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Parties Involved:
Jerry N. Parton
Appellant
Louis W. Sullivan
Appellee

Document Text:

'I 

FI LED 

l.JC'lired Scares Court of Appeals 

Tenth Circuit 

UNITED STATES COURT OF APPEALS 

JUL 12 1990 

ItOBERT L. HOECKER 

Clerk 

FOR THE TENTH CIRCUIT 

JERRY N. PARTON, 

Plaintiff-Appellant, 

v. 

LOUIS W. SULLIVAN, M.D., Secretary 

of the Department of Health and Human 

Services, 

Defendant-Appellee. 

) 

) 

) 

) 

) No. 89-7028 

) (D.C. No. 83-439-C) 

) (E.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. 

submitted without oral argument. 

The case is therefore ordered 

This case is on appeal to this court for the second time. In 

the first appeal, this court remanded claimant's action for 

supplemental security income (SSI) benefits to the district court 

* 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. 

3 6. 3. 

Appellate Case: 89-7028 Document: 010110038326 Date Filed: 07/12/1990 Page: 1 
to remand to the Secretary for an individualized determination of 

claimant's impairments, including obtaining vocational expert 

testimony. Parton v. Heckler, Unpub. No. 84-2130 (10th Cir. 

Jan. 31, 1986). On remand, after holding another hearing, the 

administrative law judge (A.L.J.) concluded claimant was disabled. 

The appeals council rejected the A.L.J.'s determinations and 

' 

concluded claimant was not disabled. The district court affirmed. 

On appeal, claimant argues the Secretary's decision is not 

supported by substantial evidence because the Secre~ary did not 

consider objective medical evidence of nonexertional impairments, 

incorrectly evaluated claimant's complaints of nonexertional 

impairments, and inappropriately rejected the opinions of 

claimant's treating doctors. After careful review of the record, 

we reverse and remand for immediate payment of SSI benefits. 

Claimant is fifty years old and has completed the eighth 

grade. She has no past relevant work experience. Throughout the 

proceedings, 

impairments. 

claimant alleged disability due to numerous 

Her primary impairments are peptic ulcer disease, 

dumping syndrome with nausea, vomiting and diarrhea after eating, 

esophagitis, and kidney disease. 

stomach surgeries, due to her ulcers, 

Claimant has undergone four 

resulting in removal of 

eighty percent of her stomach. The removal of much of her stomach 

causes her to suffer from dumping syndrome and esophagitis. 

Claimant has been hospitalized several times for problems with her 

right kidney. She testified that she eats eight small meals a day 

due to the dumping syndrome. From ten to thirty minutes after she 

eats she experiences discomfort, including cramping, diarrhea, 

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Appellate Case: 89-7028 Document: 010110038326 Date Filed: 07/12/1990 Page: 2 
nausea, and occasionally vomiting. Although she typically has 

bowel control, she stated that she sometimes cannot make it ten 

feet to the bathroom without having an accident. Claimant also 

testified that she has weak spells two to four times per week 

requiring her to lie down for an hour or two to prevent fainting. 

Between her bladder problems, requiring double voiding, and her 

dumping problems, claimant estimates that she spends most of her 

day in the bathroom. 

In recommending that claimant is disabled, the A.L.J. found 

claimant's testimony regarding her dumping syndrome, pain, and 

diarrhea to be credible and consistent with the medical evidence. 

The appeals council rejected the A.L.J.'s recommendations, finding 

that claimant was not credible because her testimony was 

internally inconsistent and was inconsistent with the medical 

evidence, including her complaints to the doctors. 

This court upholds the Secretary's decision and findings if 

they are supported by substantial evidence. Bernal v. Bowen, 851 

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

a reasonable mind would accept 

conclusion. Richardson v. Perales, 

as 

402 

adequate to 

U.S. 389, 

support a 

401 (1971). 

Although a reviewing court must meticulously examine the record, 

it cannot weigh the evidence and may not substitute its discretion 

for that of the agency. Broadbent v. Harris, 698 F.2d 407, 414 

(10th Cir. ·1983). Also, the reviewing court-considers whether the 

Secretary applied the correct legal standards in making its 

determination. Bernal, 851 F.2d at 299. Failure to apply the 

correct legal standards or to provide this court with a sufficient 

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Appellate Case: 89-7028 Document: 010110038326 Date Filed: 07/12/1990 Page: 3 
basis to determine the appropriate legal principles have been 

followed are grounds for reversal. Byron v. Heckler, 742 F.2d 

1232, 1235 (10th Cir. 1984). 

Although the appeals council may reject the A.L.J.'s 

recommendation, the A.L.J.'s recommendation cannot be ignored. If 

the appeals council rejects the A.L.J.'s decision, it must fully 

articulate its reasons for doing so. Reyes v. Bowen, 845 F.2d 

242, 245 (10th Cir. 1988). This court then decides "with 

heightened scrutiny" whether the appeals council's reasons are 

supported by the record. Fierro v. Bowen, 798 F.2d 1351, 1355 

(10th Cir. 1986), cert. denied, 480 U.S. 945 (1987). Evidence 

supporting a conclusion may be less substantial when an impartial, 

experienced A.L.J. who has observed the claimant and lived with 

the case has drawn a conclusion different from the appeals 

council. Turner v. Heckler, 754 F.2d 326, 330 (10th Cir. 1985). 

In this case, there is not substantial evidence to support 

the appeals council's conclusion that claimant's testimony is 

internally inconsistent. The appeals council believed that 

claimant first testified that most of the time she becomes sick 

after eating and later testified she experiences nausea after 

every meal. Contrary to the appeals council's belief, claimant 

first testified that most of the time she becomes "very sick" 

after eating. It is reasonable that she has nausea after· every 

meal but does not become "very sick" after every meal. 

Likewise, contrary to the appeals council's conclusion, the 

medical reports are not completely inconsistent with claimant's 

testimony. The medical reports consistently indicated that 

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Appellate Case: 89-7028 Document: 010110038326 Date Filed: 07/12/1990 Page: 4 
. 

I 

f 

are reports of doctors employed and paid by the government for 

purposes of defending against a disability claim). 

Because the medical evidence and claimant's testimony support 

a conclusion that claimant does suffer from dumping syndrome, it 

is necessary to determine whether the dumping syndrome precludes 

claimant from ~orking. The Secretary has the burden of proving 

that there are jobs in tne national economy which claimant could 

perform. Reyes v. Bow~n, 845 F.2d at 243. To meet this burden, 

the A.L.J. called the vocational expert to testify. 

The vocational expert testified that claimant could perform 

light and sedentary jobs, such as cashier, check casher, ticket 

seller, auction clerk, cashew wrapper, utility company teller, 

safe deposit box rental clerk, and lay away clerk. The vocational 

expert believed these jobs would provide adequate access to a rest 

room and permit sufficient noon, morning, and afternoon breaks for 

claimant to consume small meals. 

The A.L.J. rejected the vocational expert's testimony and 

determined that claimant could not engage in even sedentary work 

on a sustained basis as a result of her dumping syndrome and pain. 

The appeals council, however, determined claimant has the residual 

functional capacity to perform the jobs suggested by the 

vocational expert at the A.L.J. hearing. The appeals council 

admitted claimant could not perform jobs without ready access to 

toilet facilities, with high levels of stress, or without 

sufficient breaks for her meals, but believed the jobs mentioned 

by the vocational expert were suitable. 

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Appellate Case: 89-7028 Document: 010110038326 Date Filed: 07/12/1990 Page: 5 
Despite the appeals council's full articulation of its 

reasons for rejecting the A.L.J.'s recommendation, see Fierro v. 

Bowen, 798 F.2d at 1355, our study of the administrative record 

leads us to conclude claimant could not engage in substantial 

gainful 

followed 

employment. 

frequently 

Because she must have several small meals, 

by twenty to thirty minutes of nausea, 

vomiting, and diarrhea, and must lie down two to four times a week 

for a couple of hours to keep from fainting, claimant could not 

perform work on a sustained basis. Claimant could not perform her 

job with the continuity and efficiency of someone who is not 

impaired to the same degree. Furthermore, it is unlikely that an 

employer would hire claimant or permit her to take all the breaks 

she needs. Considering that most of the jobs listed as possible 

by the vocational expert are customer service jobs, it is 

doubtful, based on the report of the psychiatrist who examined 

claimant at the Secretary's request, that claimant could withstand 

the stress of leaving waiting customers while taking her needed 

breaks. 

Accordingly, we conclude claimant is disabled. Because 

additional factfinding would serve no useful purpose, we reverse 

and remand for immediate payment of benefits effective October, 

1981, claimant's alleged date of disability. See Williams v. 

Bowen, 844 F.2d 748, 760 (10th Cir. 1988). 

The judgm~nt of the United 

Eastern District of Oklahoma 

States District Court for the 

is REVERSED, and the action is 

REMANDED to the district court to remand to the Secretary for 

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Appellate Case: 89-7028 Document: 010110038326 Date Filed: 07/12/1990 Page: 6 
immediate payment of SSI benefits. Claimant's motion for oral 

argument is DENIED. 

ENTERED FOR THE COURT 

PER CURIAM 

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