Opinion ID: 420970
Heading Depth: 1
Heading Rank: 2

Heading: The Claimant's Capabilities.

Text: 20 The ALJ's second error concerns his evaluation of O'Leary's capabilities, particularly his evaluation of her pain. The ALJ stated that O'Leary's testimony regarding her pain was substantially rejected as a basis for disability in that it conflicts with the pertinent medical evidence and the ALJ's personal observations of the claimant at the hearing. 21 The ALJ's statement of a conflict with the medical evidence is not supported by the record. The medical reports all contain corroborating evidence of O'Leary's pain and limitation of motion. See Nicks v. Schweiker, supra, 696 F.2d at 635. O'Leary's treating physician, Dr. Klein, indicated that O'Leary's lumbar flexion is limited about 50%, or that she has about 40? of lumbar flexion, and he concluded in October, 1977, that her condition was consistent with a fifteen percent permanent disability of the body as a whole. He stated in a May, 1978, report that her [f]orward flexion of the lumbar spine is to a point where the hands reach the knees. At this point, and midway through lumbar extension, the patient complains of right sciatica [painful condition in the region of the hip and thighs]   . With the patient supine [lying face upward, on her back], straight leg raising is to 80 degrees on the left without pain. At 45 degrees on the right the patient complains of right sciatica. The Lasegue's and Patrick's tests are positive on the right. 22 His report concluded: This patient continues to have symptoms and findings related to a lumbar disc injury and subsequent surgery. She is unable to engage in work activity requiring prolonged standing, prolonged sitting, or any significant amount of bending or lifting. In a 1979 report, he emphasized that O'Leary's symptoms have been worsening, and he mentioned episodes where her right leg simply gave way, causing her to fall down. 23 Dr. Michael O'Neil, a consulting physician, examined O'Leary in 1978 and again in 1980. His 1978 report stated that following her surgery in 1977, she experienced pain in the right leg, and although her left leg improved, [h]er low back and right leg pain have persisted to the present time and are becoming worse. O'Neil's physical examination revealed that [t]here is tenderness to palpatation over the midline low back area and over the right buttock   . Range of motion of the lumbosacral spine is limited approximately 25 percent. She has flexion with the finger-tips 14 inches from the floor with associated pain in the midline low back area and right buttock. She also complains of discomfort with maximum extension and right and left lateral bending. Straight leg raising on the left is negative at 90 degrees. Straight leg raising on the right is positive at 75 degrees. 24 O'Neil concluded that the claimant's condition would be [in] keeping with an S1 nerve root syndrome on the right, which he suspected would be permanent unless further surgery should happen to be successful. He stated: I would agree that she will have difficulty working even at a job which is sedentary in nature. His report in 1980 contained similar findings. After recounting her 1977 surgery, O'Neil's report stated: 25 Following her operation, she continued to experience pain in the low back area and right posterior thigh and calf. Her pain did not respond to rest, physical therapy and several other treatment modalities including an epidural steroid block. Her pain has been unchanged since that time. She has difficulty in stooping, twisting or bending because of increasing pain in the low back and right posterior thigh. She has been unable to do any type of work which requires any lifting, pushing, pulling or bending. 26 Her range of motion was even more limited than in 1978: 27 Range of motion of the lumbosacral spine is limited to 40 to 50 percent with pain, primarily on maximum flexion and extension. Right and left lateral bending is limited about 25 percent with pain. Straight leg raising is positive on the right side at 90 degrees, causing low back and right buttock pain. 28 Although he noted that [s]he does not appear to be in any acute distress, he concluded: 29 Mrs. O'Leary has had a lumbar laminectomy for a herniated lumbar disc of L5-S1 and has residual low back and right leg pain secondary to nerve root fibrosis or entrapment. I do not believe that she will be capable of work which requires stooping, bending, lifting, pushing, or pulling. She has some difficulty sitting for long periods of time because of her back and right leg also and this makes employment rather difficult. 30 At the request of ALJ Edgerton, O'Leary also saw a psychiatrist, Dr. Charles Graz. Dr. Graz's report fully corroborated O'Leary's complaints of pain, stating that she did give the impression of having bona fide back pathology and discomfort.    She is bothered by pain and swelling in her right leg which is a persistent thing.    All along she described how she wished that she could have the area permanently numbed and would be willing to have surgery if the pain could be eliminated, but she said her doctors advised her that would be the incorrect thing to do. Thus far, she just has obtained relief tentatively on the basis of sitting in a hot tub of water and taking her pain medicines. 31 Dr. Graz also noted her slight limp as she walked and during the interview, her great discomfort in sitting in any one position for a prolonged time. In fact, at times she had to stand up and reply to questions, rather than be seated. 5 He concluded that [t]here were no psychiatric or psychologic impairments and offered his opinion that [h]er condition appears    to be physical. 32 In sum, there is no conflict in the medical reports cited above with O'Leary's complaints of pain. The only bit of medical evidence which conflicts with her testimony is the physical capacities evaluation form or checklist completed by Dr. O'Neil after his examination of O'Leary in 1980. Dr. O'Neil indicated on the form that the claimant could sit for four hours in an eight-hour day and could stand for four hours in an eight-hour day. 6 The ALJ concluded that O'Leary could therefore perform jobs that allowed her to sit and stand intermittently, since her treating physician, Dr. Klein, had only precluded her from engaging in work that required prolonged sitting and standing. Dr. Klein was never asked how many hours the claimant could sit and stand--the ALJ appears to have assumed that prolonged means longer than four hours. Judge Denney apparently thought prolonged was a shorter period of time, 7 however, as did the consulting psychiatrist, who after an interview with the claimant noted her great discomfort in sitting in any one position for a prolonged time. 33 Moreover, there is no indication of how Dr. O'Neil arrived at this opinion. O'Leary testified that O'Neil never asked her how long she could sit and stand in an eight-hour day, and her testimony is directly contrary to his opinion as expressed on the checklist. Further, there is nothing in the record which would show whether Dr. O'Neil's opinion was that the claimant could sit and stand for eight hours, day in and day out, as would be required to hold a competitive job. He stated in his written reports that because of her disabilities, employment--even in a sedentary job--would be difficult. 34 Because of the interpretive problems inherent in the use of forms such as the physical capacities checklist, our Court has held that while these forms are admissible, they are entitled to little weight and do not constitute substantial evidence on the record as a whole. Camp v. Schweiker, 643 F.2d 1325, 1333-1334 (8th Cir.1981); McCoy v. Schweiker, supra, 683 F.2d at 1147 n. 8; Gilliam v. Califano, 620 F.2d 691, 693 (8th Cir.1980); Landess v. Weinberger, 490 F.2d 1187, 1189 (8th Cir.1974). The primary reliance which the ALJ apparently placed on this form was thus in error. 35 The ALJ's reliance on the checklist to discount O'Leary's testimony concerning her pain is even more questionable in view of the other corroborating evidence of her pain contained in the record. See Brand v. Secretary of HEW, 623 F.2d 523, 527 (8th Cir.1980). O'Leary had worked regularly at Western Electric since 1965, a full-time job which she took as soon as her children were old enough to permit her to do so. Her daily activities are much more restricted than before her injury. Prior to her injury, she worked eight hours a day, five days a week, lifting a pan of parts that weighed between thirty and seventy pounds. She bowled, coached softball, played tennis, and cooked and cleaned house for a family of seven. 36 Both her husband and O'Leary testified at the second hearing that she now experienced a constant, significant degree of pain, which limited her daily routine. Most of her time is spent watching TV and reading. She has difficulty sleeping and can only sit for a half an hour and then has to stand for three to five minutes before she can sit again. At the hearing, she sat with her weight on her left side and her right hand under her right leg. She regularly takes Empirin # 3 and aspirin or Excedrin for her pain, and she often sits in a hot bathtub or lays on the couch with a heating pad to relieve the aches in her back and leg. Some days her pain is so bad that she cannot do anything besides lay down. On days when she is feeling better, she rinses off the breakfast dishes and cooks the evening meal. She can run the washer and dryer, but her children put their clothes away and bring them to the washer as she cannot lift a laundry basket. Her husband and children do all the heavy housework and grocery shopping, and her husband changed his shift to evenings to be able to help more during the day. There is thus ample evidence in the record to corroborate the claimant's complaints of pain. See generally Duncan v. Harris, 518 F.Supp. 751, 757-758 (E.D.Ark.1980) (factors relevant to credibility of complaints of pain). 37 Even if all of the medical evidence did not fully corroborate O'Leary's complaints, however, the ALJ may not disregard these complaints solely because the objective medical evidence does not fully support them. See Tucker v. Schweiker, supra, 689 F.2d at 780-781; Brand v. Secretary of HEW, supra, 623 F.2d at 525-526; Northcutt v. Califano, 581 F.2d 164, 166 (8th Cir.1978). Claimants are entitled to an individualized determination of the effects of their condition: [a] back condition may affect one individual in an inconsequential way, whereas the same condition may severely disable another person who has a greater sensitivity to pain or whose physical condition    is generally deteriorated. Landess v. Weinberger, supra, 490 F.2d at 1190. See Cole v. Harris, supra, 641 F.2d at 615; Brand v. Secretary of HEW, supra, 623 F.2d at 526-527. 38 On remand, the ALJ must give full consideration to O'Leary's complaints of pain. He may not rely solely on Dr. O'Neil's responses on the checklist as substantial evidence that she can perform some types of sedentary jobs. Moreover, although credibility findings are for the ALJ in the first instance, the ALJ's personal observations of the claimant may not alone constitute substantial evidence that she can perform sedentary work. See McMillian v. Schweiker, supra, 697 F.2d at 221-222; Lund v. Weinberger, 520 F.2d 782, 785 (8th Cir.1975). Rather, the ALJ must consider all of the evidence and must attempt either to reconcile the medical reports of O'Leary's treating physician, Dr. Klein, with those of the consulting physician, Dr. O'Neil, or he must direct interrogatories to each physician to obtain a more substantiated opinion as to O'Leary's capabilities. See Woodard v. Schweiker, 668 F.2d 370, 374 (8th Cir.1981). The burden is on the Secretary to show that this claimant is able to perform the requisite acts of sedentary work day in and day out in the competitive conditions of work in the real world, and O'Leary is entitled to a fair evaluation of her capabilities. Simonson v. Schweiker, supra, 699 F.2d at 428-429; Cole v. Harris, supra, 641 F.2d at 614; Rhines v. Harris, 634 F.2d 1076, 1079 (8th Cir.1980). 39