Court Opinion

ID: 9474497
Source: CourtListenerOpinion
Date Created: 2023-08-05 04:59:04.336558+00
Date Added: 2024-06-11T17:44:07.489260
License: Public Domain

JERRE S. WILLIAMS, Circuit Judge,
dissenting:
In this case both parties waive oral argument. This means that the Court rule requiring. unanimity among the three judges in a summary calendar decision does not apply. After a careful consideration I find that I must record this dissent.
I am well aware, of course, that every official decision which has been rendered thus far in this case through the administrative hierarchy, in the federal district court, and now in this Court has been against the claim of disability of appellant. I cannot escape the belief that under the law, however, the authorities and the courts have too readily concluded that someone who has very serious back trouble accompanied by a great deal of pain is not totally disabled just because he can sit long enough to go to church regularly and can engage in short periods at light work around the house or in the garden. The statute and regulations simply do not define this minimal capability as possessing a “maximum sustained capability limited to light work”, which in terms is the finding being reviewed in this Court.
I do recognize that by statute, 42 U.S.C. § 405(g), our appellate review is limited to determining whether there is substantial evidence in the record to support the factual findings of the Secretary. “We may not retry factual issues, reweigh evidence, or substitute our judgment for that of the factfinder.” Dellolio v. Heckler, 705 F.2d 123, 125 (5th Cir.1983). If supported by substantial evidence on the record considered as a whole, the Secretary’s findings are conclusive. E.g., Bowman v. Heckler, 706 F.2d 564, 567 (5th Cir.1983).
In dissenting, however, I stress the rule recognized in the majority opinion which shifts the burden of proof to the Secretary once the claimant proves that he or she can no longer engage in the work which he or she has done in the past. The Secretary must then prove that claimant is able to work at one of the defined lesser levels of work requirements. Dorsey v. Heckler, 702 F.2d 597, 603 (5th Cir.1983); Ferguson v. Schweiker, 641 F.2d 243, 246 (5th Cir. 1981). There is no dispute in this case as to claimant’s lack of physical capacity to do this prior work.
The record contains several diagnoses and prognoses by doctors. Some of them conclude either that claimant is not disabled or will recover from his disabilities over a period of time. There are two remarkable aspects of these reports, however. In-depth diagnoses by doctors, with one exception, all took place before major back surgery and before the last surgical procedure which appellant has had. With the one exception described later the diagnoses in the general time frame of the recent surgeries were only the cursory reports on Social Security forms which totally lacked the detailed evaluation of claimant’s condition found in the physician’s diagnosis which claimant submitted.
In July 1983, appellant had his third major back surgery. This third operation involved removing a substantial amount of scar tissue and fusing L-3 & 4 and L-4 & 5 with metal pins. In the later surgery in January of 1984, the greater occipital nerves were surgically explored and neuro*1289mas were found on each side and excised along with substantial segments of the nerves.
Dr. James A. Albright, who is Chairman of the Department of Orthopaedic Surgery at the Louisiana State University School of Medicine in Shreveport, Louisiana, performed the last two surgical procedures described above. Appellant has been under Dr. Albright’s orthopaedic care since June 1978, when the doctor performed an emergency operation on appellant’s lower spine to remove an acute herniated disc. This doctor’s medical diagnosis is the exception to the cursory form reports of Social Security doctors given around the time of the two surgeries. His conclusion immediately before the hearing before the Administrative Law Judge read:
Mr. Milam was totally disabled on March 31, 1983, apparently the. date in question. At the .present time, he is significantly better than he was prior to the last two operative procedures. Nevertheless, he is still totally disabled for any type of productive activity. I feel that his disability is permanent and do not feel that he will ever reach the point where he will be able to work in the future.
The Secretary relied upon the largely abbreviated and casual medical reports of doctors who were evaluating appellant’s condition before the latest two surgical procedures. While it is true that the critical disability date is before these two surgical procedures, it is routine in social security disability cases to receive evidence of later physical developments as they cast light upon the level of disability on the critical date. These two surgeries do cast a strong illumination. Thus appellant persisted in claiming serious pain in his neck area. In disability evaluations doctors kept saying they found nothing wrong. Then in surgery in January 1984, conditions causing significant pain were found and some correction was accomplished.
Further the doctors making the government’s evaluation even after the serious lower back surgery and fusion in July 1983, simply concluded that he was not disabled until the date of the surgery, with no reference at all to the disabling effects of his physical condition before the surgery which brought about the necessity for it.
Further decisional reliance was based upon the conclusion that appellant’s claim, especially with respect to the neck injury, was a subjective claim of disabling pain. Under the Social Security Benefits Reform Act of 1984, 42 U.S.C. § 423(d)(5)(A), subjective symptoms of pain alone cannot constitute conclusive evidence of disability. The amendments and the regulations state that there must be objective medical evidence showing existence of a physical impairment which could reasonably be expected to provide pain. On the basis of evidence the later surgery on his neck in an attempt to relieve pain grew out of a condition which was clearly troubling him and giving him great pain before the critical date of March 31, 1983. That surgery showed such a physical impairment existed and further showed only partial remedy.
The only other evidence in the record consists of appellant’s own testimony at the hearing by the Administrative Law Judge in which he testified that he cannot sit or stand for long without great pain. Appellant, however, usually goes to church. He is also somewhat active on church committees and goes to their meetings outside his home sometimes. He testified that he works a little bit in the yard and does some fishing from the shore and walks about a quarter of a mile every day. He stated that he leaves the home rarely and this is partially because he cannot afford excursions away from home but also partially because of his discomfort and pain when he is away from home.
On the basis of this summary of the record, I must conclude that the Secretary did not satisfy the burden of proving that appellant is capable of carrying out the “full range of light work”. 20 C.F.R. § 404.1567(b) defines light work as follows:
Light work involves lifting no more than 20 pounds at a time with frequent lifting or carrying of objects weighing up to 10 pounds. Even though the weight lifted *1290may be very little, a job is in this category when it requires a good deal of walking or standing, or when it involves sitting most of the time with some pushing and pulling of arm or leg controls. To be considered capable of performing a full or wide range of light work, you must have the ability to do substantially all of these activities.
The Secretary concluded that appellant was not disabled because he possessed “maximum sustained capability limited to light work.” 20 C.F.R. Part 404, Subpt. P, App. 2, § 202.00; Table 2, Rule 202.20. Yet, this conclusion was based heavily upon cursory form reports of doctors given before the second of the two surgical procedures carried out on appellant and ignoring the physical condition that brought about the first. Then, the only other evidence is appellant’s own description of his activities. It is difficult, as the Administrative Law Judge seemed to do, to find solace in the conclusion that appellant was capable of light work because he went to church with some regularity, participated in some church committee meetings, fished a little, helped his wife in the yard a little, and walked about a quarter of a mile a day, and with the further testimony that he found it exceedingly difficult and painful to sit any length of time.
The Secretary further concluded that the basic claim of disability was grounded upon subjective pain without medical support. It is difficult to understand why the medical support occasioned by the need for radical surgery on the lower spine and by two instances of surgery on his neck following the automobile accidents which originally caused the neck injury, together with the conclusion of the orthopaedic surgeon who did the surgery that he will continue to be disabled, is not adequate objective medical support for the subjective evidence of pain.
This case is very much like the case of Smith v. Schweiker, 646 F.2d 1075 (5th Cir.1981), in which the evidence showed that Smith regularly attended church and took short trips to pick up his children at school but that the pain was so disabling that he could not engage in any substantial amount of yard work, shopping, hunting, or fishing. In that case we overturned a finding of no disability by the Secretary. It is exceedingly difficult to translate appellant Milam’s description of his own activities, which is unchallenged in the record, to capability to engage in a full eight hour day of work in which lifting up to 10 pounds takes place regularly and a substantial amount of walking and standing on the feet is involved.
The opinion of a claimant’s regular doctor, who in this case is Dr. Albright, is to be afforded “substantial weight”. Fruge v. Harris, 631 F.2d 1244, 1246 (5th Cir. 1980). Conceding that his opinion, however, is not controlling, in this case we search the record in vain for specific countering evidence. The earlier medical opinions do not take into account the physical conditions that brought about the need for a substantial spinal fusion and second surgery upon occipital nerves in which abnormal nerve tumors were found. Further, the only description of his activities since those operations stands as strong support for Dr. Albright’s conclusion that appellant was obviously totally disabled on the critical date of March 31, 1983, and that after the surgeries there was some improvement but he continues to be totally disabled and his disability is permanent. Dr. Albright operated on appellant. He did not have to guess. He knew what appellant’s condition was before the surgery and the condition which remained after surgery.
The majority of the Court relies upon Owens v. Heckler, 770 F.2d 1276 (5th Cir. 1985); In that case the evidence showed the claimant was not as restricted in his activities as is appellant. He had only aging degenerative spinal problems and controlled high blood pressure. He had had no surgery and no trauma. Of' substantial significance is the fact that Owens had no evidence by his attending physician that he was totally disabled. Appellant, in contrast, is diagnosed as totally disabled by his orthopaedic surgeon who holds a highly responsible position in academic orthopaed*1291ic surgery. I cannot find the Owens case persuasive in appellant’s situation.
It is not necessary to review appellant’s additional claim that the Administrative Law Judge did not make findings as to what particular kinds of light work appellant could carry out. Such findings are irrelevant because the Administrative Law Judge concluded that he could “perform the full range of light work” as defined in the statute.
I find in this record a failure of the Secretary to develop and introduce substantial evidence to counter appellant’s claim of total disability once the burden of proof shifted to the Secretary. In my opinion the decision of the district court should be reversed.