Lewis v. Weinberger, 75-1757
| Citation | 541 F.2d 417 |
| Decision Date | 09 February 1976 |
| Docket Number | No. 75-1757,75-1757 |
| Parties | Robert L. LEWIS, Appellant, v. Caspar WEINBERGER, Secretary of the Department of Health, Education, and Welfare, Appellee. |
| Court | United States Courts of Appeals. United States Court of Appeals (4th Circuit) |
W. Dale Green, Charleston, W. Va., for appellant.
Fred Marinucci, Asst. Regional Atty. (John A. Field, III, U.S. Atty., Charleston, W. Va., and H. Marshall Jarrett, Jr., Asst. U.S. Atty., Charleston, W. Va., on brief), for appellee.
Before BRYAN, Senior Circuit Judge, and WINTER and BUTZNER, Circuit Judges.
Robert L. Lewis appeals from the district court's affirmance of the Secretary of H.E.W.'s denial of disability benefits under the Social Security Act. He claims to be disabled within the meaning of 42 U.S.C. §§ 416(i), 423(d), due to a severe chronic anxiety tension state and moderately severe hypochondriacal neurosis. The Secretary admits that Lewis suffers from these conditions, but contends that there is substantial evidence to support his determination that Lewis can nevertheless perform substantial gainful work, and therefore is not disabled.
We are convinced that there is a firm evidentiary base to show that Lewis is disabled due to mental impairment, and that there is not substantial evidence to refute it. We therefore reverse and direct the entry of an order requiring the Secretary to grant the claimed benefits.
Lewis was born August 7, 1922, and completed only nine years of schooling, but has the equivalent of a high school education on the basis of GED testing. He has worked as a truck driver, forklift operator, and salesman. He claimed that he had been unable to work since August 8, 1971, because of chronic prostatitis and anxiety tension state.
The evidence showed that Lewis was treated by a urologist on May 18, 1970, and that prior thereto he had had chronic prostatitis for a number of years which had been partially controlled by medication. In June, 1970, he underwent a transurethral resection of the prostate. Because of persistent perineal discomfort and evidence of residual prostatic infection, he was hospitalized again in December, 1970. His physical problems responded temporarily to medical management, but when he resumed his normal activities and attempted to work, they recurred. Beginning in May, 1971, he began to be treated for an anxiety tension state in addition to treatment for chronic prostatitis.
In November, 1971, Lewis was again hospitalized and underwent a radical prostatovesiculectomy which was performed in an effort to resolve his perineal discomfort and prostatic infection. While the operation was apparently successful in controlling the infection but not in relieving persistent lower abdominal pain he continued to have a problem with chronic anxiety tension state. Dr. Kiser, his treating physician, expressed the view in April, 1972, that Lewis was totally and permanently disabled and that it was unlikely he would return to gainful employment. Dr. Kiser thought that this condition had existed since August 7, 1971.
In a letter dated June 12, 1972, Dr. Kiser outlined that Lewis's major problem, chronic anxiety, was only partially controlled by constant therapy with tranquilizing medication. He noted that Lewis complained of continued pain in the perineal region which was aggravated by physical activity. Dr. Kiser thought it unlikely that Lewis would be able to perform heavy manual labor, but suggested that occupation in other jobs might be considered if Lewis could cope with his emotional problems. Dr. Kiser subsequently expressed the view, in his letter dated November 2, 1972, that Lewis was totally and permanently disabled and was unable to resume any substantial gainful occupation at that time or in the foreseeable future.
Dr. Rodgers, a psychologist, made a psychological evaluation of Lewis in September, 1972. His evaluation led him to suspect "marked conversion reaction overlay and significant hypochondriasis, probably with compensation neurosis aspects, to whatever physiopathology may be present, in a generally rather repressive, mildly to moderately depressed and anxious man." Dr. Rodgers urged Lewis to undertake more activity a return to work or an involvement in any kind of consistent part-time activity, but Dr. Rodgers noted that Lewis was "resistant," and added, "I (Dr. Rodgers) doubt that I have much effective to offer."
Lewis was also examined by Dr. Kitching, a psychiatrist selected by the Secretary, on January 5, 1973. Dr. Kitching diagnosed Lewis as suffering from "hypochondriacal neurosis, chronic and moderately severe, manifested by preoccupation with the body and presumed diseases of various organs and withdrawal from ordinary activities of life." By reason of impotence and physical ills, Dr. Kitching stated that Lewis had "concomitantly regressed and withdrew from life and responsibility in a moderately severe hypochondriacal neurotic adjustment . . . ." He stated flatly,
The Administrative Law Judge, whose findings were accepted by the Secretary and sustained by the district court, concluded that Lewis was not disabled within the meaning of the Act. He called attention to the fact that at the hearing Lewis did not exhibit any physical handicaps and did not appear to be in pain or suffering any difficulties. While he recognized that psychological testing showed "marked conversation reaction overlay and significant hypochondriasis," and that Dr. Kitching diagnosed "moderately severe hypochondriacal neurosis," he stressed that Dr. Kitching considered the illness "mild for industrial adaptability." Overall, the Administrative Law Judge thought that the evidence established some physical impairment together with a severe chronic anxiety tension state and moderately severe hypochondriacal neurosis, but that it failed to indicate that degree of severity which would incapacitate Lewis for all forms of substantial gainful activity.
As we view the case, it is one in which, if "disability" is to be found, disability stems from mental illness. Lewis has, of course, not completely solved his physical problems stemming from his history of prostatitis, but even he does not contend that this condition alone would justify an award of a disability benefit to him. We therefore direct our principal attention to Lewis's mental or psychological difficulties.
It is clear that the Social Security Act covers psychological disabilities. Both 42 U.S.C. § 416(i)(1)(A) and 42 U.S.C. § 423(d)(1)(A) define "disability" as "inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment . . . ." (Emphasis added.) In addition, 42 U.S.C. § 423(d)(3) states:
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