John J. Callahan was named to serve as Acting Commissioner of Social Security 1 effective March 1, 1997. He has been substituted for Shirley S. Chater pur suant to Fed. R. App. P. 43(c). The HONORABLE ROBERT R. BEEZER, United States Circuit Judge for the 2 Ninth Circuit, sitting by designation. United States Court of Appeals FOR THE EIGHTH CIRCUIT

___________ No. 97-1036

___________
Donna J. Davis, *
* Appellant, *
* Appeal from the United States
v. * District Court for the
* Eastern District of Arkansas. John J. Callahan, Acting Commissioner * 1 of Social Security, *
* Appellee. *

___________ Submitted: June 12, 1997 Filed: September 24, 1997

___________ Before R ICHARD S. ARNOLD, Chief Judge, BEEZER, and WOLLMAN, Circui t 2 Judges.

___________Harrington rods are “a system of metal hooks and rods inserted surgically in the 3 posterior element s of the spine to provide distraction and compression in treatment of scoliosis and other deformities.” The Sloan-Dorland Annotated Medical-Lega l Dictionary , p. 305 (1992 Supplement).
-2- WOLLMAN, Circuit Judge.

Donna Davis appeals from the district court’s order affirming th e Commissioner’s denial of her application for Disability Insurance Ben efits. We reverse and remand.

I.
Davis was thirty-three years old at the time she applied for benefits. She has her ge neral equivalency degree and has employment experience as an order entry clerk , secretary, cashier, and assembly line worker.

Davis filed for benefi ts on May 20, 1993, claiming that she became disabled as the result of a fall at work on August 18, 1992, w hich exacerbated pain stemming from the spinal fracture she had sustained in a car accident so me fifteen years earlier. At the he aring before the administrative law judge (ALJ), held on May 13, 1994, Davi s testifie d that soon after the fall she began experiencing severe pain in her neck an d upp er back and continued to be in severe pain for the next few weeks. In addition to the pain i n her neck and back, Davis found it painful to breathe. Also, her leg shook, making it difficult for her to control her walking. In an attempt to relieve her pain , Davis underwent surgery to remove the Harrington rods that had been inserted into her 3 back to re pair her spinal fracture. Davis testified that following that surgery th e pressure in her lower back worsened, her legs began to shake severely all the time, her knees began to lock up, and her feet “quit working.” In addition, she testified that she experiences severe migraine headaches and numbness in her legs.-3-

The ALJ discredite d Davis’s subjective complaints of disabling pain and found that although Davis suffered from a severe impairment, the medical evidence did not indicate an impairment of sufficient severity to meet a listed impairment. The AL J concluded t hat Davis was restricted in her ability to perform heavy manual labor o r work req uiring frequent stooping or working in a bent-over position for prolonge d per iods of time, restrictions which would not preclude her from performing her pas t relevant work.

On appeal, Davis argues that the Commissioner’s decision is not supported by substantial evidence because it was based on the ALJ’s erroneous determination that Davis’s subjective complaints were not credible. II. We m ust affirm the Commissioner’s decision denying benefits if substantia l evidence on the record as a whole exists. See Lawrence v. Chater , 107 F.3d 674, 676 (8th Cir. 1997). “Substantial evidence is less than a preponderance, but enough so that

a reas onable mind might find it adequate to support the conclusion.” Id. (citation s omitted). In determiningwhether substantial evidence exists, “we must consider both evidence that supports and evidence th at detracts from the [Commissioner’s] decision, but we may not reverse merely because substantial evidence exists for the opposit e decision.” Gwathney v. Chater , 104 F.3d 1043, 1045 (8th Cir. 1997) (citatio n omitted). “An ALJ may discount a claimant’s subjective complaints of pain only if there ar e inconsistencies in

the record as a whole.” Ostronski v. Chater , 94 F.3d 413, 418 (8th Cir. 1996). The ALJ m

ust consider the claimant’s prior work history; daily activities; the duration, frequency, and intensity of pain; precipitating and aggravating factors ; dosage, effectiv eness, and side effects of medication; and functional restrictions. See id. (citing Polaski v. Heckler , 739 F.2d 1320, 1322 (8th Cir. 1984)).C lonus is “alternate muscular contraction and relaxation in rapid succession.” 4 The Sloan-Dorland Annotated Medical-Legal Dictionary , p. 149 (1987). Ba clofen (Lioresal) “is useful for the alleviation of signs and symptoms o f 5 spasti city resulting from multiple sclerosis, particularly for the relief of flexor spasms and concomitant pain, clonus, a nd muscular rigidity.” Physician’s Desk Reference , p. 829 (50th ed. 1996). A Baclofen pump is recommended for chronic use of Baclofen injection, whi ch “is indicated for use in the management of severe spasticity of spinal cord origin.” Id. at 1596.
-4- The ALJ discredited Davis’s subjective complaints of pain, finding them to be contradicted b y medical evidence. He found that Davis’s “pain has not caused her to

see a physician often and she has not been prescribed medication in such dosage o r quantity so as to indicate severe disabling pain. There is no indicati on that she does not do her own household chores and other activities.” The ALJ based his determination that medical evidence contradicted Davis’ s complaints in large part on the report of Dr. Leventhal, an orthopedic specialist. Dr. Leventhal noted that he was at a loss to explain all of Davis’s complaints, concluded tha t “her problem is complex and multifactorial,” and surmised that Davis had a considerable amount of symptom magnification with functional overlay. There i s significant medical evidence, however, that supports Davis’s complaints of disabling pain, including Dr. Leventhal’s own findings. Dr. Leventhal’s examination of Davis revealed that Davis had marked limitation of fo rward bending and extension, restricted right and left lateral bending, moderate spasticity of her lower extremities with hyperreflexia in her knees and ankles , and sustained clonus of both lower extremities. 4 Dr. Leventhal noted that Davis walk ed with a spastic gait, had a difficult time walking

on her heels and toes, and that she complained bitterly of pain. He recommended a check for infection, an MRI of her thoracic and lumbar spine, and consideration of a Baclofen pump to help with her spasticity. He referred her to Dr. Feler, a 5

neur osurgeon, for consultation about an implantable Baclofen pump. Davis wa s subsequently unable to complete the MRI due to extreme claustrophobia."Dolobid is indicated for acute or long-term use for symptomatic treatment of 6

. . . [m]ild to moderate pain.” Id. at 1655. Parafon DSC is “indicated as an adjunct to rest, physical therapy, and other measures for the relief of discomfort associated with acute, painful musculoskeletal conditions.” Id. at 1581.
Darvocet N-100 is indicated for the relief of mild to modera te pain. Id. at 1434. 7
Percodan is indicated for the relief of moderate to moderately severe pain. Id. 8 at 939.
Clino rilis indicated for acute or long-term use in the relief of signs an d

9 symptoms of a number of types of arthritis and acute painful shoulder injuries. Id. at 1619.
-5- The findings of several other physicians likewise rebut the ALJ’s conclusion that the medical evidence contradicted Davis’s com plaints of pain, and they also contradict the AL J’s finding that Davis sought medical attention infrequently and was no t prescribed medications in such dosage or quantity to support her allegations of pain

. Immediately following her fall, Davis went to her family physician, Dr. Mitchell, who determined that Davis suffered muscle strain to her trapezius and mild contusion to her left hand and prescribed Dolobid and Parafon DSC for pain. The following day Davis 6 saw an emergency room physician, Dr. Page, who also diagnosed trapezius strain and prescribed Tylenol #3 for Davis’s pain and recommended that she not work the next day. The following day, August 20, 1992, Davis retur ned to Dr. Mitchell, complaining of pain in her

neck and nausea and vomiting. Dr. Mitchell recommended that she not work for an other four days, continued her on the Parafon DSC, and prescribe d Darvocet N-100 for her pain. 7 On August 24, Davis saw Dr. Shedd, a physician whom she previously had seen for back-related pr oblems. Dr. Shedd prescribed Percodan, and instructed Davis not 8 to work for

one week. On August 28, Davis returned to Dr. Mitchell, who continued Dav is on Parafon DSC and Darvocet N-100 and additionally prescribed Clinoril. 9 Davis had a follow-up visit with Dr. Mitchell on September 3, and was continued on-6-

the previously-prescribed medicati ons and continued leave from work. Davis saw Dr. Mitchell again on September 10 and September 17, and was ref erred to Dr. Thompson,

an or thopedic surgeon, whom she saw on September 18, for evaluation of the rods in her back. Dr. Thompson found that Davis had full, albeit painful, motion of he r cervical spine, difficulty in toe and heel walking, and some atrophy of the lef t quadricep, and that her reflexes were hyperactive with an unsustained clonus at both ankles and several beats at the knees. Upon referral by Dr. Thompson, Davis saw Dr. Gibson, a neurologist, o n November 3, 1992. Dr. Gibson noted tenderness over Davis’s left Harrington rod. In addition, he found her gait and legs were spastic and that she had unsustained clonus at the knees and ankles with crossed adductors. He also noted that she had decreased pinprick sensation in the lateral aspect of the right leg and thi gh. Dr. Gibson stated that Davis had been developing increased spastic ity since her fall and “there is certainly no doubt that on examination today she is quite spastic with signs suggesting a problem in the thoracic cord.” Dr. Gibson prescribed Lioresal (Baclofen) for the spasticity in Davis’s legs and recommended either a CT scan or myelogram. Davis was next referred to Dr. Reding, a neurosurgeon, who upon examinin g Davis was doubtful tha

t she had suffered a significant additional neurologic injury but who also recommended that Davis have a myelogram, which she subsequentl y underwent on November 30. The myelogram revealed that Davis had a mild narrowing of the anterior aspect of the canal at the T11-12 level secondaryto posterior osteophyte formation and evidence of a mild disc bulge, with small posterior osteophyt es at the T5- 6 level. B ased on these findings, Dr. Reding concluded that the neurologic finding s regardin g Davis’s legs related to her previous injury and suspected that her le g symptoms were assoc iated with the pain in her spine. Dr. Reding then suggested that Davis might want to proceed with removal of the Harringto n rods in hopes of obtaining some pain relief. A tomogram of T11-12 on January 7, 1993, showed minimal anterior wedging of T12, associated with mild degenerative change at the T11-12 end plate.Babinski’s sign is “the extension of the great toe with fanning of the othe r 10 toes,” and “is of spinal origin and attests to an upper motor neuron lesion.” The Merck Manual , p. 1384 (16th ed. 1992). "Daypro is indicated for acute and long-term use in the management of th e 11 signs and symptoms of osteoarthritis and rheumatoid arthritis.” Physician’s Des k Refer ence at 2426. Tegretol is indicated for use as an anticonvulsant and in th e treat ment of pain associated with trigeminal neuralgia (a disorder of the trigemina l
-7- On February 5, 1993, Davis was admitted to the hospital for removal of th e Harrington rods. Dr. Thompson, who performed surgery to remove the rods, indicated that prior to surgery Davis had weakness in her right quadricep, spasticit y of both lower extremities, unsustained prominence at the knees and ankles, extensive pla ntar response bilaterally, and decreased sensation in the lateral aspect of her right leg.

Davis was next seen by Dr. Shedd on May 4, 1993, and was again observe d having weak heel and toe walking, to the point that she had to hold on to the examining table. In addi tion, Dr. Shedd noted that Davis walked with her knees locked and that she had very hyperactive reflexes bilaterally , dyscoordination with the heel-knee-ankle test, and unsustained myoclonus in both ankles. Dr. Shedd prescribed Lioresal an d referred her to Dr. Leventhal, the orthopedic specialist whose findings are set forth above. On May 27, 1993, Davis again saw Dr. Shedd, who foun d she had paraspinuous lumbar muscle spasm and was severely limited in movement in any direction, an d prescribed additional Baclofen. Davis was next see n by Dr. Feler on August 31, 1993. Dr. Feler’s examination revealed cold allodynia and hyperthia, sustained clonu s bilatera lly, bilateral Babinski’s signs, spasticity of her lower extremities, an d 10 occasional spontaneous spasms, and noted that Davis had difficulty amb ulating and that the range of motion in her hips was mildly limited. Dr. Fel er concluded that in addition to her previous spinal cord injury, Davis had neural injury pain i n the lower extremities, facet syndrome and intractable spasticity and lower extremity spasm, and prescribed Tegretol and Daypro, in addition to Baclofen. 11nerve pr oducing bouts of severe, lancinating pain lasting seconds to minutes in th e

di stribution of one or more of its sensory divisions, The Merck Manual at 1509)

. Tegretol “should not be used for the relief of trivial aches and pains.” Ph ysician’s Desk Reference at 852.
-8- Davis returned to Dr. Feler on October 5, 1993, complaining that the Tegretol

was m aking her feel “high.” Dr. Feler adjusted her prescription accordingly. O n November 16, 1993, Davis underwent a CAT scan of her lumbar s pine, which revealed mi ld bilateral foraminal narrowing secondary to hypertrophic changes, in addition t o degenerative changes in the facet joints.

Davis te stified that although at the time of her hearing she was taking si x pr escription medications, they did not completely relieve her symptoms. She state d that “it doesn’t take the pain away and it doesn’t take the shaking away. It takes the edge off of it, to where I can actually deal with the pain . . . it helps me not be in s o much pain.” The ALJ’s finding that Davis’s subjective complaints of pain were contradicted by th e level of her daily activities is likewise without support in the record. The ALJ stated, “the re is no indication that [Davis] does not do her own household chores and other activities. She enjoys reading, watching television, needlepoint, and visiting. She is able to drive.” Uncontroverted testimony reflects, however, that Davis is not able to perf orm many of her daily activities, and the fact that Davis could perform a fe w light household chores does not constitute substantial evidence that Davis possessed the functional capacityto perform her past relevant work. See Baumgarten v. Chater , 75 F.3d 366, 369 (8th Cir. 1996) (“We have repeatedly held . . . that the ‘ability to do activities such as light housework and visiting w ith friends provides little or no support forthe fi nding that a claimant can perform full-time competitive work.’”) (citatio n omitted).-9-

Dav is testified that during a twenty-four hour period she has to lie down about twelve hours. She st ated that she has tried to do laundry and to vacuum her floor, but that “it hurts so much that by the end of the day, I’m in so mu ch pain that it’s not worth it. So I either have to take more medication, to make it through it, or not do it.” She also testified that someone else cooks the majority of her family’s meals and takes her grocery shopping, and that she cannot cle an the bathtub or mop floors. She stated that she has tried to find things to do around the house, but hasn’t found a lot that she can do, and can only do “just really the basic, the easiest things around the home.” I n addition, Davis test

ified that she occasionally drives twelve miles to take her husband to work and home again, a total driving time of only some two hours per week.

Davis’s husband testified that Davis’s condition has been worsening since her fall, that even when Davis does little things, she pays for it, and that it doesn’t tak e
muc h to make her sore. He also testified that he must often assist her in walking and that Davis does not sleep well at night because of the spasms . A friend of Davis’s who sees her nearly every day testified that since Davis’s injury and surgery to remove the Harringtonrods she has had a lot of pain in her back and bad headaches and that her knees lock up, causing her to fall. This witness testified that Davis is very limited in her activities and that she takes care of Davis and does most of Davis’s cooking. Another friend testified that she has noticed a “tremendous difference in [Davis] and in the abilities that she had” since her fall and t hat she has seen a drastic difference in Davis’s mobility since the removal of her Harrington rod s. Hyde testified that it was a major effort for Davis to climb the three steps to Hyde’s door, and for her to get up out of a chair and w alk the few steps to the door. Hyde also stated that she has heard Davis “moan and groan” when moving around in a chair. Although itwas for the ALJ as trier of fact to give the testimony of famil y members and friends such credence as he deemed warranted, he was not free to find-10-

that Davis had offered no evidence in support of her allegations regarding her dail y activities.

Because weconclude that the ALJ failed to conduct such a review, we reverse and remand for consideration of Davis’s subjective complaints of pain in accordance with the factors set forth in Polaski v. Heckler in light of all of the evidence in th e record. See Ingram v. Chater , 107 F.3d 598, 605 (8th Cir. 1997).

The judgment is reversed, and the case is remanded to the district court with directions to remand it to the Commissioner for f urther proceedings consistent with the views set forth in this opinion.
BEEZER, Circuit Judge, dissenting.
I respectfully dissent.

Davis argues that the district court erred in affirming the Commissioner’ s decision to den y benefits. Davis maintains that substantial evidence does not support the ALJ’s finding that her “allegation s [of pain] are not credible to the extent alleged.”

A plet hora of physicians have examined and treated Davis. These expert s reached conflicting conclusions regarding Davis’s pain, disability and residua l functioning capacity. One examining physician concluded that Davis was totall y disabled. On the other hand, Dr. Leventhal stated that Davis’s pain was “out o f proportion to all of her physical findings.”
Although unable to perform some work aft er her 1975 accident, Davis had been employed in a number of different capacities prior to her 1992 fall. Three neurologists that examined Davis determined that the injuries she sustained before the 1992 fall-11-

were the likely cause of her discomfort. They made no c onclusions respecting whether Davis was totally disabled.
The ALJ considered Davis’s testimony, testimony offere d by Davis’s family and friends, and the range of medical opinions introduced into evidence. “We therefore are presented with the n ot uncommon situation of conflicting medical evidence. The trier of fact has the duty to resolve that conflict.” Richardson v. Perales , 402 U.S. 389, 399 (1971). Al though the ALJ acknowledged that Davis suffered pain, he found tha t Davis’s allegations were not credible to the extent she alleged.

Substantial evidence supports the ALJ’s findings. I would affirm the decision of the district court.
A true copy.

Attest:

CLERK, U. S. COURT OF APPEALS, EIGHTH CIRCUIT.