Edwards v. Sullivan, 90-8001

• Decision Date: 05 August 1991
• Docket Number: No. 90-8001,90-8001
• Citation: 937 F.2d 580
• Parties: , Unempl.Ins.Rep. CCH 16196A Patricia A. EDWARDS, Plaintiff-Appellant, v. Louis W. SULLIVAN, as U.S. Secretary of Health and Human Services, United States of America, Defendant-Appellee.
• Court: U.S. Court of Appeals — Eleventh Circuit

Page 580

937 F.2d 580

34 Soc.Sec.Rep.Ser. 110, Unempl.Ins.Rep. CCH 16196A

Patricia A. EDWARDS, Plaintiff-Appellant, v. Louis W. SULLIVAN, as U.S. Secretary of Health and Human Services, United States of America, Defendant-Appellee.

No. 90-8001.

United States Court of Appeals Eleventh Circuit.

Aug. 5, 1991.

Arthur Frank Millard, Atlanta, Ga., for plaintiff-appellant.

Robert L. Barr, U.S. Atty., Nina Hickson Perry, Asst. U.S. Atty., Bruce R. Granger, Mary Ann Sloan, Scott C. Briles, Mack A. Davis, Holly A. Grimes and Christine Bradfield, Office of Gen. Counsel, Dept. HHS, Atlanta, Ga., for defendants-appellees.

Appeal from the United States District Court for the Northern District of Georgia.

Before ANDERSON and DUBINA, Circuit Judges, and GIBSON ^*, Senior Circuit Judge.

FLOYD R. GIBSON, Senior Circuit Judge:

Patricia Edwards appeals the district court's ¹ order affirming the denial of her application for disability insurance benefits. We affirm the district court's order.

I. BACKGROUND

Edwards was born in May 1947 and is a high school graduate. In 1969 she began working for Delta Airlines, first as a teletype operator and then as a reservation agent. Sometime in 1973, she severely injured her back when she fell out of her chair at work. Some of her discs were fused, and she stopped working until 1979; from 1974 to 1977 she received disability insurance benefits.

In May 1979, Edwards returned to work at a travel agency; she continued working on a somewhat regular basis for a variety of employers in the travel industry. Her most recent employer was United Airlines, for whom she began working as a reservation agent in January 1984. On April 8, 1986, while still employed with United, Edwards again injured her back; this time the injury occurred while she was attempting to lift some equipment at work. She stopped going to work on April 10; Edwards tried to return to work on May 8 but was terminated by United.

Edwards filed for disability insurance benefits on October 10, but her request was denied. She requested a hearing, which was held on August 24, 1987. Edwards appeared without counsel. In addition to her own testimony, she offered reports and letters from Doctors Johnson, Edwards, ² and Cabot. None of the doctors testified at the hearing.

Doctor Johnson is a psychiatrist; he first treated Edwards for severe depression in December 1985. In a two-page letter dated November 18, 1986, he diagnosed Edwards as suffering from "Axis I Dysthymic Disorder, severe; Axis II Personality Disorder with mixed compulsive, dependent and avoidant features." He also opined that "[a]pparently a combination of orthopedic and emotional problems are contributing to her inability to work."

After the claimant re-injured her back in April 1986, Doctor Johnson referred her to Doctor Edwards, who initially diagnosed the claimant as suffering from a mild acute lumbar strain. A CT scan was performed, and Doctor Edwards' notes indicated that the claimant suffered from pain and would undoubtedly require further treatment, but the prognosis was good and she was likely to improve. Doctor Edwards also indicated that she could return to work; though he initially indicated that she could work only four hours a day, he did not explain why this limitation was imposed. Doctor Edwards later indicated that it would be "appropriate" for the claimant to return to work on a trial basis and that she would not suffer any permanent harm. Beginning in June 1986, Doctor Edwards' notes make several references to Claimant Edwards' legal problems and candidly concede that the doctor and the patient were having problems objectively judging her condition.

Edwards saw Doctor Cabot in connection with a workers' compensation claim relating to the April 1986 injury. Doctor Cabot recommended that a myelogram be performed and prescribed a conservative treatment program. Tests indicated that Edwards had a less than full range of motion; however, Doctor Cabot concluded that Edwards could work so long as she was allowed to get up and walk five minutes of every half hour.

At the hearing, Edwards testified that she could not work because of muscle spasms and pain in her lower back and neck and instability in her right leg. She testified that bending increased the pain and that she had to take two or three hot baths a day to alleviate the pain. She also stated that she made occasional trips to the supermarket, fixed meals, and performed light household chores, such as washing dishes.

At the conclusion of Edwards' testimony, the ALJ determined that he needed more information and ordered consultative orthopedic and psychological examinations. The orthopedic examination was performed by Doctor Hajosey. He determined that Edwards did suffer from decreased sensation and reflex in her right leg and ankle, but he could not determine whether this was a result of her disc fusion; furthermore, there was insufficient evidence for him to determine whether she suffered from a herniated disc. Based upon his examination, Doctor Hajosey concluded that Edwards could sit, stand, and walk, and that she could engage in each activity for up to four hours per day.

The consulting psychiatric evaluation was performed by Doctor Brooks. After administering a series of tests and conducting a personal interview, Doctor Brooks concluded that Edwards exhibited indicia of "social withdrawal, limited friendships, family problems both past and continuing, unmet needs regarding affection, denial of problems, emotional repression, and depression." Doctor Best-Williams, in her capacity of "medical advisor to the administrative law judge," reviewed the evidence "pertaining to the claimant's evaluation and treatment for emotional problems," but she did not personally see the claimant. Based on her review of the records, Doctor Best-Williams concluded that Edwards suffered from a dysthymic disorder with symptoms of depression and that this impairment moderately affected Edwards' ability to function socially. However, her daily activities were "only slightly negatively impacted by her [mental] impairment." She also concluded that Edwards' IQ scores and interview responses reflected that Edwards could think and reason, and that her limitations were due to her physical health. However, after comparing the psychological reports of Doctors Brooks and Johnson, Doctor Best-Williams concluded that Edwards' "limitations seemed to have improved." Finally, in completing an assessment of Edwards' capacity to perform a variety of work-related functions, Doctor Best-Williams indicated that Edwards was not significantly limited in any way, except for her ability to concentrate, which was moderately limited on an episodic basis.

The consulting doctors' reports were received into evidence at a supplemental hearing held by the ALJ. At that time, Edwards testified again; she stated that her back had deteriorated further and that her right leg was "getting worse." A vocational expert ("VE") also testified at the supplemental hearing and responded to three hypothetical questions posed by the ALJ. In the first hypothetical, the VE was asked to assume that Edwards' capabilities were restricted as described in the reports of Doctors Cabot and Best-Williams. The second hypothetical required the VE to consider the limitations described in the reports of Doctors Hajosey and Best-Williams. The final hypothetical included only Claimant Edwards' testimony. In response to the first two hypotheticals, the VE identified a variety of occupations with duties that Edwards could perform; however, if full credit were given to Edwards' testimony, there were no jobs in the national economy she could perform.

The ALJ found that, though Edwards suffered from a chronic lumbar strain, a mild to moderate dysthymic disorder, and a mild to moderate personality disorder, her condition did not meet any of the listed impairments entitling her to disability payments. He further found that her testimony regarding the degree of pain was not fully credible and that, despite her condition, she could perform jobs that exist in significant numbers in the national economy. Consequently, he denied Edwards' request for benefits.

II. DISCUSSION

Edwards raises a variety of arguments in an attempt to demonstrate that the ALJ's decision was improper. These arguments fall into three main categories: the ALJ's findings regarding her physical condition, the ALJ's findings regarding her mental condition, and denial of counsel. For ease of discussion, we will group her arguments into these three categories and conduct our analysis within that framework.

A. The ALJ's Findings Regarding Edwards' Physical Condition

Claimant Edwards argues that the ALJ erred in not accepting Doctor Edwards' professional assessment that she should be restricted to part-time hours. This assessment, according to the claimant, was not opposed by any of the other doctors involved in the case and, in any event, could not have been rebutted by the opinions of consulting doctors because Doctor Edwards was her treating physician.

It is true that the opinion of a treating physician is entitled to substantial weight unless good cause exists for not heeding the treating physician's diagnosis. E.g., Broughton v. Heckler, 776 F.2d 960, 961-62 (11th Cir.1985) (per curiam). Here, however, good cause did exist to justify the ALJ's decision not to rely on Doctor Edwards' findings. First, Doctor Edwards' statement that Claimant Edwards was "restricted to a four (4) hour work day" contains no clinical data or information to support his opinion. The treating physician's report may be discounted when it is not accompanied by objective medical evidence or is wholly conclusory. Schnorr v. Bowen, 816 F.2d 578, 582 (11th Cir.1987). Second, approximately one week after "limiting" Claimant Edwards to four hours of work per day, Doctor Edwards' clinical notes indicate that he thought it "appropriate...