Jeffery v. Secretary of Health and Human Services, 87-1826

• Decision Date: 24 June 1988
• Docket Number: No. 87-1826,87-1826
• Parties: , Unempl.Ins.Rep. CCH 14010A Brenda JEFFERY, Appellant, v. SECRETARY OF HEALTH AND HUMAN SERVICES, Appellee.
• Court: U.S. Court of Appeals — Eighth Circuit

Page 1129

849 F.2d 1129

22 Soc.Sec.Rep.Ser. 140, Unempl.Ins.Rep. CCH 14010A

Brenda JEFFERY, Appellant, v. SECRETARY OF HEALTH AND HUMAN SERVICES, Appellee.

No. 87-1826.

United States Court of Appeals,

Eighth Circuit.

Submitted Jan. 28, 1988.

Decided June 24, 1988.

Frederick S. Spencer, Mountain Home, Ark., for appellant.

Karen J. Sharp, Dallas, Tex. and Wendy J. Miller, Baltimore, Md., for appellee.

Before HEANEY, BOWMAN and BEAM, Circuit Judges.

HEANEY, Circuit Judge.

Brenda Jeffery appeals from the district court's order affirming the decision of the Secretary of Health and Human Services (Secretary) denying her application for disability benefits and supplemental security income (SSI) under 42 U.S.C. Secs. 416(i), 423, and 1382(c). For reversal, Jeffery argues that the Secretary's decision was not supported by substantial evidence because the Administrative Law Judge (ALJ) improperly evaluated Jeffery's subjective complaints of pain and improperly concluded that Jeffery could return to her past work. ¹ For the reasons discussed below, we reverse and remand to the Secretary with directions to enter an award for Jeffery.

Jeffery filed an application for disability and SSI benefits on November 5, 1984, alleging disability commencing on June 14, 1984, due to a lower back injury and pulled hernia sustained at work on that day. The Social Security Administration (SSA) denied her applications both initially and on reconsideration. At her request, a hearing was held before an ALJ on August 8, 1985.

At the time of the hearing, Jeffery was forty years old. She had a ninth-grade education, and had worked as a cutter in a shirt factory, an inspector in a poultry plant, an assembly-line worker, a sewing-machine operator, and a custodian.

Jeffery testified that she suffers from constant, severe low-back pain which radiates into her legs, and that the pain is relieved slightly by the various prescribed and over-the-counter medications, but her only significant relief comes from lying on the floor with her feet propped up against the wall. As a result of the pain, she is unable to stand or walk for more than fifteen to twenty minutes, or sit for more than thirty minutes. After riding in a car in a reclined position for twenty-five to thirty miles, the pain becomes unbearable, and after traveling to the hearing in a reclined position, her back had begun to cause her extreme pain. She cannot bend over but must squat to pick things up and requires the aid of a chair to stand up. She further testified that even with the medication, she sleeps only about five hours a night, and awakes feeling sluggish and drugged. Her daily activities are restricted to occasional light housework, and her children do most of the housework and grocery shopping. Jeffery also testified that one evening she "loaded up" on pain pills and alcohol before going dancing. Jeffery's parents, son, daughter, and a friend corroborated her testimony regarding her pain and restricted activities.

Medical evidence included reports submitted by several treating and consulting physicians. Dr. Beard, who treated Jeffery for back injuries on two prior occasions in 1982 and 1983, examined her on the day of her accident and diagnosed possible recurrence of a right inguinal hernia, prescribed Emperin # 3 to relieve her pain, and advised her to apply local heat to the painful area. When she returned four days later, complaining of continued back pain and additional leg pains, he referred her to an orthopedist for further evaluation.

The next day Jeffery underwent an orthopedic examination by Dr. Ledbetter who diagnosed a disc injury at L4-5 or acute back strain, and hospitalized her for a week during which time she underwent conservative therapy. Lumbar spine x-rays and a CAT scan showed no significant abnormalities. Darvocet-N 100 and Soma were prescribed for her continued complaints of pain. At the time of discharge she was diagnosed as having degenerative disc disease.

Approximately one month later Jeffery was examined by another doctor who reported that she continued to suffer from decreased range of motion in her back with accompanying pain. He recommended continued bed rest and moderate exercise. She was rehospitalized for ten days and prescribed bed rest, pelvic traction, analgesics and muscle relaxants, and was diagnosed as having a low back strain with left-sided sciatica.

Approximately one month later, Jeffery saw Dr. Peeples who examined her and concluded that the medical findings were consistent with a lumbar strain but that her complaints of severe and continuous pain were exaggerated. Accordingly, he recommended she take a Minnesota Multiphasic Personality Inventory Test (MMPI) to determine if there was documental evidence of a psychological cause for her continued discomfort. The results of the MMPI profile revealed nothing of a purely psychopathological nature. Dr. Peeples noted her continued limitation in movement, and her chronic pain and prescribed the use of a TENS unit to alleviate the pain. Although the unit did provide some relief Jeffery remained in continuous pain and unable to engage in prolonged activity.

On February 19, 1985, Jeffery was examined by Dr. Vidoloff who noted that she walked with a left-sided limp and diminished knee and ankle jerks. Her lumbosacral spine, left gluteus, and left sciatic notch were tender to the touch and a visible palpable spasm was present. Considering her decreased movement and flexibility, and accounting for her pain, Dr. Vidoloff rated Jeffery as having a twenty-five percent permanent partial impairment.

Several state disability medical advisors reviewed Jeffery's medical reports and concluded that she could lift twenty-five pounds frequently, fifty pounds occasionally, had the residual functional capacity to perform her past work as a chicken inspector, and that her ability to sit, stand, or walk was not significantly restricted.

A vocational expert appeared on behalf of the Secretary and described Jeffery's past work as ranging from unskilled to skilled, and light to heavy. He testified that if Jeffery were impaired, in pain, and physically restricted as she claimed, and if her pain could be "somewhat" relieved by mostly over-the-counter medication, she would not be able to perform any of her former jobs. Moreover, he could think of no jobs in the regional or national economy Jeffery could perform. The expert testified that if Jeffery could relieve her painful conditions by medication which was not in itself disabling, she would be able to perform nearly all of her former work.

Based on this evidence, the ALJ found that the medical evidence established a severe lumbosacral strain with degenerative disc disease, but that Jeffery did not have a listed impairment or combination of impairments. He also found that she had the residual functional capacity to engage in light work activity. He discounted her allegations of pain as being not fully credible in light of the total evidence of record, noting that her testimony as to her activities was not consistent with the activities of an individual experiencing severe, intractable pain. Because he found that Jeffery had the residual functional capacity necessary to perform her past relevant work as a poultry inspector or assembly-line worker, he concluded she was not disabled. The Appeals Council affirmed the decision. The district court summarily affirmed, finding the decision to be supported by substantial evidence. We disagree.

Judicial review of disability determinations is limited to assessing whether there is substantial evidence in the record as a whole to support the Secretary's decision. 42 U.S.C. Sec. 405(g) (Supp. III 1985); Bogard v. Heckler, 763 F.2d 361, 362-63 (8th Cir.1985). This review requires more than a search for the existence of substantial evidence supporting the Secretary's decision, but rather must take into account evidence which fairly detracts from its weight. Piercy v. Bowen, 835 F.2d 190, 191 (8th Cir.1987).

Although the ALJ may disbelieve a claimant's allegations of pain, credibility determinations must be supported by substantial evidence. See Hardin v. Heckler, 795 F.2d 674, 676 (8th Cir.1986). In Polaski v. Heckler, 739 F.2d 1320 (8th Cir.1984) (subsequent history omitted), this...