Wiggins v. Schweiker, 81-7540

• Decision Date: 09 July 1982
• Docket Number: No. 81-7540,81-7540
• Citation: 679 F.2d 1387
• Parties: William P. WIGGINS, Plaintiff-Appellant, v. Richard S. SCHWEIKER, Secretary of the Department of Health and Human Services, Defendant-Appellee.
• Court: U.S. Court of Appeals — Eleventh Circuit

Page 1387

679 F.2d 1387

William P. WIGGINS, Plaintiff-Appellant, v. Richard S. SCHWEIKER, Secretary of the Department of Health and Human Services, Defendant-Appellee.

No. 81-7540.

United States Court of Appeals, Eleventh Circuit.

July 9, 1982.

Legal Services Corp. of Alabama, Gary Philip Jacobs, Montgomery, Ala., for plaintiff-appellant.

Calvin C. Pryor, Asst. U. S. Atty., Montgomery, Ala., for defendant-appellee.

Appeal from the United States District Court for the Middle District of Alabama.

Before INGRAHAM ^*, HATCHETT and ANDERSON, Circuit Judges.

R. LANIER ANDERSON, III, Circuit Judge:

I. FACTS AND PROCEEDINGS

The appellant, William P. Wiggins, is a 51-year old man who claims that various physical and psychological ailments ¹ have totally and permanently disabled him from pursuing gainful employment. The appellant applied to the Social Security Administration for disability insurance benefits and for Supplemental Security Income disability benefits, and the Social Security Administration denied the appellant's applications. The appellant then requested a hearing before an Administrative Law Judge ("ALJ") to determine whether the appellant is entitled to the benefits he seeks. The ALJ ruled that the appellant was not permanently and totally disabled within the meaning of the Social Security Act and therefore the appellant was not entitled to any Social Security benefits. When the Appeals Counsel of the Social Security Administration declined to review the ALJ's decision, that ruling became the final decision of the defendant-appellee Secretary of Health and Human Services ("Secretary").

The appellant thereafter sought judicial review of the Secretary's decision in the United States District Court for the Middle District of Alabama. The case was submitted to the district court on the pleadings, which included the administrative record, and the briefs of the parties. The district court found that the decision of the ALJ was supported by substantial evidence, and the court entered judgment in favor of the Secretary. The appellant claims that the ALJ erred in identifying and applying the relevant legal standards and that the district court should not have entered judgment for the Secretary. Finding errors of law in the opinion of the ALJ, we reverse the judgment of the district court and remand the case for reconsideration by the ALJ according to the proper legal standards.

II. STANDARD OF REVIEW

Our standard of review for appeals from the administrative denials of Social Security benefits dictates that "(t)he findings of the Secretary as to any fact, if supported by substantial evidence, shall be conclusive ...." 42 U.S.C.A. § 405(g) (West Supp. 1982) (emphasis added). See Walden v. Schweiker, 672 F.2d 835, 838, (11th Cir. 1982); Smith v. Schweiker, 646 F.2d 1075, 1076 (5th Cir. 1981). ² As is plain from the statutory language, this deferential standard of review is applicable only to findings of fact made by the Secretary, and it is well established that "no similar presumption of validity attaches to the Secretary's conclusions of law, including determination of the proper standards to be applied in reviewing claims." Smith v. Schweiker, 646 F.2d at 1076; Western v. Harris, 633 F.2d 1204, 1206 (5th Cir. 1981). See Frith v. Celebrezze, 333 F.2d 557, 560 (5th Cir. 1964). Failure to apply the correct legal standards or to provide the reviewing court with the sufficient basis to determine that the correct legal principles have been followed is grounds for reversal. ³

III. FAILURE TO GIVE APPROPRIATE WEIGHT TO THE OPINION OF

THE TREATING PHYSICIAN

In support of his claim of disability, the appellant introduced into the record two reports submitted by his treating physician, Dr. James F. Mracek, which contain diagnoses, medical and treatment histories, laboratory and clinical findings, and a prognosis. Dr. Mracek's second report concluded:

Mr. Wiggins has attempted to work and after activity he has to remain in the bed for several days due to joint swelling and pain. In my opinion, he is not capable of performing his usual work or sedentary work (lifting 10 pounds, carrying or lifting small objects, sitting 6 hours a day, walking or standing max. 2 hours). It is my opinion that Mr. Wiggins has a progressive type disability which has shown no improvement and he is totally disabled.

Record on Appeal, vol. II, at 115.

Our case law requires that unless good cause is shown to the contrary, the ALJ must accord "substantial weight" or "considerable weight" to the opinion, diagnosis, and medical evidence of the claimant's treating physician. Walden v. Schweiker, 672 F.2d 835, 840; Smith v. Schweiker, 646 F.2d at 1081; Fruge v. Harris, 631 F.2d 1244, 1246 (5th Cir. 1980). Yet, the opinion of the ALJ in the present case does not mention Dr. Mracek, let alone reveal what weight, if any, the ALJ gave to the treating physician's evidence.

With respect to the appellant's claims of heart problems, the ALJ's opinion did refer to an attachment to Dr. Mracek's first report, a hospital discharge summary signed by Dr. Hiroshi Mitsuoka relating to appellant's hospitalization in 1976 for sharp, stabbing chest pains. The ALJ concluded, however, based on the findings of consulting physicians, Drs. Lewis R. Pummer and J. P. Evans, who examined the appellant respectively on July 17, 1979, and November 5 1979, "that the medical evidence in this file establishes that the claimant has recovered from his myocardial infarction and at the present time does not have any significant cardiovascular problem." Record on Appeal, vol. II, at 16. The ALJ did not mention or even allude to Dr. Mracek's second report which contains physical findings that the appellant had chest pains in June, July, and August of 1979, and which diagnoses the appellant as having a "(h)istory of acute ME due to ASCHD." ⁴

Moreover, with respect to the appellant's claims of disability due to arthritis, the ALJ's opinion states: "The first medical finding in this file involving the musculoskeletal system was in Dr. Pummer (sic) report (Exhibit 17 ) ...." Record on Appeal, vol. II, at 16-17 (emphasis added). This assertion completely ignores Dr. Mracek's first report (Exhibit 16), filed over a month before Dr. Pummer's report (Exhibit 17), that contains diagnoses of arthritis and a summary of the treatment for that disorder and the appellant's response to treatment ("unimproved").

The ALJ's opinion, thus, not only fails to mention the appellant's treating physician and the weight, if any, the ALJ gave to the treating physician's evidence and opinion, but also strongly suggests that the ALJ did not accord the opinion of the appellant's treating physician the weight required by law. At the very least, we are unable to determine whether the ALJ applied the proper legal standard and gave the treating physician's evidence substantial or considerable weight or found good cause not to do so. If we are to provide the parties with any sort of meaningful judicial review, we must be able to ascertain whether the ALJ correctly followed the law. Unable to divine this from the ALJ's opinion, we must reverse the district court and remand the case for reconsideration by the ALJ, who should evaluate all the evidence according to the respective weight required by law and should render a decision that will provide reviewing courts with the basis for determining that he applied the correct legal standards.

IV. INCORRECT STANDARD FOR EVALUATING SUBJECTIVE COMPLAINTS OF PAIN

There is another reason why the judgment in favor of the Secretary must be reversed. The ALJ stated that the appellant's "subjective symptoms of chest pain, joint pain ... (would) be conceded only insofar as the complaints are supported by clinical and laboratory diagnostic techniques." Record on Appeal, vol. II, at 15. The ALJ further observed that while pain by itself can be disabling, "(t)o be considered disabling within the purview of the Social Security Act, an impairment must be supported by medical findings which at least give probability to the allegations of pain as opposed to a possibility." Id. at 18. These simply are erroneous statements of the law. The Fifth and Eleventh Circuits have emphatically rejected the notion that to be disabling subjective claims of pain must be supported by objective medical evidence or by clinical or laboratory findings. Walden v. Schweiker, 672 F.2d 835, 840 ("It is well established in the Fifth and Eleventh Circuits that pain alone can be disabling, even when its existence is unsupported by objective evidence."); Benson v. Schweiker, 652 F.2d 406, 408-09 (5th Cir. 1981) ("This Court has held that subjective evidence of pain, as testified to by the claimant, when linked to a 'medically determinable impairment' may be sufficient to support a finding by the secretary of the inability to engage in any substantial gainful activity, although testimony about the claimant's pain is based on the purely subjective experience of the patient and the existence of pain itself is unsupported by objective medical evidence."); Ware v. Schweiker, 651 F.2d 408, 412 (5th Cir. 1981) ("Thus, pain resulting from a 'medically determinable impairment,' even when its existence is unsupported by objective medical evidence, may of itself be so intense as to cause disability."); Smith v. Schweiker, 646 F.2d at 1082 ("As the ALJ's own words reveal, he apparently disregarded Smith's complaints of pain because they were unsupported by objective clinical and laboratory findings. This runs counter to the views voiced for years and years by this court recognizing that the claimant's subjective complaints of pain may not be disregarded simply because th...