Opinion ID: 585576
Heading Depth: 2
Heading Rank: 2

Heading: Pain Evidence and Medical Improvement

Text: 29 The ALJ also cited as a basis for his decision that disability had terminated the unbelievability of Sparhawk's claim that she continued to suffer disabling pain after January 1, 1988. At the outset of his decision, the ALJ ruled: 30 The incapacity or inability of the claimant to perform substantial and gainful work because of pain caused by medically determinable impairments as of the date disability ended is not established by the evidence and any testimony to that effect is not given credence. Later, the ALJ elaborated on his holding: 31 While it is not doubted the claimant experienced or has some degree of pain and discomfort, the evidence does not establish that such pain, either of itself or considered in conjunction with any found impairments, was so intense or severe as to prevent or have prevented the claimant from being able to engage in some existing type of substantial gainful work as of the time disability is found to have ended. 32 By contrast, the ALJ specifically found that Sparhawk's testimony as to pain was credible during the period from November 1984 to January 1988. He based this conclusion on her testimony that the pain was so severe that she was unable to work foot pedals or sit for more than an hour and a half. The ALJ also noted that, during this period, Sparhawk's condition worsened and she had to wear casts and braces. 33 We hold that the ALJ improperly discounted Sparhawk's testimony concerning pain after January 1, 1988. Sparhawk's complaints of pain alone will not support a finding of continuing disability. 42 U.S.C. § 423(d)(5)(A); Bunnell v. Sullivan, 947 F.2d 341, 344 (9th Cir.1991) (en banc). Instead, Sparhawk needed to produce objective medical evidence of an underlying impairment 'which could reasonably be expected to produce the pain or other symptoms alleged....'  Id. (quoting 42 U.S.C. § 423(d)(5)(A)). 34 Once Sparhawk satisfied this showing, the ALJ could not dismiss Sparhawk's testimony concerning pain based solely on a lack of objective medical evidence to fully corroborate the alleged severity of pain. Bunnell, 947 F.2d at 345. Furthermore, while the ALJ was entitled to find Sparhawk's allegations of severe pain to be not credible, he needed to make specific findings that supported the non-credibility determination. Id. Bunnell mandates that these findings must be supported by the record and must be sufficiently specific to ensure that the ALJ did not 'arbitrarily discredit a claimant's testimony regarding pain.'  Id. at 345-46 (quoting Elam v. Railroad Retirement Bd., 921 F.2d 1210, 1215 (11th Cir.1991)). We should not be forced to speculate as to the grounds for the ALJ's rejection of Sparhawk's allegations of disabling pain. Bunnell, 947 F.2d at 346. 35 The ALJ failed to articulate specific reasons for disbelieving Sparhawk's pain testimony concerning the post-January 1, 1988 period. The ALJ, after all, did not deny the existence of an underlying impairment (the spondylolysis and spondylolisthesis) that could reasonably produce such pain. He simply found Sparhawk to be exaggerating the severity of the pain. Yet the ALJ proffers no rational basis for his decision to disregard Sparhawk's testimony. It cannot be that the ALJ found Sparhawk to be an untrustworthy or incredible witness. He expressly found her testimony about sitting limitations, an inability to operate foot pedals, and the excruciating level of the pain to be credible for the pre-January 1988 period. When Sparhawk broached the subject of the post-January 1, 1988 status of her disability, however, the ALJ did an about-face and announced, without explanation, that Sparhawk's credibility had evaporated. 36 The ALJ implicitly suggests that, with the solidifying of the fusion in January 1988, Sparhawk's back impairment was no longer capable of causing disabling levels of pain. However, the medical evidence in the record simply does not support such a conclusion. While the fusion no doubt kept Sparhawk's condition from worsening, no medical evidence was introduced either (1) suggesting that a successful fusion could or would significantly reduce Sparhawk's extant pain level or (2) explaining how much time it would take after surgery for Sparhawk's pain to diminish to tolerable levels. The record, moreover, revealed that the same condition that generated Sparhawk's disabling pain from 1984 to 1988 appeared by January 1988 to have set in at the L5-S1 area. The ALJ did not consider this as a possible alternative source of Sparhawk's pain. 37 The ALJ did list a number of factors he considered in concluding that Sparhawk's credibility dissolved once she began to testify about the post-January 1, 1988 period. The ALJ stated, without elaboration, that he considered in his credibility decision Sparhawk's daily activities, what medications were being prescribed, Sparhawk's appearance and credibility, doctors' comments, laboratory findings, and observable signs of impairment. However, the mere listing of factors, without explaining how each factor contributes to the credibility decision, does little to strengthen the ALJ's position. That is especially so here because an individualized review of the factors reveals that most, if not all, weigh in favor of a continued finding of disability. 38 Sparhawk's unrebutted testimony discloses that her daily activities consisted of light household chores, such as cooking, washing dishes, and laundry. She drives infrequently and only for short distances. These limited activities are consistent with a continuing disability. See Howard v. Heckler, 782 F.2d 1484, 1488 (9th Cir.1986) (restricted travel due to pain); Gallant, 753 F.2d at 1453 (cooking meals and washing dishes not inconsistent with disabling leg and back pain). 39 With respect to medications, the record reveals that Sparhawk saw a doctor at least monthly for treatment of her back, leg, shoulder, and neck pain. In early 1988, she was undergoing physical therapy and various other treatments to alleviate her pain. Such a treatment regimen is consistent with continuing severe pain. 40 Sparhawk's appearance and credibility cannot explain the ALJ's decision because he considered her trustworthy and believable for all aspects of her testimony except the post-January 1, 1988 evidence. Furthermore, [t]hat a claimant does not exhibit manifestations of pain at the hearing before the ALJ is, standing alone, insufficient to rebut a claim of pain. Fair, 885 F.2d at 602. 41 As noted earlier, the comments of physicians in the record did not address whether Sparhawk's pain persisted at a disabling level after the successful fusion. On the other hand, the clinical laboratory findings, and especially the x-ray showing minimal movement in the L5-S1 area, support a finding of continued substantial impairment that could generate disabling levels of pain. See id. at 601. ([I]t is possible to suffer disabling pain even where the degree of pain, as opposed to the mere existence of pain, is unsupported by objective medical findings.). 42 Finally, Sparhawk's frequent visits to her doctors support a finding of disability. Cf. id. at 603. 43 Because the listed factors strongly favor a finding of disabling pain, we cannot elevate the ALJ's rote recitation of considerations to the level of specific evidence justifying the dismissal of Sparhawk's pain testimony. Cf. Sprague, 812 F.2d at 1230-31 (mere reference, without elaboration, to inconsistencies in medical opinion does not constitute specific, legitimate reasons for disregarding the evidence). 44 The ALJ's failure properly to explain his rejection of Sparhawk's post-fusion pain testimony is in itself reversible error. 45 [T]he ALJ gives no reason for disregarding Varney's pain testimony, other than the assertion that her subjective complaints are disproportionate to the medical evidence; nor does he isolate particular complaints of pain and discuss the evidence suggesting that those complaints are not credible. In this circuit, these omissions are improper as a matter of law; they require that we reverse the ALJ's decision.... 46 Varney v. Secretary of Health & Human Servs., 846 F.2d 581, 584 (9th Cir.), modified on other grounds, 859 F.2d 1396 (9th Cir.1988). 47 Similarly, in Gallant, we reversed a denial of disability benefits for a claimant who suffered from chronic back pain and a mild depression. There, as here, virtually every medical report noted Gallant's complaints about pain. 753 F.2d at 1455. Again, like Sparhawk, [t]here was no positive evidence that claimant was not suffering as much pain as he claimed to suffer and [n]o witness, qualified expert or otherwise, expressed the opinion that claimant was in any way malingering. Id. Both Gallant and Sparhawk produced substantial medical evidence verifying the existence of a disability and its continuing objective manifestation of symptoms. Id. Although the ALJ's explanation for discrediting Gallant's pain testimony was more extensive than that offered by the ALJ in the instant case, see id., we nevertheless reversed: 48 Although it is within the power of the Secretary to make findings concerning the credibility of a witness and to weigh conflicting evidence, he cannot reach a conclusion first, and then attempt to justify it by ignoring competent evidence in the record that suggests an opposite result. 49 Id. at 1456 (citation omitted). 50 In sum, in finding medical improvement, the ALJ failed to explain adequately his rejection of Sparhawk's post-fusion pain testimony. Neither an unelaborated list of factors nor an unexplained finding of witness non-credibility constitutes the specific evidence commanded by Bunnell and other opinions of this court before pain testimony can be discarded. 2