Richardson v. Perales

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Plaintiff

Perales

Defendant

Robinson

Facts

Plaintiff claims he was injured in September of 1965 as a result of lifting a box. His first doctor, Dr. Munslow, conducted surgery and diagnosed him with "neuritis, lumbar, mild." Plaintiff continued to complain of the pain but Dr. Munslow and Dr. Lampert could not find the problem and told him to go back to work. In April of 1966 plaintiff consulted Dr. Morales, who said that the issue was "Back sprain, lumbosacral spine."

Plaintiff then filed a claim as required by the Social Security Act. The agency got records from Dr. Morales who this time said that the diagnosis was a moderately severe back sprain. The agency then arranged for a medical examination from Dr. Langston. Dr. Langston concluded that plaintiff was weak from inactivity and there there were no abnormalities in his lumbar spine. Because of this report, the agency denied the benefits.

Plaintiff requested reconsideration and submitted another report from Dr. Morales stating that he was "totally and permanently disabled." After another examination by a psychiatrist and further examination of the record, the claim for benefits was again denied.

Plaintiff as this point requested a hearing before a hearing examiner. The agency then referred plaintiff to Dr. Mattson and Dr. Langston for more tests. The results of these tests lead to similar diagnoses to the initial diagnosis by Dr. Langston.

There were two hearings and oral evidence was submitted by the plaintiff, Dr. Morales, and an independent medical advisor brought in by the agency (Dr. Leavitt). This advisor is paid a fee by the government and does not examine the claimant but rather hears and reviews medical evidence. Dr. Leaviit testified (over objections by plaintiff's attorney), that plaintiff had a mild low-back syndrome. The hearing examiner, using Dr. Leavitt's testimony and other written records, denied plaintiff any benefits.

The Act allows the claimant to request the issuance of subpoenas for hearings, but the plaintiff in this case did not exercise that right. If he had he might have been able to cross examine Doctors whose written reports the hearings examiner had relied on in making his decision.

Procedural History

The case was originally in front of a Social Securities hearings examiner. The hearing examiner ruled in favor of the defendant. Plaintiff then appealed within the administrative agency, and the Appeals Council ruled that the decision of the hearings examiner was correct. The plaintiff then appealed to the 5th circuit. The 5th circuit ruled that even though the hearsay evidence in the case was admissible under the Act and that Dr. Leavitt's testimony was admissible, but that all this evidence together did not constitute "substantial evidence when it was objected to and contradicted by evidence from the only live witnesses."

Discussion

The court first says that sections 205(a) and 205(b) of the act set up an informal rule making structure that "should be understandable to the layman claimant, should not necessarily be stiff and only for the trained attorney, and should be liberal and not strict in tone and operation." The Secretary should establish the hearing procedures and the normal evidence rules do not necessarily apply.

The court next asks what procedural due process requires with respect to the written reports that were submitted into evidence. The court states that a written report can be received as evidence given that the plaintiff did not exercise his right to subpoena the reporting physician. The court also states that the written evidence was both reliable and demonstrative.

The court then dismisses a few other arguments put forward by the plaintiff:

  1. Having a medical advisor (Dr. Leavitt) is not "reprehensible" as plaintiff suggested. He is a neutral advisor and his opinion was not different from those in the reports.
  2. APA rather than the Social Security Act governs. The court said that this doesn't matter, because both describe similar procedures. Both allow evidence in written form and both allow cross-examinations as required for full disclosure of fact. Hearsay is allow under either Act.

Dissent

Hearsay may be received but cannot be the basis for any adverse ruling. The court is also deeply troubled by the one doctor (who was paid by the government) who made an oral testimony but who did not himself examine the patient. The court also claims that three of the doctors who the plaintiff was not able to cross examine were employed by the workmen's compensation insurance company.