The opinion of the court was delivered by: Bua, District Judge.
The instant action was instituted by plaintiff pursuant to
42 U.S.C. § 405 (g) to review a final decision of the Secretary of
the Department of Health & Human Services (the Secretary) terminating
plaintiff's disability insurance payments under Title II of the Social
Security Act. Before the Court are the plaintiff's Motion for Summary
Judgment or, in the alternative, for a Remand to the Secretary and the
defendant's Motion for Summary Judgment For the reasons stated herein,
plaintiff's Motion for Summary Judgment is denied, but the Motion for
Remand is granted. Defendant's Motion for Summary Judgment is denied.
Plaintiff is a 45-year-old man with three years of college education.
He was self-employed for approximately 12 years as the president of a
collection firm. In October, 1978, plaintiff was injured in an automobile
accident, suffering head injuries which required extended hospitalization
and therapy. In April, 1979, plaintiff filed an application for
disability insurance benefits and a period of disability was established
dating from the time of the accident.
In November, 1981, plaintiff was informed by the Social Security
Administration that his period of disability had ceased since evidence
showed he was able to perform substantial gainful work. Plaintiff's last
disability insurance payment was in January, 1982.
A district court's review of a decision by the Secretary in a
disability benefits case is limited to a determination of whether
substantial evidence is present in the administrative record to support
the Secretary's decision. Whitney v. Schweiker, 695 F.2d 784, 786 (7th
Cir. 1982). Substantial evidence is defined as "such relevant evidence as
a reasonable mind might accept as adequate to support a conclusion."
Richardson v. Perales, 402 U.S. 389, 401, 91 S.Ct. 1420, 1427, 28 L.Ed.2d
842 (1971). A district court cannot make its own appraisal of the
evidence. Johnson v. Weinberger, 525 F.2d 403, 406-7 (7th Cir. 1975). The
court has the ability to affirm, modify or reverse the Secretary's
decision and has the option of remanding the cause for a rehearing.
42 U.S.C. § 405 (g).
Plaintiff's general argument is that the Secretary's findings that the
plaintiff's period of disability has ceased is not supported by
substantial evidence. Plaintiff specifically focuses on his nonexertional
impairments, and contends that the ALJ did not properly evaluate both the
extent of these impairments and the testimony of plaintiff and his wife.
Plaintiff also contends that the ALJ did not provide a full and fair
hearing by failing to develop a record and determine the type of work
plaintiff is capable of performing. The Secretary contends that the ALJ's
findings are supported by objective medical evidence and refers to
psychological examinations of plaintiff conducted in July, 1980 at Mercy
Center for Health Care Services and in September, 1981 by William
McManus, a registered psychologist. The Secretary also refers to
neurological examinations of plaintiff conducted in July, 1980 by Dr.
McCoy and in March, 1982 by Dr. Baumann. Although Mr. McManus recommended
a continuation of plaintiff's disability insurance payments, the
Secretary argues that the Regulations do not warrant acceptance of this
recommendation. In addition, the Secretary argues that Dr. Baumann's
conclusion that plaintiff is disabled need not be accepted by the ALJ but
should be weighed in relation to other evidence.
The Secretary also contends that the testimony of plaintiff and his
wife is insufficient to establish existence of a disability and must be
supported by objective medical evidence. Finally, the Secretary argues
that the ALJ correctly determined that plaintiff could engage in work
based on consideration of factors such as plaintiff's age, education, and
work experience, and reference to the Regulations.
Three reasons exist which require this Court to remand the matter to
the ALJ. First, the ALJ did not explicitly state his reasons for
rejecting the conclusion of plaintiff's treating physician, Dr. Baumann.
Second, the ALJ failed to expressly consider and note the testimony of
plaintiff's wife. Third, the ALJ did not make explicit findings regarding
plaintiff's work capacity in light of his exertional and nonexertional
limitations. These three reasons for remand of the matter shall be
discussed in detail.
With respect to the first reason, the record contains results of
examinations of plaintiff performed by Doctors McCoy and Baumann, and
Mr. McManus. Both Doctor Baumann and Mr. McManus examined plaintiff and
concluded that he is disabled. An ALJ is not bound to accept the
conclusions of an examining physician but the conclusion is entitled to
explicit consideration, especially where, as here, it relates to the
issue of the severity of plaintiff's impairment. Prill v. Schwciker,
546 F. Supp. 1381, 1388-89 (N.D.Ill. 1982). The ALJ must explicitly state
and note his reasons if he rejects the physician's conclusions. Holndoner
v. Schweiker, 542 F. Supp. 739, 742 (N.D.Ill. 1982). In the instant
case, the ALJ failed to explicitly state
and note his reasons for rejecting Dr. Baumann's conclusion, even though
it was supported by Mr. McManus' opinion. Thus, this Court is required to
remand the matter to the ALJ with directions to explicitly consider and
note the effect of Dr. Baumann's conclusion.
Regarding the second reason for remand, the ALJ found plaintiff's
testimony to be nonpersuasive self-serving exaggeration. Plaintiff's
testimony covered his current activity level, the extent of his pain and
his mental capacity. Plaintiff's wife also testified regarding these
areas. The ALJ can reject subjective complaints after weighing them
against other evidence in the record and after considering the interest
and credibility of the witnesses. Prill v. Schweiker, 546 F. Supp. 1381,
1390 (N.D. Ill. 1982). However, the ALJ is required to provide a reason
for rejecting the probative evidence. Gronbeck v. Schweiker,
534 F. Supp. 642, 646 (D.So.Dakota 1982). In the instant case, the ALJ
evaluated plaintiff's testimony, and gave a reason for rejecting the
testimony. Yet, no mention is made of plaintiff's wife's testimony. The
ALJ did not comment on the credibility of plaintiff's wife or the effect
of her testimony, although his conclusion that plaintiff's nonexertional
limitations do not significantly affect his capacity for work would seem
to indicate he rejected it. The failure of the ALJ to provide an
evaluation of the wife's testimony and reasons for rejecting her
testimony require this Court to remand the matter to the ALJ with
directions to consider the testimony of plaintiff's wife and provide
reasons for rejecting her testimony.
Finally, regarding the third reason for remand, the ALJ's findings
indicate that plaintiff is unable to perform his past relevant work as
the president of a collection firm. This finding shifts the burden to the
Secretary to show that there exists some other form of gainful
substantial activity which plaintiff would be able to perform. Smith v.
Secretary of Health, Education & Welfare, 587 F.2d 857, 861 (7th Cir.
1978). To sustain this burden, the Secretary must consider plaintiff's
functional capacity as well as his age, education, work experience and
other relevant factors. This data is applied to a grid, in this case set
out in 20 C.F.R. Part 404, Subpart P, App. 2, Table No. 1, § 201.22,
which determines whether, in light of plaintiff's limitations, he would
be able to engage in any gainful activity and thus, whether plaintiff is
or is not disabled. Heckler v. Campbell, ___ U.S. ___, 103 S.Ct. 1952,
1957, 76 L.Ed.2d 66 (1983).
The conclusion reached through consultation of the grid is substantial
evidence upon which a benefits determination may be based. Id. However,
the determination suggested by the grid is not necessarily conclusive
where nonexertional limitations are relevant. The grid only takes into
account exertional limitations. Where nonexertional limitations are
involved, the ALJ must go beyond the grid and must make findings relating
to the severity of plaintiff's nonexertional limitations and the effects
of such limitations on plaintiff's residual functional capacity before
making a determination granting or denying benefits. Cummins v.
Schweiker, 670 F.2d 81, 84 (7th Cir. 1982).
In the instant case, the ALJ noted plaintiff's nonexertional
limitations but failed to make specific findings. The conclusory
statement of the ALJ that "[t]he claimant's nonexertional limitations do
not significantly affect his residual functional capacity for unskilled
sedentary work . . ." standing alone, is insufficient. Full and detailed
findings of fact are essential to the Secretary's decision and are
required. Lewin v. Schweiker, 654 F.2d 631, 634 (9th Cir. 1981). In the
instant case, nonexertional factors such as plaintiff's pain, memory and
judgment difficulties have been clearly raised as issues and such factors
must be specifically and explicitly considered to substantiate any
conclusion of the ALJ relating to the effects of such facts on his
residual capacity. Cannon v. Harris, 651 F.2d 513, 519 (7th Cir. 1981).
This is so even if the evidence relating to such factors does not support
a finding of disability.
Id. Thus, ...