Court Opinion

ID: 9494686
Source: CourtListenerOpinion
Date Created: 2023-08-05 15:44:04.298911+00
Date Added: 2024-06-11T17:56:33.394094
License: Public Domain

KENNEDY, Circuit Judge,
dissenting.
Because I disagree with the majority’s conclusion that the ALJ’s decision was supported by substantial evidence, I would remand. The majority avoids this result by observing that this court has a limited scope of review over the Board’s decisions and is not to assess the credibility of Dr. Blue. My decision to remand, however, would not be based on an assessment of Dr. Blue’s credibility, but rather on the ALJ’s failure to analyze the reasoning of, and support for, Dr. Blue’s conclusion. *837The ALJ accepted Dr. Blue’s conclusion that a lack of oxygenation to Groves’ tissues, resulting from pneumoconiosis, contributed to Groves’ arterial sclerotic heart disease, and ultimately, to his death. The ALJ found that Dr. Blue’s treatment notes and letter supported this conclusion. In weighing the medical evidence, the ALJ gave the most weight to Dr. Blue’s opinion because he had personally examined and treated Groves for nearly twenty-five years. Yet, the ALJ failed to explain why the personal examinations or treatment notes are sufficient to support a conclusion that the lack of oxygenation caused the arterial sclerotic heart disease that killed Groves. Certainly, the ALJ is entitled to give extra weight to a treating physician’s assessment of a patient’s condition. But I can see no reason why a treating physician’s opinion that one condition caused or contributed to another should be accepted in the face of expert opinions to the contrary, at least where there is no logical explanation for doing so offered by the ALJ. Here, Drs. Fino and Branseomb both rejected Dr. Blue’s theory with regard to causation. Although Dr. Branseomb did not believe that Groves suffered from pneumoconiosis, he stated that even if he assumed he did, there would be no reasonable basis to conclude that it contributed to, aggravated, or accelerated Groves’ death. Dr. Fino also noted that Dr. Blue’s causation theory was not supported by any valid, objective evidence. Dr. Fino’s opinion then cited to several studies concluding that pneumoconiosis did not increase the likelihood of coronary artery disease.1 Simply dismissing the opinions of Drs. Fino and Branseomb, as the ALJ did, because they did not personally examine the patient or because they did not believe that Groves suffered from pneumoconiosis misses the point. The personal examination and treatment of Groves over the course of his lifetime does not obviously place Dr. Blue in a better position to determine whether one condition could have caused the other. If there were a reason to believe that personal examination would enable a treating doctor to better assess the possibility that two conditions were causally connected, then reliance on Dr. Blue’s conclusion would be reasonable. But the ALJ gave no such reason. See Peabody Coal Co. v. McCandless, 255 F.3d 465, 468 (7th Cir.2001). Further, Dr. Blue’s opinion and treatment notes contain no objective support for his lack of oxygenation theory. Drs. Fino and Branseomb both discredit Dr. Blue’s theory as unsupported, and the only objective medical support cited in the record undermines Dr. Blue’s theory.2 The ALJ failed to critically analyze Dr. Blue’s causation theory or discount the opinions of Drs. Fino or Bran-scomb on any logical grounds. Hence, I would remand for further proceedings consistent with my dissent.

. Among the works cited by Dr. Fino were the article "Mortality From Heart Disease in Coal Miners,” published by Dr. Coestello, et al., in the journal Chest, an article by Dr. Lindars in 108 Journal of Pathology 249-59, a textbook entitled Occupational Lung Disorders published by Dr. W. Raymond Parkes, the Textbook of Occupational Lung Diseases published by Morgan and Seaton, and a textbook entitled Occupational Respiratory Disorders, published by the U.S. Department of Health and Human Services.

. The ALJ also failed to address the qualifications of the doctors. Dr. Fino is a board-certified specialist in internal medicine and pulmonary disease. Dr. Branseomb is a Professor of Medicine at the University of Alabama at Birmingham, and has expertise in the diagnosis and treatment of pulmonary disease. Dr. Blue, however, has only a general practitioner's experience with pulmonary diseases.