George N. Wiles v. Kenneth S. Apfel, Commissioner, Social Security Administration
Docket: 98-7009
Court: Court of Appeals for the Tenth Circuit; January 14, 1999; Federal Appellate Court
Unpublished opinions may now be cited if they possess persuasive value on a material issue, provided a copy is attached or furnished to the Court and parties. George N. Wiles appeals the Tenth Circuit's affirmation of the Social Security Administration's denial of his supplemental security income claim for the period from April 1, 1990, to July 4, 1992. The appellate panel decided to review the case based on briefs alone, without oral argument. The review assesses whether the Commissioner's factual findings are backed by substantial evidence and whether the legal standards were correctly applied. The court found the Commissioner’s conclusion that Wiles could perform medium work unsupported by substantial evidence, leading to a reversal of the decision. Wiles had claimed disability due to respiratory issues, joint pain, and weakness, and his initial application was denied in November 1991. After a remand for a new hearing, an Administrative Law Judge (ALJ) determined Wiles had severe impairments but concluded he could perform medium work, which led to a finding of "not disabled" based on the Medical-Vocational Guidelines. The Appeals Council later found Wiles disabled as of July 5, 1992, but upheld the ALJ's prior ruling. The current appeal focuses on whether Wiles could perform medium work during the disputed period, primarily hinging on the consultative examining physician's report regarding his respiratory issues.
Dr. Strom's October 1, 1991 report on Mr. Wiles highlights his primary complaints: shortness of breath, low back pain, and dizziness. While records indicate a diagnosis of atypical tuberculosis, sputum cultures did not confirm tuberculosis. Examination findings included symmetrical chest expansion, decreased diaphragm movement, hyperresonance, and fine crackling rales. Dr. Strom diagnosed restrictive lung disease with fibronodular changes consistent with atypical tuberculosis but noted that the diagnosis was not definitive, and Mr. Wiles was identified as a chronic smoker. He assessed Mr. Wiles as a debilitated individual with symptoms suggestive of disseminated tuberculosis, despite negative cultures and limited supporting data. Dr. Strom recommended further lung function testing and x-rays to evaluate Mr. Wiles’ capabilities, noting that he appeared weak but had adequate muscle strength and joint function. He indicated that Mr. Wiles' ability to lift, carry, and sit was unaffected by his impairment, while his ability to stand and walk was limited by dyspnea, although he could walk at his own pace. Environmental restrictions due to dyspnea were also noted.
On the same day, pulmonary function studies were conducted, but their results were not available to Dr. Strom; however, they indicated below-predicted total vital capacity and FEV1 values, yet were interpreted as within normal limits. The ALJ observed that Mr. Wiles did not demonstrate dyspnea during the examination despite complaints of it and noted Dr. Strom's recommendation for further evaluation. Subsequent pulmonary function studies on October 10, 1991, showed some decreased function but were also classified as within normal limits.
Dr. Strom's report from October 1, 1991, indicated that the claimant, Mr. Wiles, was not limited in lifting and carrying but had walking limitations due to dyspnea, primarily based on subjective complaints. Despite previous examinations showing no shortness of breath, Dr. Strom suggested further evaluation to assess functional limitations. The case reached step five of the disability determination process, requiring the Commissioner to demonstrate that Mr. Wiles could perform work in the national economy, specifically medium work, which entails lifting fifty pounds and standing or walking for about six hours daily. The Commissioner needed to prove Mr. Wiles could perform these tasks consistently over an eight-hour workday, as established in relevant case law and Social Security regulations.
Dr. Strom's ambiguous opinion did not provide substantial evidence of Mr. Wiles' ability to perform medium work sustainably, as his primary complaint of shortness of breath on exertion suggested he could not maintain such work. Although Dr. Strom noted Mr. Wiles was not significantly dyspneic at rest, he did not evaluate him post-exercise and expressed uncertainty about Mr. Wiles' functional limitations. Dr. Strom's assessment indicated limitations due to dyspnea, and his statement about Mr. Wiles walking at his own pace did not support a conclusion of unrestricted ability to walk. The ALJ dismissed this statement, attributing it to Mr. Wiles' subjective complaints, but this did not confirm an unrestricted walking ability. Furthermore, concerns regarding Mr. Wiles' dyspnea were not alleviated by pulmonary function studies, which were performed at rest and showed results below predicted values without physician review or interpretation, leaving doubts about their implications on exertion.
The Commissioner determined that Mr. Wiles could perform medium work based on his testimony of part-time cattle feeding for four hours daily during winters. However, this intermittent work does not demonstrate his ability to sustain full-time medium work (eight hours a day, five days a week), nor does it address concerns raised by Dr. Strom. As a result, the Commissioner did not meet the burden of proof required to establish that Mr. Wiles could perform a full range of medium work. The lengthy duration of this case (over eight years) supports a finding of disability at step five. Upon reversing the Commissioner's decision, the court has the discretion to remand for further proceedings or to award benefits immediately. Given the circumstances, including the Commissioner’s failure to prove disability and the delays in the proceedings, an immediate award of benefits is deemed appropriate.
The judgment of the district court is reversed, and the case is remanded with directions for the Commissioner to award benefits. The court notes that while this order is not binding precedent, it may be cited under specific conditions. Mr. Wiles, due to his advanced age, limited education, and history of unskilled work, would be presumed disabled if he could only perform light or sedentary work. Mr. Wiles’ height and weight (six feet five inches, 143 pounds) indicate weight loss linked to his tuberculosis. A computer-generated report suggested potential medical significance but lacked confirmation from a physician. Mr. Wiles did not contest the ability to meet lifting and carrying requirements for medium work, but Dr. Strom identified environmental restrictions that undermine reliance on the grids. The Appeals Council dismissed these restrictions based on Mr. Wiles’ smoking and part-time work, yet no medical evidence supports this conclusion. Furthermore, Mr. Wiles argued against the Commissioner’s rejection of his treating physician's opinion regarding total disability due to shortness of breath and lack of tuberculosis medication. While the opinion lacks clinical support, it is not necessarily inconsistent with Dr. Strom’s report. The court finds the Commissioner’s decision unsupported by substantial evidence, making further evaluation of the treating physician rule unnecessary.
