Anderson v. Bowen
| Decision Date | 14 February 1989 |
| Docket Number | No. 88-1049,88-1049 |
| Citation | 868 F.2d 921 |
| Parties | , Unempl.Ins.Rep. CCH 14535A Willie B. ANDERSON, Plaintiff-Appellant, v. Otis R. BOWEN, M.D., Secretary of Health and Human Services, Defendant-Appellee. |
| Court | U.S. Court of Appeals — Seventh Circuit |
Janet F. Gerske, Chicago, Ill., for plaintiff-appellant.
Linda E. Tucker, U.S. Dept. of Health and Human Services, Chicago, Ill., for defendant-appellee.
Before COFFEY, FLAUM, and MANION, Circuit Judges.
Willie Anderson seeks review of a final decision of the Secretary of Health and Human Services (the "Secretary") denying his applications for disability insurance benefits and supplemental security income ("SSI") under the Social Security Act, 42 U.S.C. Secs. 423 and 416(i). We affirm the district court's approval of the Secretary's decision.
Anderson filed applications for SSI and disability insurance benefits on October 9, 1985. The applications alleged that as of September 1980 he became incapable to pursue his usual line of employment resulting from a heart condition, diabetes, swelling of the legs, headaches, nosebleeds and poor vision. 1 The Secretary denied the applications initially and on reconsideration. Counsel was appointed for Anderson and a hearing was held before an Administrative Law Judge ("ALJ") on June 16, 1986. Anderson testified at the hearing that he was physically unable to return to his former work as a laundry sorter because it required too much walking, standing and lifting of heavy weights. He also complained of sore hands and constant pain in his legs and chest. Regarding his functional capacity, he claimed an inability to stand for more than five or six minutes, to sit for more than five minutes, to lift more than four pounds and to walk more than half a block.
Anderson was born July 15, 1937, and has an eighth grade education. 2 He is five feet eleven inches tall and weighs approximately 275 pounds. Anderson was most recently employed from approximately 1979 through 1983 as a laundry sorter, a job that required him to stand all day and lift bundles of clothes weighing over 100 pounds. Anderson has not worked since late 1983, when the laundry went out of business.
The medical record reveals that Anderson had regular check-ups from January 1982 to May 1986 at the Fantus Health Center, located in Cook County Hospital, Chicago, Illinois ("Fantus"). Medical progress notes prepared by examining physicians after each check-up reflect that Anderson was consistently treated for hypertension, diabetes and obesity during this period. Some of the medical notes made after examination and/or treatment refer to but do not specifically diagnose congestive heart failure and edema, and also suggest that Anderson was suffering from cardiomegaly and tachycardia on several isolated occasions. 3 Anderson contends that these references provide substantial evidence that he is disabled.
On June 24, 1985, Anderson was examined by Dr. U. Gowda, a physician retained for consultation by the State of Illinois. 4 Anderson complained to Dr. Gowda of a six month history of sharp chest pain with an onset after physicial exertion. Upon examination Dr. Gowda specifically noted a "massively obese" man "in no acute distress." Further, Dr. Gowda noted his uncorrected visual acuity in both eyes at 20/25. Examination of the chest and heart sounds were normal, although Dr. Gowda did observe a grade I/VI ejection systolic heart murmur. There was no enlargement of the abdominal organs and no edema (fluid build-up) in the lower extremities. The musculoskeletal system was entirely normal with no complaints of pain with movement. Dr. Gowda's "final impression" states that Anderson's hypertension was uncontrolled by his prescribed medication "but there are no clinical features suggestive of congestive heart failure."
At the request of the Illinois Bureau of Disability Adjudication Services, Dr. Mila Bacalla, an internist, performed another consultative examination of Anderson on December 9, 1985. At that time plaintiff-appellant Anderson complained of constant leg pain and sharp chest pain for the previous five years, generally brought on by exertion. Examination showed uncorrected visual acuity of 20/40 on the right and 20/30 on the left, with retinopathy (a noninflammatory disease of the retina). 5 There were no deformities or edema in the upper and lower extremities, and Anderson displayed full range of motion in those joints. Dr. Bacalla found "no evidence of any congestive heart failure at this time," and a "murmur suggestive of aortic stenosis" (a narrowing of the trunk of the arterial system). 6
Anderson also underwent a stress test in January 1986. The test revealed coronary artery disease and sinus tachycardia but was negative for ischemia (deficiency of blood in a part due to obstruction of a blood vessel). 7
After reviewing the medical evidence and Anderson's hearing testimony, the ALJ found that Anderson could not return to his former work as a laundry sorter because he could no longer perform the heavy lifting required in that job. However, he went on to state that Anderson did retain the residual functional capacity to perform a full range of light work. The ALJ then applied the Secretary's Medical-Vocational Guidelines (the "Grid"), 20 C.F.R., Pt. 404, Subpt. P, App. 2, Table No. 2, Rule 202.17, which mandated a finding that Anderson was not disabled in light of his age (forty-eight), education (eighth grade), previous work experience (unskilled) and residual functional capacity (light work). 8 The Appeals Council denied Anderson's request for review of the ALJ's decision. The district court affirmed.
Our task is to determine whether the Secretary's findings are supported in the record with substantial evidence, 42 U.S.C. Sec. 405(g). Substantial evidence is "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion, taking into account whatever in the record fairly detracts from its weight." Richardson v. Perales, 402 U.S. 389, 91 S.Ct. 1420, 28 L.Ed.2d 842 (1971).
Anderson raises two issues on appeal. Initially, he claims that the ALJ failed to discuss significant evidence in his medical records that he suffers from congestive heart failure, which requires a finding that he is disabled at Step 3 of the five-step sequential procedure for evaluation of disability claims. 9 Further, he argues that because of his physical and medical problems he is unable to perform a full range of light work and should have been declared disabled at Step 5 of the Secretary's regulations.
A claimant is considered to be disabled at Step 3 of the five-step disability determination procedure upon proof of one of the impairments listed in Appendix 1 to the Secretary's regulations, 20 C.F.R., Pt. 404, Subpt. P, App. 1 (the "Listings"). Anderson contends that he has congestive heart failure ("CHF"), which appears at section 4.02 of the Listings, and requires a showing of persistent CHF manifested by evidence of vascular congestion such as hepatomegaly or edema, either peripheral or pulmonary. 10
The ALJ reviewed the evidence presented in the patient's medical history from the Fantus Health Center, and in his decision noted the various blood pressure readings, the results of an electrocardiogram and heart examinations, blood sugar counts as well as Anderson's severe obesity. He made no mention of any evidence of congestive heart failure. He also discussed the results of the consultative medical examinations performed by Dr. Gowda and Dr. Bacalla. He ultimately stated:
"A perusal of all the medical evidence in the record reveals no impairment or impairments either singularly or in combination that meets or equals any of the listed impairments and more particularly Section 4 (cardiovascular system)."
Anderson argues that the ALJ's discussion ignores evidence of congestive heart failure. He directs our attention to a number of references to CHF in progress notes from the Fantus Health Center dating from 1982 through 1986. We have repeatedly held that a written evaluation of every piece of testimony and submitted evidence is not required. Zalewski v. Heckler, 760 F.2d 160, 166 (7th Cir.1985), quoting Zblewski v. Schweiker, 732 F.2d 75, 79 (7th Cir.1984). Instead, we are interested in knowing that the Secretary has considered and discussed "the important evidence," Stephens v. Heckler, 766 F.2d 284, 287 (7th Cir.1985), including "all medical evidence that is credible, supported by clinical findings and relevant to the question at hand...." Garfield v. Schweiker, 732 F.2d 605, 610 (7th Cir.1984). Because the evidence Anderson relies upon is not supported with clinical findings in the record we conclude that the ALJ was not obliged to discuss it in his written decision.
None of the references to CHF in the Fantus medical history are supported by evidence of vascular congestion, as section 402(A) of the Listings requires. There is no evidence at all of liver enlargement (hepatomegaly). Indeed, Fantus notes from September 1985 and January 1986 specifically state "no hepatomegaly," and Dr. Gowda found no enlargement of any abdominal organ. In addition, Anderson relies on only two references to edema in his voluminous Fantus records. Not only are those references ambiguous, they are also overwhelmed by negative findings. References to pedal edema appear in notes from April 1985 (Tr. 126) and August 1985 (Tr. 125). In the April 1985 note the term "pedal edema" is preceded by a circle with a plus sign inside. In the August 1985 note, "pedal edema" is preceded by a circle with a line through it. We are unable to decipher the exact meaning of some of those symbols, and thus are unable to determine whether they actually are supportive of Anderson's position. Even if we were to interpret the references in Anderson's favor, there is...
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