Gunnels v. Bowen, 88-1328
| Decision Date | 14 February 1989 |
| Docket Number | No. 88-1328,88-1328 |
| Citation | 867 F.2d 1121 |
| Parties | , Unempl.Ins.Rep. CCH 14510A Mary GUNNELS, Appellant, v. Otis R. BOWEN, M.D., Secretary of Health and Human Services, Appellee. |
| Court | U.S. Court of Appeals — Eighth Circuit |
Denver L. Thornton, El Dorado, Ark., for appellant.
Lawrence M. Meister, Baltimore, Md., for appellee.
Before HEANEY * and BEAM, Circuit Judges, and STUART, ** Senior District Judge.
Mary Gunnels appeals from the district court's order affirming the decision of the Secretary of Health and Human Services denying Gunnels' application for disability benefits under the Social Security Act, 42 U.S.C. Secs. 416(i) and 423. We reverse and remand.
Gunnels filed for disability benefits in September, 1985, alleging disability since February 5, 1984, as a result of congestive heart failure and chronic obstructive pulmonary disease. The application was denied initially and on reconsideration. Pursuant to Gunnels' request, an ALJ held a hearing on April 18, 1986.
Gunnels was born in June, 1936, has a high school education, and was employed for fifteen years as a switchboard operator a receptionist and most recently as a part-owner and manager of a dress shop.
Gunnels' major medical impairments include congestive heart failure, mitral valve disease, obstructive lung disease and shortness of breath after exertion. She also appears to be unable to tolerate stressful situations, as this aggravates her heart condition.
The evidence shows that Gunnels was hospitalized initially in October 1974, due to congestive heart failure and mitral stenosis. She underwent mitral valve surgery at that time. She was hospitalized in 1978 for pneumonia and three times in 1983 for chronic pulmonary disease.
Gunnels received a mitral valve replacement and a pacemaker in January 1984. These operations were performed by Dr. A.J. Thompson, a cardiac specialist. Gunnels was hospitalized in March 1984, for pacemaker repositioning. Dr. Thompson monitored Gunnels' pacemaker and her heart condition until October, 1985, at which time Gunnels returned to her family physician, Dr. Allen S. Pirnique, for regular checkups. Over the two years after the heart surgery, Dr. Thompson saw Gunnels approximately five times. Two weeks after the pacemaker insertion, Dr. Thompson's examination revealed a regular heart rhythm and near normal heart size.
In July 1984, Gunnels was admitted to the hospital for ear and back problems related to her medication. Gunnels' medication was adjusted and she was discharged after several days rest. On September 25, 1984, Dr. Thompson reported that Gunnels suffered from palpitations and that she was bothered by her upcoming divorce, but that she denied having angina, shortness of breath, or dyspnea on exertion. This September examination also revealed that Gunnels had clear lungs with mild bibasilar crackles, regular heartbeat, and an overall improvement of her chest x-ray. In April 1985, Dr Thompson reported that Gunnels had normal heart size and that she continued to deny angina, shortness of breath, or dyspnea.
On October 31, 1985, Dr. Thompson reported that the site of Gunnels' pacemaker was sore and sensitive to the touch. His report stated that Gunnels suffered from moderate dyspnea on exertion and mild right facial numbness, but no angina or shortness of breath. Several months later, Dr. Thompson used this examination to classify Gunnels according to the American Heart Association rating system as a Class II-C. 1
In a letter dated September 26, 1985, Dr. Pirnique reported that Gunnels was suffering from possible gout, mitral valve disease, significant obstructive lung disease, and shortness of breath after exertion. Dr. Pirnique reported that, as a result of these medical impairments, Gunnels had difficulty working at her dress shop.
On November 8, 1985, Dr. Pirnique conducted a consultative examination at the request of the Social Security Administration. He reported that Gunnels suffered from shortness of breath with some chest pain. He stated that Gunnels' breathing problems prevented her from performing such activities as sweeping, vacuuming, and climbing stairs. She could no longer do the tasks required to work in her dress shop and she had sold her interest in the store to her partner. He confirmed that she suffered from organic heart disease, mitral valve disease, heart block, and obstructive lung disease. He described Gunnels as having clear lungs, a bronchitic-sounding cough, regular heart rhythm, and a normal functioning pacemaker. Using the American Heart Association rating system Dr. Pirnique classified Gunnels as a III-C on the basis of dyspnea occurring at less than normal activities. He believed this was in some degree due to the lung disease, although the heart condition also limited her activities considerably. 2
A November 15, 1985, residual functional capacity assessment resulted in findings that Gunnels was limited to lifting no more than twenty pounds, standing or walking no more than six hours a day, sitting no more than six hours a day, and that she was precluded from working around high voltage equipment. It was reported that Gunnels complained of sharp chest pain and shortness of breath brought on by activities such as sweeping and climbing stairs.
At an administrative hearing on April 18, 1986, Gunnels testified that she is five feet seven inches tall and weighs one hundred twenty-five pounds. She does a minimal amount of housework with her daughter's help, reads, and watches television. She stated that at her doctor's suggestion she walks, at her own pace, one mile or more a day, and that she does not pick up objects or walk up stairs. She described her circulation as "not that good" and stated she could not sit in one position very long. Gunnels testified that she suffers from shortness of breath brought on by physical activity or stress, from stress-induced pain in the form of muscle spasms in her chest, and from headaches due to her medication. 3 She also testified that she does not engage in any activity due to her daily fear that activity will exacerbate her condition. Gunnels indicated that she cannot communicate with people without experiencing stress. Because she fears a heart attack brought on by stress, Gunnels stated that she could not return to any of her former occupations. When the ALJ stated that he presumed Gunnels' previous position as a switchboard operator or receptionist was a sedentary job 4 and asked whether she could return to that job, Gunnels responded that she could not.
The ALJ concluded that Gunnels had not engaged in substantial gainful activity since February 15, 1984, and that the medical evidence established that Gunnels suffered from the severe impairments of organic heart disease and chronic obstructive pulmonary disease. Although the ALJ described Gunnels as unable to engage in sustained strenuous physical activity, prolonged walking in excess of one mile, lifting objects, or working around pulmonary irritants, he concluded that Gunnels retained "the residual functional capacity to engage in light work activity, which would not preclude her from engaging in her past relevant work as a switchboard operator." 5 In making this determination, the ALJ specifically relied on Dr. Thompson's Class II-C rating as opposed to Dr. Pirnique's Class III-C rating. The ALJ stated that...
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