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

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1. 

' 

FILED a1s 

l.Joited Staces Co~rt '?f Appe Tenth C1tcu1t 

UNITED STATES COURT OF APPEALS JUL 111990 

FOR THE TENTH CIRCUIT &OBERT L. HOECKER 

Clerk 

TI MMY L. HESS, 

Plaintiff-Appellant, 

v . 

LOUIS W. SULLIVAN, M.D., Secretary of 

Health and Human Services, 

Defendant-Appellee. 

) 

) 

) 

) 

) No. 89-5026 

) (D.C. No. 84-C-1002-E) 

) (N.D. Okla.) 

) 

) 

) 

) 

ORDER AND JUDGMENT* 

Before ANDERSON, BARRETT, and BALDOCK, 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. 

s ubmitted without oral argument. 

The case is therefore ordered 

Claimant-appellant Timmy L. Hess appeals from the district 

court's order affirming the decision of the appellee Secretary of 

* 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: 89-5026 Document: 010110038255 Date Filed: 07/11/1990 Page: 1 
Health and Human Services to deny claimant's applications for 

Social Security disability benefits, 42 U.S.C. §§ 401-33, and 

supplemental security income (SSI) benefits, 42 U.S.C. 

§§ 1381-83c. After reviewing the record on appeal, we conclude 

claimant was disabled for over twelve months, commencing with his 

first back surgery and ending sometime after his second back 

surgery. Accordingly, we reverse in part and remand for further 

proceedings. 

At the time of the second administrative hearing, claimant 

was thirty years old and had a high school general equivalency 

diploma obtained while in the military. His prior work experience 

as a tube roller, machine operator, welder, roofer, painter, and 

box boy all involved medium to heavy work requiring continuous 

standing or walking. Claimant injured his back while working as a 

tube roller. On November 5, 1982, claimant underwent back 

surgery, laminectomy, foraminotomy and disc excision at L-5 and 

fusion at L5-Sl. On November 18, 1983, claimant underwent a 

second back surgery, laminectomy, disc excision, foraminotomy and 

excision of adhesions at L-4, laminectomy and foraminotomy at L-5, 

and fusion at L4-L5 and L5-Sl. In 1985, claimant received 

treatment for rectal bleeding and abdominal problems. He was 

diagnosed as suffering from inflammatory bowel disease, such as 

proctosigmoiditis or irritable bowel syndrome. 

Claimant's applications for disability and SSI benefits, 

alleging problems with his back, were denied initially and on 

reconsideration. After holding a hearing, the Administrative Law 

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Appellate Case: 89-5026 Document: 010110038255 Date Filed: 07/11/1990 Page: 2 
Judge (A.L.J.) denied benefits. When the appeals council declined 

to review the A.L.J. 's decision, claimant appealed to the district 

court. The district court accepted the magistrate's 

recommendation and remanded the case to the Secretary to consider 

additional evidence regarding claimant's pain after the second 

surgery and testimony from a vocational expert if necessary. On 

remand, the A.L.J. admitted additional medical evidence, took 

additional testimony from claimant, and called a vocational expert 

to testify. The A.L.J. concluded that although claimant is status 

post laminectomy and fusion L4-Sl; has a chronic inflammatory 

bowel disease such as proctosigmoiditis or irritable bowel 

syndrome, asymptomatic with prescribed medical treatment; and had 

bronchitis, he did not have a severe impairment lasting for a 

continuous period of twelve months. Rejecting claimant's 

complaints of pain as not credible to the extent alleged, the 

A.L.J. determined claimant had the residual functional capacity to 

perform light or sedentary work. Based on claimant's residual 

functional capacity, age, education, and work experience, the 

A.L.J. concluded claimant was not disabled. The appeals council 

adopted the A.L.J.'s findings and conclusions with minor 

modifications and denied benefits. The district court affirmed 

after adopting the magistrate's report and recommendation. 

In reviewing the decision of the Secretary, we consider only 

whether the decision is supported by substantial evidence. Bernal 

v. Bowen, 851 F.2d 297, 299 (10th Cir. 1988). Although we do not 

weigh the evidence or substitute our judgment for that of the 

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Appellate Case: 89-5026 Document: 010110038255 Date Filed: 07/11/1990 Page: 3 
Secretary, we do determine if there is sufficient evidence in the 

record to support the Secretary's conclusions. Frey. v. Bowen, 

816 F.2d 508, 512 (10th Cir. 1987). Also, in reviewing, we 

consider whether the Secretary applied the correct legal standards 

in making his determinations. Bernal, 851 F.2d at 299. 

After consideration of all the evidence, we are convinced the 

A.L.J. lacked substantial evidence to support a finding that 

claimant was not disabled for a period of more than twelve months. 

The Social Security Act defines disability as the inability "to 

engage in any substantial gainful activity by reason of any 

medically determinable physical or mental impairment" for at least 

twelve months. 42 U.S.C. §§ 423(d}(l}(A}, 1382c(a}(3}(A}. A 

claimant is deemed disabled "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. §§ 423(d} (2) (A}, 1382c(a} (3) (B}. 

"Under the Social Security Act the claimant bears the burden of 

proving a disability, as defined by the Act, which prevents him 

from engaging in his prior work activity." Gossett v. Bowen, 862 

F.2d 802, 804 (10th Cir. 1988). If the claimant establishes a 

disability, the burden shifts to the Secretary to prove there are 

jobs in the national economy which claimant can perform. Reyes v. 

Bowen, 845 F.2d 242, 243 (10th Cir. 1988). 

The Secretary has established 

determining whether a claimant 

4 

a five-step process for 

is disabled. 20 C.F.R. 

Appellate Case: 89-5026 Document: 010110038255 Date Filed: 07/11/1990 Page: 4 
§§ 404.1520, 416.920 (1989). This process has been set forth 

repeatedly by this court, see, e.g., Williams v. Bowen, 844 F.2d 

748, 750-51 (10th Cir. 1988), and was recited in the magistrate's 

recommendation and the parties' briefs. It will not be repeated 

here. 

The A.L.J. stopped at step five of the process, 

after applying the medical-vocational guidelines 

C.F.R. pt. 404, subpt. P, app. 2 and § 416.969 

concluding, 

(grids), 20 

(1989), that 

claimant could perform light or sedentary work. While we agree 

that claimant was not disabled at the time of the A.L.J. decision, 

we conclude there was substantial evidence that claimant was 

disabled for a period of time after his back surgeries. 

On November 5, 1982, claimant had his first back surgery. 

Dr. James C. Mayoza, the orthopedic surgeon who performed the 

surgery, reported on January 13, 1983, that claimant must not work 

for one year in order to recover from the surgery, even though 

claimant continued to rehabilitate and progress satisfactorily 

with no neurological deficit. Dr. Philip Joseph, who examined 

and x-rayed claimant on January 25, 1983, and February 14, 1983, 

noted that claimant would be temporarily totally disabled for 

performing manual labor and should continue under the care and 

treatment of Dr. Mayoza. On April 14, 1983, Dr. Mayoza noted that 

claimant continued to have pain in his lower back. In a letter 

dated August 17, 1983, Dr. Mayoza stated that claimant was 

temporarily and totally disabled since November 4, 1982, and he 

would continue to be disabled for three to nine months. Even 

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Appellate Case: 89-5026 Document: 010110038255 Date Filed: 07/11/1990 Page: 5 
though Dr. Mayoza was pleased with claimant's progress, he 

believed that additional time was needed to determine whether the 

back fusion was complete without complications. Dr. Mayoza's 

testing revealed a good range of motion of the lumbosacrum, 

negative straight leg raising, loss of flexibility, and pain. Dr. 

Robert T. Rounsaville, who examined claimant once on September 27, 

1983, however, indicated claimant could perform light work with 

limited bending and lifting. On October 6, 1983, Dr. Mayoza, 

still uncertain the fusion was solid, indicated claimant was 

disabled on the basis of his symptoms of pain. Dr. Mayoza 

believed claimant's complaints of pain, did not believe claimant 

was malingering, and indicated further surgery could be needed. 

After examining claimant again on November 10, 1983, Dr. Mayoza 

concluded additional surgery at another location of the back was 

needed. 

Claimant did undergo further back surgery on November 18, 

1983. After surgery, Dr. Mayoza indicated claimant had good 

results and would need six to eight months recovery time. On 

August 2, 1984, Dr. Mayoza stated that progress after the second 

surgery was excellent with good pain relief. Again, mentioning a 

need for time to determine whether the fusion was complete and 

solid with no complications, Dr. Mayoza predicted continuing 

disability for three to nine more months. Throughout his 

treatment of claimant, Dr. Mayoza emphasized claimant would need 

retraining when he was able to work. 

Dr. Mayoza, claimant's treating physician, stated 

consistently that ,claimant was disabled for a period of time after 

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Appellate Case: 89-5026 Document: 010110038255 Date Filed: 07/11/1990 Page: 6 
the back surgeries. Although Dr. Rounsaville's opinion was to the 

contrary, he examined claimant only once. Dr. Joseph, who 

examined claimant twice, did not disagree with Dr. Mayoza. The 

A.L.J. failed to set forth specific, legitimate reasons for 

rejecting Dr. Mayoza's opinion. See Byron v. Heckler, 742 F.2d 

1232, 1235 (10th Cir. 1984); Jozefowicz v. Heckler, 811 F.2d 1352, 

1358 (10th Cir. 1987). Because no good cause was shown for 

rejecting Dr. Mayoza's reports, we give substantial weight to his 

opinion. See Bernal v. Bowen, 851 F.2d at 301. 

Based on this medical evidence alone, without consideration 

of claimant's subjective complaints, we conclude claimant was 

disabled for more than twelve months from the time of his first 

back surgery until sometime after the second surgery. Claimant 

established his inability to return to his past work for more than 

twelve months, and no substantial evidence supported the Secretary 

in his burden to establish that plaintiff was capable of 

performing alternate gainful employment during that time. Because 

claimant worked up until the time of his first surgery, the date 

of the first surgery is the date his disability commenced. We 

cannot determine, however, from the record when the disability 

ended. Although Dr. Mayoza stated on August 3, 1984, that 

claimant would be disabled for three to nine more months, claimant 

started working at least part time in early September, 1984, and 

worked for nine months. Cf. Snyder v. Bowen, 694 F. Supp. 90, 95 

(M.D. Pa. 1988)(working for six months at substantial gainful 

employment was not an unsuccessful work attempt). Because there 

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Appellate Case: 89-5026 Document: 010110038255 Date Filed: 07/11/1990 Page: 7 
is a factual issue as to when claimant's disability from the back 

surgeries ended, we remand to the Secretary to determine the date 

disability ended and to immediately award benefits for the time of 

disability. 

We agree with the Secretary that claimant is no longer 

disabled, and has not been disabled since sometime in 1984 after 

the second back surgery. Claimant challenges the Secretary's 

evaluation of his symptoms of pain and application of the grids to 

determine he can do light and sedentary work. After careful 

consideration of the record on appeal, we conclude the Secretary 

accurately evaluated claimant's complaints of pain after the 

period of disability ceased and appropriately applied the grids. 

The judgment of the United States District Court for the 

Northern District of Oklahoma is AFFIRMED in part and REVERSED in 

part. The action is REMANDED to the district court to remand to 

the Secretary for a determination of the date claimant's 

disability ended and for immediate payment of benefits. 

ENTERED FOR THE COURT 

PER CURIAM 

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