8 Soc - Sec.rep - Ser. 133, Unempl - Ins.rep. CCH 15,655 Hector Oscar Coria v. Margaret M. Heckler, Secretary of Health and Human Services, 750 F.2d 245, 3rd Cir. (1984)
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Scribd Government Docs8 Soc - Sec.rep - Ser. 133, Unempl - Ins.rep. CCH 15,655 Hector Oscar Coria v. Margaret M. Heckler, Secretary of Health and Human Services, 750 F.2d 245, 3rd Cir. (1984)
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8 Soc.Sec.Rep.Ser. 133, Unempl.Ins.Rep. CCH 15,655
Hector Oscar CORIA, Appellant,
v.
Margaret M. HECKLER, Secretary of Health and Human
Services.
No. 84-5108.
United States Court of Appeals,
Third Circuit.
Submitted Pursuant to Third
Circuit Rule 12(6)
Oct. 30, 1984.
Decided Dec. 17, 1984.
Barry L. Frank, Joel M. Solow, Freeman & Bass, P.A., Newark, N.J., for
appellant.
W. Hunt Dumont, U.S. Atty., Vincent E. Gentile, Asst. U.S. Atty.,
Newark, N.J., for appellee.
Before GARTH and SLOVITER, Circuit Judges, and LORD, District
Judge.*
OPINION OF THE COURT
SLOVITER, Circuit Judge.
Before us is the appeal of Hector Oscar Coria from the order of the district
court granting summary judgment for the Secretary on Coria's appeal from the
decision of the Secretary that he was not entitled to disability benefits.
Coria filed an application for disability benefits on September 18, 1981,
alleging disability since January 5, 1977 due to internal, neurological,
orthopedic, and neuropsychiatric impairments. Following administrative denial
of his claim, the case was heard by an Administrative Law Judge who found
that Coria has chronic low back syndrome and anxiety, that his complaints of
pain were "exaggerated and not credible", and that he does not have a severe
impairment because he has no impairment or impairments which significantly
limit his ability to perform basic work-related functions. In making his
determination, the ALJ decided to accord "little weight" to the medical
evidence presented by appellant as it had been gathered originally for an earlier
worker's compensation hearing. Tr. at 13. The ALJ's decision was approved by
the Appeals Council.
3
Coria contends that the decision of the Secretary is not supported by substantial
evidence, and that the medical evidence he presented supports his assertions of
disabling pain and the existence of impairments that significantly limit his
ability to perform basic work-related functions.
The record shows that Coria had a history of industrial accidents. In 1974, he
was injured in an explosion at the chemical plant where he worked; in 1976, he
was injured when a broken hatch cover fell on him and injured his leg,
necessitating subsequent hospitalization. He resigned from that plant, and took
a part-time job the following year which he quit, allegedly due to pain and
discomfort.
Coria claims to have pain in his legs, back and head and to suffer from a loss of
sensation in his right leg. He has been diagnosed by various physicians as
having right sciatic neuritis, a 40% hearing loss in both ears, chronic
conjunctivitis of both eyes, chronic bronchitis, difficulty in certain movements,
chemical dermatitis, and various psychological problems.
In support of his disability claim, Coria submitted his hospital records, as well
as medical reports from numerous doctors. Among those reports were:
(1) the report of Dr. I Ahmad, a diplomate American Board of Orthopedic
Surgery who reported that his examination disclosed swollen knees, local
tenderness, paravertebral muscle guarding in the cervical spine, restricted
movements in flexion, spastic trapezius muscles, tenderness in the region of the
lumbosacral spine, restricted extension, painful lateral bending, difficulty in
squatting, and standing on the toes and heels, and back pain when straight leg
raising was performed. Dr. Ahmad diagnosed Coria as having cervical and
lumbosacral sprain and fibromyositis, and concluded he had orthopedic
disability of 25% of total.
(2) The report of Dr. Atif Z. Ghander who found a 40% hearing loss in both
ears, which he diagnosed as bilateral hearing impairment and rhinosinusitis. He
also estimated a "permanent disability of 7- 1/2% of partial total" [sic]. Tr. at
97.
9
(3) The report from the office of Warren M. Klein (signed by Dr. Saveran
Scannapiego) diagnosing chronic conjunctivitis of both eyes, and opining that
the irritants at work have resulted in a total disability of 8%.
10
(4) The report of Dr. Sidney E. Friedman finding Coria had some difficulty
getting from a supine to an erect position, and that his pulmonary function
testing was 27% of predicted normal, which he stated "points to both severe
restrictive and obstructive pulmonary disease." Dr. Friedman concluded that
Coria was suffering from chronic bronchitis which he estimated was a
disability of 35% of normal.
11
(5) The report of Dr. Robert T. Latimer, a psychiatrist, who diagnosed Coria as
having severe anxiety and depression.
12
(6) The report of Dr. Samuel L. Pollock, a psychiatrist, who performed a
neuropsychiatric examination and found neurological residuals of exposure to
noxious fumes, dust and loud noise and traumatic anxiety psychoneurosis and
right sciatic neuritis. Dr. Pollock estimated permanent neuropsychiatric
disability to be 30% of partial total.
13
Coria also submitted medical reports of other doctors. The ALJ considered and
discussed the findings of the other doctors, but as to the six medical reports
referred to above, the ALJ stated:
14
Medical
reports from Drs. Pollock, Ahmad, Ghander, Klein, Friedman and Latimer
are accorded little weight by the undersigned since they deal with the claimant's
workmen's compensation case. Such documentation is geared for a different test of
disability (Minitee v. Harris, 80-1238, December 4, 1980 510 F.Supp. 1216).
15 opinions expressed by Drs. Pollock, Friedman and Ahmad that the claimant is
The
"totally disabled" are not controlling over the Secretary who is charged with the
responsibility of making the ultimate decision under Title II of the Social Security
Act. The weight given to a physician's statement depends upon the extent it is
supported by specific and clinical findings (CFR 404.1527). Moreover, the fact that
a claimant suffers from a physical impairment does not prove that she is disabled.
Disability is present only when the functional limitations imposed by the
impairments are so severe as to prevent all substantial gainful activity.
16
Although the Secretary correctly states that the function of deciding whether or
not a person is under a disability belongs to the Secretary, the ALJ's decision
must comport with proper procedure and apply proper legal standards. In
Dobrowolsky v. Califano, 606 F.2d 403, 406-07 (3d Cir.1979), this court stated
that "[t]his Court has repeatedly emphasized that the special nature of
proceedings for disability benefits dictates extra care on the part of the agency
in developing an administrative record and in explicitly weighing all evidence."
In Cotter v. Harris, 642 F.2d 700, 704 (3d Cir.1981), we held that "[t]he ALJ
has a duty to hear and evaluate all relevant evidence in order to determine
whether an applicant is entitled to disability benefits" (emphasis added). Coria
contends that the ALJ was obliged to consider the medical reports of the six
doctors, and that the reason given by the ALJ for according "little weight" to
these reports is unpersuasive.
17
In this connection, it is important to distinguish between those portions of the
physicians' reports that represent the physician' medical findings and those
portions of the reports that represent conclusions as to the claimant's disability
for purposes of worker's compensation. The ALJ correctly noted that there are
different statutory tests for disability under worker's compensation statutes and
under the Social Security Act. For example, Social Security disability insurance
is available only where the disability could be expected either to lead to death
or last for more than twelve months, and prevents the ability to engage in any
substantial gainful activity. 42 U.S.C. Sec. 423(d)(1)(A) (1983). In contrast,
under worker's compensation even temporary and partial disability are
compensated. See, e.g., N.J.Stat.Ann. 34:15-12 (West 1984-85 Supp.).
Furthermore, Social Security disability conclusions are not geared to a
percentage of disability, as are worker's compensation disability conclusions.
Id. See generally, 3 A. Larson, The Law of Workmen's Compensation Sec.
79.52(c) (1983). Thus, we believe the ALJ could reasonably disregard so much
of the physicians' reports as set forth their conclusions as to Coria's disability
for worker's compensation purposes.
18
On the other hand, the physicians' findings, qua findings, do not necessarily
suffer from similar defects. We have frequently stated, "an ALJ is not free to set
his own expertise against that of physicians who present competent medical
evidence." Fowler v. Califano, 596 F.2d 600, 603 (3d Cir.1979) quoted in
Wallace v. Secretary HHS, 722 F.2d 1150, 1155 (3d Cir.1983); Van Horn v.
Schweiker, 717 F.2d 871, 874 (3d Cir.1983).
19
Although a worker's compensation hearing, unlike a Social Security disability
hearing, may be adversarial in nature, this should not affect the reliability of the
objective medical findings of the examining physician. There seems to be no
valid reason why a claimant such as Coria should be required to undergo a
second series of medical examinations that duplicate the series made for the
worker's compensation claim. Instead, the ALJ should evaluate the objective
medical findings set forth in the medical reports for submission with the
worker's compensation claim by the same standards that s/he uses to evaluate
medical findings in reports made in the first instance for the Social Security
claim, unless there is some reasonable basis to believe a particular report or
finding is not entitled to comparable weight.
20
Since the ALJ explicitly disregarded a substantial portion of the medical
evidence, the ALJ failed to consider "all the evidence" as is required by Cotter.
Coria asks us to review the evidence and to make the determination that he was
under a severe impairment and was incapable of engaging in his prior work
activity. We decline to interfere with the administrative process in such a
manner. Congress has delegated that determination to the Secretary. We
express no opinion on the persuasiveness of the six medical reports at issue.
That should be determined in the first instance by the ALJ.
21
For the foregoing reasons, we will remand this case to the district court with
instructions to remand to the Secretary for further proceedings consistent with
this opinion.
GARTH, Circuit Judge, concurring:
22
I share the concern of the majority when an Administrative Law Judge, in
determining whether a claimant is entitled to Social Security disability benefits,
ignores physicians' findings which may help establish that claimant's disability.
In this case the Administrative Law Judge stated that he "accorded little weight"
to the medical reports from Doctors Pollock, Ahmad, Ghander, Klein,
Friedman and Latimer.
23
In my opinion, given the nature of these reports, it was entirely appropriate for
the Administrative Law Judge to discount the reliability of the physicians'
conclusions. However, as Judge Sloviter points out, the Administrative Law
Judge under law cannot disregard medical findings which are relevant to the
claimant's condition no matter how little substance may be attributed to them in
the final analysis.
24
A number of the doctors' reports in question reveal virtually no findings of
consequence submitted on Coria's behalf. In his hearing before an
Administrative Law Judge, Coria alleged that he was totally disabled due to
internal, neurological, orthopedic, and neuropsychiatric ailments. However, two
of the medical reports that were submitted in support of Coria's claim, those of
Doctors Klein and Ghander, appear in no way relevant to Coria's alleged
medical problems.
25
Ophthalmologist Klein submitted a report (signed by Dr. Scannapiego) based
on an eye examination performed on Coria in May, 1978. In that report Coria
was diagnosed as suffering from chronic conjunctivitis and in the doctor's
opinion, Coria was 8 percent totally disabled as a result of exposure to dust,
gases and fumes at work. Dr. Klein also found that Coria's vision was 20/20,
and that his eyes were normal in every other respect. Apart from the fact that
Dr. Klein's findings bear little relation to Coria's claim for disability benefits
(which recites internal, neurological, orthopedic, and neuropsychiatric
problems), the report apparently was also inaccurate. In reviewing Coria's
medical and work-related history, Dr. Klein stated that Coria was a "59 year old
male," when, in fact, Coria was 47 years old at the time of the examination. In
addition, although the record indicates that Coria worked for two years as a
chemical operator at U.S. Pipe Foundry, Dr. Klein recounted in his report that
the job lasted for "approximately one year."
26
Coria also submitted the medical findings of Dr. Ghander, an otolaryngologist.
Dr. Ghander concluded that Coria suffered from a 40 percent hearing loss in
both ears, and diagnosed bilateral hearing impairment and rhinosinusitis. Dr.
Ghander estimated that Coria suffered permanent disability of seven and onehalf percent of partial total. However, like the report of Dr. Klein, Dr.
Ghander's findings with regard to Coria's hearing are unrelated to Coria's claim
for disability, and thus could have been properly ignored by the reviewing
Administrative Law Judge.
27
As far as the reports of the other physicians are concerned, had the
Administrative Law Judge stated in his opinion that he had read and evaluated
the doctors' findings, but recognized their lack of substance and thus placed
little weight on their reports, I doubt that we would now be remanding for
further proceedings.1 In this regard, I do not believe that we should blind
ourselves to the fact that some of the doctors who examined Coria filed reports
that bear a striking resemblance to reports which they have filed for other
examinees. This regrettable circumstance has been recognized not only by
Administrative Law Judges, see, e.g., Glover v. Heckler, No. 84-5337 (App. at
11) (Barlow, ALJ), but by at least one judge in the District of New Jersey. See
Morrison v. Schweiker, Nos. 79-1962 & 81-1526 (D.N.J. April 5, 1982)
(Debevoise, J.). It is difficult to determine how many Social Security claimants
have been the subject of medical examinations and reports of this quality and
character since every panel of judges does not sit on every social security
disability case. What is apparent to me, however, from even my limited
experience with these types of reports, is that Coria's counsel uses the same
doctors to support each of their client's claims.
28
In many instances, the doctors' reports have little relevance to the claimant's
alleged disability, and often look as if they are carbon copies of other
examinations which are unrelated to the particular claimant seeking disability
status. For example, after Dr. Pollock's neuropsychiatric examination of Coria,
he concluded that Coria suffered from "[n]eurological residuals of exposure to
noxious fumes, dust and loud noise and traumatic anxiety psychoneurosis, also
right sciatic neuritis, attributable to accident at work and attributable to
exposure at work." Dr. Pollock submitted the identical diagnosis with regard to
another disability claimant whose appeal is also before this court, but who,
unlike Coria, did not suffer an accident at work. See Glover v. Heckler, No. 845337 (App. at 111).
29
I do not say that these similarities may not be coincidental, or may not arise
from factually similar circumstances of the various claimants. Nevertheless, the
proliferation of such reports can give rise to a suspicion on the part of the court
and Administrative Law Judges that the findings (to the extent they are
findings) and conclusions reported, are entitled to little, if any, weight.
30
Accordingly, by joining in the present remand, I do not mean to convey the
impression that I am attributing weight or credence to the reports which Coria
has submitted. I join in this remand because, as the court holds, an
Administrative Law Judge must consider all the evidence and evaluate the
medical findings. In this case, the Administrative Law Judge's opinion fails to
disclose that this was done.
Hon. Joseph S. Lord, III, Chief Judge Emeritus, United States District Court for
the Eastern District of Pennsylvania, sitting by designation
I note from the evidence that Coria sees no doctor regularly, takes only aspirin
as medication, and is capable of climbing a flight of 15-18 stairs each day
