Waller v. Shalala ( 1995 )

UNITED STATES COURT OF APPEALS
Filed 9/1/95
TENTH CIRCUIT
VONDEARL WALLER, )
)
Plaintiff-Appellant, )
)
v. ) No. 95-7032
) (D.C. No. CV-93-647-S)
SHIRLEY S. CHATER, Commissioner, ) (E.D. Okla.)
Social Security Administration, )
)
Defendant-Appellee. )
ORDER AND JUDGMENT *
Before SEYMOUR, Chief Judge, McKAY and HENRY, Circuit Judges.
After examining the briefs and appellate record, this panel
has determined unanimously to honor the parties’ request for a
decision on the briefs without oral argument. See Fed. R. App.
P. 34(f); 10th Cir. R. 34.1.9. The case is therefore ordered
submitted without oral argument.
Vondearl Waller appeals a district court decision affirming
the Commissioner’s 1 denial of his application for disability and
*
This order and judgment is not binding precedent, except
under the doctrines of law of the case, res judicata, and
collateral estoppel. The court generally disfavors the citation
of orders and judgments; nevertheless, an order and judgment may
be cited under the terms and conditions of the court’s General
Order filed November 29, 1993. 151 F.R.D. 470.
1
Effective March 31, 1995, the functions of the Secretary of
Health and Human Services in social security cases were
transferred to the Commissioner of Social Security. P.L. No.
103-296. Pursuant to Fed. R. App. P. 43(c), Shirley S. Chater,
Commissioner of Social Security, is substituted for Donna E.
Shalala, Secretary of health and Human Services, as the defendant
supplemental security income benefits. Mr. Waller asserts that
the conclusion that he can perform medium work and can therefore
perform his past relevant work is not supported by substantial
evidence. We reverse.
Mr. Waller is now sixty-one years old. He has a ninth grade
education, and his intellectual functioning is rated as
borderline. He worked for thirty-five years in the oil fields as
a well service operator and a pumper gauger, positions described
by the vocational expert in this case as involving medium skilled
work. Mr. Waller bases his claim for disability benefits
primarily upon a back condition that impairs his ability to walk,
sit, or lift, and causes pain in his lower back that radiates
down his legs. X-ray examination disclosed a right-sided L3-L4
disk space narrowing.
The ALJ determined that Mr. Waller retains the residual
functional capacity to perform a wide range of medium work. In
light of the vocational expert’s testimony that Mr. Waller’s past
work in oil production involved medium work, the ALJ further
concluded that Mr. Waller could perform his past relevant work.
In so doing, the ALJ rejected both Mr. Waller’s complaints of
pain and the opinion of Mr. Waller’s treating physician, Dr.
Scott Malowney. Moreover, the ALJ did not consider the x-ray
evidence disclosing Mr. Waller’s back disorder.
in this action. Although we have substituted the Commissioner
for the Secretary in the caption, in the text we continue to
refer to the Secretary because she was the appropriate party at
the time of the underlying decision.
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An ALJ’s determination will not be upheld unless it is
supported by substantial evidence. Frey v. Bowen, 816 F.2d 508,
512 (10th Cir. 1987). Evidence is not substantial if it is
overwhelmed by other evidence, particularly evidence offered by a
treating physician, or “‘if it really constitutes not evidence
but mere conclusion.’” Id. (quoting Knipe v. Heckler, 755 F.2d
141, 145 (10th Cir. 1985)). An ALJ’s decision will also be
reversed if the ALJ failed to apply the correct legal standards
as set out in the relevant regulations and case law. See Ellison
v. Sullivan, 929 F.2d 534, 536 (10th Cir. 1990).
The dispositive issue before us is whether the ALJ’s
conclusion that Mr. Waller could perform a wide range of medium
work is supported by substantial evidence. We conclude that it
is not. “Medium work involves lifting no more than 50 pounds at
a time with frequent lifting or carrying of objects weighing up
to 25 pounds.” 20 C.F.R. § 404.1567(c) (1994). 1 The series of
x-rays performed on Mr. Waller’s back shows “L2-L3 osteoarthritis
with disk bridging and the L3-L4 area shows a right-sided
probable disk space compression consistent with his symptoms.”
Rec., vol. II at 176. Dr. Malowney diagnosed “[p]robable right
L3-L4 disk herniation,” id., and recommended a CAT scan and
1
Surprisingly, the hypothetical the ALJ proffered to the
vocational expert described an individual who could lift 10
pounds frequently and up to 20 pounds occasionally. This, of
course, describes light work, not medium. 20 C.F.R. §
404.1567(b)(1994). Based on this hypothetical the vocational
expert opined that the described individual could not perform any
of the past work of Mr. Waller.
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surgery. 2
Dr. Malowney further opined that Mr. Waller was disabled on
the basis of his back impairment. Under the five-step analysis
applicable to disability benefits claims, see, e.g., Sorenson v.
Bowen, 888 F.2d 706, 710 (10th Cir. 1989), a claimant will be
found disabled at step three if his impairment meets one of the
impairments listed in 20 C.F.R. Pt. 404, Subpt. P, App. 1. Dr.
Malowney stated that Mr. Waller met the requirements under which
disability will be found on the basis of:
Other vertebrogenic disorders (e.g., herniated
nucleus puplosus, spinal stenosis) with the following
persisting for at least 3 months despite prescribed
therapy and expected to last 12 months. With both 1
and 2:
1. Pain, muscle spasm, and significant limitation
of motion in the spine; and
2. Appropriate radicular distribution of
significant motor loss with muscle weakness and sensory
and reflex loss.
Id. at § 1.05(C). The ALJ rejected Dr. Malowney’s opinion
because it was inconsistent with his initial observation that Mr.
Waller retained a “quite normal” range of back motion, without
2
Dr. Malowney stated that the problem could probably be
remedied through surgery. The surgery, for which Mr. Waller
could not pay, would apparently be available to him once he was
approved for vocational rehabilitation. Accordingly, Dr.
Malowney recommended that Mr. Waller go through vocational
rehabilitation rather than apply for disability. Counsel for Mr.
Waller states that he applied for vocational rehabilitation and
was turned down because of his age. It is undisputed that Mr.
Waller does not have the financial ability to pay for the
treatment recommended by Dr. Malowney and that Dr. Malowney was
in fact treating Mr. Waller without charge.
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assessing the impact of the subsequent x-rays.
Even if this perceived inconsistency supported the ALJ’s
rejection of Dr. Malowney’s opinion that Mr. Waller met the
requirements of section 1.05(C), it does not support the ALJ’s
complete failure to address Dr. Malowney’s unrebutted diagnosis
that Mr. Waller suffers from a herniated disk which requires
surgery and which is consistent with Mr. Waller’s complaints of
pain and other symptoms. 3
3
Dr. George LeBeau appeared at the hearing as a medical
expert. He had not treated Mr. Waller, but he was hired by the
Social Security Administration as a consulting physician to
review Mr. Waller’s records. When Mr. Waller’s attorney asked
Dr. LeBeau about Dr. Malowney’s evaluation, the following
exchange took place:
Q. And do you disagree with Dr. Maloney’s
evaluation that there is something at the L3-4?
A. I don’t -- I cannot agree or disagree. I’ve
not even seen the x-rays. All I can do is read reports
--
Q. Okay.
A. -- so I can’t agree or disagree with them. I
can just tell you what the reports say.
Q. Would it help if you had the x-rays to look
at?
A. No, ma’am, because I am an internist. I do
not do these [sic] type of work. I refer this to an
orthopedic surgeon to go ahead and have them to
evaluate it.
Q. I see. All right.
A. And I would rely on either the orthopedic
surgeon or a radiologist to read x-rays. I can just
tell you that whenever somebody has narrowed disc
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The ALJ also concluded that Mr. Waller’s pain was not severe
enough to be a nonexternal limitation in his ability to perform
medium work because his medical records indicate that he does not
take pain medications. However, it is undisputed that Mr. Waller
cannot afford to buy medicine and that the medications he did
receive were physician’s samples given to him by his doctor. As
we have noted, it is also undisputed that Mr. Waller cannot
afford surgery. It would hardly seem necessary to point out that
a claimant will not be denied disability benefits because he is
financially unable to obtain treatment. See Teter v. Heckler,
775 F.2d 1104, 1107 (10th Cir. 1985); see also Lovelace v. Bowen,
813 F.2d 55, 59 (5th Cir. 1987).
In sum, we conclude that the ALJ erred in determining that
Mr. Waller could perform a wide range of medium work. The ALJ
evaluated Mr. Waller’s complaints of pain under an improper
standard and did not adequately address his treating physician’s
opinion that Mr. Waller’s objective medical condition was
consistent with his symptoms. Moreover, the record contains no
evidence to support the ALJ’s conclusion that a claimant such as
Mr. Waller, who suffers from a herniated disk requiring surgery,
has the ability to perform work requiring him to lift fifty
pounds and frequently lift and carry twenty-five pounds.
space, the etiology is very far from determined. You
usually have to get a CAT scan. Quite often, a CAT
scan with a myelogram, to see if you’ve got a herniated
disc.
Rec., vol. II at 56-57.
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Accordingly, we reverse the ALJ’s determination that Mr.
Waller can perform medium work and can therefore perform his past
relevant work. We remand for further proceedings at step five of
the sequential analysis to determine whether Mr. Waller can do
other work. In so doing, we point out that the ALJ must consider
the impact of 20 C.F.R. § 404.1563(d)(1994), which addresses age
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as a vocational factor, and the impact of Mr. Waller’s borderline
intellectual functioning.
REVERSED AND REMANDED.
ENTERED FOR THE COURT
Stephanie K. Seymour
Chief Judge
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