Allsafe, that she felt embarrassed when she was with people, that she was very self-conscious, and that she felt she should hide. He also stated that she had developed definite feelings of depression, being concerned about her future, and that she did not enjoy the things that she used to enjoy. In conclusion, Dr. Amato said:

 I strongly feel that this injury was a serious blow to Mrs. Grable's mental health and I strongly believe that the combination of physical and emotional injury has been very debilitating and I consider her permanently and totally disabled.

 The nonmedical evidence of record is as follows:

 Plaintiff testified at the hearing that she completed high school in Georgia, but received no vocational training either in high school or after high school. Prior to moving to Buffalo in 1953, she worked in a laundry pressing clothes. She began work in Buffalo in 1963 cleaning offices. She then worked as a vegetable inspector and as a maid. In 1968 she worked for Trico Industries assembling windshield wiper blades. In 1969 she began working for American Allsafe, assembling safety goggles.She also operated a punch press ...

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