Dillon v. Celebrezze, 9763.

• Decision Date: 04 May 1965
• Docket Number: No. 9763.,9763.
• Parties: Clyde DILLON, Appellant, v. Anthony J. CELEBREZZE, Secretary of Health, Education, and Welfare, Appellee.
• Court: U.S. Court of Appeals — Fourth Circuit

345 F.2d 753 (1965)

Clyde DILLON, Appellant, v. Anthony J. CELEBREZZE, Secretary of Health, Education, and Welfare, Appellee.

No. 9763.

United States Court of Appeals Fourth Circuit.

Argued March 5, 1965.

Decided May 4, 1965.

Clay S. Crouse, Beckley, W. Va. (E. Carl Meadows, Jr., Beckley, W. Va., on brief), for appellant.

Harvey L. Zuckman, Atty., Dept. of Justice (John W. Douglas, Asst. Atty. Gen., and Sherman L. Cohn, Atty., Dept. of Justice, and Donald P. Moore, U. S. Atty., on brief), for appellee.

Before SOBELOFF and J. SPENCER BELL, Circuit Judges, and LARKINS, District Judge.

J. SPENCER BELL, Circuit Judge.

This is an appeal from an order of the district court dated and filed October 6, 1964, which granted the Secretary's motion for summary judgment and affirmed a decision of the hearing examiner denying the claimant, Clyde Dillon, a period of disability and disability insurance benefits under the Social Security Act, 42 U.S.C.A. §§ 416(i) and 423.

The examiner, after considering the evidence introduced before him at a hearing on May 9, 1961, concluded that it

"certainly does not show that the claimant\'s impairments in combination had reached a stage of severity to preclude substantial gainful employment when he last met the earnings requirements — March 31, 1960."

The Appeals Council affirmed the examiner's decision on July 31, 1961. On review, the district judge upheld the Appeals Council. Considering the record before us as a whole, we do not think it contains substantial evidence to support the prior rulings adverse to the claimant. Accordingly, these rulings must be reversed.

The claimant was born on May 20, 1906, and was fifty-four years old when he filed the disability claims presently in issue. His education is limited to writing his name, and he cannot read. He has worked most of his adult life as a coal miner, but he was laid off in June, 1958, when the mine at which he was employed at the time closed down.¹ Attempts to locate other employment after this layoff were unsuccessful.

Dillon asserts that he was disabled, as that term is used in the Social Security Act, when his insured status expired because of a combination of impairments to his heart, back, and lungs. Without intending to minimize in any way the seriousness of his lung difficulties, the claimant, through his counsel, placed primary emphasis before us upon his heart and back conditions. In support of his assertions, counsel for Dillon has directed our attention to the reports of the several doctors who examined the claimant between 1959 and 1961.

Because both parties to this suit have placed such emphasis upon the objective medical findings, we deem it appropriate to restate what this court has observed before — that clinical medical reports are not necessarily dispositive of the question of a claimant's disability. Thus, we said in Underwood v. Ribicoff, 298 F.2d 850, 851 (1962):

"For the purpose of making a finding of fact on this issue disability, the fact finder must recognize the obvious interrelation of the various elements of proof. The objective medical findings may show more or less clearly the existence of certain clinically determinable physical or mental impairments. However, a recitation of objective, clinical findings will seldom show, without more, the over-all effect of these impairments on a particular individual. This is a matter of medical judgment to be decided with reference to the individual\'s general physical condition and the state of development of each of the defects." (Emphasis added.)

In the Underwood case, we pointed out that there are really four elements of proof to be considered in determining whether a claimant is disabled within the meaning of the Social Security Act: (1) the objective medical facts, which are the clinical findings of the treating and/or examining physicians divorced from their expert judgment or opinions as to the significance of these clinical findings; (2) the diagnoses and expert medical opinions of the treating and examining physicians on subsidiary questions of fact, such as the effect of clinically determinable impairments upon an individual; (3) the subjective evidence of pain and disability testified to by the claimant and corroborated by his wife, other members of his family, his neighbors, and/or others in a position to observe him; and (4) the claimant's age, educational background, and work history. We proceed to a consideration of the evidence in this case in the light of these elements of proof.

We think it of significance that every doctor who examined Dillon reported some medically determinable physical ailment. To be sure, their evaluation of his condition varied to some extent, and some of the doctors emphasized different aspects of his problems. Several of the doctors who examined the claimant filed more than one report; without exception their later reports noted that the conditions which they had observed during their initial examinations not only still existed but they had worsened with the passage of time.

The first physician to examine Dillon whose report is a part of this record was Dr. Philip Preiser, an internist in Charleston, West Virginia. He filed two reports, dated March 14 and October 26, 1959, in which he stated that his patient was suffering from arteriosclerotic heart disease, coronary sclerosis, angina pectoris, and chronic bronchitis. In the latter report, he also reported evidence of peribronchial fibrosis and emphysema and added early nephrosclerosis to his previous diagnoses. Dr. Preiser's reports also noted that the claimant experienced considerable pain and tired quickly with...