Opinion ID: 677524
Heading Depth: 3
Heading Rank: 2

Heading: The Medical Expert

Text: 36 Ms. Tuohy next argues that it was unreasonable for the ALJ to rely on the testimony of the medical advisor, Dr. Engelman. It is clear that the ALJ rested his determinations that Ms. Tuohy did not meet or equal the listing of impairments and that Ms. Tuohy suffered from no functional limitations from the MS, on Dr. Engelman's testimony. 37 When asked by the undersigned if the severe impairment of multiple sclerosis he had previously diagnosed met or equalled any of the Listing of Impairments during the period in question over 12 continuous months, [Dr. Engelman] responded it did not. He stated he also considered Listing Section 11.09(A) based on difficulty with walking, complaints of hip pain at times, not knowing where the floor was, and complaining of right arm with weakness and pain. The doctor further testified claimant certainly did not meet or equal Listing Sections 11.04(B) or 11.00(C), because it was no longer than three months during the period in question. 38 When asked by the undersigned if the relevant medical evidence of record reflected any functional limitations from the multiple sclerosis during the period in question, the medical expert responded that it did not. 39 The crux of Ms. Tuohy's complaint with Dr. Engelman is that his usefulness as a medical advisor in this case is highly suspect due to the fact that he is a thoracic surgeon, with very little exposure to victims of MS. Dr. Engelman's qualifications, which are contained in the record, indicate that his medical specialty is thoracic surgery, and that he engages in direct patient care. These are the only qualifications presented, and there is no mention of any practice associated with neurological diseases generally, or MS specifically. Dr. Engelman testified that he had no particular expertise in the area of MS. 5 In addition, he was unable to define certain terms associated with the disease, at least one of which appears numerous times in Ms. Tuohy's medical records. 40 There is very little law addressing the issue of what qualifications a medical expert must possess in order to be competent to offer a medical opinion at an administrative hearing. The one case from this circuit addressing this issue is Sherrill v. Secretary of HHS, 757 F.2d 803 (6th Cir.1985). In Sherill, despite the fact that claimant's phychiatrists offered evidence that supported a finding that claimant was disabled due to a psychiatric impairment, the ALJ and district court relied on the testimony of a non-treating physician to deny this claim. Particularly disturbing to the Sherill court was the fact that the medical advisor being relied upon to rebut claims of psychiatric impairment was a physician who specializes in internal medicine and sub-specializes in pulmonary disease. Id. at 805. The Sherrill court ultimately concluded that the medical advisor's testimony alone does not rise to the level of substantial evidence establishing the nonexistence of [the] impairment. Id. 41 The situation at hand is similar insofar as the testimony of the medical advisor, a thoracic surgeon who does not specialize or have any expert knowledge in the area of MS, and indeed who sends his patients with MS to see a neurologist, does not rise to the level of substantial evidence to support the ALJ's determination that Ms. Tuohy did not suffer from any functional limitations from the MS during the period in question. This is especially true in light of the fact that two of Ms. Tuohy's treating physicians, who are experts in the area of MS, determined that she was permanently disabled. As this court has held,  'the opinion of a nonexamining physician is entitled to little weight if it is contrary to the opinion of the claimant's treating physician.'  Shelman v. Heckler, 821 F.2d 316, 321 (6th Cir.1987) (quoting Broughton v. Heckler, 776 F.2d 960, 962 (11th Cir.1985)). 42 Finally, Ms. Tuohy argues that the ALJ improperly rejected the credibility of her testimony concerning her physical limitations. The Secretary argues that the ALJ properly rejected Ms. Tuohy's testimony because she engaged in activities that are inconsistent with her complaints of fatigue and because medication effectively controlled her other symptoms of MS. We find this aspect of the case very similar to that presented to this court in Cohen v. Secretary of HHS, 964 F.2d 524 (6th Cir.1992). In Cohen, the claimant suffered from Chronic Epstein-Barr virus and the associated chronic fatigue syndrome. Chronic fatigue syndrome, like MS, is characterized by periods of exacerbation and remission. Despite her illness, the claimant in Cohen attempted to lead some semblance of a normal life by continuing to engage in some of her pre-illness activities, and by attending a few law school classes. This court reversed the district court and the ALJ, finding that despite the fact that Ms. Cohen engaged in these activities, the nature of her illness was such that she was unable to engage in gainful employment in the national economy. 43 We find that the logic of Cohen is particularly apposite here. Ms. Tuohy has attempted to continue her life in as normal a fashion as possible, despite the fact that she suffers severe limitations. We believe that Ms. Tuohy's attempts to engage in normal activities is a tribute to her courage and determination in refusing to surrender to the debilitating effects of her illness. Cohen, 964 F.2d at 530; see also Wilcox, 917 F.2d at 277 ([Claimant] should not be penalized because he had the courage and determination to continue working despite his disabling condition.)