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Newhouse v. Heckler

January 23, 1985

NEWHOUSE, PATRICIA, APPELLANT
v.
HECKLER, MARGARET, SECRETARY DEPARTMENT OF HEALTH AND HUMAN SERVICES, APPELLEE



On Appeal from the United States District Court for the Eastern District of Pennsylvania.

Gibbons and Garth, Circuit Judges, and Rosenn, Senior Circuit Judge.

Author: Garth

GARTH, Circuit Judge

Patricia Newhouse, a disability claimant who contended that her disability benefits were improperly terminated, appealed an order of the district court which granted summary judgment in favor of the Secretary of Health and Human Services. During the pendency of this appeal, Newhouse died. Because her estate claims to have a valid persisting claim if the termination of benefits was improper,*fn1 Newhouse's intervening death does not moot this appeal. We reverse.

I.

Newhouse had a history of chronic thrombophlebitis. On May 5, 1980, she was first found to be disabled due to that disease. In October 1980, she underwent venous bypass surgery to repair damage to her impaired left leg. In the spring of 1982, she was hospitalized because of cardiovascular and associated complaints. Extensive clinical tests, however, failed to reveal significant abnormalities in her condition. In July 1982, the Social Security Administration determined Newhouse's disability was no longer of sufficient severity to prevent gainful activity. Her benefits were terminated in August 1982.

In January 1983, Newhouse was granted a hearing to challenge the termination of her benefits. She attempted to show that substantial evidence as well as another hospitalization (November 1982) confirmed that she was still disabled. The Administrative Law Judge found Newhouse was no longer disabled within the meaning of the Act and refused to reinstate benefits. On May 11, 1983, the Appeals Council affirmed.

Thereafter, in June 1983, Newhouse was hospitalized for seventeen days for possible pulmonary embolus. Diagnostic tests revealed complete obstruction of the deep veins of the left thigh and a positive Homan's sign.*fn2 Her discharge diagnosis included angina pectoris, resolving phlebitis left leg, chronic coronary insufficiency, and acute superficial phlebitis.

On June 27, 1983, she commenced this action in the district court. She sought a retroactive renewal of his discontinued benefits or, alternatively, a remand for another hearing. The district court determined that substantial evidence supported the Secretary's decision and that new evidence sufficient to satisfy the materiality requirement of 42 U.S.C. § 405(g) was lacking.*fn3

On appeal, Newhouse contended that her case should have been remanded to the Secretary for further consideration in light of her June 1983 hospitalization. We agree.

II.

In reviewing final determinations by the Secretary after an administrative hearing, courts are bound by the Secretary's findings of fact if they are supported by "substantial evidence." 42 U.S.C. §§ 405(g) (Supp. V 1981); 1383(c)(3) (1976); see also Daring v. Heckler, 727 F.2d 64, 68 (3d Cir. 1984). "Substantial evidence" has been defined as relevant evidence which a reasonable mind might deem adequate to support a conclusion. Richardson v. Perales, 402 U.S. 389, 401, 28 L. Ed. 2d 842, 91 S. Ct. 1420 (1971); Daring v. Heckler, supra at 68.

Absent consideration of Newhouse's June 1983 hospitalization, it cannot be said the Administrative Law Judge erred in finding substantial evidence supported termination of Newhouse's disability benefits. This court has held that ". . . in a termination proceeding, once the claimant has introduced evidence that his or her condition remains essentially the same as it was at the time of the earlier determination, the claimant is entitled to the benefit of a presumption that his or her condition remains disabling." Kuzmin v. Schweiker, 714 F.2d 1233, 1237 (1983). This presumption of a continuing disability in turn imposes on the Secretary the burden of advancing evidence sufficient to rebut or meet the presumption. Id. at 1237. As Kuzmin states: "Once the burden to come forward has shifted to the Secretary, the Secretary must present evidence that there has been sufficient improvement in the claimant's condition to allow the claimant to undertake gainful activity." Id. at 1237.

Newhouse offered evidence adequate to establish her prima facie case under Kuzmin. Drs. Fiedler and McNamara, Newhouse's treating physicians, each diagnosed her condition as recurring thrombophlebitis with incompetency of deep venous return. Tr. at 301-03; 305-07. Dr. Fiedler further stated that Newhouse's symptoms were mainly subjective and hard to evaluate by concrete physical evidence of disease. Tr. at 329. These medical reports, as ...


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