The opinion of the court was delivered by: Moran, District Judge.
Ruby M. Floyd brings this suit under 42 U.S.C. § 405(g)
to review the final decision of the Secretary of Health & Human
Services denying her application for Social Security disability
benefits and for Supplemental Securing Income (hereinafter
collectively referred to as "disability benefits"). Cross
motions for summary judgment have been filed asking this court
to determine whether the Secretary's decision is supported by
substantial evidence or, alternatively, whether the claim
should be remanded to the Secretary and another hearing held
with counsel present. For the reasons set forth below, the
motion to remand is granted.
42 U.S.C. § 423(d)(1)(A) defines disability as "inability
to engage in any substantial gainful activity by reason of any
medical impairment that can be expected to last for over twelve
months." More specifically, disability means not only inability
to do the previous type of work but also the incapacity to do
any other kind of work which exists in the national economy,
"considering opportunities that exist either in the claimant's
region or in the several regions of the country."
42 U.S.C. § 423(d)(2)(A). See Spencer v. Schweiker,
678 F.2d 42 (5th Cir. 1982), Hogan v. Schweiker, 532 F. Supp. 639
To be eligible for disability benefits a claimant must make
a prima facie showing of an impairment sufficiently severe to
preclude a return to his or her previous employment. Decker
v. Harris, 647 F.2d 291, 293 (2d Cir. 1981). Once this is
established the burden shifts to the Secretary to present
evidence showing that there exists in the national economy
substantial gainful work which claimant, considering his or her
age, education, experience and training, is able to perform.
Spencer v. Schweiker, supra; Stark v. Weinberger,
497 F.2d 1092 (7th Cir. 1974).
In response to criticism over disparate treatment of
seemingly similar claims, the Social Security Administration
recently promulgated new and detailed regulations which
establish an orderly sequence of adjudication for Social
Security disability claims. Kirk, et al. v. Secretary of
Health & Human Services, 667 F.2d 524 (6th Cir. 1981). The
Seventh Circuit described the "sequential evaluation for
adjudication of disability claims as follows:
The first inquiry under the sequence concerns
whether a claimant is currently engaged in
substantial gainful employment. If it is found
that he is, the claim is denied without reference
to the other steps in the sequence. If he is not,
the second inquiry is whether the claimant has a
"severe" impairment. If he does not, the claim is
denied. If a severe impairment is present, the
third inquiry is whether such impairment meets or
equals one of the impairments listed under
Appendix I to Subpart P of the Administrative
Regulations No. 4. If it does, the claim is
approved. If it does not, the fourth inquiry is
whether the claimant's impairments prevent him
from performing his past relevant work. If he is
found to be capable of returning to his past
relevant work, the claim is denied. If he is not
found to be so capable, the fifth and final
inquiry is whether claimant is able to perform
other forms of substantial gainful activity,
considering his age, education and prior work
experience. If he is not, the claim is approved.
The medical-vocational guidelines, which are
contained in Appendices 2, Subparts P and I, Parts
404 and 416, 20 C.F.R., are used in determining
whether the claimant is disabled when and if the
fifth step in the evaluation process is reached.
To apply the guidelines, the ALJ must make
findings of fact as to the claimant's vocational
factors, i.e., age, education, and work
experience, as those terms are defined by the
regulations . . . and his residual functional
capacity. . . . When the findings of fact made as
to all factors coincide with the criteria of a
rule [contained in the guidelines], that rule
directs a factual conclusion of disabled or not
Cannon v. Harris, 651 F.2d 513 (7th Cir. 1981).
See also Cummins v. Schweiker, 670 F.2d 81 (7th Cir.
1982), Hogan v. Schweiker, supra, at 643. These
regulations necessarily require a detailed factual analysis of
plaintiff's background and medical condition.
Ms. Floyd was born on April 12, 1924, has an eleventh grade
education and has minimal additional training as a nurse's aid.
With the exception of a two-year stint as a cook's helper,
plaintiff's primary work experience between 1962 and 1979 was
as a nurse's aid, a job that requires a significant amount of
standing, bending and lifting. Plaintiff maintains that she is
incapable of performing her prior work or pursuing any other
type of employment because she suffers from high blood
pressure, depression, and arthritis in various joints. Such
ailments, of undeterminate dates of origin, evidently worsened
over time and ultimately caused her to quit her work as a
nurse's aid in May of 1979. One year later Ms. Floyd filed a
claim for disability benefits with the Social Security
Administration. That claim was denied initially and upon
reconsideration. Exercising her right to an independent de
novo review of the matter, plaintiff appeared without
counsel at a hearing before an Administrative Law Judge ("ALJ")
on April 8, 1981.
Ms. Floyd was the only witness to testify at the hearing.
Under questioning by the ALJ she stated the following: In
addition to arthritis in her side, hands and knees, plaintiff
experiences shortness of breath, she can walk only two blocks
before tiring, she cannot climb steps without resting every
third or fourth step, and she is unable to stoop or run. As for
lifting, Ms. Floyd said, "I can't lift anything too well that
is over ten pounds. Maybe around seven or eight pounds,
roughly. It makes me so tired." Other physical complaints
include high blood pressure, which occasionally causes
dizziness, a tumor in the womb, with unspecified effect on her
ability to work, cancer, which was not elaborated upon, and
pain around her heart, stomach and chest. Finally, plaintiff
testified that she suffers from emotional disorders and at some
point in the past had a nervous breakdown. When asked how her
nervous condition affected her now, plaintiff responded
Well, noises and depression. I can't stand worry
and noises. I have to have something for insomnia.
I have to take these nerve pills there. I got two
of the same nervous pills there, but one of them
is a higher milligram.
Because of these ailments Ms. Floyd visits a doctor once a
month. Dr. J. Niazir has been her treating physician at least
since 1978. Her prescribed medications include Clinoril, 20
milligrams twice a day, presumably for arthritis; Valium, 5
milligrams twice a day, and Tylenol #3 which plaintiff says she
takes twice a day to alleviate pain.
With regard to her daily activities Ms. Floyd testified that
she cooks, washes dishes and cares for her personal needs,
although experiencing some difficulties. In exchange for free
rent plaintiff cleans the kitchen and halls, collects the rent
and moves empty garbage cans. Finally, while she used to visit
friends and relatives frequently, she rarely does so now except
for attending church on Sunday.
In addition to plaintiff's testimony, information secured
from Dr. Niazir was admitted into evidence. Submitted evidence
included both the records kept by the doctor of Ms. Floyd's
visits, and reports filled out at the behest of the Social
Security Administration. Unfortunately, the monthly notations
of plaintiff's condition are virtually illegible. What can be
discerned is a significant weight gain of thirty pounds over
the course of a year and, conversely, a steadily decreasing
blood pressure. In a report dated July 12, 1980, Dr. Niazir
described his patient's conditions as hypertension, depression
and osteoarthritis of the lower back. He indicated that there
was no end organ damage as a result of the high blood pressure,
no symptoms of heart disease, nor any evidence of chest pain.
Dr. Dilts, of the Social Security Administration, reviewed the
medical evidence and concurred with Dr. Niazir's ...