Williams v. Bowen, No. 86-2353

• Court: United States Courts of Appeals. United States Court of Appeals (10th Circuit)
• Writing for the Court: Before McKAY, SEYMOUR, and TACHA; McKAY
• Citation: 844 F.2d 748
• Decision Date: 19 April 1988
• Docket Number: No. 86-2353
• Parties: , Unempl.Ins.Rep. CCH 17974.7 Glen W. WILLIAMS, Plaintiff-Appellant, v. Otis R. BOWEN, M.D., Secretary of Health and Human Services, Defendant-Appellee.

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844 F.2d 748 21 Soc.Sec.Rep.Ser. 337, Unempl.Ins.Rep. CCH 17974.7 Glen W. WILLIAMS, Plaintiff-Appellant,
v.
Otis R. BOWEN, M.D., Secretary of Health and Human Services,
Defendant-Appellee. No. 86-2353. United States Court of Appeals,
Tenth Circuit. April 19, 1988.

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Ron Arnold of McCartney & Arnold, P.C., Cheyenne, Wyo., for plaintiff-appellant.

Jeffrey C. Blair, Asst. Regional Counsel, Dept. of Health and Human Services, Denver, Colo. (Ronald S. Luedemann, Chief Counsel, Thomas A. Nelson, Jr., Deputy Chief Counsel, Dept. of Health and Human Services, Denver, Colo., Richard A. Stacy, U.S. Atty., and Carol A. Statkus, Asst. U.S. Atty., D. Wyo., with him on the brief), for defendant-appellee.

Before McKAY, SEYMOUR, and TACHA, Circuit Judges.

McKAY, Circuit Judge.

Appellant, Glen W. Williams, appeals from an order of the district court affirming a decision of the Secretary of Health and Human Services (Secretary) that denies Mr. Williams' application for disability insurance benefits and supplemental security income (SSI) under Titles II and XVI of the Social Security Act.

I.

Mr. Williams' claim for benefits has followed a lengthy and somewhat complicated course. However, it is sufficient for purposes of our review to note that (1) two applications for benefits were filed, December 10, 1982, and December 14, 1983, claiming both Social Security disability insurance benefits and SSI benefits; (2) an administrative law judge (ALJ) issued a favorable decision on February 27, 1986, recommending that disability insurance benefits be awarded retrospectively and SSI benefits be calculated and paid accordingly; and (3) the Appeals Council on its own motion reversed the ALJ's decision. ¹ The decision of the Appeals Council represents the Secretary's final decision for purposes of further appeal. 20 C.F.R. Secs. 404.981, 416.1481 (1986). The district court affirmed the decision of the Appeals Council, finding that substantial evidence supported the decision. Mr. Williams subsequently filed a timely notice of appeal to this court.

II.

Mr. Williams, who is 51 years old and has a tenth grade education, has not been engaged in substantial gainful activity since May 15, 1982. Prior to that time and for the majority of his adult life, Mr. Williams had been employed as a diesel mechanic. Mr. Williams claims he is disabled within the meaning of the Social Security Act and has been under a disability since May 15, 1982, as a result of (1) chronic, disabling pain stemming from musculoskeletal impairments and (2) severe alcohol-related problems.

Mr. Williams underwent two surgeries of the cervical spine, including a spinal fusion, following a long history of degenerative disc disease. Despite this surgical intervention, the treating physician reported that Mr. Williams had not received "significant relief from pain and that his physical activity was very limited." Record, vol. 2, at 23. The ALJ stated that "it seems clear based on the objective medical evidence of record and the testimony at the hearing that [Mr. Williams] would have difficulty sitting for even two hours without experiencing a good deal of discomfort." Id. The ALJ also found that the medical evidence established that Mr. Williams is an alcoholic with peripheral neuropathy, liver damage, and seizures. Mr. Williams had been hospitalized following grand mal seizures and has Dilantin prescribed to control this disorder. Mr. Williams' "drinking, in combination with the medication he takes for his severe pain and seizures, would make it impossible for him to concentrate on basic work-related functions." Id. at 24. The ALJ found that these combined impairments were so severe that Mr. Williams was disabled and entitled to benefits.

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On review the Appeals Council noted one instance where Mr. Williams "had mild neck pain but no back pain," id. at 5, and acknowledged that medical notes between October 1977 and December 1985 revealed complaints of chronic neck pain. See id. at 5, 327-40. However, the Appeals Council did not enter a specific finding regarding Mr. Williams' pain. The Appeals Council found Mr. Williams to have only "mild degenerative disc disease of the cervical spine[,] alcohol abuse with occasional seizures, liver inflammation and mild peripheral neuropathy." Id. at 7. Thus, while the existence of Mr. Williams' impairments is not disputed, the Appeals Council concluded that none of the impairments, singly or in combination, met or were medically equal to any impairment on the Secretary's listing of impairments. See 20 C.F.R. pt. 404, Subpt. P., App. 1 (1986). The Appeals Council further concluded that Mr. Williams retained the residual functional capacity to perform sedentary and light work, 20 C.F.R. Secs. 404.1567(a)-(b), 416.967(a)-(b) (1986), and was not disabled within the meaning of the Social Security Act. Consequently, the Appeals Council rejected the ALJ's recommended decision.

We must determine whether the Secretary's decision of nondisability, reached through action of the Appeals Council, is supported by substantial evidence, i.e., "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Broadbent v. Harris, 698 F.2d 407, 414 (10th Cir.1983) (quoting Richardson v. Perales, 402 U.S. 389, 401, 91 S.Ct. 1420, 1427, 28 L.Ed.2d 842 (1971)). "Evidence is not substantial 'if it is overwhelmed by other evidence ... or if it really constitutes not evidence but mere conclusion.' " Knipe v. Heckler, 755 F.2d 141, 145 (10th Cir.1985) (quoting Kent v. Schweiker, 710 F.2d 110, 114 (3d Cir.1983)). A decision not supported by substantial evidence must be reversed. Additionally, "[f]ailure to apply the correct legal standard or to provide this court with a sufficient basis to determine that appropriate legal principles have been followed is grounds for reversal." Byron v. Heckler, 742 F.2d 1232, 1235 (10th Cir.1984) (quoting Smith v. Heckler, 707 F.2d 1284, 1285 (11th Cir.1983)). In reviewing the Secretary's decision, we meticulously examine the record and view it in its entirety. Dollar v. Bowen, 821 F.2d 530, 532 (10th Cir.1987).

III.

"Disability" is defined in the Social Security Act as the "inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment...." 42 U.S.C. Secs. 423(d)(1)(A), 1382c(a)(3)(A) (1982). The Social Security Act further provides that an individual "shall be determined to be under a disability only if his physical or mental impairment or impairments are of such severity that he is not only unable to do his previous work but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy...." 42 U.S.C. Secs. 423(d)(2)(A), 1382c(a)(3)(B) (1982 & Supp. III 1985).

The Secretary has established a five-step sequential evaluation process for determining whether a claimant is disabled. 20 C.F.R. Secs. 404.1520, 416.920 (1986); see Bowen v. Yuckert, --- U.S. ----, 107 S.Ct. 2287, 2290-95, 96 L.Ed.2d 119 (1987); Campbell v. Bowen, 822 F.2d 1518, 1521 (10th Cir.1987). If a determination can be made at any of the steps that a claimant is or is not disabled, evaluation under a subsequent step is not necessary.

Step one determines whether the claimant is presently engaged in substantial gainful activity. If he is, disability benefits are denied. If he is not, the decision maker must proceed to step two: determining "whether the claimant has a medically severe impairment or combination of impairments." Bowen v. Yuckert, 107 S.Ct. at 2291. This determination is governed by the Secretary's severity regulations, 20 C.F.R. Secs. 404.1520(c), 416.920(c) (1986), is based on medical factors alone, and, consequently, does not include consideration of such vocational factors as age, education, and work experience. Pursuant to the severity

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regulations, the claimant must make a threshold showing that his medically determinable impairment or combination of impairments significantly limits his ability to do basic work activities, i.e., "the abilities and aptitudes necessary to do most jobs." 20 C.F.R. Secs. 404.1521(b), 416.921(b) (1986); accord Bowen v. Yuckert, 107 S.Ct. at 2291. Presumptively, if the medical severity of a claimant's impairments is so slight that the impairments could not interfere with or have a serious impact on the claimant's ability to do basic work activities, irrespective of vocational factors, the impairments do not prevent the claimant from engaging in substantial gainful activity. Bowen v. Yuckert, 107 S.Ct. at 2293. If the claimant is unable to show that his impairments would have more than a minimal effect on his ability to do basic work activities, he is not eligible for disability benefits. If, on the other hand, the claimant presents medical evidence and makes the de minimis showing of medical severity, the decision maker proceeds to step three.

In this case, the Appeals Council found that Mr. Williams "has not engaged in substantial gainful activity since October 1981." Record, vol. 2, at 7. In addition, Mr. Williams apparently made the threshold showing that his impairments are medically severe enough to interfere with his ability to do basic work activities. Id. at 5-8.

Step three "determines whether the impairment is equivalent to one of a number of listed impairments that the Secretary acknowledges are so severe as to preclude substantial gainful activity," pursuant to 20 C.F.R. Secs. 404.1520(d), 416.920(d) (1986). Bowen v. Yuckert, 107 S.Ct. at 2291. If the impairment is listed and thus conclusively presumed to be disabling, the claimant is entitled to benefits. If not, the evaluation proceeds to the fourth step, 20 C.F.R. Secs. 404.1520(e), 416.920(e) (1986), where the claimant must show that the "impairment prevents [him] from performing work he has performed in the past." Bowen v....