Court Opinion

ID: 9495502
Source: CourtListenerOpinion
Date Created: 2023-08-05 16:04:20.345707+00
Date Added: 2024-06-11T17:57:03.348462
License: Public Domain

POSNER, Circuit Judge,
dissenting.
According to the uncontroverted facts, the applicant for disability benefits, Linda Sims, age 46 at the time of the administrative law judge’s decision, is of dwarfish stature (4 feet 9 inches), is anemic, and has a shriveled kidney that may be responsible for her stratospheric blood pressure (220/108). Her blood pressure is controllable by medication, but she sometimes forgets to take it. She has had three strokes, has bouts of depression, a history of alcoholism, and an IQ of only 72 — a combination of mental and psychological deficiencies implying a level of mentation at which it is easy to forget things. She is prone to fainting. The idea that she is capable, as the administrative law judge found, of doing “light work”' — which is not sedentary work, but is light factory work — “standing and walking” (I am quoting the ALJ) “for at least six hours per day, with maximum lifting of twenty pounds and frequent lifting of ten pounds,” see Allen v. Sullivan, 977 F.2d 385, 389-90 (7th Cir.1992), is laughable. No employer would dare to hire her. Her fainting fits alone would make her a menace to her coworkers as well as herself in a factory setting and expose her employer to substantial liability, as in DeFrancesco v. Bowen, 867 F.2d 1040, 1044-45 (7th Cir.1989). It is true that she once had more or less regular employment; but as the ALJ correctly determined, in recent years her work has been too sporadic to count as substantial gainful employment.
Although the majority opinion states that the ALJ “considered the combined effect of Sims’s impairments,” the opinion goes on to make clear that he did so in an oblique way, though it was approved in Perez v. Secretary of Health & Human Services, 958 F.2d 445, 448 (1st Cir.1991) (per curiam): namely by asking a vocation*433al expert whether, assuming Sims had the impairments the administrative law judge had found, there is a substantial number of factory jobs in Indiana that she can perform. I will not question the method of taking into account the totality of Sims’s impairments; but the implementation of the method fell woefully short. To begin with, the administrative law judge instructed the vocational expert to take into account the fact that Sims has “the equivalent of a high-school education.” (She left school after the eighth grade but later earned a GED certificate.) That was irrational. Sims obtained the equivalent of a high-school education before she had any strokes, a point ignored by the ALJ; he might as well have said of an Alzheimer’s patient that he might still be able to work because he had a college degree. It is surprising that he made this mistake since he was mindful of the fact that she had ceased being gainfully employed, presumably because of her strokes and other ailments.
More important, the ALJ failed to include Sims’s blood pressure and resulting fainting fits in the list of impairments on which the vocational expert was to base the judgment of disability. His ground for the omission was that Sims’s blood pressure is controllable by medication. The ALJ failed to connect Sims’s low intelligence with her failure to take her medicine regularly. She is not being willful; her low intelligence makes her unable to remember to take her medicine. The ALJ thus withheld from the vocational expert the key “combined effect of Sims’s impairments”- — namely the interaction between her low IQ and her high, though theoretically controllable, blood pressure. As a result, the vocational expert’s finding, on which the ALJ, who made no independent judgment of the combined effect of Sims’s impairments, based his denial of disability benefits, rests on air.
The majority opinion indicates misgivings about the handling of the “combined effect” issue by “urg[ing] the [Social Security Administration] in the future to carefully examine the issue of disability in light of a claimant’s total impairments.” For Sims, the future is now. She was entitled to a competent examination of the issue of disability in light of her total impairments. She did not receive it.