Landsaw v. Secretary of Health and Human Services

Decision Date21 August 1986
Docket NumberNo. 85-5852,85-5852
Citation803 F.2d 211
Parties, Unempl.Ins.Rep. CCH 17,019 Ersa LANDSAW, Plaintiff-Appellant, v. SECRETARY OF HEALTH AND HUMAN SERVICES, Defendant-Appellee.
CourtU.S. Court of Appeals — Sixth Circuit

Louis DeFalaise, U.S. Atty., John S. Osborn, III, Lexington, Ky., for defendant-appellee.

Sue Ellen Prater, Appalachian Research and Defense Fund of Kentucky, Jackson, Ky., for plaintiff-appellant.

Before MILBURN and BOGGS, Circuit Judges, and DeMASCIO, District Judge *.

MILBURN, Circuit Judge.

Plaintiff Ersa Landsaw appeals the district court's summary judgment affirming the final decision of the Secretary denying plaintiff's application for supplemental security income under Title XVI of the Social Security Act, 42 U.S.C. Secs. 1381-83. Plaintiff filed an application on July 6, 1983, alleging disability as of July, 1974, due to "heart trouble." The application was denied at all administrative levels. At plaintiff's request, a de novo hearing was held before an administrative law judge ("ALJ"). The ALJ's decision, which became the final decision of the Secretary after the Appeals Council's refusal to grant review, is that plaintiff failed to establish the existence of a severe impairment, thus terminating the sequential evaluation at step two. For the reasons that follow, we affirm.

I.

In reviewing the final decision of the Secretary, our inquiry is limited to a determination of whether substantial evidence exists in the record to support the Secretary's decision and to a review for any legal errors. Kirk v. Secretary of Health and Human Services, 667 F.2d 524 (6th Cir.1981), cert. denied, 461 U.S. 957, 103 S.Ct. 2428, 77 L.Ed.2d 1315 (1983). The determination of whether there is substantial evidence to support the Secretary's findings must be based on the record as a whole. Hephner v. Mathews, 574 F.2d 359, 362 (6th Cir.1978). Substantial evidence means more than a scintilla; it is such relevant evidence as a reasonable mind would 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).

An impairment is non-severe only if it is a "slight abnormality which has such a minimal effect on the individual that it would not be expected to interfere with the individual's ability to work, irrespective of age, education and work experience." Farris v. Secretary of Health and Human Services, 773 F.2d 85, 90 (6th Cir.1985); see also Salmi v. Secretary of Health and Human Services, 774 F.2d 685, 692 (6th Cir.1985). Plaintiff first argues that this standard has not been met because Dr. Robert Cornett, his treating physician, stated that plaintiff "is not able to be gainfully employed. Even mild exertion brings on the angina pectoris." App. at 119. Dr. Cornett stated in his one-page letter that plaintiff suffers from heart enlargement, coronary artery disease, generalized arthritis, conversion reaction psychosis and obesity. However, the record contains no underlying clinical findings. See Houston v. Secretary of Health and Human Services, 736 F.2d 365 (6th Cir.1984):

[T]he opinion of the treating physician should be given greater weight than that of the government's physician.... This is true, however, only if the treating physician's opinion is based on sufficient medical data.... Ultimately, the determination of disability is the prerogative of the Secretary, not the treating physician, and the brief conclusory letter from [the] treating physician, was not dispositive of the issue.

Id. at 367 (citations omitted); see also 20 C.F.R. Sec. 404.1527:

Conclusion by physicians concerning your disability.

We are responsible for determining whether you are disabled. Therefore, a statement by your physician that you are "disabled" or "unable to work" does not mean that we will determine that you are disabled. We have to review the medical findings and other evidence that support a physician's statement that you are "disabled." (emphasis supplied).

Plaintiff also relies on a one-page letter from Dr. Emanuel Turner, who states he saw plaintiff sixty-six times between February 1977 and February 1984. Dr. Turner asserted that plaintiff suffers from hiatal hernia, hypertension, unstable angina pectoris and osteoarthritis. Dr. Turner continues:

I feel that Ms. Landsaw's most disabling condition is the unstable angina pectoris. I understand that Dr. Cornett referred her to a cardiologist in Lexington at one time who recommended cardiac catherization. I am not sure if that was ever done.

In my judgment Ms. Landsaw is totally and permanently disabled from seeking and holding gainful employment at this time and also in the future.

App. at 97. However, Dr. Turner's opinion suffers from the same infirmity as Dr. Cornett's in that the record contains no underlying clinical data.

On the other hand, the Secretary relies on a one-page letter from Dr. James Cooper, of the Mountain Comprehensive Health Corporation ("MCHC"), dated July 8, 1983, wherein he states, "There is no evidence of disability of any kind today." App. at 87. Dr. Cooper's opinion, unlike those of Drs. Cornett and Turner, is supported by the following clinical data from plaintiff's stay at MCHC.

On May 4, 1983, a chest X-ray showed fluid levels in both lung bases. Although an EKG was within normal limits, plaintiff was diagnosed as suffering from congestive heart failure. App. at 89. From May 6, 1983, through June 15, 1983, plaintiff showed steady improvement. App. at 89-92. On July 8, 1983, the following progress note was entered:

She has multiple vague complaints.... No chest pain. No nocturnal dyspnea.... Exercise tolerance is impossible to evaluate.... Lungs are clear, without rales or wheezes. Heart normal rhythm.... This patient does not appear to have high blood pressure or to be in [congestive heart failure].... I reviewed her chest X-rays and they do not indicate [congestive heart failure]. Her EKG today is normal.

App. at 93.

As the government argues, Dr. Cooper's letter along with its supporting clinical data represents substantial evidence that plaintiff's heart trouble improved during 1983 and does...

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