Pratt v. Sullivan

Citation956 F.2d 830
Decision Date12 February 1992
Docket NumberNo. 91-1679,91-1679
Parties, Unempl.Ins.Rep. (CCH) P 16462A, 2 NDLR P 233 Gerald R. PRATT, Appellant, v. Louis W. SULLIVAN, M.D., Secretary of Health and Human Services, Appellee.
CourtUnited States Courts of Appeals. United States Court of Appeals (8th Circuit)

George H. Smith, Minneapolis, Minn., for appellant.

Roylene A. Champeaux, Minneapolis, Minn. (Edward P. Studzinski, on brief), for appellee.

Before BEAM, Circuit Judge, HEANEY, Senior Circuit Judge, and LOKEN, Circuit Judge.

PER CURIAM.

This is a social security appeal. Gerald R. Pratt asserts error in the denial of his application for social security disability insurance benefits and supplemental security income (SSI) benefits under Titles II and XVI of the Social Security Act, 42 U.S.C. §§ 401-433, 1381-1383c (1991). The district court granted summary judgment to the Secretary of Health and Human Services in appellant's action for judicial review of the Secretary's final decision denying his claims. We remand.

I. BACKGROUND

Pratt, a forty-two-year-old bachelor, is a high school graduate with two years of vocational training as an electrician and one year of community college credits. He has past relevant work experience of four years as a machinist, five months as a lighting salesman, and ten years as a punch press operator. He last worked as a punch press operator on April 28, 1986, when his employer closed its business and terminated his job.

Pratt applied for disability insurance benefits and SSI on November 30 and December 1, 1987, alleging disability with an onset date of April 28, 1986, due to bursitis and tendinitis of the left shoulder and degenerative disease of the spine. He also alleges that he suffers from an emotional problem related to his other ailments which exacerbates his physical disabilities. Pratt's applications were denied initially and on reconsideration, and he requested and received a hearing before an administrative law judge.

The ALJ concluded from evidence offered at the hearing that Pratt suffered from bicipital tendinitis/bursitis of the left shoulder and pseudoarthrosis of the spine, but that these impairments were not equal to any listed in the social security regulations. The ALJ also concluded, however, that Pratt could not return to his past relevant work.

On review of the evidence from Pratt's psychological evaluations, the ALJ concluded that Pratt did not suffer from a medically determinable mental impairment. The ALJ found that because the only one of his symptoms that matched the listing of impairments was "thoughts of suicide," Pratt did not have an affective disorder. 1 Similarly, because Pratt's only listed symptom was an "unrealistic interpretation of physical signs or sensations associated with the preoccupation or belief that one has a serious disease or injury," the ALJ found Pratt did not have a somatoform disorder. 2 The ALJ stated that Pratt had "never pursued medical treatment for any mental impairment nor ha[d] he told any physician or other third party in the record about any possible mental impairment."

The ALJ thus concluded that Pratt retained the residual functional capacity to perform work that did not require lifting more than fifteen pounds or doing overhead work, with restrictions on bending, twisting, and stooping. Examples of such work are benchwork, electronic assembly and inspection, and cashier positions. Because such jobs exist in substantial numbers in the State of Minnesota, the ALJ found Pratt not disabled.

The Appeals Council denied review, making the ALJ's determination the final decision of the Secretary. The district court granted summary judgment for the Secretary in Pratt's action for judicial review, and Pratt appeals.

II. DISCUSSION

Pratt argues on appeal that the ALJ improperly discredited his subjective complaints of pain, failed to properly assess his psychological problems, and failed to consider the combined effect of his impairments. Our task on review is to determine whether substantial evidence in the record as a whole supports the Secretary's denial of benefits to Pratt. See Gavin v. Heckler, 811 F.2d 1195, 1199 (8th Cir.1987). In our review of the evidence, we must also take into account whatever in the record fairly detracts from its weight. Cline v. Sullivan, 939 F.2d 560, 564 (8th Cir.1991).

As stated, it is not our task to review the evidence and make an independent decision. Neither is it our task to reverse the holding of the ALJ simply because there is evidence in the record which contradicts his findings. The test, we emphasize, is whether there is substantial evidence in the record as a whole which supports the decision of the ALJ. In this case, there is not.

Little precedential value will ensue from a detailed restatement of the facts adduced at the hearing. They are sufficiently set forth in the ALJ's decision. It is appropriate, however, to discuss the major issue raised by appellant on appeal: whether the ALJ properly addressed Pratt's alleged psychological problems and their effects, if any, on his shoulder and back disorders.

The ALJ erroneously found that Pratt had neither sought treatment for, nor told any physician about, any possible mental impairment. The record shows that Pratt had been prescribed Xanax for depression and anxiety in 1986. 3 He reported a "nerve problem" to a physician, Dr. Kraft, in 1986. In 1987, he told Dr. Ellen Snoxell, a psychologist, that he took Halcion for stress. 4 Pratt also underwent several psychological evaluations. He took the Minnesota Multi-phasic Personality Inventory (MMPI) in February 1987 and, although his results on the test fell essentially within normal limits, he was diagnosed as having an anxiety disorder. His second MMPI indicated psychological distress. The psychologist, Dr. Snoxell, recommended at that time that he be evaluated for depression. He was treated at Hennepin County Mental Health Center in February 1988, and psychiatrist Stephen Greenwald, M.D., diagnosed a schizotypal personality disorder. He was prescribed Doxepin, and BuSpar. 5 Pratt visited the Mental Health Center five times in March and April 1988. In July 1988, a psychiatrist, Dr. Haberle, completed a Psychiatric Technique Review Form on Pratt for the Social Security Administration. 6 Doctor Haberle concluded that Pratt suffered from schizotypal personality disorder but that it was not so severe as to be disabling.

Pratt took a third MMPI in August 1988 while awaiting surgery at the Veteran's Administration Medical Center. His profile was highly elevated, indicating "psychological turmoil of significant proportions." Dr. Gordon Braatz, the interpreting psychologist, noted a high degree of somatic concern with a tendency toward dramatized and possibly exaggerated somatic complaints. Dr. Braatz concluded that "[t]he three MMPI's obtained over the past eighteen months show a progressive intensification of the patient's psychological symptoms." Pratt was examined by John E. Mulvahill, M.D., a psychiatrist, for the Minnesota Social Security Disability Determination Services on May 18, 1989. Dr. Mulvahill concluded that Pratt had a somatoform pain disorder.

In short, the five mental health professionals whose reports appear in the record all agreed that Pratt suffered from psychological distress. Pratt's MMPI results showed progressive intensification of his symptoms over time. Instead of crediting the opinions of the mental health professionals, the ALJ substituted his own unsubstantiated conclusion concerning a mental impairment for the express diagnoses of Pratt's examining psychiatrists and psychologists. Such disregard of the record constitutes reversible error. See, e.g., Delrosa v. Sullivan, 922 F.2d 480, 484-85 (8th Cir.1991).

The ALJ found that because Pratt's symptoms did not match the listing of impairments for affective or somatoform disorders, Pratt did not suffer from a medically determinable mental impairment. 7 The ALJ's conclusion misapplies the Social Security regulations. A mental disorder need not be of listing-level severity in order to be medically determinable within the meaning of the Social Security regulations. To establish the existence of a medically determinable disorder, the claimant need only meet one or more of the clinical findings criteria. See 20 C.F.R. § 404.1520a; 20 C.F.R. pt. 404, subpt. P, app. 1, pt. A, § 12.00(B), at 377 (the purpose for including the clinical findings criteria is to medically substantiate the presence of a mental disorder). The ALJ thus erred in concluding that Pratt's failure to meet all the criteria for affective or somatoform disorders meant that he suffered from no medically determinable impairment.

The Secretary has supplemented the familiar five-step sequential process for generally evaluating a claimant's eligibility for benefits with additional regulations dealing specifically with mental impairments. See 20 C.F.R. § 404.1520a (1991). A special procedure must be followed at each level of administrative review. Id. § 404.1520a(a). The regulations also require that the steps of the procedure are to be documented at each level by completion of a standard document, the "Psychiatric Technique Review Form." See id. § 404.1520a(d). The form must be attached to the ALJ's decision. Id. § 404.1520a(d)(2).

The ALJ did not follow those procedures in this case. Instead, the ALJ confused the required sequential steps of the evaluation process and misconstrued the regulations. He also neglected to complete the required Psychiatric Technique Review Form. These errors require a remand. 8 See Stambaugh v. Sullivan, 929 F.2d 292, 296 (7th Cir.1991); Hill v. Sullivan, 924 F.2d 972, 975 (10th Cir.1991).

The sequential process for evaluating mental impairments is set out in 20 C.F.R. § 404.1520a. The first step is to record pertinent signs, symptoms, and findings to determine if a mental impairment exists. Id. §...

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