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A written report by a licensed physician who has examined the claimant and who sets forth in his report his medical findings in his area of competence may be received as evidence in a disability hearing and, despite its hearsay character and an absence of cross-examination, and despite the presence of opposing direct medical testimony and testimony by the claimant himself, may constitute substantial evidence supportive of a finding by the hearing examiner adverse to the claimant, when the claimant has not exercised his right to subpoena the reporting physician and thereby provide himself with the opportunity for cross-examination of the physician.
Claimant Pedro Perales, a San Antonio truck driver, filed a claim for disability insurance benefits under the Social Security Act (SSA). Sections 216 (i)(1), 42 U.S.C. § 416 (i)(1), and 223 (d)(1), 42 U.S.C. § 423 (d)(1) (1964 ed., Supp. V) of the SSA, both of which provide that the term "disability" means "inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which . . . ." Section 205 (g), 42 U.S C. § 405(g), relating to judicial review, states, "The findings of the Secretary as to any fact, if supported by substantial evidence, shall be conclusive .
At the administrative proceeding, the hearing examiner admitted in evidence the written reports of some licensed physicians who had examined Perales, which were generally unfavorable to Claimant. These physicians were not present and did not testify at the hearing. The examiner also admitted testimony of a physician, selected as the examiner's medical adviser, which testimony was based on the other medical evidence rather than on an examination of Perales. Perales’ objections to the admission of such testimony and the medical reports, based on hearsay and denial of the right to cross-examine the physicians who had prepared the reports, were overruled by the examiner, who concluded that Perales had not met his burden of proving entitlement to disability benefits, notwithstanding the testimony of the Claimant and the Claimant's treating physician that the Claimant was totally and permanently disabled. The examiner's conclusion was affirmed by the Appeals Council. On review, the United States District Court for the Western District of Texas remanded the case for a new hearing before a different examiner, concluding that admission of the reports denied Perales the opportunity to cross-examine the witnesses. On appeal, the Court of Appeals for the Fifth Circuit held that Perales’ failure to request subpoenas precluded his complaint about inability to cross-examine, and that the reports, although hearsay evidence, were admissible in administrative hearings. However, the Court of Appeals affirmed the District Court's judgment because of its conclusion that the reports did not constitute "substantial evidence," as required by 205(g) of the SSA, 42 U.S C. § 405(g), that would support the hearing examiner's findings in view of the objections made to it and its contradiction by evidence from the only live witnesses. Richardson, the Secretary of Health, Education, and Welfare, petitioned for certiorari review.
May physicians' written reports of medical examinations they have made of a disability claimant constitute "substantial evidence" supportive of a finding of nondisability, within the § 205 (g) standard, when the claimant objects to the admissibility of those reports and when the only live testimony is presented by his side and is contrary to the reports?
The United States Supreme Court held that written reports by licensed physicians who had examined plaintiff could be received as evidence in a disability hearing and could constitute substantial evidence supportive of a finding by the hearing examiner. The Court held that such reports were admissible despite their hearsay character and despite the presence of opposing direct medical testimony when plaintiff had not exercised his right to subpoena the reporting physicians for cross-examination.