Stewart v. Apfel, 11

• Decision Date: 04 January 2001
• Docket Number: 996132,11
• Parties: Shelby J. STEWART, Plaintiff-Appellant, v. Kenneth S. APFEL, Commissioner of Social Security, Defendant-Appellee.United States Court of Appeals, Eleventh Circuit
• Court: United States Courts of Appeals. United States Court of Appeals (11th Circuit)

Shelby J. STEWART, Plaintiff-Appellant v Kenneth S. APFEL, Commissioner of Social Security, Defendant-Appellee

No. 99-6132

United States Court of Appeals, Eleventh Circuit.

December 20, 2000.

Januray 4, 2001

Appeal from the United States District Court for the Northern District of Alabama.(No. 98-0067-CV-H-NW), James H. Hancock, Judge.

Before BLACK, BARKETT and FAY, Circuit Judges.

PER CURIAM:

In this appeal we review the district court's affirmance of the Social Security Commissioner's decision denying disability benefits to Claimant Shelby J. Stewart ("Stewart"). Stewart argues that the Commissioner, acting through an administrative law judge ("ALJ"), erred as a matter of law in failing to accord adequate weight to the opinions and assessment of Stewart's treating physician. Stewart also contends that the ALJ, and subsequently the district court, erroneously focused on the lack of objective medical evidence supporting the treating physician's diagnosis. After reviewing the record, we conclude that the ALJ did not afford proper deference to the treating physician and that Plaintiff is entitled to compensation.

On August 11, 1994, Stewart filed an application for disability insurance benefits under Title II of the Social Security Act, 42 U.S.C. 401, et seq. Stewart claimed disability due to auto-immune deficiency disease, connective tissue disease, undifferentiated collagen disease, and fibromyalgia-fibrositis. Her application was denied initially and upon reconsideration, so Stewart requested a hearing before an ALJ. The ALJ, H. Evins Hamm, conducted hearings on April 22, 1996, and August 12, 1996, and issued a decision denying benefits on September 6, 1996. Stewart requested review of the hearing decision by the Appeals Council of the Social Security Administration, but the Appeals Council denied and dismissed the Request for Review. On December 17, 1998, the district court affirmed the Commissioner's decision.

The ALJ found that Stewart met the disability insured status from December 15, 1993 through September 30, 1995 and has not engaged in substantial gainful activity since December 15, 1993. The ALJ also determined that, on or prior to September 30, 1995,¹ Stewart suffered from fibromyalgia, hypertension, residuals from breast implant removal, mitral valve prolapse, chronic obstructive pulmonary disease, and non-severe depression and panic attacks, and that these conditions together constituted a "severe impairment" within meaning of the Social Security Act.² However, the ALJ concluded that the record contained no objective clinical evidence of an impairment that met or equaled any impairment listed in Appendix 1, Subpart P of the regulations. See 20 C.F.R. 404 (1999).

In reaching this decision, the ALJ relied on the testimony of internal medicine specialist Lester L. Hibbett, M.D. over the findings of Stewart's examining physician, David A. McLain, M.D., a specialist in rheumatology. Dr. Hibbett testified that the Social Security regulations require objective findings of disability, and that he found no objective findings by Dr. McLain to support the conclusion that Stewart was disabled under the Social Security regulations. Dr. Hibbett opined that Dr. McLain probably diagnosed fibromyalgia based on Stewart's history of muscle pain/weakness which were subjective complaints, and on finding certain pressure points associated with the condition. Dr. Hibbett also explained that fibromyalgia is not a listed disability, so he (Hibbett) looked at equivalent conditions,³ all of which required positive laboratory tests, x-rays, and examination results which were not present in Stewart's records.

We review the Commissioner's decision to determine whether it is supported by substantial evidence and based upon proper legal standards. See McRoberts v. Bowen, 841 F.2d 1077, 1080 (11th Cir.1988). We will not disturb the Commissioner's decision if, in light of the record as a whole, it appears to be supported by substantial evidence. See 42 U.S.C. 405(g); MacGregor v. Bowen, 786 F.2d 1050, 1053 (11th Cir.1986). Substantial evidence is more than a scintilla and is such relevant evidence as a reasonable person would accept as adequate to support a conclusion. See Richardson v. Perales, 402 U.S. 389, 401, 91 S.Ct. 1420, 1427, 28 L.Ed.2d 842 (1971).

The law of this circuit is that the testimony of a treating physician must be given substantial or considerable weight unless "good cause" is shown to the contrary. Lewis v. Callahan, 125 F.3d 1436, 1440 (11th Cir.1997); MacGregor, 786 F.2d at 1053. The Commissioner's regulations also require that the findings of a treating physician be given controlling weight:

Generally, we give more weight to opinions from your treating sources, since these sources are likely to be the medical professionals most able to provide a detailed, longitudinal picture of your medical impairment(s) and may bring a unique perspective to the medical evidence that cannot be obtained from the objective medical findings alone or from reports of individual examinations, such as consultive examinations or brief hospitalizations.

20 C.F.R. 404.1527(d)(2). Thus, the ALJ must clearly articulate the reasons for giving less weight to the opinion of a treating physician, and the failure to do so is reversible error. MacGregor, 786 F.2d at 1053.

We find that the ALJ erred as a matter of law in failing to provide any explanation for his rejection of the treating physician's opinion and diagnosis.

The ALJ's decision did not provide sufficient reasons for rejecting an extensive report by Stewart's treating physician in which Dr. McLain outlined the signs and symptoms supporting his diagnosis...