Opinion ID: 487727
Heading Depth: 2
Heading Rank: 2

Heading: Reports of Treating Physicians

Text: 19 Because a claimant's treating physicians have great familiarity with his condition, their reports must be accorded substantial weight. 74 The administrative law judge assigned two reasons for discounting the unanimous conclusion of appellant's treating psychiatrists that appellant was disabled by schizophrenia. First, he found the doctors' opinions to be unsupported by sufficient adequate underlying findings to prove a severe impairment at the point in question. 75 Second, he found them inconsistent with Dr. Perron's report of 1974. 76 20 A physical or mental impairment must result[ ] from anatomical, physiological, or psychological abnormalities which are demonstrable by medically acceptable clinical and laboratory diagnostic techniques. 77 However, unlike a broken arm, a mind cannot be x-rayed: 21 [A] psychiatric impairment is not as readily amenable to substantiation by objective laboratory testing as a medical impairment ... consequently, the diagnostic techniques employed in the field of psychiatry may be somewhat less tangible than those in the field of medicine.... In general, mental disorders cannot be ascertained and verified as are most physical illnesses, for the mind cannot be probed by mechanical devices [sic ] in order to obtain objective clinical manifestations of medical illness.... [W]hen mental illness is the basis of a disability claim, clinical and laboratory data may consist of the diagnosis and observations of professionals trained in the field of psychopathology. The report of a psychiatrist should not be rejected simply because of the relative imprecision of the psychiatric methodology or the absence of substantial documentation, unless there are other reasons to question the diagnostic techniques. 78 22 Clearly, the administrative law judge misconstrued this standard, and concomitantly undervalued the treating psychiatrists' reports. The record shows just such diagnostic techniques--psychiatric monitoring, interviews, and objective symptomology--as psychiatrists normally rely upon. 79 Indeed, the current regulations accord entirely with this standard, and instruct that [t]he presence of a mental disorder should be documented primarily on the basis of reports from individual providers, such as psychiatrists and psychologists, and facilities such as hospitals and clinics. 80 The administrative law judge exacerbated his error by failing to develop the record. 81 Had the doctors been informed that more detail or underlying findings were necessary--records, clinical reports, and test results that they may well have reviewed in preparing their summary reports 82 --then the information they supplied might well have met the administrative law judge's overly-stringent standards. 83 23 The judge also discounted the medical reports--including those of Dr. Perron--as inconsistent with a statement in Dr. Perron's 1974 report 84 that I saw [Poulin] for the first time in October 1972 when hospitalized on emergency into our regional mental hospital. He was disassociated and in a typical schizophrenic state. He has a rapid and fine recovery under neuroplegics only. 85 Appellant suggests that the administrative law judge seriously misinterpreted the reference to rapid and fine recovery as indicating recovery from schizophrenia; rather, appellant makes the plausible argument that Dr. Perron's statement, read in context, refers only to recovery from the acute episode that mandated the October 1972 hospitalization. 86 Both the ordinary course of acute and residual phases of schizophrenia 87 and Dr. Perron's other reports in the record 88 accord entirely with this interpretation of the 1974 report. On remand, the administrative law judge should consider this alternative view, which, if he finds it more plausible, would support rather than detract from the other medical records. 89