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Parties Involved:
Norma L. Briggs
Appellant
Louis W. Sullivan
Appellee

Document Text:

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United Scates Court of Appeals 

UNITED STATES COURT OF APPEALS Tenth Ci:cuit 

FOR THE TENTH CIRCUIT 

NORMAL. BRIGGS, 

Plaintiff-Appellant, 

v. 

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

Health and Human Services, 

Defendant-Appellee. 

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ORDER AND JUDGMENT * 

OCT 1 9 1990 

&OBERT L. HOECKER 

Clerk 

No. 89-7027 

(D.C. No. 88-135-C) 

(E.D. Okla.) 

Before McKAY, LOGAN, and SEYMOUR, Circuit Judges. 

Claimant Norma L. Briggs appeals from an order of the United 

States District Court for the Eastern District of Oklahoma, 

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

for social security disability benefits pursuant to the Social 

Security Act, 42 u.s.c. §§ 416(i) and 423(a). 

Claimant filed her first claim for disability insurance 

benefits on December 10, 1985. Her claim was denied initially and 

on reconsideration. Claimant did not pursue this claim. 

* 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 estoppal. 10th Cir. R. 

36.3. 

Appellate Case: 89-7027 Document: 010110060417 Date Filed: 10/19/1990 Page: 1 
On August 25, 1986, claimant filed a second claim for 

disability benefits which was also denied initially and on 

reconsideration. She then requested a hearing before an 

administrative law judge (ALJ). The ALJ found claimant was not 

disabled, and she could perform her past relevant work as a sales 

clerk and small motor checker. The Appeals Council affirmed, the 

decision thus becoming the final decision of the Secretary. 

Claimant requested judicial review and the district court 

affirmed. Claimant raises the following issues on appeal: 

1. The Secretary erred by disregarding the treating 

physician's opinion of disability without citing 

specific and legitimate reasons for doing so. 

2. The Secretary 

neglecting to 

of pain. 

erred as a matter of law by 

consider objective medical evidence 

3. The Secretary failed to consider all of plaintiff's 

evidence of pain. 

4. The Secretary's decision is not supported by 

substantial evidence. 

Our review of the Secretary's decision is limited to 

determining whether that decision is supported by substantial 

evidence. Bernal v. Bowen, 851 F.2d 297, 299 (10th Cir. 1988). 

Substantial evidence is "such relevant evidence as a reasonable 

mind might accept as adequate to support a conclusion." 

Richardson v. Perales, 402 U.S. 389, 401 (1971). Evidence is not 

substantial if it is overwhelmed by other evidence in the record 

or if there is only a mere scintilla of evidence supporting it. 

Ray v. Bowen, 865 F.2d 222, 224 (10th Cir. 1989). In order to 

determine whether the Secretary's decision is supported by 

substantial evidence, we must meticulously examine the record. 

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However, we may not reweigh the evidence, nor substitute our 

discretion for that of the Secretary. Broadbent v. Harris, 698 

F.2d 407, 414 (10th Cir. 1983). 

The evidence showed that claimant, a fifty-one year old 

female, had a history of back ailments dating back to a work place 

injury in 1972. This injury resulted in a left herniated or 

ruptured disc at the LS-Sl level in her lower back. She underwent 

surgery to repair the disc and was unable to work for eighteen 

months. In 1983, claimant again began having back pain. She then 

consulted Dr. Blair Holder, an internist, her current treating 

physician. 

In 1984, due to claimant's complaints of unbearable pain, Dr. 

Holder referred claimant to Dr. John Coates, a neurosurgeon. Dr. 

Coates performed surgery for a right herniated disc again at the 

LS-Sl level. Claimant attempted to return to work following this 

second surgery, but was not able to continue and has not been 

gainfully employed since August 12, 1985. 

Dr. Holder issued five separate reports, two in response to 

the Secretary's request that he provide a consultative examination 

of the claimant. In his initial report in early 1986, Dr. Holder 

concluded that claimant suffered from (1) subsequellae including 

radiculopathy and neuropathy of the lower extremities with 

associated motor weakness and intermittent sensory abnormalities 

arising from the two ruptured lumbar discs in 1972 and 1984; (2) 

moderate to severe degenerative osteoarthritis; (3) degenerative 

disc disease involving the cervical and lumbar spine with 

associated radiculopathy and neuropathy demonstrated on 

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electromyeographic 

osteoporosis. 

studies; ( 4) hypertension; and (5) 

Later in 1986, Dr. Holder stated that claimant was totally 

and permanently disabled due to "advanced degenerative 

osteoarthritis with refractory severe pain." Record at 168. He 

also noted that claimant's pain and condition worsened with even 

minimal activity. 

In his final report in 1987, Dr. Holder 

claimant was permanently and totally 

again opined that 

disabled. Further, 

claimant's medication caused drowsiness and multiple other side 

effects, and both her pain and arthritic condition significantly 

worsened with even minimal activity. He stated that claimant 

could be expected to experience further muscle weakness, pain, and 

sensory nerve problems. 

The ALJ rejected Dr. Holder's reports. He appears to have 

arbitrarily translated Dr. Holder's diagnosis of "advanced 

degenerative osteoarthritis" into a finding of mild degenerative 

osteoarthritis at C5-6. A 1985 x-ray report showed advanced disc 

space narrowing L5-Sl which the ALJ misstated as showing a slight 

narrowing at L5-S1. 

"Unless good cause is shown to the contrary, the Secretary 

must give substantial weight to the testimony of the claimant's 

treating physician." Byron v. Heckler, 742 F.2d 1232, 1235 (10th 

Cir. 1984). If the opinion of the treating physician is to be 

disregarded, "specific, legitimate reasons" must be given. Id. 

Reports of the treating physician are given greater weight than 

are reports of physicians employed and paid by the government for 

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purposes of defending against disability claims. Frey v. Bowen, 

816 F.2d 508, 513 (10th Cir. 1987). Dr. Holder wore both hats in 

this case. He has been and continues to be claimant's treating 

physician and was also requested by the Secretary to act in the 

role of consultant. In both roles, he maintained his opinion that 

claimant was disabled. 

The ALJ did not give specific legitimate reasons for 

disregarding Dr. Holder's opinions. Further, Dr. Holder's 

opinions are amply supported by the evidence. Therefore, we must 

give substantial weight to Dr. Holder's opinions. 

The ALJ also held that claimant's allegations of severe pain 

were "exaggerated, self-serving and lack[ed] credibility." Record 

at 18. 

This court has held that in determining disability based on 

the nonexertional limitation of pain: 

[T]he decision maker must consider the relationship 

between the impairment and the pain alleged. . .. 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. This 

evidence includes the medical data previously presented, 

any other objective indications of the degree of the 

pain, and subjective accounts of the severity of the 

claimant's pain. Only at this point may the decision 

maker decide whether he believes the claimant's 

assertions of severe pain. 

Luna v. Bowen, 834 F.2d at 161, 163 (10th Cir. 1987); see also 

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

abused discretion in rejecting medical opinions on basis of 

objective test results alone); Avery v. Secretary of Health & 

Human Servs., 797 F.2d 19 (1st Cir. 1986)(statute permits awarding 

disability based on pain where subjective statements consistent 

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with objective findings convince decision maker to find claimant 

disabled even though objective evidence alone was insufficient). 

An impairment likely to produce some back pain may reasonably be 

expected to produce severe back pain in a particular claimant. 

Luna, 834 F.2d at 164. 

Claimant testified that she had constant, severe pain that 

was "numbed" with medication which, along with affording her a 

measure of relief, made her drowsy and sleepy. She could not 

stand for any length of time, had difficulty walking distances in 

excess of two blocks, could not reach above her head or bend over, 

had weakness in her arms and legs, and was only able to do light 

housework for less than two hours. She further testified that she 

experienced a toothache-like pain in her neck and took medication 

for muscle spasms. She attempted to do swimming exercises two 

hours each week although any increase in activity increased her 

pain. Her husband did most of the yard and garden work, and he 

and her daughter helped with the housework and shopping. 

The ALJ found that the claimant walked and sat for prolonged 

periods, swam for exercise, did all her own cooking, housework, 

shopping, driving, working in a garden, sewing, and reading. He 

found she exhibited no difficulty or discomfort in walking, 

standing, sitting or rising from a seated position at the hearing, 

and therefore, discredited claimant's testimony based on his 

observations. 

Claimant's efforts to maintain some semblance of her former 

lifestyle and to engage in former activities at least on a minimal 

level do not necessarily contradict her claim of disabling pain. 

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See Broadbent, 698 F.2d at 413. While some claimants may appear 

at a hearing prepared to exaggerate their pain and symptoms, such 

was not the case here. Further, claimant's failure to demonstrate 

her severe pain and discomfort during the hearing cannot be the 

sole basis used by the ALJ to reject claimant's assertions of pain 

which are corroborated by uncontroverted record evidence. See 

Teter v. Heckler, 775 F.2d 1104, 1106 (10th Cir. 1985.). Before 

reaching a conclusion as to disability, the Secretary must 

consider all relevant medical evidence in the record. See Baker 

v. Bowen, 886 F.2d 289, 291 (10th Cir. 1989). Here, the ALJ's 

observations are overwhelmed by the evidence in the record. The 

medical evidence and reports support claimant's allegations of 

severe pain. Her testimony was substantiated by Dr. Holder's 

various reports that claimant suffered from severe pain which was 

refractory to treatment. 

Accordingly, we hold that the Secretary's decision is not 

supported by substantial evidence. Claimant is disabled. Because 

additional factfinding would serve no useful purpose, we reverse 

and remand for immediate payment of benefits effective August 12, 

1985, claimant's alleged date of disability. See Williams v. 

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

The judgment of the United States District Court for the 

Eastern District of Oklahoma is REVERSED, and the action is 

REMANDED to the Secretary for immediate payment of disability 

benefits. 

ENTERED FOR THE COURT 

PER CURIAM 

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