Court Decisions

Effect of reduced rent on SSI. Upheld constitutionality of SSI regulation counting below-market rent charged by relative/landlord as in-kind income even though government rental subsidies do not count as in-kind income. Appeal after remand, Usher v. Sec'y HHS, 721 F.2d 854. Regulation requiring…

Court consider the medical opinion given by one or more physicians designated by the Secretary in deciding medical equivalence. Disability finding for widow's benefits requires meeting or medical equivalence to a listed impairment. It is for the Secretary, not the court, to resolve conflicts in…

Failure of putative father to claim paternity directly in the two weeks available to him prior to his death from lung cancer is not proof of nonpaternity of illegitimate minor child seeking child's insurance benefits. Secretary has considerable latitude to determine the type and extent of…

Regulations permitting not-actually-available funds to be attributed to disabled step-child, where regs were not promulgated in accordance with the APA, are procedurally defective and hence invalid.

A doctor's conclusory reflections as to claimant's employability, unaccompanied by any formal opinion and diagnoses, do not constitute substantial evidence. Due to non-adversarial nature of proceedings, SSA's responsibility to develop the evidence increases where claimant is…

"Final decision" of the Secretary generally means the initial substantive decision of the Secretary on the benefits claim. 405(g) cannot be read to authorize judicial review of alleged abuses of agency discretion in refusing to reopen claims for social security benefits. This is so…

Unemployment Benefits.Although Court has reservations about the significance of evidence that claimant collected unemployment benefits, Court is reluctant to say that a claimant's decision to hold himself out as able to work for the purpose of receiving unemployment benefits may never be…

Disparity between claimant's symptoms and medication prescribed did not compel conclusion that doctor was inaccurate in describing severity of claimant's mental impairments, even though that inference could be drawn. Doctor was a general practitioner, not a psychiatrist. Court comments that…

SSA's Failure to answer complaint. The question presented to us is whether the district court acted within its authority and discretion when in response to this frustrating inaction, it struck the denials in the Secretary's answers, found the claimants entitled to benefits and remanded to the…

Secretary affirmed in finding that claimant's domestic work for her brother-in-law was not employment and that she lacked sufficient quarters of coverage to be entitled to retirement benefits. The payment of a sum of money alone does not establish an employer-employee relationship. That depends upon…

Cert. denied 444 U.S. 858, 100 S.Ct. 120, 62 L.Ed.2d 78 (1979). The Secretary is not at the mercy of every claimant's subjective assertions of pain," however, administrative law judges should make specific findings when the issue of pain arises.

Transportation to Work. Appeal after remand, Lopez-Diaz v. Sec'y HHS, 673 F.2d 13 (1st Cir. 1982). Although distance from work and inconvenience of commute are not relevant factor in the disability determination process, if a hypothetical claimant could not transport herself to work, utilizing some…

ALJ has duty to develop evidence of side effects of seizure medication where claimant alleged side effects disabled him from working. Where claimant asserted that seizure medication made him so sleepy, hot and ill-tempered so as to disable him from working, ALJ should have sought further medical…

A claimant who was earlier denied at reconsideration, and then filed a new claim but presented no new evidence, cannot get a hearing and/or court review. Res judicata operates even if earlier decision was below hearing level.

Where claimant does not follow the prescribed medical advice which would remedy or reduce his impairments, such conduct is "arguably inconsistent with his complaints of pain."

Stipulation and order in a class action enjoining housing authorities from denying eligibility for or participation in public housing to persons because they are non citizens of the United States.

Califano v. Sanders, (430 U.S. 99 [1977]) foreclosed judicial review of reopening decision absent a constitutional claim. Claimant's 1973 claim was properly dismissed on res judicata grounds, since the claim was identical to one heard and denied in 1965, after claimant's eligibility for…

Where there is a colorable constitutional claim, it is error for district court to dismiss appeal of denial of reopening for lack of subject matter jurisdiction.

A decision that a claimant lacks the necessary quarters of coverage can be reopened only under certain limited circumstances. The decision not to reopen a claim is not subject to judicial review absent a constitutional claim.

ALJ does not have to explicitly state that she is discrediting the claimant's subjective testimony concerning the extent of his pain.

Discussion of observable signs of pain. ALJ under no duty to go to "inordinate lengths to develop a claimant's case." Holding that Secretary is not at the mercy of every claimant's subjective assertions of pain applies equally well to subjective claims of dizziness. Claimant must…

The claimant has the burden of showing an impairment that is medically determinable. In some rare instances (this case is not such an instance), a claimant can satisfy that burden without medical evidence.

Environmental Conditions at Work. At Step 4, the claimant bears the burden of showing that he cannot return to his previous work. At Step 5, the burden shifts to the Secretary to show the existence of other jobs in the national economy that the claimant can nonetheless perform. To meet her initial…

Certainly board certification has never been held a prerequisite to qualification as an expert medical witness. The medical opinion of specialists may be entitled to greater weight than that of general practitioners.

Once claimant makes a prima facie case by proving she cannot return to her prior work, the burden shifts to the Secretary to show that there is other work she can perform.

Pre-GRID case. Once it is determined that claimant cannot perform her past work, Secretary's burden of showing capacity to do other work is not met by taking administrative notice of the general availability of light and sedentary work in the national economy. Step 5 burden is not met by ALJ…

Raises, but does not resolve, the issue of whether a claimant's mental disability should relieve him of the time limitations on reopening.

Supports judicial review of reopening decisions.

District Court erred by reweighing the evidence. The resolution of conflicting evidence is solely within the province of the Secretary and the District Court is required to accept as conclusive the Secretary's determination, if supported by substantial evidence.

A written report submitted by a non- testifying, non-examining physician who merely reviewed the written medical evidence could not alone constitute substantial evidence to support the Secretary's conclusion. The report "lacks the assurance of reliability that comes on the one hand from first-hand…

Substantial evidence is "such relevant evidence as a reasonable mind might accept in support of a conclusion."

Fact that claimant was not supplied with counsel at government expense did not prejudice his claim, since the record, which shows that the examiner was exceptionally solicitous and helpful, and that the claimant was fairly treated, does not suggest that having counsel would have resulted in the…

Fact that claimant failed to seek medical treatment was arguably inconsistent with his complaint of pain and lent credence to suspicions that he may have been exaggerating. Only when claimant meets his burden to establish that he's unable to return to his former work is there a need for SSA to…

Plaintiff must show an attempt to reopen for "good cause" within four years of the "notice of initial determination."

Vacates a judgment by the district court awarding claimant's counsel fees for representation of the claimant before the administrative agency. Counsel can recover for services rendered before the administrative agency only from the Secretary.

The claimant has the initial burden of showing that he is unable to return to his former work, the burden is upon the government to offer evidence showing there is generally available employment of a kind for which the claimant is fit and qualified. The fact that the claimant has made no attempt to…

"Substantial evidence" is the standard of review by the District Court; issues of credibility and drawing of permissable inferences are for the Secretary.