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PEARCE v. SECRETARY OF HEALTH & HUMAN

February 19, 1988

GUY PEARCE, PLAINTIFF
v.
SECRETARY OF HEALTH & HUMAN SERVICES, DEFENDANT.



The opinion of the court was delivered by: Mihm, District Judge.

ORDER

The Defendant, Secretary of Health and Human Services (hereafter Secretary), seeks affirmation of this decision denying the Plaintiff, Guy Pearce (hereafter Pearce), benefits under the Social Security Act as amended. 42 U.S.C. § 401 et seq. Pearce seeks summary reversal of the Secretary's decision and that the case be remanded for further findings.

FACTS

Pearce filed an application for Disability Insurance Benefits on December 31, 1981 alleging disability beginning in March of 1978. (Tr. 145-148). Pearce's insured status expired prior to the alleged onset date, and his claim for benefits was denied.

On January 19, 1983, Pearce filed a second application for Disability Insurance Benefits and Supplemental Security Income, again alleging disability beginning in March of 1978. (Tr. 160-163, 169-173).*fn1 Both of these claims were denied. (Tr. 179).

On March 17, 1983, Pearce requested reconsideration, amending his application to reflect an alleged disability onset date of January 1985. (Tr. 175). Upon reconsideration, both claims were again denied. (Tr. 176-177).

Subsequently, Pearce requested an administrative hearing on both claims. (Tr. 178) On November 4, 1983, a hearing was held before an Administrative Law Judge (hereafter ALJ). (Tr. 44-77). The ALJ determined that Pearce did not suffer from a severe impairment, and was, therefore, not entitled to Supplemental Security Income. (Tr. 283). Regarding Pearce's claim for Disability Insurance Benefits, the ALJ applied administrative res judicata pursuant to Pearce's December 23, 1981 application and dismissed the claim. (Tr. 286-287).

On March 29, 1984, Pearce requested review of the hearing decision by the Appeals Council (Tr. 288), and submitted new evidence. (Tr. 298-301). Regarding Pearce's Supplemental Security Income claim, the Appeals Council determined that the new evidence established that Pearce did, in fact, suffer from a severe impairment. (Tr. 303). However, the new evidence was found to not conform to the standards set forth by the Social Security regulations. (Tr. 303). For this reason, the Appeals Council specifically remanded the case to an ALJ and ordered the ALJ to obtain medical testing, which conformed to the regulations, and a medical assessment of Pearce's ability to perform work related activities. (Tr. 304).

As to Pearce's claim for Disability Insurance Benefits, the Appeals Council determined that Pearce's insured status date had been incorrectly computed, and therefore, reopened both the December 1981 and January 1983 applications. (Tr. 304). The Appeals Council noted that Pearce reported work activity from 1974 to 1978. (Tr. 304). Based on this work activity, the ALJ was directed to make a finding as to whether Pearce had engaged in gainful activity, and, if so, the testimony of a vocational expert (hereafter VE) was ordered to assess Pearce's transferable skills. (Tr. 304).

Pursuant to the Appeals Council's remand order, Pearce arrived at a consultative examination on September 28, 1984. (Tr. 309).*fn2 In addition, two further hearings were held where testimony was heard from Pearce, Pearce's friend, and a VE. (Tr. 78-126). Subsequently, the ALJ issued a decision finding that because Pearce had refused to meaningfully participate in the consultative examination, his claims for Disability Insurance Benefits and Supplemental Security Income were denied. (Tr. 34-35).

On April 26, 1985, Pearce requested review of the hearing decision (Tr. 26), and submitted additional evidence to the Appeals Council. (Tr. 16-21). The Appeals Council determined that the additional evidence did not follow the protocol established by the Social Security regulations or otherwise did not provide a basis to invalidate the ALJ's decision. (Tr. 4). Thus, on January 22, 1986, the decision of the ALJ became the Secretary's final decision. Subsequently, Pearce sought judicial review of the Secretary's final decision.

DISCUSSION

Both parties identify the issue before this Court to be "whether the final decision of the Secretary is supported by substantial evidence in the record." Neither party discusses the weight, presence or absence, or interpretation of any of the medical evidence present in the record.

Pearce's appeal arises from the provisions of the Act which allow an ALJ to deny benefits to a claimant, who is unwilling to cooperate in a consultative examination to which he is sent by the Secretary. ...


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