Appeal from the United States District Court for the Northern District of Illinois, Eastern Division. No. 81-C-2652 -- John A. Nordberg, Judge.
Wood, Posner, and Flaum, Circuit Judges.
This appeal is from a district court judgment upholding the Secretary's denial of Social Security disability benefits. For the reasons discussed below, we reverse and remand the case for a new determination.
The claimant, Irene Garfield, is a 58-year-old woman with an eighth grade education. She worked in the past as a cook, worker in a gum factory, and bus driver.*fn1 She has not worked since May of 1978, when she was hospitalized complaining of dizziness, numbness, and chest pains. Since that time she has been hospitalized again and has had surgery to remove a cataract from her eye. She applied for Social Security disability benefits in October 1979 and, following an initial denial, obtained a hearing before an Administrative Law Judge (ALJ) on July 29, 1980. She was represented by counsel at the hearing.
The ALJ did not find that the medical evidence or her testimony, which he determined to be "exaggerated," established the presence of her claimed disabilities of hypertension, heart disease, arthritis, headaches, and recurrent bladder infections. He did however find that she suffered from the following significant impairments: "aphaic left eye correctable to 20/40" and "incipient cataract right eye." He further found that the visual impairment "does not significantly affect ability to perform work-related functions except for work involving binocular vision." Concluding that two of her former jobs as cook and gum factory worker did not require binocular vision and that she could still perform those jobs, the ALJ determined that she was not disabled; this determination was reached on the fourth step of the regulatory test for disability.*fn2
After review of the record and a supplemental medical report, the Appeals Council adopted the decision of the ALJ, making it the final determination of the Secretary. The claimant then brought suit in district court. The district court granted summary judgment for the Secretary. The court held that the findings of the ALJ were supported by substantial evidence and that the ALJ could properly discount claimant's subjective testimony and the report of her treating physician because neither were supported by objective medical evidence. Plaintiff appeals from that decision.
The question before us is whether the record as a whole contains substantial evidence to support the Secretary's findings. Whitney v. Schweiker, 695 F.2d 784, 786 (7th Cir. 1982); 42 U.S.C. § 405(g) (1976 & Supp. 1981). Substantial evidence is evidence that "a reasonable mind might accept as adequate to support [the] conclusion." Richardson v. Perales, 402 U.S. 389, 401, 28 L. Ed. 2d 842, 91 S. Ct. 1420 (1971). If the record contains such support, we must affirm, 42 U.S.C. § 405(g) (1976 & Supp. 1981), unless there has been an error of law. Schmoll v. Harris, 636 F.2d 1146, 1150 (7th Cir. 1980).
Looking only at the finding related to claimant's vision, we will first evaluate the ALJ's conclusion that she is limited only in tasks requiring binocular vision. The ALJ indicated that he relied on a December 4, 1979, report from Dr. Sol R. Kaufman.*fn3 That report, he stated, "indicates that she has 20/30 vision in her right eye and that her left eye, from which the cataract was removed, is correctable to 20/40." The ALJ also noted the doctor's expectation of "good visual acuity after correction is complete." Although not mentioned by the ALJ, this report also states that the claimant had "no apparent [visual] field loss." There was no further discussion of claimant's vision problems in the ALJ's decision except the specific finding outlined above.
The record, however, contains two subsequent reports by Dr. Kaufman which indicate more severe visual difficulties. A report, dated June 16, 1980, was written "to certify changes in Miss Irene Garfield's opthalmological condition which should be differentiated from [the earlier report]." Dr. Kaufman noted that "it was expected that she would have good visual acuity following her o.s. cataract extraction." However, shortly after the surgery, the doctor found that "Miss Garfield suffered from glaucoma which rapidly deteriorated her peripheral fields." The doctor provided specific readings indicating enlargement of the blind spot and constriction of the visual fields.*fn4 He concluded that "the patient has a marked, visual field loss secondary to glaucoma."
Dr. Kaufman's third report, dated December 2, 1980, was added to the record when it was reviewed by the Appeals Council. This report states that the claimant had severe glaucoma bilaterally, aphakia of the left eye, and cataract in the right eye. The doctor reported visual field indexes which showed central constricted tunnel vision.*fn5 He also noted "characteristic glaucomatous field producing tunnel vision with no usable peripheral vision." Dr. Kaufman concluded that although the claimant did "not quite" meet the standard for legal blindness, she was "severely impaired by [her] loss of peripheral vision [and] somewhat decreased central visual acuity."
As noted, the ALJ relied on the first report but made no reference to the second one, although the second report explicitly rejected the prognosis contained in the first. Presented with the third report, the Appeals Council stated only that "this report as well as the other evidence of record fails to show that this impairment is so ...