Hurst v. Secretary of Health and Human Services

• Decision Date: 28 January 1985
• Docket Number: No. 83-5923,83-5923
• Citation: 753 F.2d 517
• Parties: , Unempl.Ins.Rep. CCH 15,839 Brenda C. HURST, Plaintiff-Appellant, v. SECRETARY OF HEALTH AND HUMAN SERVICES, Defendant-Appellee.
• Court: U.S. Court of Appeals — Sixth Circuit

Page 517

753 F.2d 517

8 Soc.Sec.Rep.Ser. 243, Unempl.Ins.Rep. CCH 15,839

Brenda C. HURST, Plaintiff-Appellant, v. SECRETARY OF HEALTH AND HUMAN SERVICES, Defendant-Appellee.

No. 83-5923.

United States Court of Appeals Sixth Circuit.

Argued Nov. 30, 1984.

Decided Jan. 28, 1985.

Philip P. Durand (argued), Ambrose, Wilson & Grimm, Knoxville, Tenn., for plaintiff-appellant.

John W. Gill, U.S. Atty., Jimmie Baxter, Marilyn Hudson (argued), Asst. U.S. Attys., Knoxville, Tenn., for defendant-appellee.

Before EDWARDS ^* and JONES, Circuit Judges, and PHILLIPS, Senior Circuit Judge.

NATHANIEL R. JONES, Circuit Judge.

Appellant, Brenda Hurst, appeals from the Secretary of Health and Human Services (the Secretary's) denial of her application for disability insurance benefits under the Social Security Act, as amended, (the Act). We reverse the district court and remand for award of benefits.

In January, 1979, Hurst filed an application for disability benefits in which she alleged that she had been disabled by rheumatoid arthritis since July 21, 1976. An administrative law judge (ALJ) found that medical evidence established that Hurst was impaired by joint pain of undetermined etiology, that her testimony of severe pain could be discounted as unsupported by objective medical findings, and that she was not disabled within the meaning of the Act. The Appeals Council sustained the ALJ. Hurst filed a complaint in district court and sought a remand to the Secretary for consideration of new evidence in the form of a letter from Dr. Donna Winn, dated August 11, 1980. The district court denied Hurst's motion to remand and granted the Secretary's motion for summary judgment. On appeal, this Court determined that Hurst had established good cause to remand and reversed the district court. 663 F.2d 1071.

On remand, an ALJ considered the new evidence and attempted to affirm the previous ALJ's decision. The Appeals Council remanded the case once again, and required the ALJ to make new findings of fact and conclusions because the first ALJ's decision had been vacated. In January, 1983, the ALJ concluded that Hurst suffered brief, episodic symptoms of rheumatoid arthritis, possibly diffuse fibrositis, and periods of pain which were not continuous and intractable. He found that her impairments were slight and not disabling. The Appeals Council and district court affirmed and this appeal follows.

Appellate review of the Secretary's decision to deny disability benefits is limited to determining whether substantial evidence in the record taken as a whole supports the Secretary's findings. 42 U.S.C. Sec. 405(g) (1976). Substantial evidence is " 'such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.' " Richardson v. Perales, 402 U.S. 389, 401, 91 S.Ct. 1420, 1427, 28 L.Ed.2d 842 (1971) (quoting Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229, 59 S.Ct. 206, 216, 83 L.Ed. 126 (1938)). In determining whether the evidence is substantial, the court must " 'take into account whatever in the record fairly detracts from its weight.' " Beavers v. Secretary of H.E.W., 577 F.2d 383, 387 (6th Cir.1978) (quoting Universal Camera Corp. v. NLRB, 340 U.S. 474, 488, 71 S.Ct. 456, 464, 95 L.Ed. 456 (1951)).

A claimant bears the burden of establishing a prima facie case that she suffers a disability as defined by the Act: 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. Sec. 423(d)(1). A " 'physical or mental impairment' ... results from anatomical, physiological or psychological abnormalities which are demonstrable by medically acceptable clinical and laboratory diagnostic techniques." 42 U.S.C. Sec. 423(d)(3). In the present case, Hurst must establish that she was disabled during the period between November 3, 1977--when her non-disability was determined on a previous application--and December 31, 1981--when she last met the Act's earnings requirement.

Hurst is currently thirty-six years old and has a high school education. From 1967 through July, 1976, she was employed as a seamstress, a job which required manual dexterity, and lifting and carrying bundles of upholstry material. Her former employer testified that Hurst had been a dependable employee who was good at her job and who did not attempt to avoid work before her disability began. He also testified that in July, 1976, she initially left her job on sick leave and only later recognized that she would not be able to return. Hurst testified that severe joint pain prevented her from returning to work, that her legs and hands swell unless she takes gold shots, and that she is unable to grip. Her husband and aunt corroborated this testimony.

Dr. Donna M. Winn, a board-certified specialist in internal medicine and a board eligible rheumatologist, began treating Hurst on December 31, 1979. As a result of her examination, Dr. Winn concluded that Hurst suffered from seronegative rheumatoid arthritis. The doctor noted that Hurst was being treated with gold and with prednisone, another drug which removes swelling and warmth from joints. In her March 25, 1980 letter Dr. Winn sets out the criteria upon which her diagnosis, that Hurst suffered disabling rheumatoid arthritis, was based. The guidelines originated in the Primer on Rheumatic Disease, published by The Arthritis Foundation. Dr. Winn characterized these criteria as acceptable "throughout the world." The Secretary has not challenged the reliability of the criteria relied upon by Dr. Winn; therefore, it is uncontested that those guidelines represent "medically acceptable clinical" techniques for demonstrating a disability.

Morning stiffness of at least two hours and pain on motion or tenderness in the joints are Dr. Winn's first two criteria. Hurst's own testimony at the hearings concerning her claim, and the corroborating testimony of her husband and aunt, support Dr. Winn's conclusions regarding the presence of both stiffness and pain. The Secretary does not address, and credit or discredit, Dr. Winn's conclusion or Hurst's testimony. The Secretary simply reports that stiffness and pain are criteria and then discusses other criteria, as though stiffness and pain are patently irrelevant.

First, failure to consider the record as a whole undermines the Secretary's conclusion. Allen v. Califano, 613 F.2d 139, 145 (6th Cir.1980) (citing Futernick v. Richardson, 484 F.2d 647 (6th Cir.1973)). Secondly, pain alone may establish a disability for the purposes of the Act. Kirk v. Secretary of Health and Human Services, 667 F.2d 524, 538 (6th Cir.1981) (citing Glass v. Secretary of Health, Education & Welfare, 517 F.2d 224 (6th Cir.1975)). Finally, lay testimony joined with medical evidence may establish disabling pain. Allen v. Califano, 613 F.2d at 145, (citing Beavers v. Secretary of Health, Education and Welfare, 577 F.2d 383 (6th Cir.1978); Noe v. Weinberger, 512 F.2d 588 (6th Cir.1975)). In the present case, Dr. Winn linked Hurst's own reports of pain with medical evidence in order to reach her professional conclusion. This was entirely proper. While the ALJ's credibility determinations deserve great respect, no credibility determination has been made with regard to this evidence. As the Seventh Circuit has noted:

In the absence of an explicit and reasoned rejection of an entire line of evidence, the remaining evidence is "substantial" only when considered in isolation. It is more than merely "helpful" for the ALJ to articulate reasons ... for crediting or rejecting particular sources of evidence. It is absolutely essential for meaningful appellate...