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Bell v. Secretary of Department of Health and Human Services of United States

decided: April 13, 1984.

SYBIL BELL, PLAINTIFF-APPELLANT,
v.
SECRETARY OF THE DEPARTMENT OF HEALTH AND HUMAN SERVICES OF THE UNITED STATES, DEFENDANT-APPELLEE



Appeal from a judgment of the Eastern District of New York, Mark A. Costantino, Judge, affirming a decision of the Secretary of Health and Human Services finding appellant Sybil Bell eligible for Supplemental Security Income benefits under Title XVI of the Social Security Act, 42 U.S.C. §§ 1381, et seq., as of January 26, 1982, but not before that date.

Feinberg, Chief Judge, Mansfield and Cardamone, Circuit Judges.

Author: Mansfield

MANSFIELD, Circuit Judge:

Sybil Bell appeals from a judgment of the Eastern District of New York, Mark A. Costantino, Judge, affirming a decision of the Social Security Administration, Department of Health and Human Services (HHS), entitling her to Supplemental Security Income (SSI) benefits under Title XVI of the Social Security Act, 42 U.S.C. §§ 1381, et seq., as of January 26, 1982, but not prior to that date. Bell argues that the Secretary's determination of January 26, 1982, as the onset date of Bell's disability was not supported by substantial evidence, that the Administrative Law Judge (ALJ) failed to develop the record adequately, and that the district court erred in declining to issue a declaratory judgment that the Appeals Council's ten-month delay in ruling on Bell's claim violated the Social Security Act. We reverse the district court's affirmance of the Secretary's denial of benefits for the period prior to January 26, 1982, with directions to enter a modified judgment awarding appellant SSI benefits as of June 4, 1981. In all other respects the judgment is affirmed.

Sybil Bell is a 48-year old high school graduate with a history of mental problems. She was hospitalized at Pilgrim State Psychiatric Center in 1967, at the Hoch Psychiatric Center in late 1977 through early 1978, and twice at the Nassau County Medical Center, first in September 1980 for three weeks and again in January 1981 for another three weeks. As early as March 15, 1978, upon her release from the Hoch Psychiatric Center, she was diagnosed as suffering from chronic undifferentiated schizophrenia. The same diagnosis was made upon her admission to the Nassau County Medical Center on January 1, 1981, and on her discharge on January 22, 1981. Ms. Bell formerly worked as a nurse's aide, but the record indicates that she has been unemployed for the past 20 years.

Bell applied for SSI benefits on June 4, 1981, claiming disability due to emotional problems and to pain in her left hip, the latter complaint apparently attributable to a childhood injury that twice resulted in surgery. The application was denied initially and upon reconsideration, whereupon Bell requested a hearing to review the determination. A hearing was held on January 26, 1982, before ALJ L. Charles Leonard of the Social Security Administration's Office of Hearings and Appeals. Although Bell obtained counsel several days before the hearing, she lacked the presence of mind to inform her counsel of the impending hearing. When questioned by the ALJ as to whether she was represented by an attorney, Ms. Bell replied that she was not. The hearing proceeded with her being treated as acting pro se, but the ALJ later permitted her counsel to make additional submissions, which were included in the record. It does not appear that Bell's counsel requested further hearings to present live testimony. Thus the record before the SSA Office of Hearings and Appeals consists entirely of documents except for Bell's brief testimony in response to questions by the ALJ.

The ALJ issued his decision on March 30, 1982, finding Bell unable to perform work-related mental functions as of January 26, 1982, the date of the hearing. He went on to state that "[a] careful appraisal of the medical record leads to the conclusion claimant was not disabled prior to January 26, 1982." Bell took exception to the latter finding and on May 14, 1982, she filed a request for review by the Social Security Administration's Appeals Council.

Despite numerous inquiries from Bell's attorneys, the Appeals Council still had not rendered a decision 10 months after the request was filed. On March 9, 1983, Bell filed this action in the Eastern District of New York, seeking a Writ of Mandamus directing the Appeals Council to render a decision and a declaratory judgment that the Secretary's failure to render a decision violated her responsibilities under the Social Security Act, 42 U.S.C. §§ 1381a, 1383(a)(1), and the Administrative Procedure Act, 5 U.S.C. § 555(b). Only 15 days later, on March 24, the Appeals Council denied the request for review, so that the ALJ's opinion became the final decision of the Secretary. On May 13, 1983, Bell amended her complaint to exclude the request for a Writ of Mandamus and to add an appeal from the Secretary's determination that the onset date of her disability was January 26, 1982.

On September 19, 1983, Judge Costantino affirmed the decision of the Secretary, finding that it was supported by substantial evidence. He did not address the other two claims raised by the amended complaint. Appellant timely filed a notice of appeal on October 21, 1983.

Discussion

Bell's principal argument is that the Secretary erred in not finding that she was disabled prior to January 26, 1982. The burden of proving a disability, it should be noted at the outset, lies with the claimant. Carroll v. Secretary of H&HS, 705 F.2d 638, 642 (2d Cir. 1983).*fn1 Moreover, the Secretary's findings with respect to disability are factual and will not be disturbed by a reviewing court as long as they are supported by substantial evidence, 42 U.S.C. § 405(g), which means "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion," Richardson v. Perales, 402 U.S. 389, 401, 28 L. Ed. 2d 842, 91 S. Ct. 1420 (1971) (quoting Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229, 83 L. Ed. 126, 59 S. Ct. 206 (1938)); Gold v. Secretary of HEW, 463 F.2d 38, 41 (2d Cir. 1972).

In our view the Secretary's determination in the present case that Bell's disability did not begin before January 26, 1982, is unsupported by substantial evidence. With regard to the onset date of appellant's illness, the ALJ reasoned as follows:

"A careful appraisal of the medical record leads to the conclusion claimant was not disabled prior to January 26, 1982. A report from Dr. Robert Boese, board-certified consultant physician who examined the claimant on September 18, 1981 reveals that the claimant retained the physical capacities to perform, at least, light work as described in Section 416.967(b), Regulations No. 16. . . . The report from the claimant's treating phychiatrist [Dr. Steven Alper] demonstrates she was not significantly limited from performing basic work related mental functions on August 14, 1981, the date of the doctor's last examination. (Exhibits 31 and 32). Consideration of the claimant's physical and mental impairments, singly or in combination, requires a finding she was not unable to perform any substantial gainful activity prior to January 26, 1982."

In our view this determination cannot withstand scrutiny even on its own terms. Moreover, it fails to take into account significant undisputed portions of the record, all of which is documentary except for Bell's own testimony, that clearly establish Bell's disability at least as early as June 4, 1981. Dr. Boese, who rendered one of the two reports upon which the ALJ relied, is a surgeon who was consulted only with respect to Bell's physical problems. Since the ALJ's finding of disability was based exclusively on Bell's mental condition, Dr. Boese's conclusion ...


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