Embrey v. Bowen, 87-6064

• Decision Date: 13 June 1988
• Docket Number: No. 87-6064,87-6064
• Citation: 849 F.2d 418
• Parties: , Unempl.Ins.Rep. CCH 14012A Donald E. EMBREY, Plaintiff-Appellant, v. Otis R. BOWEN, Secretary of Health and Human Services, Defendant-Appellee.
• Court: U.S. Court of Appeals — Ninth Circuit

Page 418

849 F.2d 418

22 Soc.Sec.Rep.Ser. 124, Unempl.Ins.Rep. CCH 14012A

Donald E. EMBREY, Plaintiff-Appellant, v. Otis R. BOWEN, Secretary of Health and Human Services Defendant-Appellee.

No. 87-6064.

United States Court of Appeals, Ninth Circuit.

Argued and Submitted Dec. 11, 1987.

Decided June 13, 1988.

Ronald B. Eisman, Whittier, Cal., for plaintiff-appellant.

Dennis J. Mulshine, Asst. Regional Counsel, Dept. of Health and Human Services, San Francisco, Cal., for defendant-appellee.

Appeal from the United States District Court for the Central District of California.

Before BROWNING, Chief Judge, HUG and REINHARDT, Circuit Judges.

REINHARDT, Circuit Judge:

The claimant, Donald Embrey, appealed to the district court the decision of the Secretary of Health and Human Services denying his application for Social Security disability benefits. The district court granted summary judgment for the Secretary, affirming the administrative decision. We reverse the district court and remand the case to the Secretary for further proceedings.

FACTS AND PROCEEDINGS BELOW

Donald Embrey was born in 1935 and completed twelve years of schooling. He has worked in various capacities in the hospital equipment repair business. In 1979, Embrey suffered a heart attack. He was hospitalized for chest pains in May of 1982 and, while hospitalized, sustained a second heart attack. He underwent quadruple coronary bypass surgery in July of 1982. Embrey also suffers from back problems: he was operated on for a ruptured disc in 1969 or 1970 and in recent years has experienced increasing pain in his back, hips, and legs. Embrey has also been diagnosed as suffering from diabetes mellitus.

Embrey stopped working in April of 1982, shortly before his hospitalization, because of his medical problems. He remained on his employer's payroll until February of 1983, when he was terminated, but after his heart surgery he apparently performed only some telephone and paperwork at home. He worked for another employer on a trial basis from April to June of 1983, but his medical problems caused him to leave that job as well and he has not worked since that time. Embrey applied for disability benefits in August of 1984, claiming that he was unable to work as of April 23, 1982. ¹ The application listed Embrey's disabling conditions as herniated disc and acute lumbosacral strain, heart disease with continuing arrythmia, and diabetes mellitus.

Embrey's application was denied initially and on reconsideration, and he requested a hearing before an Administrative Law Judge ("ALJ"). At the hearing, which was held on October 21, 1985, Embrey testified as to his condition. He stated that he must stay in bed for one to two days every seven to ten days because of fatigue, and must also lie down for one to two hours every day. He can walk five to six blocks if he rests along the way, and can stand for one hour. He stated that he could sit for two hours but it would be difficult for him to get up, and that because of his back he sometimes has trouble getting out of bed in the morning. He believed he would be able to lift and carry 25 pounds, but could not lift a 50-60 pound tool box. He experiences a constant dull ache in his back, which worsens after 15 to 20 minutes of sitting, and shooting pains in his back at least three or four times a day. He also has cardiac arrythmia and experiences chest pains two or three times a week. His diabetes can make him feel sick, light-headed, and dizzy; it also causes blurred vision and a burning sensation in his feet. Embrey also testified that he suffers from arthritis which can limit the use of his right hand.

In addition to Embrey's testimony, the ALJ considered the medical evidence regarding Embrey's various conditions and the reports of his doctors. In the view of Embrey's treating orthopedist, Dr. Macs, Embrey is permanently disabled. A second doctor, consulting neurologist Dr. Goldman, reported that Embrey met the requirements for Social Security disability. Embrey's treating cardiologist, Dr. Hermann, stated that Embrey could not tolerate any job involving a "considerable degree of physical activity," and later stated that Embrey was "on total disability" pending completion of a cardiac rehabilitation program. The family physician who treated Embrey for his diabetes, Dr. Baker, indicated that Embrey could not stand because The ALJ found that Embrey has not engaged in substantial gainful activity since April 23, 1982. From the medical evidence, the ALJ concluded that Embrey suffers from mild coronary artery disease as a result of his heart attack and bypass surgery; from lumbar spine stenosis; and from diabetes mellitus with mild radiculopathy controllable with medication. He found that Embrey's assertions of disabling pain and substantial work limitations were not credible, and that the physicians' opinions of total disability were "unsupported by sufficient objective findings and contrary to the preponderant conclusions mandated by those objective findings." Based on the testimony of a vocational expert, the ALJ also found that while Embrey could no longer perform his past work as a technical specialist for hospital equipment, he did have the residual functional capacity to perform the full range of sedentary to light work. He accepted the expert's opinion that Embrey could return to his former job as a service coordinator and could also perform a number of other available jobs. Therefore, the ALJ concluded that Embrey was not disabled.

of the pain in his feet and could sit for only 30 minutes (after which it took him five minutes to get up); that he could do no lifting or carrying and only limited bending; and that he could walk only five blocks. Dr. Baker, too, concluded that Embrey was permanently "unemployable."

Embrey appealed the denial of benefits to the district court, which granted summary judgment for the Secretary. Embrey appeals to this court pursuant to 42 U.S.C. Sec. 405(g) (1982). He claims that the ALJ improperly rejected the opinions of Embrey's physicians and that the hypothetical on which the vocational expert based her opinion was not supported by the record. He also contends that his case should be remanded to the Secretary for reconsideration in light of new evidence. We find all of these claims persuasive.

DISCUSSION

I. Treating Physicians' Opinions

We have made it clear that the medical opinions of a claimant's treating physicians are entitled to special weight and that, if the ALJ chooses to disregard them, "he must set forth specific, legitimate reasons for doing so, and this decision must itself be based on substantial evidence." Cotton v. Bowen, 799 F.2d 1403, 1408 (9th Cir.1986); see Summers v. Bowen, 813 F.2d 241, 243 (9th Cir.1987); Murray v. Heckler, 722 F.2d 499, 502 (9th Cir.1983). "The ALJ can meet this burden by setting out a detailed and thorough summary of the facts and conflicting clinical evidence, stating his interpretation thereof, and making findings." Cotton, 799 F.2d at 1408. Even if a treating physician's opinion is controverted, the ALJ must provide specific, legitimate reasons for rejecting it. Id.

The ALJ failed to meet that burden here. While his opinion does review the medical evidence, it concludes only that:

The opinions of total disability tended [sic] in the record are unsupported by sufficient objective findings and contrary to the preponderant conclusions mandated by those objective findings. The duration of the claimant's stress treadmill testings and relative lack of positive findings, the results of other laboratory and x-ray testing, the objective observations of the physicians of record, all preponderate toward a finding that the claimant has never lost the residual functional capacity for light work for any period approaching 12 months.

To say that medical opinions are not supported by sufficient objective findings or are contrary to the preponderant conclusions mandated by the objective findings does not achieve the level of specificity our prior cases have required, even when the objective factors are listed seriatim. ² The ALJ must do more than offer his conclusions. He must set forth his own interpretations Here, the ALJ does not give sufficiently specific reasons for rejecting the conclusion of Dr. Macs, Embrey's treating orthopedist, that Embrey is "permanently disabled from his medical condition as well as his orthopaedic problems." Nor does the ALJ explain why he disagrees with Dr. Baker's conclusion that Embrey is permanently unemployable, or give reasons for rejecting Dr. Baker's detailed assessment of Embrey's capacity for standing, lifting, carrying, and sitting for longer than 30 minutes. Instead, he merely states that the objective factors point toward an adverse conclusion and makes no effort to relate any of these objective factors to any of the specific medical opinions and findings he rejects. This approach is inadequate.

                and explain why they, rather than the doctors', are correct.  Moreover the ALJ's analysis does not give proper weight to the subjective elements of the doctors' diagnoses.  The subjective judgments of treating physicians are important, and properly play a part in their medical evaluations.  Accordingly, the ultimate conclusions of those physicians must be given substantial weight;  they cannot be disregarded unless clear and convincing reasons for doing so exist and are set forth in proper detail.   See Delgado v. Heckler, 722 F.2d 570, 574 (9th Cir.1983)
                

Three treating physicians and one consulting physician determined that Embrey is disabled. The ALJ reached the opposite conclusion. Particularly in a case where the medical opinions of the physicians differ so markedly from the ALJ's, it is incumbent on the ALJ to provide detailed, reasoned, and legitimate rationales for disregarding the physicians' findings. See Cotton, 799 F.2d at 1408. The ALJ failed to do so here. Therefore, we must remand...