Woody v. Secretary of Health and Human Services

• Decision Date: 21 October 1988
• Docket Number: No. 87-5818,87-5818
• Citation: 859 F.2d 1156
• Parties: , Unempl.Ins.Rep. CCH 14224A Walter WOODY, Appellant, v. SECRETARY OF HEALTH AND HUMAN SERVICES.
• Court: U.S. Court of Appeals — Third Circuit

Page 1156

859 F.2d 1156

23 Soc.Sec.Rep.Ser. 370, Unempl.Ins.Rep. CCH 14224A

Walter WOODY, Appellant, v. SECRETARY OF HEALTH AND HUMAN SERVICES.

No. 87-5818.

United States Court of Appeals Third Circuit.

Argued May 6, 1988.

Decided Oct. 21, 1988.

Frank A. Cristaudo (argued), West Deptford, N.J., for appellant.

Samuel A. Alito, Jr., U.S. Atty., Cornelia E. Dude, Sp. Asst. U.S. Atty. (argued), Newark, N.J., for appellee.

Before HIGGINBOTHAM, STAPLETON and GREENBERG, Circuit Judges.

OPINION OF THE COURT

STAPLETON, Circuit Judge.

This appeal from a district court order affirming the denial of Social Security disability benefits comes to us after more than eight years of administrative and district court proceedings. We will reverse and direct that benefits be paid.

I.

The claimant, Walter Woody, is a married 40-year old male with three children and has a full scale IQ of 77. Between his graduation from high school and 1979, when he last worked regularly, Woody was steadily employed for 14 years. During the last nine of these years, he worked as a maintenance mechanic for CBS Records. Woody claims that in April, 1979, he developed a disability that has prevented him from working.

Woody has testified that the symptoms of his disability include pain "all over his body," especially in his legs, back, ribs, and right arm. He also claims to have difficulty walking, standing, or sitting for an extended period of time. In addition, he claims that he has difficulty bending, lifting, and climbing.

As of 1981, Woody had had 12 hospitalizations resulting from these symptoms and had been examined by numerous doctors. Other hospitalizations and examinations have followed, but no doctor has been able to diagnose definitively a physical cause of Woody's symptoms. The failure of Woody's doctors to find either a cause of or a cure for Woody's perceived physical problems has resulted in psychological difficulties for Woody. He is profoundly depressed and obsessed with his perceived illness and his inability to provide for himself and his family. He has testified that this depression has severely restricted his daily activities. Woody stays home in bed most of the time and does not drive. He has difficulty sleeping, shaving, bathing, and dressing himself. He feels isolated from his wife and children and does not participate in family social events or chores. Woody's testimony in this regard has been corroborated by the testimony of his wife and neighbors. A Social Security interviewer has noted that Woody "was completely frustrated because of his inability to get around and yet the doctors can't seem to find out what's wrong. He has a family to support and this upsets him also because the situation is getting desperate." 153a.

Woody underwent two psychiatric evaluations in 1981. Dr. N.J. George filed a report that diagnosed Woody as suffering from "reactive depression." Dr. George's report includes the following observations and conclusions:

[Woody] stays home all the time. He is either on the bed or on the couch most of the time. He needs assistance to take a shower, dress etc. He is unable to shave, standing up. He does not go out of the house because of his difficulty in walking. He is unable to drive a car....

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Patient is depressed because of severe pain and his inability to function normally. He has dif[f]use neurological signs. He is very much disgusted with himself and appears to have given up as he has not had any relief even after three years of hospitalizations and evaluations. It appears from the history his condition is progressing. I would consider him totally and permanently disabled because he is even unable to take care of his basic needs like shaving, dressing, etc.

Id. at 416a-17a.

Dr. James Nelson also concluded that Woody was totally disabled. Dr. Nelson included anxiety and depression among Woody's presenting problems, and found Woody to be

obsessively pre-occupied with his multiple somatic complaints and he impressed me as somewhat tense and anxious and worried about his problems. In addition to this, I am sure that I was able to pick up significant hysterical features including unconscious tendencies to exaggerate his responses, exhibit his disability and over-react to stimuli.

Id. at 419a. Two doctors' reports from 1986 indicate that Woody continues to suffer from depression and anxiety.

Woody first filed an application for disability insurance benefits on November 14, 1979. After this application was denied initially and on reconsideration, Woody requested a review hearing, which was held on December 10, 1980. On January 26, 1981, the administrative law judge (ALJ) found that Woody was not entitled to disability benefits. Woody did not appeal, but he instead filed a second application. The second application was denied both initially and on reconsideration. Woody then requested a second hearing, which was held on June 29, 1982.

On September 17, 1982, a second ALJ held that Woody was not entitled to disability benefits. The ALJ found no objective medical findings corroborating Woody's subjective complaints and disbelieved Woody's own testimony regarding his pain. This decision was approved by the Appeals Council on January 5, 1983, and thereby became the final decision of the Secretary.

Woody then sought judicial review. The district court vacated the Secretary's decision and remanded for further administrative proceedings. Of relevance here is the district court's determination that the ALJ's conclusion that Woody's return to work would significantly alleviate his depression constituted an unauthorized medical opinion contrary to that of Dr. George.

Thereafter, a third hearing was held on March 13, 1985 and on June 26, 1985 the ALJ again denied Woody's claim. The ALJ found "no convincing evidence of a mental impairment which alone or in conjunction with other impairments, would impose significant limitations of function." 258a. The Appeals Council remanded to the ALJ, however, to reconsider the claim in light of the new regulations concerning mental impairments published on August 28, 1985 pursuant to the Social Security Disability Benefits Reform Act of 1984, Pub.L. No. 98-460, Sec. 5, 98 Stat. 1794 (1984). The Appeals Council also directed the ALJ to complete a Psychiatric Review Technique Form along with its recommended decision.

On May 13, 1986 a fourth administrative hearing was held. An updated report from Dr. George was submitted reflecting that Woody continued to report constant pain and remained in a state of depression. Dr. George noted "suicidal ideation" and "poor" sleeping, as well as the following lifestyle:

Patient stated that he stays in bed all the time because of the pain. Listens to his radio and very seldom goes out shopping or outside. He does hardly any driving because he is afraid to drive because of the weakness of his legs.

His hobbies are fishing but has not done this for the past 4 years. He does not do any cooking or cleaning. He has no social activity. Does not even visit family members. Has difficulty getting into the tub. He takes sponge baths and needs help from his wife to wash below the knees. He is unable to put on his socks or tie shoes.... Has lost interest in sex; feels hopeless and helpless.

683a. On July 16, 1986 the ALJ once again denied Woody's claim.

The Appeals Council adopted the ALJ's recommended decision and Woody again sought judicial review. This time the district court affirmed the Secretary's decision on the ground that substantial evidence supported the ALJ's application of the new regulations concerning mental impairments. This appeal followed. We have jurisdiction under 28 U.S.C. Sec. 1291 (1982).

II.

The standard of review in this case is whether there is substantial evidence in the record to support the Secretary's decision. Brown v. Bowen, 845 F.2d 1211, 1213 (3d Cir.1988). Substantial evidence has been defined as "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Richardson v. Perales, 402 U.S. 389, 401, 91 S.Ct. 1420, 1427, 28 L.Ed.2d 842 (1971) (quoting Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229, 59 S.Ct. 206, 217, 83 L.Ed. 126 (1938)). It is more than a mere scintilla of evidence but may be less than a preponderance. Brown, 845 F.2d at 1213.

The Social Security Act defines "disability" as the "inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment ... which has lasted or can be expected to last for a continuous period of not less than 12 months." 42 U.S.C. Sec. 423(d)(1)(A) (1982). A "physical or mental impairment" is defined as "an impairment that results from anatomical, physiological, or psychological abnormalities which are demonstrable by medically acceptable clinical and laboratory diagnostic techniques." Id. Sec. 423(d)(3). A physical or mental impairment constitutes a disability under the Act only if it is "of such severity that [the claimant] is not only unable to do his previous work but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy." Id. Sec. 423(d)(2)(A) (Supp. IV 1986). In demonstrating his disability, the claimant may not rely solely on his own stated symptoms, but must provide

medical signs and findings, established by medically acceptable clinical or laboratory diagnostic techniques, which show the existence of a medical impairment that results from anatomical, physiological, or psychological abnormalities which could reasonably be expected to produce the pain or other symptoms alleged and which ... would lead to a conclusion that the individual is under a disability.

Id. Sec. 423(d)(5)(A) (Supp. IV 1986).

A claimant may show that he is disabled in one of two ways. First, he can introduce evidence that his symptoms, signs, and laboratory findings match or surpass...