Searching over 5,500,000 cases.


searching
Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

Santise v. Schweiker

decided: April 8, 1982.

CATHERINE SANTISE, APPELLEE IN 81-1904 & 81-2026; MICHAEL STETSKO, APPELLEE IN 81-1905 & 81-2027; SALVATORE ALTOMONTE, APPELLEE IN 81-1906 & 81-2028; OLIVER MCCAULEY, APPELLEE IN 81-1907 & 81-2029; ELFRIEDE F. SIMMONS, APPELLEE IN 81-1908 & 81-2030; JOAN M. FINUCANE, APPELLEE IN 81-1909 & 81-2031; JOSEPH MUSCOVITCH, APPELLEE IN 81-1910 & 81-2032; GERALDINE G. ROCHE, APPELLEE IN 81-2722; FARIES L. THOMAS, APPELLEE IN 81-2725
v.
RICHARD S. SCHWEIKER, SECRETARY OF HEALTH AND HUMAN SERVICES, APPELLANT



ON APPEAL FROM THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW JERSEY

Before Adams, Gibbons and Garth, Circuit Judges.

Author: Adams

Opinion OF THE COURT

We are asked in this appeal to decide whether certain medical-vocational regulations promulgated by the Department of Health and Human Services ("HHS" or "Department") satisfy the requirements of the Social Security Act. The district court concluded that the regulations-which take the form of a "grid" and are used in determining eligibility for disability benefits-are at variance with both the Act and previous decisions of this Court. We disagree, and therefore will reverse.

I

For more than a quarter-century, disabled workers and their dependents have been provided monetary benefits under the Social Security Act. Originally, the Social Security Act defined a disabled worker, or disability, in purely medical terms, without reference to vocational factors.*fn1 In 1967, however, Congress amended the statute to require explicitly that a decision as to an individual's disability take into account that person's potential for employment.*fn2 According to the amended Act, which remains in force today, a claimant is to be adjudged disabled

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.

42 U.S.C. § 423(d)(2)(A). The statute proceeds to explain that "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"; in this connection, it is irrelevant whether "such work exists in the immediate area in which (an individual) lives, or whether a specific job vacancy exists for him, or whether he would be hired if he applied for work." Id.

In 1978, after giving interested parties an opportunity for notice and comment, HHS promulgated rules intended to implement the 1967 vocational amendment to the Act.*fn3 These rules establish a sequential decision-making process to be followed by an administrative law judge (ALJ) in a disability case. See 20 C.F.R. § 404.1520. First, the ALJ ascertains whether the applicant currently is working; if so, the claim is denied. Id. at § 404.1520(b). Second, the ALJ determines, solely on the basis of medical evidence, see id. at § 404.1526, whether the claimed impairment is "severe," that is, of a magnitude sufficient to limit significantly the individual's "physical or mental ability to do basic work activities"; if it is not, the claim is denied. Id. at § 404.1520(c). Third, the ALJ decides, again using only medical evidence, whether the impairment equals or exceeds in severity certain impairments described in Appendix 1 of the regulations; if it does, the claimant automatically is awarded disability benefits. Id. at § 404.1520(d). Fourth, the ALJ considers whether the applicant has sufficient "residual functional capacity"-defined as what an individual "can still do despite (his) limitations"-to perform his past work; if so, the claim is denied. Id. at § 404.1520(e); see id. at § 404.1545(a). Finally, the ALJ adjudicates, on the basis of the claimant's age, education, work experience, and residual functional capacity, whether the applicant can perform any other gainful and substantial work within the economy. Id. at § 404.1520(f). It is only during this final stage of the decisionmaking process that the ALJ is authorized to make use of the "grid"-i.e., the medical-vocational tables set out in Appendix 2 of the regulations-which is at issue in this proceeding.

Before employing the medical-vocational tables, however, an ALJ is obligated to make a number of factual findings about the applicant in question. Specifically, the claimant must be classified according to his or her age,*fn4 education,*fn5 prior work experience,*fn6 and residual functional capacity.*fn7 With regard to each of these factors, moreover, the claimant is permitted to introduce evidence and to rebut any evidence proffered by the Secretary. Id. at Appendix 2, § 200.00(a). It is only after this detailed inquiry as to an applicant's medical and vocational characteristics, therefore, that the regulatory tables invalidated by the district judge come into play.

The tables themselves are relatively straightforward in nature. In brief, they contain all possible combinations of the four relevant vocational factors-age, education, work experience, and residual functional capacity. With respect to each combination, the guidelines reveal whether an individual described by those particular characteristics is "disabled" or "not disabled"-that is, able or not able to engage in any other significant, gainful employment that exists in the national economy. In determining whether a claimant is eligible for disability benefits, therefore, an ALJ simply plots the applicant's "vocational profile" on an appropriate grid and arrives at the result indicated by the regulations for that specific combination of traits. For example, a person "closely approaching advanced age," with a "limited" educational background, no previous work experience, and the ability to perform light work would be classified as "not disabled" under the regulations. Id. at Appendix 2, Rule 202.10. By contrast, an individual of identical age, work experience, and residual functional capacity, who is "illiterate or unable to communicate in English" would be adjudged "disabled." Id. at Rule 202.09.*fn8 If a claimant's characteristics do not fit neatly into one of the many categories defined by the tables,*fn9 the ALJ is permitted to arrive at a conclusion as to disability independent of, but consonant with, the regulations.*fn10 If, however, an individual's medical-vocational status in fact is described by the grid, the regulations require that a particular decision be reached. Id. at § 404.1569 & Appendix 2.

According to HHS, underlying the regulations is the Secretary's determination, arrived at by taking administrative notice of relevant information,*fn11 "that a given number of unskilled jobs exist in the national economy that can be performed by persons with each level of residual functional capacity." Brief for Appellant at 14. For example, the Department has concluded that approximately 200 unskilled sedentary positions are available throughout the country, with each position representing "numerous jobs." See 20 C.F.R. part 404, Appendix 2, § 201.00(a). Similarly, the Department has identified 1600 unskilled positions for persons able to perform light work, and 2500 unskilled positions for those individuals with a maximum sustained work capability limited to medium work. Id. at Appendix 2, §§ 202.00(a) & 203.00(a). With respect to each table entry, or "rule," the Secretary has ascertained, by combining this administrative notice with expertise derived from previous experience in administering the disability program, the degree to which an individual's vocational factors will affect his chances of obtaining one of these many existing jobs. The regulations are accompanied by a detailed textual statement that explains and justifies each of the Department's medical-vocational rules.

II

Nine cases have been consolidated for review on this appeal. In each instance, an ALJ determined, relying on the medical-vocational regulations described previously, that a particular claimant was not disabled. In each instance, upon appeal pursuant to 42 U.S.C. § 405(g), the district judge assumed, without deciding, that "substantial evidence" existed in the record to support the factual determinations reached by the ALJ-namely, that the claimant was a certain age, possessed a certain educational level and residual functional capacity, and had certain previous work experience. Santise v. Harris, 501 F. Supp. 274, 275 (D.N.J.1980). The district judge instead criticized, for two reasons, the grid system employed by HHS in disability cases.

First, the district court concluded that the medical-vocational regulations were "inconsistent with" and "contradictory to" the "plain language and meaning" of the Social Security Act. The Department, declared the court, was "clearly" obligated by 42 U.S.C. § 423(d)(2)(A) in each instance to "determine as a matter of fact whether a claimant is capable of retaining "substantial gainful work.' " HHS' regulatory arrangement, however, merely required an ALJ to identify four vocational characteristics about a particular applicant-and, having done so, the ALJ's task was "finished," since "the grid decides the "fact' of whether the claimant is capable of retaining "substantial gainful work.' " Such a result, the district judge believed, could not be squared with the mandates of the Act:

Simply put, the human function of judging cannot be replaced by a robotized resort to a grid. It is my conclusion that the Act requires that when a claimant is denied disability benefits that denial must be the product of individualized fact finding based on substantial evidence in ...


Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.