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Nathaniel H. STEWART, Plaintiff-Appellant, v. Margaret HECKLER, Secretary of Health and Human Services, Defendant-Appellee
Citations: 730 F.2d 1065; 1984 U.S. App. LEXIS 23858; 4 Soc. Serv. Rev. 309Docket: 83-5211
Court: Court of Appeals for the Sixth Circuit; April 4, 1984; Federal Appellate Court
Nathaniel H. Stewart, the plaintiff-appellant, appeals a decision from the District Court of the Eastern District of Tennessee, which affirmed the denial of his social security benefits. Stewart, now 61, claims he is unable to work as an insurance salesman due to a disability stemming from a heart attack and subsequent quadruple coronary bypass surgery in 1980. He reports ongoing issues such as high blood pressure, extreme fatigue, and severe leg pain resulting from the surgery. Dr. Charles E. Allen, Stewart's treating physician, provided a letter to the Social Security Administration stating that Stewart is totally and permanently disabled due to uncontrolled hypertension exacerbated by emotional stress related to his work. The letter details Stewart's medical history, including previous hospitalizations and ongoing treatment, which consists of multiple medications for his condition. During a hearing before an Administrative Law Judge, Stewart confirmed that his previous job required driving, which he can still do but only under limited conditions. He expressed concerns about his ability to drive safely due to his medical issues, supported by his doctor's advice against driving. The court's decision to deny benefits is based on the evaluation of Stewart's medical condition and testimony regarding his capacity to perform his previous work duties. A work history was presented for Judge Overton, indicating that the individual believes they cannot perform any past employment currently. Previously, the individual engaged in outside sales, which involved driving, long hours, and stress while selling heavy-duty construction equipment. The individual is under the care of Dr. Charles Allen, with recent appointments scheduled every 2 to 3 months, the last being on the 6th of the month, and a follow-up in March. They confirm compliance with their medication regimen. The individual underwent open-heart surgery on November 13, 1980, at Saint Thomas Hospital in Nashville, Tennessee, following two heart attacks in September and October 1980. The surgery involved a full bypass due to clogged veins and arteries, which required veins to be taken from the legs for the procedure. A medical report from Dr. Misra indicates that the individual, a 58-year-old male, is stable post-surgery, with no chest pains and controlled blood pressure (130/90). He has no signs of congestive heart failure or significant heart murmurs. However, an EKG shows abnormal results consistent with a past myocardial infarction. An attempted exercise test was halted due to fatigue, raising concerns about muscle tone or deconditioning. The individual maintains daily physical activity with a mile walk and experiences no shortness of breath on level ground, though increases in activity have led to rising blood pressure. The patient's blood pressure (B/P) increases under stress but is currently well-controlled. He has a history of depression managed with Elavil, and he presents as clean, alert, cooperative, and well-oriented. He demonstrates normal interaction and is capable of managing his finances. The patient is diagnosed with cardiovascular disease, including hypertension and arteriosclerotic heart disease (ASHD), and is noted to be receiving competent medical care, though his prognosis remains guarded. His heart rate is slightly slow, likely due to medication, and he has developed a right eye cataract, though surgery is not planned. Dr. Misra confirms the cardiovascular diagnosis but does not provide an opinion on the patient's ability to engage in substantial gainful employment. The patient receives a total disability award of $100 monthly from Veterans Administration insurance. There is no evidence that he is exaggerating his condition, and concerns regarding fraudulent examinations related to Dr. Thurman's practice result in the dismissal of his opinion. Consequently, the appeal is remanded to the District Court for an award of benefits.