Hines v. Barnhart

• Decision Date: 11 July 2006
• Docket Number: No. 05-1299.,05-1299.
• Parties: Jeffery HINES, Plaintiff-Appellee, v. Jo Anne B. BARNHART, Commissioner of Social Security, Defendant-Appellant.
• Court: U.S. Court of Appeals — Fourth Circuit

Page 559

453 F.3d 559

Jeffery HINES, Plaintiff-Appellee, v. Jo Anne B. BARNHART, Commissioner of Social Security, Defendant-Appellant.

No. 05-1299.

United States Court of Appeals, Fourth Circuit.

Argued December 1, 2005.

Decided July 11, 2006.

ARGUED: Catherine Yvonne Hancock, United States Department of Justice, Civil Division, Appellate Staff, Washington, D.C., for Appellant. Susan Marie O'Malley, Keel, O'Malley, L.L.P., Tarboro, North Carolina, for Appellee. ON BRIEF: Peter D. Keisler, Assistant Attorney General, Frank D. Whitney, United States Attorney, Thomas M. Bondy, Civil Division, Appellate Staff, United States Department of Justice, Washington, D.C., for Appellant.

Before WILKINS, Chief Judge, GREGORY, Circuit Judge, and WALTER D. KELLEY, JR., United States District Judge for the Eastern District of Virginia, sitting by designation.

Affirmed by published opinion. Judge KELLEY wrote the opinion, in which Chief Judge WILKINS and Judge GREGORY concurred.

OPINION

KELLEY, District Judge.

Sickle Cell Disease ("SCD"), also known as sickle cell anemia, is a blood disorder that principally afflicts individuals of African and Indian descent. The disease leaves its victims easily fatigued and often suffering from episodes of acute pain. SCD is particularly insidious because it rarely produces the objective medical evidence that clinicians desire. In fact,

[p]atient[s] with SCD . . . are in an almost uniquely disadvantaged position from the point of view of pain management. The condition is life threatening at times, yet patients are healthy between sickling episodes. Some individuals are affected by painful episodes much more than others, and pain is often the only or main symptom of an acute episode of illness.

James Elander & Kenny Midence, A Review of Evidence About Factors Affecting Quality of Pain Management in Sickle Cell Disease, 12(3) The Clinical J. of Pain 180-93 (Sept.1996). Because there is no way to demonstrate objectively that a SCD patient has pain, sufferers are often accused of "faking" their debilitating symptoms. Deborah G. Oster Pannell, Living With Sickle Cell Disease: From Suffering to Empowerment, American Pain Society, http://www.ampainsoc.org/pub/bulletin/jul99/advocacy.htm (last visited May 19, 2006).

Appellee Jeffery Hines, an SCD patient, applied for disability benefits based on his disease. The Social Security Administration ("SSA") denied his claim largely because Mr. Hines' claims of disabling pain were not supported by objective evidence. The district court reversed the SSA's denial of benefits, and we affirm. Given the unique characteristics of the disease at issue in this case, we hold that the SSA Administrative Law Judge ("ALJ") applied an improper standard to disregard the treating physician's opinion that Mr. Hines was fully disabled. The ALJ also improperly relied on a vocational expert's opinion that did not consider all relevant evidence in the record.

I.

Section 405(g) of Title 42 of the United States Code authorizes judicial review of the Social Security Commissioner's denial of social security benefits. Mastro v. Apfel, 270 F.3d 171, 176 (4th Cir.2001). "`Under the Social Security Act, [a reviewing court] must uphold the factual findings of the [ALJ] if they are supported by substantial evidence and were reached through application of the correct legal standard.'" Id. (alteration in original) (quoting Craig v. Chater, 76 F.3d 585, 589 (4th Cir.1996)). "Although we review the [Commissioner's] factual findings only to establish that they are supported by substantial evidence, we also must assure that [her] ultimate conclusions are legally correct." Myers v. Califano, 611 F.2d 980, 982 (4th Cir.1980).

II.

Mr. Hines was employed for 13 or 14 years as a railroad crew leader until his SCD became so severe that he could no longer work. (J.A. 122-23). He ceased work on April 6, 2001 upon advice from his treating physician, Dr. Myung Kil Jeon. (J.A. 79-80). Dr. Jeon has treated Mr. Hines' SCD condition for approximately 17 years. Dr. Jeon determined that the chronic pain caused by Mr. Hines' SCD is exacerbated by exertion and prevents Mr. Hines from maintaining steady employment. (J.A. 85, 90, and 156). In reports dated September 6, 2001, February 27, 2002, and July 5, 2002, Dr. Jeon stated that Mr. Hines was fully disabled by SCD.

Since leaving work in 2001, Mr. Hines has suffered from insomnia, has occasional blurred vision in his right eye, and experiences pain regularly. In addition to chronic pain, Mr. Hines has periodic acute pain crises which require approximately one month of recovery time. The record indicates that Mr. Hines was treated by Dr. Jeon on September 24, 2001 and April 24, 2003 for acute sickle cell pain crises and on November 22, 2002 for generalized weakness, aching, and pain.

Mr. Hines regularly experiences fatigue due to a combination of his SCD and insomnia. The fatigue prevents him from performing many everyday tasks. For example, when Mr. Hines attempts to mow his lawn, he is unable to complete the job in one effort and is forced to lie down. Indeed, Mr. Hines testified that his condition forces him to lie down and rest approximately half of every day, and he is able to attend church only two to three times per month. (J.A. 133). At the ALJ hearing, Mr. Hines' wife testified that he is not able to do much around the house, he is forgetful, he does not leave the house for trips or visiting friends, and "a lot of time he have a lot of pains in his leg." (J.A. 139). This evidence was unrebutted.

Mr. Hines' disability insurance company referred him to Dr. Rupa Redding-Lallinger ("Dr. Lallinger"), a hematologist, for an evaluation of his SCD. Dr. Lallinger noted there was no objective evidence of "major end-organ damage in the bones, although it is possible for early avascular necrosis not to show up on plain films, but be apparent in an MRI. No sign of recurrent bony infarction to explain his frequent pain." (J.A. 66). Dr. Lallinger then qualified his observation by stating that "[i]t must be noted, however, that with pain from sickle cell disease there are no confirmatory laboratory or radiologic tests that will prove or disprove whether a patient is having pain." (J.A. 66).

III.

"Disability" is the "inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." 42 U.S.C. § 423(d)(1)(A). The "[d]etermination of eligibility for social security benefits involves a five-step inquiry." Walls v. Barnhart, 296 F.3d 287, 290 (4th Cir.2002). This inquiry asks:

whether (1) the claimant is engaged in substantial gainful activity; (2) the claimant has a medical impairment (or combination of impairments) that are severe; (3) the claimant's medical impairment meets or exceeds the severity of one of the impairments listed in Appendix I of 20 C.F.R. Part 404, subpart P; (4) the claimant can perform her past relevant work; and (5) the claimant can perform other specified types of work.

Johnson v. Barnhart, 434 F.3d 650, 654 n. 1, (4th Cir.2005)(citing 20 C.F.R. § 404.1520 (2005)).

The ALJ found that Mr. Hines satisfied steps one and two of the inquiry. At the third step of his inquiry, the ALJ concluded that Mr. Hines' SCD did not meet or exceed the severity of the qualifying impairments recognized in an Appendix to the regulations. The ALJ therefore sought to determine Mr. Hines' Residual Functional Capacity ("RFC") for employment.

RFC is a measurement of the most a claimant can do despite his limitations. See 20 C.F.R. § 404.1545(a). According to the Social Security Administration,

RFC is an assessment of an individual's ability to do sustained work-related physical and mental activities in a work setting on a regular and continuing basis. A `regular and continuing basis' means 8 hours a day, for 5 days a week, or an equivalent work schedule.

Social Security Regulation (SSR) 96-8p (emphasis added). RFC is to be determined by the ALJ only after he considers all relevant evidence of a claimant's impairments and any related symptoms (e.g., pain). See 20 C.F.R. § 404.1529(a).

The ALJ concluded that Mr. Hines had the RFC "to perform a wide range of sedentary work with limitations to working in temperature extremes, working at a production rate, or performing more than simple, routine, repetitive tasks." (J.A. 151). In light of SSR 96-8p, this conclusion implicitly contained a finding that Mr. Hines physically is able to work an eight hour day.

Having concluded that Mr. Hines had the RFC to perform a sedentary job, the ALJ then evaluated Mr. Hines' case at the fifth step of the inquiry.¹ This step requires the Commissioner to prove that a significant number of jobs exist which the claimant could perform, despite his impairments.

The ALJ found that the Commissioner carried her burden of proving that Mr. Hines could perform certain jobs in the national economy. In reaching this conclusion, the ALJ relied on the opinion of Steven D. Carpenter, a vocational expert who had never met Mr. Hines. The vocational expert assumed that Mr. Hines could work a full eight hour day. Based on this assumption, the vocational expert opined that "claimant could work as an order clerk . . ., call out operator. . ., and laundry pricing clerk." (J.A. 143). He testified that significant numbers of these jobs exist in the North Carolina economy.

A.

We begin by reviewing the ALJ's finding that Mr. Hines has the RFC "to perform a wide range of sedentary work with limitations . . ." for a full eight hour work day. See SSR 96-8p. In reaching this conclusion, the ALJ improperly refused to credit Dr. Jeon's medical opinion that his long term patient (Mr. Hines) was totally disabled. The ALJ was obligated to evaluate and weigh medical opinions "pursuant to the following...