Court Opinion

ID: 9557761
Source: CourtListenerOpinion
Date Created: 2023-08-21 16:56:57.639328+00
Date Added: 2024-06-11T09:06:34.739675
License: Public Domain

BYE, Circuit Judge,
dissenting.
I respectfully dissent as I do not believe there is substantial evidence in the record to support the administrative law judge’s (ALJ’s) rejection of the treating physician’s opinion regarding Robert House’s need to elevate his legs as much as possible during the day.
The ALJ gave two reasons for rejecting the treating physician’s opinion regarding House’s need to elevate his legs. Specifically, the ALJ said:
There is nothing in the record to support Dr. MeFarlin’s assertion that the claimant’s left lower extremity lymp-hedema will be exacerbated if he cannot elevate both of his legs throughout the day. More importantly, the medical evidence indicates that the claimant developed recurrent deep vein thrombosis and pulmonary embolism in June 2001 because he stopped taking Coumadin, not because he did not spend most of the day with his legs elevated (Exhibit 6F). Since the June 2001 hospitalization, the claimant has been taking Coumadin faithfully and he had not developed further deep vein thrombosis or pulmonary embolism. Finally, the claimant did not testify that he needed to elevate his legs during the day. It is clear that the statements of opinion were manufactured for the purpose of this adjudication, and are not well supported by the clinical findings and/or laboratory studies (20 CFR 404.1527(d), 416.972(d)).
Administrative Record at 22.
Thus, the two reasons the ALJ gave for rejecting the treating physician’s opinion on House’s need to elevate his legs were: (1) House was hospitalized because he failed to take his Coumadin, not because he was not elevating his legs; and (2) House did not testify he needed to elevate his legs.
The ALJ’s first reason simply does not support the conclusion House does not need to elevate his legs. The only conclusion that follows from the fact House was hospitalized for failure to take his Couma-din is House will require hospitalization if he fails to take his Coumadin. The issue whether he should also elevate his legs is an entirely separate matter.
The second reason given by the ALJ is not supported by substantial evidence in the record. In fact, the record indicates just the opposite — House specifically testified he needs to — and does — elevate his legs:
Q. About how long can you sit?
A. Usually 20 minutes. If I try, I can sit 30 at the most.
Q. And then after 20 minutes, what happens?
A. I have to get up and stand and walk around.
Q. If you’re sitting down, do you need to have your legs elevated?
A. Yes.
Q. All the time or—
A. Supposed to be, but I try to elevate them as much as possible.
Administrative Record at 524 (emphasis added).
House also testified he elevates his leg while driving:
*747Q. Do you have that pain all the time or does it come and go?
A. It’s pretty much all the time. I got to keep moving my leg and even when I drive I have to keep picking my leg up and moving it.
Id. at 546.
When the ALJ asked House about his daily activities, such as cooking and cleaning at the mission, the ALJ did not ask House whether he took breaks to elevate his legs.
In sum, I do not believe there is substantial evidence in the record to support the ALJ’s rejection of the treating physician’s opinion about House’s need to elevate his leg during a typical work day. The record indicates House may have to amputate his leg if his lymphedema does not improve. The record also indicates a failure to elevate his leg aggravates the lymphedema. Because the adverse consequences of House’s lymphedema could be severe, I believe this is an issue which should be looked at more closely in a further hearing after additional information is developed on whether and how often House needs to elevate his legs during a typical work day.
For the reasons stated, I would reverse and remand for additional consultative exams to be performed to address House’s need to elevate his legs during the work day.