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June 6, 1991

ARITHA PARKS, Plaintiff,
LOUIS W. SULLIVAN, M.D., Secretary of Health and Human Services, Defendant

The opinion of the court was delivered by: SHADUR


 Aritha Parks ("Parks") seeks judicial review of a final decision of Secretary of Health and Human Services Louis Sullivan ("Secretary") denying Parks' claim for social security disability insurance benefits, disabled widow's benefits and supplemental security income ("SSI") under the Social Security Act ("Act"), 42 U.S.C. ยงยง 402(d), 416(i), 423(d) and 1383. *fn1" Each party has filed a motion for summary judgment pursuant to Fed. R. Civ. P. ("Rule") 56. *fn2" For the reasons stated in this memorandum opinion and order, Parks' motion is granted and Secretary's is denied.


 Personal History

 Parks was born in Arkansas on September 14, 1933 and completed school through the eighth grade. She married and had five children, three of whom are still living. Her husband died in 1984.

 Parks worked as a packer for Solo Cups from 1962 to 1971. Then she worked as a nurse's aide in a nursing home until 1977. Next she worked briefly in 1977 and 1978 as a bakery custodian, a job in which she had to stand or walk throughout her work day and frequently had to lift or carry up to 25 pounds. Her duties included washing the bowls and pans, cleaning the table, sweeping and mopping the floors, cleaning the freezer and oven, washing the windows and taking out the garbage. Then from 1978 to 1983 she worked as a private duty nurse-companion. In 1983 she stopped working entirely and has not returned to work since.

 Parks testified that the reason she stopped working was that she became short of breath easily, had pain in her back, right side and chest and had headaches and that she continues to experience those symptoms (R. 71-73, 79-81, 118-26). Different pain medication prescribed by her doctors over the years has never given her full relief (R. 80, 84, 90, 119-20). She also testified that she can sometimes walk only a block or two before getting tired and can lift only 5 to 10 pounds with her left hand but none with her right (R. 127-29). She prepares her own meals, does dishes and dusts, but her son or sister's nurse takes her to the grocery store, does the laundry, takes out the garbage, sweeps and cleans the bathroom (R. 82-83, 135, 139, 143-44, 148). She used to sew, knit, crochet and embroider but no longer does so because of the pain in her hand (R. 82, 144). Though Parks goes to church occasionally, she seldom socializes or otherwise leaves her apartment (R. 141-43, 147).

 Medical History and Evidence

 1. Physical Impairments

 From November 1983 through at least April 1987 Parks received treatment from various clinics at Cook County Hospital, including the General Medicine Clinic, the Orthopaedic Clinic, the Back Clinic and the Neurosurgery Clinic (R. 83). Diagnoses over the years included hypertension, degenerative joint disease, right shoulder nerve impingement or rotator cuff tear and atypical chest pain. Parks refused the Back Clinic's recommendations in 1986 that she undergo surgery on her right shoulder and see a psychiatrist about a pain syndrome. Dr. Edward Castro of Cook County Hospital, who treated Parks every 2 to 4 weeks for one year, diagnosed right shoulder anterior impingement syndrome or rotator cuff tear and lower back pain syndrome and felt that Parks could lift and carry less than 5 pounds (R. 300-01). In addition, Parks was hospitalized in 1987 for chest pains and in 1987 and 1988 for left leg pain that was diagnosed both times as thrombophlebitis--on those occasions she was treated so that she improved.

 Four physicians examined Parks pursuant to the Secretary's request. Dr. Ashok Shah examined her on January 25, 1985, reaching this opinion as to Parks' physical condition (R. 277):

1) Right leg pain probably related to myalgia *fn3" or muscle spasms.
2) Low back pain related to lumbosacral sprain and muscle spasms (there were no signs of degenerative changes seen on these x-rays).
3) History of hypertension.
4) Shortness of breath -- rule out mild COPD [chronic obstructive pulmonary disease].
5) Chest pain -- rule out ischemic heart disease.

 Dr. David Daniels examined Parks on August 16, 1985 and made these determinations (R. 289):

1) The patient has low back pain with posture and habitus suggesting right nerve root involvement.
2) Hypertension, well controlled.
3) Chest pain of variable qualities, not relieved by Nitroglycerin. The etiology of which is unclear. On exertion, she has mild dyspnea *fn4" on exertion with the activity, causing her to rest, which some authorities say is more suggestive of heart disease and lung disease, however, the etiology of her dyspnea on exertion is also unclear.
4) History of tobacco abuse.

 Dr. Robert Beswick examined her on August 3, 1987 and made these notations (R. 416):

This has been chronic for the last 15 years. The patient did indeed have mild bilateral paralumbar tenderness and could only bend over within eight inches of her toes and walked slowly. She had limited exercise tolerance, although she did not require any assistive devices.
This is well-controlled on her current medical regimen.
This has been present for three years occurring on a daily basis. There are several atypical features to it and the patient had a suboptimal treadmill test due to her limited exercise tolerance. Although an echocardiogram did show concentric left ventricular hypertrophy, there is no evidence on clinical examination to support congestive heart failure.

 Finally, Dr. Irving Sherman performed a neurologic consultive examination on Parks on February 29, 1988 and summarized his views this way (R. 452):

It is my opinion that the patient does not have any objective evidence of organic neurologic disease. There is certainly a great deal of difficulty with her mobility and there are many subjective complaints. Her capacity to cooperate in examining the right side of her body was very limited. My total impression was that we were dealing much more with a functional disorder than anything else. I did not have access to the detailed studies about whether she really had arthritic changes in the right extremities that could account for the immobility. In any case I do not see a neurological problem in this situation. There can very well be some psychological problem.

 2. Mental Disorders *fn5"

 Five separate professionals evaluated Parks for mental disorders. First Parks was examined by clinical psychologist Dr. Darrell Snyder at her attorney's suggestion. Snyder concluded (R. 325-26):

It appears this woman is displaying more frequent pain with greater intensity than could be explained by physical findings. She would display a diagnosis of psychogenic pain disorder, 307.80. *fn6" She also appears to manifest a conversion disorder, 300.11. *fn7" She did appear to manifest a restricted range of motion and did ...

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