Court Opinion

ID: 9496419
Source: CourtListenerOpinion
Date Created: 2023-08-05 16:26:12.993731+00
Date Added: 2024-06-11T17:57:34.154485
License: Public Domain

HEANEY, Circuit Judge,
dissenting.
I respectfully dissent. The ALJ in this case failed to adequately consider the medical opinion of Paul Anderson’s treating doctor; improperly ignored Anderson’s undisputed account of his own pain and abilities; and, as a result, posed the wrong question to the vocational expert regarding Anderson’s future in the competitive job market. For these reasons, I would reverse and remand to the Commissioner.
Paul Anderson, a right-hand dominant person, injured his right shoulder at his place of employment in March of 1997. He required surgery on August 18, 1997, and has been unable to obtain steady work since his injury. He has been diagnosed with severe degenerative disc disease and *816an impaired right shoulder. No one disputes the existence of Anderson’s injury; the ALJ, however, concluded that despite his injury, Anderson can find other work in a full time competitive economy.
In making this determination, the ALJ improperly disregarded the opinion of Anderson’s treating physician, Dr. Garber. She discounted Dr. Garber’s Residual Functional Capacity Questionnaire because of perceived internal inconsistencies in his report. Most of the inconsistencies the ALJ describes, however, are not inconsistencies at all, but rather lingering questions she had about the medical reasons for Anderson’s limitations. The ALJ contends that there are several points in the report where Dr. Garber indicated a restriction on Anderson’s ability to work, but did not provide an explanation for the restriction. Dr. Garber answered each question on the Residual Functional Capacity Questionnaire as it was framed. He indicated that Anderson would need to take a break every forty-five minutes and would need frequent rests on the job. The ALJ takes issue with this assessment because Dr. Garber did not explain why such breaks would be necessary, but the undisputed record reflects that there is no space on the form to provide such an explanation. Rather than summarily dismissing Dr. Garber’s assessment for this reason, the ALJ should have contacted Dr. Garber to obtain further explanation. See Cox v. Apfel, 160 F.3d 1203, 1209 (8th Cir.1998) (noting that an ALJ has an independent duty to fully and fairly develop the facts of the case). Just because the ALJ determined Dr. Garber’s assessment was incomplete, does not mean the doctor’s assessment was inconsistent.
It is clear on the record as it stands that Anderson would need to take frequent breaks on a job due to his shoulder injury and severe degenerative disc disease. Dr. Brokke, the consultative physician, noted Anderson experienced fatigue after his physical examination. Dr. Brokke’s observation supports Dr. Garber’s conclusion that Anderson would need frequent breaks on a job. If testing in a doctor’s office tires Anderson out, certainly a few hours on the job would do the same.
The ALJ drew hasty conclusions from Dr. Garber’s statements that Anderson has an unimpaired ability to walk, yet would require a break every forty-five minutes. The ALJ maintains that these two statements cannot coexist. Anderson’s ability to walk, however, does not speak to his ability to maintain a certain body position throughout the workday. His need for breaks clearly derives from his undisputed back and shoulder problems.
The ALJ also placed too great an emphasis on Dr. Garber’s later correction to his Residual Functional Capacity Questionnaire. In the original report, Dr. Garber did not place restrictions on Anderson’s ability to lift weights. He corrected, this by submitting a letter indicating Anderson could lift ten pounds occasionally, and less than ten pounds frequently. The ALJ disregarded this opinion, noting that Dr. Gar-ber altered his restriction after talking to Anderson’s attorney. There is nothing to suggest Dr. Garber altered his medical opinion because Anderson’s attorney convinced him to do so. Rather, it is more likely that Dr. Garber realized his mistake and sought to rectify it by supplementing the record. Furthermore, as this court has said before, a person’s ability to lift weights does not translate into his ability to work in a competitive national economy. McCoy v. Schweiker, 683 F.2d 1138, 1147 (8th Cir.1982) (stating that the residual functional capacity of a claimant “is not [found by] the ability merely to lift weights occasionally in a doctor’s office; it is the *817ability to perform the requisite physical acts day in and day out, in the sometimes competitive and stressful conditions in which real people work in the real world”).
The ALJ continued to incorrectly label other statements in Dr. Garber’s report as inconsistencies. These include: 1) a limitation on Anderson’s ability to handle and finger objects; 2) a limitation on Anderson’s ability to sit for more than three hours; and, 3) a limitation on Anderson’s ability to reach, push, and pull. The ALJ dismissed all of these observations as unsupported by any medical explanation. Once again, the ALJ is labeling an incomplete medical record as an inconsistent one. The proper course for the ALJ was to seek further explanation of Anderson’s limitations, not to dismiss them outright. Cox, 160 F.3d at 1209.
Not only did the ALJ discount the treating physician’s assessment of Anderson, but she also improperly disregarded Anderson’s own unchallenged statements about his pain and abilities. The ALJ found Anderson’s testimony incredible for three reasons. First, Dr. Martin, Anderson’s evaluating psychologist, noted that during his examination of Anderson, Anderson appeared to be “convincing” him that he was in pain. Second, the ALJ concluded that Anderson was overusing his properly prescribed pain medications, and this was a contributing factor to his current problems. Finally, the ALJ maintained that Anderson’s account of his pain and abilities was inconsistent with the findings upon medical examination. Even though the majority correctly points out that a claimant’s “ ‘credibility is primarily a matter for the ALJ to decide,’ ” ante at 815 (quoting Edwards v. Barnhart, 314 F.3d 964, 966 (8th Cir.2003)), the ALJ must have a basis for discounting a claimant’s credibility. Here there is no such basis.
Nothing in the record indicates that Anderson ever lied about the level of pain he was experiencing. In fact, the medical history supports the notion that Anderson was in fact experiencing severe pain. An ALJ should look to the dosage of the pain medication as a factor in determining the credibility of a claimant’s stated level of pain. See Polaski v. Heckler, 739 F.2d 1320, 1322 (8th Cir.1984). Anderson was on several medications to help alleviate the pain he was experiencing in his shoulder. Certainly his treating doctors found his accounts of pain to be credible, or they would not have continued to prescribe him pain medication. Dr. Martin’s statement that he thought Anderson was trying to “convince” him of his pain, suggesting he was not really in pain, is unfounded. During Anderson’s one visit with Dr. Martin, a psychologist, he never examined Anderson’s shoulder. Even Dr. Brokke, the consultative examiner, notes in his report that Anderson’s right shoulder became “quite painful” only ten minutes after his physical examination of Anderson. Anderson consistently complained to all of his medical doctors about his pain, and none of them expressed doubt as to the sincerity of his complaints. There was no basis for the ALJ to rely solely on the speculation of Dr. Martin, when every other medical doctor that treated or examined Anderson believed he was in pain.
The ALJ also opined that Anderson was using too much pain medication. She based her conclusion on the “suspicions” of more than one physician. While several doctors expressed to Anderson the serious nature of the pain medications he was taking,3 the only doctor who expressed *818such “suspicions” regarding addiction was Dr. Martin, the evaluating psychologist. Dr. Martin’s conclusion was pure conjecture; during Anderson’s single visit he did not evaluate the severity of Anderson’s pain, and consequently could not know the proper level of pain medication. In fact, Dr. Martin himself suggested further diagnostic testing was necessary to test his “hypothesis” regarding Anderson’s perceived misuse of prescription drugs. None of the other medical doctors expressed Dr.' Martin’s concern.4 Once again, the ALJ chose to disregard the treatment plan prescribed by all of Anderson’s other doctors, and relied on Dr. Martin’s unsubstantiated “hypothetical” of Anderson’s drug abuse.
The ALJ further dismissed Anderson’s statements regarding his range of motion and lifting ability as being inconsistent with Dr. Brokke’s examination. Dr. Brokke, however, only examined Anderson once, and could not have been aware of how Anderson would perform overtime on a job. Accordingly, the ALJ had no basis for discrediting Anderson’s testimony regarding the level of pain he experienced as a result of his back and shoulder problems.
Having improperly discredited Dr. Gar-ber’s assessment of Anderson’s capabilities and Anderson’s own account of his capabilities, the ALJ posed the wrong question to the vocational expert regarding Anderson’s future in the competitive job market. The ALJ told the expert that Anderson could lift twenty pounds occasionally, could do work at shoulder or chest level, could sit, stand, or walk for six hours in an eight-hour day with normal breaks, and was not restricted in the use of his hands or fingers. On these facts, the vocational expert answered that Anderson could be employed as a telephone solicitor, gate tender, or a general clerk. The facts the ALJ detailed, however, are not Anderson’s actual capabilities. Dr. Garber’s evaluation indicates Anderson would have to take many breaks on the job, Anderson testified that he gets sore and would need to take many breaks on the job, and his treating physicians all agree that Anderson cannot lift more than ten pounds. The ALJ provided the vocational expert with an inaccurate view of Anderson’s medical condition, and hence the vocational expert’s opinion that Anderson could find work is not sound.
The ALJ failed to take into account important medical evidence from Dr. Gar-ber and from Anderson in finding Anderson was not disabled. The ALJ’s decision was based primarily on information provided by a one-time examining doctor, which, in my view, is not substantial evidence. Accordingly, I would reverse the district court with directions to remand to the Commissioner for a full and fair hearing, answering all of the questions that are raised by the ALJ’s inadequate decision. See Payton v. Shalala, 25 F.3d 684, 686 (8th Cir.1994) (holding where an ALJ does not fully develop the record, the court may remand for taking of further evidence).

. Dr. Green, while indicating he would “try to stop the Vicodin,” never indicated this was due to Anderson’s misuse of the drug. Report of Dr. Green (Nov. 4, 1997) [Record at 215]. *818Similarly, Dr. Jones, the VA doctor, "warned the patient about continued use of [Perco-cet],” but never revealed he was concerned that Anderson was overusing the drug. Report of Dr. Jones (June 8, 1998) [Record at 226]. These appear to be words of caution about potential addiction, rather than words of rebuke about a current addiction.

. Dr. Garber did note that Anderson was receiving pain medication from two doctors, but nonetheless he continued prescribing Anderson pain medications.