Christine HOUSTON, Plaintiff-Appellant, v. SECRETARY OF HEALTH AND HUMAN SERVICES, Defendant-Appellee

736 F.2d 365, 1984 U.S. App. LEXIS 21540, 5 Soc. Serv. Rev. 344

• Court: Court of Appeals for the Sixth Circuit
• Decided: June 14, 1984
• Docket: 83-5325
• Status: Published

Opinions

KRUPANSKY, Circuit Judge.

Appellant Christine Houston appealed from an order of the United States District Court for the Western District of Kentucky affirming the Secretary’s decision that appellant was not entitled to disability benefits or supplemental security income under the Social Security Act as amended.

When she applied for benefits appellant was fifty-three years old and had worked from 1962 to 1979 as a hotel maid for the Commonwealth of Kentucky, Department of Parks. In her application dated March 25, 1980 appellant claimed that she was totally disabled because of muscle spasms. She was denied benefits initially by both the examiner and the reviewer. A hearing was subsequently held, and on January 16, 1981, the Administrative Law Judge (A.L.J.) found appellant to be ineligible for benefits. The Appeals Council upheld this decision initially and on remand from the district court, after the submission of additional evidence.

When supported by substantial evidence, the findings of fact of the Secretary are conclusive, and a decision denying benefits cannot be overturned. 42 U.S.C. § 405(g). Substantial evidence means more than a mere scintilla of evidence. There must be “such relevant evidence as a reasonable person 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) (citing Consolidated Edison v. N.L.R.B., 305 U.S. 197, 229, 59 S.Ct. 206, 216, 83 L.Ed. 126 (1938)); Kirk v. Secretary of Health and Human Services, 667 F.2d 524 (6th Cir.1981). Substantiality must also be based on the record “as a whole”. Allen v. Califano, 613 F.2d 139 (6th Cir.1980). This court is, therefore, charged to review the record in its entirety to determine if the finding of ineligibility was supported by substantial evidence.

To qualify for disability benefits the appellant must provide evidence of a medically determinable disability of a continuous twelve months duration which precluded her from engaging in substantial gainful activity. 42 U.S.C. § 423(d)(1)(A). Appellant was required to prove that the impairment was severe and that it significantly limited her ability to perform basic work-related tasks such as walking, standing, sitting, seeing, speaking, following directions, getting along with co-workers, etc. 20 C.F.R. §§ 404.1520, 404.1521. 20 C.F.R. § 404.1522 proscribes combining unrelated physical impairments to satisfy the twelvemonth durational mandate.

Appellant’s medical records disclosed that she had several unrelated chronic physical ailments. She had abdominal muscle spasms resulting in urinary difficulties which occasionally required catheterization and the use of muscle relaxants. She had hypertension, cardio-vascular disease, osteoarthritis, decreased visual acuity, chronic cystitis, and adjustment disorder with atypical features. She was hospitalized nine times from August 1979 through February 1982 for treatment related to these problems and for other ailments including pneumonia, peptic ulcer and hiatal hernia, from which she recovered. Her treating physician, in a brief conclusory letter, stated that she was permanently and totally disabled. Appellant argued that the diagnosis of these various conditions, her nine hospitalizations, and her doctor’s brief statement constituted sufficient proof of disability.

The diagnosis of multiple impairments in appellant’s hospital records, however, did not automatically entitle appellant to benefits, absent proof of sufficient duration and disabling effect. The medical evidence reflected that appellant’s impairments were controlled with medication and were not seriously disabling. Her physician described the hypertension as “mild”. It did not result in a severe impairment of her cardiac reserve or in any retinal, renal, cerebral, or cardiac involvement, or in any end organ damage. The osteoarthritis caused no real loss of movement. The visual decrease was not significant in acuity or field. The urinary tract infection, although recurrent was treatable, as were the muscle spasms. Moreover, a review of the final diagnoses from the various hospitalizations did not show that any of appellant’s impairments lasted for a continuous twelve months. Appellant recovered totally from several of her maladies. Hence there was no clear support for a finding of disability. See Henry v. Gardner, 381 F.2d 191, 195 (6th Cir.1967).

Appellant correctly asserted that the opinion of the treating physician should be given greater weight than that of the government’s physician. See Allen v. Califano, supra at 145. This is true, however, only if the treating physician’s opinion is based on sufficient medical data. 20 C.F.R. § 404.1529. Ultimately, the determination of disability is the prerogative of the Secretary, not the treating physician, and the brief conclusory letter from appellant’s treating physician, was not dispositive of the issue. Kirk v. Secretary of Health and Human Services, supra at 538; 20 CFR § 404.1527 (1981).

Appellant claimed that her muscle spasms alone caused disabling pain. Although pain caused by clinically proven multiple impairments can be the disabling illness, Allen v. Califano, supra at 145, (citing Beavers v. Secretary of Health, Education and Welfare, 577 F.2d 383 (6th Cir.1978) and Noe v. Weinberger, 512 F.2d 588 (6th Cir.1975)), tolerance of pain is a highly individual matter and a determination of disability based on pain by necessity depends largely on the credibility of the claimant. Since the A.L. J. had the opportunity to observe the demeanor of the appellant, his conclusions with respect to credibility “should not be discarded lightly”. Beavers v. Secretary of Health, Education and Welfare, supra at 387.

The A.L.J. noted that plaintiff did not appear preoccupied with personal discomfort and was able to get about without difficulty. The medical evidence contained no proof that appellant’s spasms were frequent or of disabling severity, and appellant took muscle relaxants to control the spasms. Based on the evidence of record, on appellant’s personal appearance and demeanor, he concluded that appellant’s muscle spasms were not of such severity, duration, or frequency as to be disabling for a continuous period of twelve months, appellant’s testimony notwithstanding.

In conclusion, the record included substantial evidence in support of the finding that appellant was not disabled under the provisions of the Social Security Act. Since the findings of the Secretary were supported by substantial evidence, deference to his decision is statutorily mandated. The decision of the district court is, therefore, affirmed.