Clifford v. Apfel

• Decision Date: 14 September 2000
• Docket Number: No. 99-3831,99-3831
• Citation: 227 F.3d 863
• Parties: (7th Cir. 2000) Donna J. Clifford, Plaintiff-Appellant, v. Kenneth S. Apfel, Commissioner of Social Security, Defendant-Appellee
• Court: U.S. Court of Appeals — Seventh Circuit

Page 863

227 F.3d 863 (7th Cir. 2000)

Donna J. Clifford, Plaintiff-Appellant, v. Kenneth S. Apfel, Commissioner of Social Security, Defendant-Appellee.

No. 99-3831

In the United States Court of Appeals For the Seventh Circuit

Argued May 18, 2000

Decided September 14, 2000

Appeal from the United States District Court for the Southern District of Indiana, Indianapolis Division. No. IP 98-1695-C-Y/S--Richard L. Young, Judge. [Copyrighted Material Omitted] Before Posner, Diane P. Wood, and Williams, Circuit Judges.

Williams, Circuit Judge.

Donna J. Clifford applied for supplemental security income ("SSI") under Title XVI of the Social Security Act, 42 U.S.C. sec.sec. 1381 et seq., alleging a disability resulting from high blood pressure, depression, double vision, arthritis in her legs, pain in her hands, and back and nerve problems. Clifford's claim was denied initially, upon reconsideration, and after a hearing before an Administrative Law Judge ("ALJ"). The ALJ determined that Clifford was not "disabled" within the meaning of the Social Security Act. The Appeals Council declined review and the ALJ's decision became the final decision of the Commissioner of Social Security ("Commissioner"). Clifford sought judicial review of the Commissioner's decision denying her SSI benefits, and the district court affirmed the Commissioner. We reverse.

I

A. Administrative Hearing

At the time of the administrative hearing, Clifford was 53 years old, 5'3" tall, and weighed 199 pounds. She testified that she has a twelfth grade education. Her only work experience was as a waitress in 1965. She stated that she shared a three room apartment with her husband, where she does some housework, including cooking, vacuuming, making the bed, washing dishes, and grocery shopping. She is able to take a shower and dress herself. She further stated that she does not engage in many social activities outside of visiting her daughter and grandchildren. She testified that on a few occasions she babysat her grandchildren. At her doctor's suggestion, Clifford stated that she walks for exercise. She testified that she walks six blocks to visit her daughter's house in the summertime. During the walks (six blocks each way), she stated that she must sit and rest (near the fourth or fifth block) due to pain in her legs.

According to Clifford, she is unable to work because of nerve and vision problems and her inability to lift significant weight or sit, stand or walk on a sustained basis. She explained that she is nervous around people and often cries for no apparent reason. She further reported that she wears an eye patch to avoid double vision. She testified that she experiences pain in both hands and often drops things due to numbness in her left hand. She also testified that she can lift a 20 pound sack of potatoes. She stated that she experiences pain in both her legs, which requires her to sit or lie down periodically throughout the day. However, she testified that she can sit for about two hours at a time. Clifford further reported that she is taking prescription medications for depression, sinus, arthritis, and pain problems.

B. Medical Evidence

1. Ball Memorial Hospital

From 1994 to 1996, Clifford made frequent visits to the emergency room ("ER") at Ball Memorial Hospital.¹ In 1994, she made several ER visits because she experienced symptoms of high blood pressure; each time she was treated with medication and released. In January 1995, Clifford returned to the ER complaining of shoulder and back pain. The attending ER physician, Dr. Gary Gaddis, M.D., prescribed pain medication and released her. Six months later (in July), she made another ER visit, this time complaining of knee pain. On examination, Dr. Iguban Querubin, M.D., found positive tenderness in both of her knees. Dr. Querubin diagnosed arthralgia (joint pain) in Clifford's right knee and prescribed medication. Later that month, Clifford returned to the ER complaining of arm pain. She received a diagnosis of radiculopathy (nerve root disease) with cervical and left arm pain.

The following January (1996), Clifford went to the ER after she slipped and fell on her right knee. An x-ray showed no acute abnormalities but indicated a marked amount of degenerative change. On April 7, 1996, she entered the ER complaining about leg pain. Dr. Max H. Rudicel, M.D., indicated that her problems were associated with degenerative arthritis. In November of that year, Clifford returned to the ER complaining of a possible cerebrovascular accident (i.e., a stroke). She was admitted and referred to a clinical neurologist, Dr. Jay G. Panszi, M.D., who reported that her problems were caused by microvascular brain stem disease that was aggravated by her high fat diet. At one point during her many ER visits, Clifford was described as a "well-developed, well-nourished" woman.

2. Dr. Jeffrey A. Heavilon, M.D.

On August 10, 1995, Clifford saw Dr. Jeffrey A. Heavilon at Central Indiana Orthopedics, P.C., complaining of left arm and neck pain. At that examination, Clifford wore a cervical collar and a wrist splint. Dr. Heavilon described Clifford as a "healthy appearing" woman who was in no acute distress. He reviewed x-rays of her cervical spine and noted that they showed degenerative arthropathy (joint disease), with some radiculopathy (nerve root disease) in her left shoulder. He recommended continued conservative treatment, including use of a Prednisone Dosepak. Dr. Heavilon later reported that Clifford's left shoulder pain improved with the use of the Prednisone Dosepak, but noted that Clifford also complained about pain in her right foot.

3. Dr. Cheryl Keech, M.D.

At the request of the Social Security Administration, Clifford saw Dr. Cheryl Keech, a consulting physician, on August 16, 1995. Dr. Keech described Clifford as an "obese" woman who moved about the examination room without difficulty and showed no signs of shortness of breath or fatigue. Dr. Keech indicated that Clifford had no anatomical deformities, inflammation, or swelling. She noted that Clifford's range of bodily motions was normal and that her grip strength was intact. She also recorded Clifford as having no loss of hand functioning. Dr. Keech did find pain with palpation in Clifford's right ankle and both knee joints. She also found mild muscle spasm in Clifford's upper cervical area across her shoulder. She reported that Clifford had arthritis and "very high" blood pressure. She further stated that Clifford had a pinched nerve in her neck that caused pain, but indicated that the pinched nerve had not caused any loss of functioning or any nerve damage. Dr. Keech recommended that Clifford consult an ophthalmologist for her vision problems.

4.Open Door Health Clinic/Dr. Arnold L. Carter, M.D.

In February 1996, Clifford saw Dr. Arnold L. Carter at the Open Door Health Clinic, a community health clinic where she sought medical treatment from 1981 until the hearing. On examination, Dr. Carter diagnosed arthritis in Clifford's knee joints and probable carpal tunnel syndrome in her left wrist (but a treatment note from a prior visit to the clinic indicated that Clifford had "good grip" strength in her left hand). Dr. Carter recommended that Clifford continue taking medication for arthritis and that she continue using her carpal tunnel brace. A month later, Dr. Carter noted that Clifford still had problems with pain in her wrists and knees. That April, Dr. Carter examined Clifford and found tenderness in her knee joints. Dr. Carter observed that Clifford had "marked excessive weight" and recommended that she monitor her dietary fat intake. Three weeks later, Clifford returned to Dr. Carter complaining about bilateral knee pain and swelling and shortness of breath. The following December, Dr. Carter observed that Clifford walked with an unsteady gait and noted that she could not perform tandem walking. A treatment note from the clinic dated December 30, 1996, indicated that Clifford experienced pain in her left knee that extended to her thigh after she walked three blocks. Clifford also complained about numbness in her left hand and tightening of her fingers.

5. Dr. Andrew H. Combs, M.D.

In September 1996, Clifford saw her treating physician, Dr. Andrew H. Combs, an orthopedic specialist at Central Indiana Orthopedics, P.C., for pain in her right knee. Following an examination, Dr. Combs diagnosed right knee arthritis and suggested that Clifford would eventually require a total knee replacement. Four months later (January 1997), Clifford returned to Dr. Combs for left knee and bilateral hand pain that had persisted for at least a year. On examination, Dr. Combs opined that Clifford's history of bilateral knee osteoarthritis limited her ability to stand. Based on x-rays, he stated that her left knee showed degenerative arthritis in the medial joint space. Dr. Combs noted that this finding was similar to Clifford's right knee osteoarthritis. He also reviewed x-rays of both her wrists. He noted that her hands showed mild joint osteoarthritis. He also diagnosed right arm paresthesias, but he indicated that this condition did not warrant electromyographic (EMG) testing. He recommended that if her paresthesias worsened, she could start using her wrist splints.

Consistent with his examination in September 1996, Dr. Combs indicated that Clifford would eventually require a knee replacement. According to him, Clifford's medical condition severely limited her ability to perform any work that required standing or walking. Dr. Combs also opined that Clifford was unable to perform work that required repetitive use of her hands. He further predicted that her double vision would severely limit her ability to perform reading and computer monitor work.

6. Dr. S.L. Rumschlag, O.D.

Following the hearing before the ALJ (but while the record remained open), Clifford saw Dr. S.L. Rumschlag on February 3, 1997. Dr. Rumschlag reported that...