substantial gainful employment. Barats v. Weinberger, 383 F. Supp. 276, 282 (E.D.Pa. 1974).
In determining whether a statutorily-recognized disability exists, there are four elements of proof to be considered: (1) the objective medical facts, which are the clinical findings of the treating and/or examining physicians divorced from their expert judgment or opinions; (2) the diagnoses and expert medical opinions of the treating and examining physicians; (3) the subjective evidence of pain and disability testified to by the claimant and corroborated by others in a position to observe him; and (4) the claimant's age, educational background and work history. Dillon v. Celebrezze, 345 F.2d 753, 755 (4th Cir. 1965).
While we do not believe that the record here is so lacking in evidentiary support of the decision made by the Administrative Law Judge as to justify its summary reversal, the Court does believe that there is a conspicuous absence of any discussion in the Administrative Law Judge's findings of what was clearly the primary basis for plaintiff's claim of disability -- namely, the pain and related problems resulting from his back condition. Not only was the focus of the hearing testimony directed at the existence of plaintiff's pain and its effect on his ability to function, but four of the five doctors
who examined plaintiff recognized his pain as real and noted resulting limitations on his ability to work. Dr. Renzi described plaintiff's prognosis as "poor" and stated that plaintiff, due to his condition, "cannot engage in substantial employment." (Tr. 99). Dr. Christedes found that plaintiff's "physical capacity to perform sedentary, light, and medium work on a sustained basis is guarded." He felt that in two years, if plaintiff continued his gout therapy and lost 40 pounds (plaintiff was 5 feet, 9 1/2 inches tall and weighed 207 pounds at the time of examination in August, 1973), he would be able to perform his former occupations as a cab driver or bartender (Tr. 103). Dr. Goodnick, while believing it worthwhile to motivate plaintiff through therapy to find some suitable employment, stated that he "would tend to believe the reality of that pain" which plaintiff described to him (Tr. 117). Dr. Freedman also recommended therapy, but reported that "the prognosis is not good" and that plaintiff's " physicial (sic) symptoms preclude his return to a strenuous job. . . ." (Tr. 120.)
Despite the large amount of evidence contained in the record concerning plaintiff's discomfort from his condition, we are unable to discern any direct finding by the Administrative Law Judge as to the effect of the subjective pain of plaintiff on his ability to work. This Court believes the pain factor is critical in determining whether there was substantial evidence to support the decision made by the Administrative Law Judge. As fact finder, he has the right to reject any testimony or contradictory medical evidence entirely, but failure to indicate rejection can lead to a conclusion that he neglected to consider it at all. Baerga v. Richardson 500 F.2d 309, 312 (3d Cir. 1974), cert. denied, 420 U.S. 931, 43 L. Ed. 2d 403, 95 S. Ct. 1133 (1975).
The Administrative Law Judge must make specific findings. They should be as comprehensive and analytical as feasible and, where appropriate, should include a statement of subordinate factual foundations on which ultimate factual conclusions are based. 500 F.2d at 312. As a reviewing court, we may not speculate about the Administrative Law Judge's opinion of the credibility of plaintiff's accounts of pain and suffering. Id. at 312; Wilson v. Weinberger, 398 F. Supp. 1071 (E.D.Pa. 1975). Explicit findings are particularly important on this point since pain, in itself, may be a disabling condition and the present record includes medical data which lends credence to plaintiff's complaints of pain. Baerga v. Richardson, supra, 500 F.2d at 312.
When, as in the case at bar, there is an inadequate foundation to decide whether the determination of the Administrative Law Judge is supported by substantial evidence, remanding the issue to the Secretary is the only proper course. On remand, all evidence pertaining to this matter, including such additional evidence as is necessary to be adduced, should be weighed, and specific findings should be made concerning the degree of effect plaintiff's pain has on his disability and the extent to which the Administrative Law Judge accepts or rejects plaintiff's claims of extreme pain. Wilson v. Weinberger, supra.
An appropriate Order will be entered.
AND NOW, TO WIT, this 3rd day of September, 1975, IT IS ORDERED that:
1. Defendant's motion for summary judgment is denied;
2. Plaintiff's motion for summary judgment is denied; and,
3. The case is hereby remanded to the Secretary of Health, Education and Welfare for further proceedings in accordance with the Opinion filed this day.
LOUIS C. BECHTLE, J.