United States District Court, D. South Dakota, Central Division
OPINION AND ORDER AFFIRMING DECISION OF
ROBERTO A. LANGE UNITED STATES DISTRICT JUDGE.
Deborah Rinehart (Rinehart) seeks reversal of the decision of
the Commissioner of Social Security (Commissioner) denying
Rinehart widow's insurance benefits. Doc. 14. The
Commissioner argues for this Court to affirm the denial of
benefits. Doc. 16. For the reasons explained below, this
Court affirms the Commissioner's decision.
Summary of Case A. Procedural
14, 2012, Rinehart filed an application for Social Security
widow's insurance benefits. Doc. 12 at 55-61. The
Commissioner denied Rinehart's claim initially on June 4,
2012, on the basis that Rinehart was not married to Richard
Harter (Harter) for at least nine months before the date of
his death as required by the Social Security Act (Act). Doc.
12 at 65. On August 2, 2012, Rinehart requested
reconsideration of her claim. Doc. 12 at 68-69. Upon
reconsideration, the claim was denied. Doc. 12 at 70-73.
then sought a hearing before an Administrative Law Judge
(ALJ), which was conducted on July 26, 2013.Doc. 12 at 74,
107. At the hearing, Rinehart proceeded pro se. Doc. 12 at
110. On August 14, 2013, the ALJ issued his opinion denying
Rinehart's claim for widow's insurance benefits. Doc.
12 at 107-10. The ALJ considered statements from Rinehart
that Harter was healthy on the date of their marriage on
August 27, 2011, and was expected to live for many years.
Doc. 12 at 29, 109. The ALJ also considered Dr. Vinod
Parameswaran's (Dr. Parameswaran) prediction that Harter
had a median survival rate of 3.3 years from January 2012
when Dr. Parameswaran had begun his care for Harter's
blood cancer. Doc. 12 at 29, 109. However, the ALJ concluded
that Rinehart was not entitled to widow's benefits
because Harter's death did not meet the definition of
"accidental" in the Code of Federal Regulations
(regulations). Doc. 12 at 29, 109. The ALJ Judge reasoned
that "[n]o evidence has been submitted that definitively
establishes that the insured's blood cancer did not cause
or contribute to his death" to support a conclusion that
his death was an "accident." Doc. 12 at 27, 109.
hired an attorney, Doc. 12 at 127, who appealed to the
Appeals Council and submitted new material, Doc. 12 at
114-322; Doc. 12-1 at 1-25. The new material included an
affidavit, medical evidence, a summary of the evidence, and a
brief. Doc. 12 at 115-322; Doc. 12-1 at 1-25. The Appeals
Council remanded the case to the ALJ to determine whether the
preexisting condition was the proximate cause of the wage
earner's death or whether his death satisfies the
statutory requirements of an accidental death which would
entitle Rinehart to widow's insurance benefits. Doc. 12-1
provided additional evidence for the second ALJ to consider on
remand. Doc. 12 at 15. Before the hearing, Rinehart submitted
an expert opinion from Ronald Citron, M.D (Dr. Citron). Doc.
12-1 at 77-88. After the hearing was held on June 23, 2015,
Dr. Parameswaran submitted responses to interrogatories, and
counsel made written argument. Doc. 12-1 at 94-98, 107-08,
112-26. On September 14, 2015, the ALJ held that
Rinehart's marriage to Harter did not satisfy the
nine-month durational marriage requirement and that no
exception, including the accidental death exception, applied.
Doc. 12 at 17. Rinehart was thus denied benefits. Doc. 12 at
appealed the second ALJ decision to the Appeals Council. Doc.
12 at 7. On January 30, 2018, the Appeals Council affirmed.
Doc. 12 at 7-9. The Appeals Council considered Rinehart's
argument against the ALJ's decision, and stated
"[w]e found that the reasons do not provide a basis for
changing the Administrative Law Judge's decision."
Doc. 12 at 7. By denying Rinehart's request for review,
the decision of the ALJ became the final decision of the
Commissioner. Doc. 12 at 7.
filed a Complaint in this Court appealing the
Commissioner's final decision. Rinehart contends that the
Commissioner's decision denying her benefits is not based
upon substantial evidence and that substantial evidence shows
she is entitled to widow's insurance benefits. Rinehart
seeks reversal of the Commissioner's decision.
second ALJ properly observed that "[t]he facts of this
matter are largely undisputed" and that Rinehart's
"credibility is not at issue." Doc. 12 at 16-17.
Harter and Rinehart met in 2002 in Highmore, South Dakota.
Doc. 12 at 45-46. Rinehart had a real estate business and was
hired by Harter to sell some property. Doc. 12 at 37-38.
During the course of this business relationship, Rinehart and
Harter developed a close friendship. Doc. 12 at 39. They
became a couple and eventually got engaged. Doc. 12 at 41,
45. On August 27, 2011, Rinehart and Harter were married in
Highmore. Doc. 12 at 58, 116. The marriage was not a sham;
Rinehart and Harter had a loving and close relationship for a
prolonged period of time leading up to the wedding. Doc. 12
month before the wedding, Harter woke up with
petechiae all over his body. Doc. 12 at 115, 204,
312. He visited his family physician in Miller, South Dakota,
who found that Harter had a very low blood platelet count.
Doc. 12 at 115-16, 312. Harter was referred to Michael
McHale, M.D. (Dr. McHale), a hematologist/oncologist in Sioux
Falls, South Dakota. Doc. 12 at 116, 312. On August 2, 2011,
Harter saw Dr. McHale for his idiopathic thrombocytopenic
purpura (ITP). Doc. 12 at 116, 312. Dr. McHale ordered a
bone marrow biopsy. Doc. 12 at 116, 307. On August 5, 2011, a
pathologist reported that the bone marrow biopsy results were
not typical of ITP, but of myeloproliferative
neoplasm blood cancer and most likely of a type of
leukemia called primary myelofibrosis. Doc. 12 at 303.
Harter was prescribed Prednisone. Doc. 12 at 157, 296, 313.
September 2011, Prednisone had not succeeded in increasing
Harter's platelet count, so Dr. McHale prescribed
Rituximab. Doc. 12 at 116, 158. On Rituximab, Harter
experienced a skin reaction without improvement of his
platelet counts. Doc. 12 at 116, 296. On September 13, 2011,
Harter returned to Dr. McHale. Doc. 12 at 294. Dr.
McHale's impression was, again, ITP and questioned
whether there was myelofibrosis leukemia. Doc. 12 at 294,
296. Dr. McHale subsequently prescribed WinRho,
Harter experienced a severe reaction to WinRho and stopped
taking it. Doc. 12 at 117, 296.
October of 2011, Harter and Rinehart visited the Mayo Clinic.
Doc. 12 at 117, 159. Harter was seen by specialists,
including Dr. Robert Phyliky, hematologist, and Dr. Ayalew
Tefferi (Dr. Tefferi), a specialist in proliferative
disorders of hematic cells. Doc. 12 at 117-18, 165, 206, 215.
The physicians diagnosed chronic myeloproliferative neoplasm
with dysplastic features. Doc. 12 at 206, 215. Harter was
placed on Danazol for long-term treatment. Doc. 12 at 215.
Dr. Tefferi advised Harter to connect with a hematologist
close to Highmore to have access to blood and platelets for
transfusions in case of bleeding. Doc. 12 at 118, 166,
January 6, 2012, Harter met with Christina Gant (Gant),
oncology certified nurse practitioner at St. Mary's
Hospital in Pierre. Doc. 12 at 166, 312. She set up a
telemedicine conference with Dr. Parameswaran. Doc. 12 at
118, 167, 312. On January 18, 2012, Gant acted as a scribe
for Dr. Parameswaran, by recording:
[H]e agreed with the Mayo Clinic doctors that
myeloproliferative neoplasm is incurable. However, there is
some talk that sometimes it can be treated as
[myelodysplastic syndrome (MDS)],  especially if the patient
has dysplastic features within his bone marrow which this
patient looked as though he did. Dr. [Parameswaran] also
[wanted to] to repeat a bone marrow biopsy to check for
leukemia and to see if acute leukemia is present. If the
patient is more MDS than MPD [myeloproliferative disorder],
Dr. [Parameswaran] discussed with him that he could possibly
be started on Vidaza ....
Doc. 12 at 314.
Parameswaran ordered another bone marrow biopsy and
peripheral blood test on January 23, 2012. Doc. 12 at 285-88.
A pathologist deemed the results consistent with MDS, best
classified as refractory anemia with excess of blasts
(RAEB-1) or acute myeloid leukemia. Doc. 12 at
169, 288. A Seattle laboratory performed additional studies.
Doc. 12 at 290. On January 26, 2012, Dr. Parameswaran
reported his diagnosis as MDS RAEB-1. Doc. 12 at 192. He
reviewed the laboratory results through a telemedicine
conference with Harter. Dr. Parameswaran recorded:
I have discussed the diagnosis and prognosis with him in
detail. I have indicated that his median survival is in the
order of three to five years at this stage of disease with
the 25% AML [acute myeloid leukemia] progression in the
absence of therapy at a median of 3.3 years .... Clearly, he
can continue his danazol and his platelet stabilized then we
can back off on danazol. I have recommended azacytidine which
I will be prescribing at a dose of 75 mg/m2 IV daily for
seven days repeated every month. The side effects of the drug
were discussed in detail. I have told him that his disease
will progress to leukemia if it is untreated. I have informed
him that it may take several weeks to months for the drug to
work and his counts may deteriorate in the meanwhile .... We
will consult Dr. Becker to have a central venous catheter,
Port-a-Cath placed.... He will start therapy this coming
Monday. We will give him six units of platelets prior to
Doc. 12 at 192.
the appointment, Harter researched Vidaza and wrote questions
to ask Dr. Parameswaran. Doc. 12 at 315-18. Gant faxed Dr.
Parameswaran that Harter had his port placed but "now
doesn't know if he wants chemo. He has been researching
and doesn't know if it is the best thing for him right
now ...." Doc. 12 at 318. Dr. Parameswaran, on February
27, 2012, had a telemedicine visit with Harter, for which the
His next question was could the treatment leave him
permanently worse off than he was originally. Dr.
[Parameswaran] stated that no, the disease process may
progress and that may leave him in a worse state than he was
originally but the Vidaza will not leave his counts
permanently damaged .... The next question was were there
real benefits for starting the treatment now rather than
waiting and watching to see how the disease develops. Dr.
[Parameswaran] stated that yes, if the disease is caught
prior to it becoming acute myelocytic leukemia, there are
definite benefits in the form of greatly increased life
expectancy of greater than 10 years as opposed to if he
should develop acute myelocytic leukemia a life expectancy of
4 months to a year.
Doc. 12 at 319.
underwent infusions of Vidaza in Pierre from March 5 to March
13, 2012. Doc. 12-1 at 7. On March 18, 2012, Harter began
shaking, sweating, and had a fever. Doc. 12-1 at 7. He went
to the emergency room, was diagnosed with
pneumonia/septicemia, and was admitted to the hospital. Doc.
12 at 177; Doc. 12-1 at 7. Pneumonia with sepsis is a known