Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-ca10-89-05103/USCOURTS-ca10-89-05103-0/pdf.json

Nature of Suit Code: 863
Nature of Suit: Social Security - DIWC/DIWW (405(g))
Cause of Action: 

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FI LED 

United Scates Court of Appeals 

UNITED STATES COURT OF APPEALS Tenth Circuit 

FOR THE TENTH CIRCUIT MAY 2 - 1991 

CLYDE A. MELTON, 

Plaintiff-Appellant, 

v. 

LEWIS SULLIVAN, M.D., Secretary of 

Health and Human Services, 

Defendant-Appellee. 

ROBERT L. HOECKER 

) Clerk 

) 

) 

) 

) No. 89-5103 

) (D.C. No. 88-C-471-C) 

) ( N. D. Okla . ) 

) 

) 

) 

ORDER AND JUDGMENT* 

Before HOLLOWAY, Chief Judge, MOORE, and BRORBY, Circuit Judges. 

After examining the briefs and appellate record, this panel 

has determined unanimously that oral argument would not materially 

assist the determination of this appeal. See Fed. R. App . P . 

34(a); 10th Cir. R. 34.1.9. 

submitted without oral argument. 

The case is therefore ordered 

Claimant-appellant Clyde A. Melton seeks review of an order 

of the United States District Court for the Northern District of 

Oklahoma affirming the Secretary's decision to deny claimant's 

application for social security benefits under 42 u.s.c. § 401-33. 

* This order and judgment has no precedential value and shall 

not be cited, or used by any court within the Tenth Circuit, 

except for purposes of establishing the doctrines of the law of 

the case, res judicata, or collateral estoppel. 10th Cir. R. 

36.3. 

Appellate Case: 89-5103 Document: 010110106435 Date Filed: 05/02/1991 Page: 1 
Claimant filed his request for benefits in December of 1986, 

alleging disability as of May 1986 due to an enlarged spleen, 

cirrhosis of the liver, and a low blood platelet count. Benefits 

were denied initially and on reconsideration, after which claimant 

requested a hearing before an administrative law judge (ALJ). 

The case as presented to the ALJ involved whether certain 

other impairments met or equaled an impairment listed in 20 C.F.R. 

pt. 404, subpt. P, App. 1, or whether the totality of claimant's 

impairments qualified claimant as disabled under the Social 

Security Act. 

The ALJ found that Mr. Melton had severe morbid obesity; 

history of alcohol abuse, with associated micronodular cirrhosis 

and alcoholic liver disease (hepatitis); hypersplenism; episodes 

of pitting edema in both ankles; and stasis dermatitis in both 

lower legs, but did not have an impairment or combination of 

impairments listed in or medically equal to one listed in 

Appendix 1. 

After rejecting claimant's subjective complaints, including 

severe continuous pain, as "not credible to the extent alleged," 

the ALJ then concluded that although claimant was unable to 

perform his past relevant work, claimant had the residual 

functional capacity (RFC) to perform sedentary work, and that 

therefore under "[s]ection 404.1569 of Regulations No. 4 and Rule 

201.21, Table No. 1 of Appendix 2, Subpart P, Regulations No. 4, 

considering the claimant's residual functional capacity, age, 

education, and work experience, [claimant] is not disabled." 

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Claimant then sought review in the district court pursuant to 

42 u.s.c. § 405(g). Following a hearing, the magistrate submitted 

findings and recommendations, determining that the ALJ had ignored 

certain medical evidence of causes for disabling pain and the 

opinion of claimant's treating physician (Dr. Gerald D. Wooton) 

that claimant's problems met or equaled the criteria of the 

listing of impairments. The magistrate recommended reversing the 

ALJ and finding claimant disabled and entitled to benefits. 

The district court overruled the magistrate's recommendation, 

concluding that the ALJ's decision to reject Dr. Wooten's opinion 

was supported by relevant evidence and specific legitimate 

reasons. The court also held that the ALJ had considered 

claimant's nonexertional impairments in finding that claimant's 

impairments "did not further limit the jobs available to the 

plaintiff in the ALJ's application of the grids." 

From the district court's order affirming the Secretary's 

denial of benefits, claimant has timely appealed. The issues he 

raises are as follows: 

1. The court below and the Secretary ignored the 

uncontradicted findings of the appellant's treating 

physician and the treating physician's opinion and 

relied on unsubstantiated statements of social security 

physicians. 

2. The appellant's medical condition meets and even 

exceeds the criteria of the social security listing of 

impairments. 

3. The Secretary misapplied the medical vocational 

guidelines when he failed to consider the appellant's 

nonexertional impairments and pain, effectiveness (sic) 

medications, and avoidance of trauma to the body. 

4. The Secretary failed to fully develop the record. 

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A reviewing court considers only whether the Secretary's 

decision is supported by substantial evidence. Bernal v. Bowen, 

851 F.2d 297, 299 (10th Cir. 1988). Substantial evidence is 

evidence a reasonable mind would accept as adequate to support a 

conclusion. Richardson v. Perales, 402 U.S. 389, 401 (1971). 

Although we will meticulously examine the record, we will not 

weigh the evidence or substitute our discretion for that of the 

Secretary. Broadbent v. Harris, 698 F.2d 407, 414 (10th Cir. 

1983). 

A decision is not based on substantial evidence if it is 

overwhelmed by other evidence in the record or if there is a mere 

scintilla of evidence supporting it. Ray v. Bowen, 865 F.2d 222 

(10th Cir. 1989)(evidence not substantial if overwhelmed by other 

evidence or merely a conclusion); Bernal v. Bowen, 851 F.2d at 

299; Williams v. Bowen, 844 F.2d 748, 750 (10th Cir. 1988)(same). 

The agency decision is also subject to reversal if the incorrect 

legal standard was applied. Gatson v. Bowen, 838 F.2d 442, 449 

(10th Cir. 1988); W-----=i=l=l=i~am=s ____ v-----'-.-=B~o~w~e-=n, 844 F.2d at 750. 

Nonetheless, the question on appeal is not whether there was 

evidence which would have supported a different result but whether 

there was substantial evidence in support of the result reached. 

The ALJ followed the sequential analysis required by the 

social security regulations. The order of this five-step analysis 

is as follows: 

1. Is the claimant presently pursuing work that 

constitutes substantial gainful activity? If so, he or 

she is not disabled, even if medically impaired. 

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2. If the claimant 

gainful activity, 

impairment -- i.e., 

physical or mental 

If not, there is no 

is not presently doing substantial 

then does the claimant have a severe 

one that significantly limits one's 

ability to do basic work activities? 

disability. 

3. If the claimant has a severe impairment, does the 

impairment meet or equal a listed impairment in 

20 C.F.R. § 404, Subpart P, Appendix 1 (1986)? If so, 

and if it has lasted or can be expected to last for at 

least twelve months, it constitutes a disability, and 

there is no need to proceed with further evaluation. 

4. If the severe impairment does not meet or equal a 

listed impairment, does it, when considered along with 

claimant's residual functional capacity and the physical 

and mental demands of the job, prevent the claimant from 

doing past relevant work? If not, there is no 

disability, and the evaluation process stops. 

5. If the claimant cannot return to past relevant work 

because of a severe impairment, the final question is 

whether the claimant's residual functional capacity, 

age, education, and work experience allow the 

performance of other work? If not, there is a 

disability. 

Jozefowicz v. Heckler, 811 F.2d 1352, 1355 (10th Cir. 

1987)(footnote omitted); see also Gossett v. Bowen, 862 F.2d 802, 

805 (10th Cir. 1988). 

If a finding of disabled or not disabled can be made at any 

step, further inquiry is not needed. Campbell v. Bowen, 822 F.2d 

1518, 1521 (10th Cir. 1987); Reyes v. Bowen, 845 F.2d 242, 243 

(10th Cir. 1988)(review ends at any point finding of disabled or 

not disabled made). 

The claimant bears the burden of establishing a disability, 

i.e., the first four steps. Williams v. Bowen, 844 F.2d at 748 

n.2. However, once the ALJ determines that petitioner can no 

longer perform his past relevant work, the burden shifts to the 

Secretary to show that claimant has the residual capacity to 

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Appellate Case: 89-5103 Document: 010110106435 Date Filed: 05/02/1991 Page: 5 
perform some other kind of work in the national economy. Gossett 

v. Bowen, 862 F.2d at 804; Dixon v. Heckler, 811 F.2d 506, 511 

(10th Cir. 1987). 

The ALJ recited at length claimant's medical history, 

including hospitalizations and outpatient visits, which we need 

not repeat. The areas of contention are the interpretation of 

certain medical notations and diagnoses, the weight accorded two 

evaluation letters furnished by claimant's primary (but not only) 

treating physician, Dr. Wooton, and the ALJ's evaluation of 

claimant's subjective claim of pain. 

The first two issues raised by claimant are 

overlapping, and we consider them together. 

somewhat 

Claimant contends that his impairments meet or equal those in 

App. 1 of Subpt. P, § 10.10 A and D. Section 10, entitled 

"Multiple Body Systems," covers impairments involving more than a 

single body system: 

this 

10.10 Obesity. Weight equal to or greater than the 

values specified in Table 1 for males, Table II for 

females (100 percent above desired level) and one of the 

following: 

A. History of pain and limitation of motion in any 

weight bearing joint or spine (on physical examination) 

associated with X-ray evidence of arthritis in a weight 

bearing joint or spine; or 

D. Chronic venous insufficiency with superficial 

varicosities in a lower extremity with pain on weight 

bearing and persistent edema. 

As noted above, claimant bears the burden of establishing 

disability. Although the record contains evidence of 

different weights over the several years prior to the alleged 

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onset of disability, claimant's weight was most frequently in the 

neighborhood of 350 lbs., which is greater than the value in Table 

1 for a man of his height. The question is whether he also 

established the criteria needed by either section A or D. 

As to part A, there are references to "degenerative joint 

disease" and (from chest X-rays) to some "degenerative change of 

the dorsal spine." However, Dr. Wooton's "bare statement in his 

letter of [September 18, 1987,] that claimant has a section [lOA. 

and D] impairment does not meet the level of evidence required to 

prove the existence of such an impairment. See 20 C.F.R. 

§ 404.1527." Harris v. Secretary of Health & Human Servs., 821 

F.2d 541, 543 (10th Cir. 1987). In other words, claimant must 

prove all the elements of a particular listing. 

Conspicuously absent is any history of "limitation of motion 

in any weight bearing joint or spine (on examination)." Indeed, 

in his brief, claimant makes no argument that the record shows any 

limitation of motion associated with a weight bearing joint or 

spine. To the contrary, the record shows from several extensive 

examinations made in connection with the hospitalizations that 

there was "no abnormal lateral curvatures of the vertebrae column" 

and "adequate" range of motion (Supp. Vol. II, p. 106), claimant's 

denial (on examination) of "any arthritic complaints" (Supp. Vol. 

II, p. 126), "no limitation of motion or pain on movement of the 

extremities, and no back pain elicited" (Supp. Vol. II, p. 140), 

and "no evidence of red or painful, swollen joints, and no 

decreased range of motion" (Supp. Vol. II, p. 189). Also absent 

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from the evidence is any indication that claimant has sought 

medical treatment for pain in a weight bearing joint. 

Impairments of the musculoskeletal system, of which arthritis 

is one, 20 C.F.R. pt. 404, subpt. P, App. 1, §§ 1.02-1.08, are 

established through detailed history, physical examination, 

X-rays, 20 C.F.R. pt. 404, subpt. P, App. 1, § 1.00(b)(1986), and 

the use of specific findings, such as "pain, muscle spasm, and 

significant limitation of motion in the spine" and "appropriate 

radicular distribution of significant motor loss with muscle 

weakness and sensory and reflex loss." Id. at section 1.0S(C). 

Other than the nonspecific references to joint disease and 

one other to a past history of arthritis (Supp. Vol. II, p. 143), 

there is simply no evidence indicating any limitation in motion. 

Claimant next argues that he meets the criteria of subpt. D, 

or, alternatively, that he in fact exceeds the requirements when 

his impairments are considered in combination. Again, however, he 

does not meet all the required elements of subpt. D. Missing is 

any indication of varicosities, spider angioma or other vascular 

disturbances. (Supp. Vol. II, p. 140.) Claimant's assertion that 

he suffers from persistent edema comes from a notation of "mild 

pretubial edema" (Supp. Vol. II, p. 140) and another of "trace 

lower extremity edema" (Supp. Vol. II, p. 181). Other notations, 

listed in our discussion of subpt. A, specifically declare the 

absence of swollen joints and pain. Again, likewise, lacking is 

any indication he has sought treatment for this condition. 

The only mention of chronic venous insufficiency is a 

reference to "discoloration of skin apparently from chronic venous 

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Appellate Case: 89-5103 Document: 010110106435 Date Filed: 05/02/1991 Page: 8 
insufficiency" (Supp. Vol. II, p. 142) in connection with one of 

his hospitalizations (emphasis ours). However, even assuming that 

stasis dermatitis (evidence of which is contained in the record) 

is caused by venous insufficiency, lack of references to the other 

criteria of subpt. D supports the ALJ's determination that 

claimant has failed to meet the burden of establishing he meets 

the requirements of the listing. Finally, the mere presence of 

several impairments, some of which only partly fulfill the 

requirements of a particular listing, does not establish a medical 

equivalence. 

Claimant's argument that the ALJ ignored his treating 

physician's opinion and relied on the social security physicians' 

evaluations is without merit for several reasons. First, Dr. 

Wooton was only one of several treating physicians. The only 

record evidence of Dr. Wooton's treatment consists of progress 

notes and does not involve the extensive reports compiled by 

treating doctors when claimant was hospitalized. Nothing in the 

progress notes accounts for the subsequent determination of 

disability issued by Dr. Wooton. 

Claimant relies heavily on two evaluation letters written by 

this doctor. The evaluation letter written by Dr. Wooton in March 

of 1987 (Supp. Vol. II, p. 199) outlined in conclusory form 

plaintiff's various complaints and advised that a blow to the 

stomach could cause a life-threatening situation. This letter is 

clearly in response to the idea that plaintiff could not perform 

his job as a boilermaker (his lifelong career) or possibly as a 

night watchman (his last job). The opinion that plaintiff could 

9 

Appellate Case: 89-5103 Document: 010110106435 Date Filed: 05/02/1991 Page: 9 
not perform his pervious occupations, however, is devoid of any 

basis for the claim of total disability. In addition, plaintiff 

fell from a ladder and landed on his stomach in April of 1987 with 

apparently no long-lasting effects. The April incident undercuts 

the credibility of Dr. Wooton's assessment of the severity of 

claimant's condition. 

In September of 1987, apparently five or six months after the 

last time he saw claimant, Dr. Wooton furnished another letter 

concluding that claimant had "X-ray evidence of arthritis of the 

dorsal spine, with complaints of pain, and that [claimant] also 

was chronic venous insufficiency of the lower extremities with 

pain on weight bearing, with persistent edema, and that [claimant] 

would, therefore, meet the criteria of 10.10 A. and D. of the 

Listing of Impairments [20 C.F.R. pt. 404, subpt. P, App. 1, 

§ 10.10 A and D)]." (Supp. Vol. II, p. 239). This evaluation is 

conclusory, however, and not supported by the record evidence. 

The reports of the other treating physicians, none of whom even 

remotely suggested that claimant was disabled, simply do not 

establish the existence of extreme impairments. 

Second, although the ALJ mentioned that the two social 

security 

concluded 

physicians had evaluated 

claimant had failed to 

the medical evidence 

establish entitlement 

and 

to 

disability benefits, the ALJ did not rely on those evaluations to 

arrive at his decision. Finally, we are persuaded that the ALJ 

adequately articulated specific reasons for disregarding Dr. 

Wooton's September, 1987, opinion which was (1) issued several 

months after the doctor had last seen claimant and (2) not based 

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on substantial medical evidence in the record. 

Bowen, 845 F.2d at 245. 

See Reyes v. 

Claimant next asserts the ALJ misapplied the medical 

vocational guidelines by failing to consider nonexertional 

impairments of pain, adverse side effects of medication, and 

avoidance of trauma to the body. The latter has been discussed 

(and in any event is irrelevant to the consideration of whether 

claimant can perform sedentary work). 

Having now reached step five of the sequential process, the 

ALJ determined that claimant could perform the full range of 

sedentary work and was therefore not disabled. Sedentary work is 

that which: 

involves lifting no more than 10 pounds at a time and 

occasionally lifting or carrying articles like docket 

files, ledgers, and small tools. Although a sedentary 

job is defined as one which involves sitting, a certain 

amount of walking and standing is often necessary in 

carrying out job duties. Jobs are sedentary if walking 

and standing are required occasionally and other 

sedentary criteria are met. 

20 C.F.R. § 404.1567(a) (1988). 

In applying the Medical Vocational Guidelines, 20 C.F.R. 

404.1569 and 1 404, App. 2, Table 1, Rule 201.21 (the grids) to 

claimant, there is no dispute as to his age, education, literacy, 

and work experience. The question is whether there is substantial 

evidence on the record to support the ALJ's determination that 

petitioner could perform the full range of sedentary work. See 

Dixon v. Heckler, 811 F.2d at 508. Only if this factor in the 

grids equation, the residual functional capacity (RFC), was 

properly decided can the automatic application of the grids be 

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upheld. 

1984) . 

See Channel v. Heckler, 747 F.2d 577, 582 (10th Cir. 

A claimant's RFC to do work is what the claimant is 

still functionally capable of doing on a regular and 

continuing basis, despite his impairments: the 

claimant's maximum sustained work capability. The 

decision maker first determines the type of work, based 

on physical exertion (strength) requirements, that the 

claimant has the RFC to perform. In this context, work 

existing in the economy is classified as sedentary, 

light, medium, heavy, and very heavy. To determine the 

claimant's "RFC category," the decision maker assesses a 

claimant's physical abilities and, consequently, takes 

into account the claimant's exertional limitations 

(i.e., limitations in meeting the strength requirements 

of work). No doubt, a claimant may have significant 

exertional limitations that prevent him from performing 

the strength requirements of even sedentary work. 

Williams v. Bowen, 844 F.2d at 751-52 (footnote omitted). 

The grids may not be applied conclusively in a given case 

unless the plaintiff's characteristics precisely match the 

criteria of a particular rule. Ray v. Bowen, 865 F.2d at 225; 

Eggleston v. Bowen, 851 F.2d 1244, 1247 (10th Cir. 1988); Gatson 

v. Bowen, 838 F.2d at 446. This is because the grids measure a 

claimant's exertional limitations, i.e., strength, Ray v. Bowen, 

865 F.2d at 225; Gossett v. Bowen, 862 F.2d at 806, and because an 

individual's capacity to work may also be limited by nonexertional 

limitations, such as pain. Gossett v. Bowen, 862 F.2d at 806; Ray 

v. Bowen, 865 F.2d at 225; Channel v. Heckler, 747 F.2d at 580. 

Thus, the presence of a nonexertional limitation which 

prevents the applicant from performing the full range of work may 

preclude application of the grids and dictate their use only as a 

framework to determine disability. See Gossett v. Bowen, 862 F.2d 

at 806; Talbot v. Heckler, 814 F.2d 1456, 1460 (10th Cir. 1987); 

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Gatson v. Bowen, 838 F.2d at 446; Campbell v. Bowen, 822 F.2d at 

1522-23 n.2. 

However, the mere presence of a nonexertional impairment does 

not automatically preclude reliance on the grids. Ray v. Bowen, 

865 F.2d at 225; Gossett v. Bowen, 862 F.2d at 807-808. Rather, 

use of the grids is foreclosed only "[t]o the extent that 

nonexertional impairments further limit the range of jobs 

available to the claimant." Channel v. Heckler, 747 F.2d at 582 

n.6 (quoting Grant v. Schweiker, 699 F.2d 189, 192 (4th Cir. 

1983). Here, the ALJ in effect concluded that petitioner's 

ability to perform the full range of jobs was not diminished by 

the pain. See Channel v. Heckler, 747 F.2d at 581. 

This court recently outlined the framework that is to be 

used in evaluating a disability claim based on pain. 

See Luna v. Bowen, 834 F.2d 161 (10th Cir. 1987). The 

process is described as follows: 

If a pain-producing impairment is demonstrated by 

objective medical evidence, the decision maker must 

consider the relationship between the impairment 

and the pain alleged. "[T]he impairment or 

abnormality must be one which 'could reasonably be 

expected to produce' the alleged pain." ... If 

an appropriate nexus does exist, the decision maker 

must then consider all the evidence presented to 

determine whether the claimant's pain is in fact 

disabling. 

Id. at 163 (citation omitted). The first component of 

the inquiry, the objective impairment prerequisite, is 

fulfilled without regard to subjective evidence. The 

second component, a nexus between the impairment and the 

alleged pain, is examined "tak[ing] the subjective 

allegations of pain as true." Id. Upon reaching the 

third component--considering all evidence presented--the 

decision maker considers all medical data presented, any 

other objective indications of pain, and subjective 

accounts of the severity of the pain. At this point, 

the decision maker may assess the claimant's 

credibility. Id. 

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It is undisputed that Mr. Williams' degenerative 

disc disease is an impairment capable of producing pain. 

Since the first component is present, our attention 

focuses on the nexus between this impairment and Mr. 

Williams' subjective allegations of pain. The 

impairment must be reasonably expected to produce the 

pain that is being claimed. Id. However, the nexus 

between the impairment and the alleged pain can be 

loose. "[I]f an impairment is reasonably expected to 

produce some pain, allegations of disabling pain" are 

sufficiently consistent to satisfy this part of the 

evaluation process. Id. at 164. 

Williams v. Bowen, 844 F.2d at 753-54. 

We have long recognized that substantial weight must be given 

evidence provided by treating physicians. See Bernal v. Bowen, 

851 F.2d at 301; Eggleston v. Bowen, 851 F.2d at 1246; Reyes v. 

Bowen, 845 F.2d at 244-45; Broadbent v. Harris, 698 F.2d at 412 

(opinions of treating physicians must be given greater weight than 

Secretary's doctor who examined claimant only once). In this 

case, however, the weight of the evidence of all the treating 

physicians simply does not support claimant's assertion of 

disabling pain. 

It is also clear from the record that the ALJ considered and 

evaluated claimant's allegations of pain. See Huston v. Bowen, 

838 F.2d 1125, 1131 (10th Cir. 1988)(claimant entitled to 

consideration of nonmedical objective and subjective testimony of 

pain); see also Williams v. Bowen, 844 F.2d at 754; Luna v. Bowen, 

834 F.2d at 165. However, subjective pain must be evaluated with 

due consideration for credibility, motivation, and medical 

evidence. Nieto v. Heckler, 750 F.2d 59, 61 (10th Cir. 1984); 

Broadbent v. Harris, 698 F.2d at 413. The ALJ's determination of 

credibility is a factor to be considered in determining whether 

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his decision is supported by substantial evidence. Nieto v. 

Heckler, 750 F.2d at 62. See also Gossett v. Brown, 862 F.2d at 

807 (generally ALJ's credibility determinations are treated as 

binding). 

Although the medical reports indicate the presence of some 

pain, the evidence is not so strong as to support claimant's 

allegation of disability. None of the majority of the treating 

physicians determined Mr. Melton to be disabled either by virtue 

of his physical impairments or by disabling pain. Only Dr. 

Wooton, in a conclusory statement not attendant to an examination, 

opined that claimant was disabled. We therefore conclude there is 

sufficient evidence on the record as a whole to support the ALJ's 

determination that petitioner's pain was not sufficiently 

disabling to preclude use of the grids. 

Finally, claimant vaguely asserts that the ALJ and the 

Secretary are required "to fully develop the record and to take 

all the facts into consideration and weigh them equally and 

fairly." There is no indication what was not fully developed in 

this record. We fail to see anything missing, and thus this 

argument is without merit. Under the applicable regulations, if 

sufficient medical or other evidence is not provided by claimant, 

the Secretary is required to make a decision on the information 

available. See 10 C.F.R. § 404.1516; Jones v. Bowen, 829 F.2d 

524, 526 (5th Cir. 1987). 

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... 

Accordingly, the judgment of the United States District Court 

for the Northern District of Oklahoma is AFFIRMED. 

16 

Entered by the Court 

Wade Brorby 

Circuit Judge 

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