The plaintiff told Dr. Solnick that he had suffered with asthma for the past three or four years. Examination of the plaintiff's lungs revealed the presence of a prolonged expiratory phase and expiratory wheezes were audible throughout all lung fields. Ventilation studies indicated the presence of moderately severe obstructive pulmonary disease. However, the chest X-ray was within normal limits and revealed no evidence of active or acute pulmonary disease. Dr. Solnick diagnosed a condition of moderately severe chronic obstructive pulmonary disease combined with asthma, allergic in origin. However, he concluded that this condition would respond to medical treatment if plaintiff stopped smoking completely and received medical therapy. Plaintiff gave a smoking history of one-half pack of cigarettes per day for 34 years.
Although plaintiff said he had a heart problem, Dr. Solnick's examination was negative as to any heart condition. There was no evidence that the plaintiff's heart was enlarged, no murmurs were audible and the rhythm was regular.
On February 15, 1977, plaintiff was examined by Dr. James P. Marvel, a board-certified specialist in orthopedic surgery. He diagnosed the condition as minimal degenerative disease of the lower lumbar spine (Tr. 179). Physical examination revealed an apparent 60 percent restriction of motion of the lumbar spine and tenderness in the lower lumbar midline. A neurological examination revealed equal deep tendon reflexes with no apparent weakness. Dr. Marvel concluded that even though plaintiff did not have good strength in extending his knees, there was no muscle atrophy or vasiculation to establish the existence of a true weakness. Plaintiff appeared to have full hip flexor strength and dorsiflexor strength of both feet and toes. Deep tendon reflexes were equal and active, straight leg raising test and sitting root test were negative bilaterally (Tr. 179).
Dr. Marvel concluded that plaintiff had the physical capacity to stand or walk for up to four hours, to sit for up to five hours, and to lift up to 10 pounds frequently (Tr. 180). He further concluded that plaintiff's symptoms were "somewhat exaggerated" given the objective findings of the clinical examination and X-ray. Dr. Marvel further concluded that plaintiff could work at a sedentary position but should be restricted from prolonged standing, repeated bending and heavy lifting (Tr. 178-180). He ruled out the need for a myelography to aid diagnosis.
Medical records from Hahnemann Hospital revealed that the plaintiff received treatments for complaints of back pain beginning in December 1973 as a result of a fall. In March 1974 the records show that the plaintiff complained of pains and numbness in his left leg. The plaintiff was diagnosed as having a lumbosacral strain. However, in April 1974, it was noted that he had no pain over the lumbosacral area and in May the strain had not become worse. In June 1974, the plaintiff experienced pain and swelling with effusion of the left knee as a result of a fall. However, X-rays showed no fracture, dislocation or abnormalities (Tr. 151). Tenderness in the paraspinal muscles was noted in December 1974 but there was full range of motion of the joints with no edema present when plaintiff was examined on April 18, 1975.
The plaintiff stated that he had had an ulcer for the past ten years and that he was on a special diet and medication. However, he admitted that he had not required medical treatment for the three previous years (Tr. 64).
In describing his daily activities, plaintiff indicates that he only leaves his house about twice a week. He spends most of his time either sitting at the window or at the table or watching television. He sometimes naps during the day since he does not sleep well at night (Tr. 76-78). He does not do any housework, cooking or shopping. His wife helps him bathe, shave and dress (Tr. 78-79). He does not drink but he continues to smoke a half pack of cigarettes each day (Tr. 79). Plaintiff indicates that he does read occasionally but has difficulty seeing. He testified that he had been prescribed eyeglasses but could not afford to buy them (Tr. 66).
A vocational expert, H. D. Friedman, testified at the administrative hearing. He characterized plaintiff's work experience as unskilled and primarily in the medium to light category since it has required gross eye-hand coordination, the ability to push, pull, lift and carry, some bending and gross eye-hand-foot coordination. He added that no specific academic requirements were necessary for any of the jobs plaintiff had previously performed (Tr. 89). Mr. Friedman opined that if plaintiff had all of the restrictions, limitations and pain alleged, given his age, education and work history, he would not be able to perform any kind of job. However, he further opined that if the plaintiff did not suffer from all of the physical impediments he claimed to have, he could perform sedentary work such as simple bench work including binding, labelling, dipping, collating and inspection. He stated that in such case plaintiff would be capable of performing tasks in the light work category such as ticket taker, laundry porter and selective light janitorial or grounds keeping work (Tr. 92). He concluded that plaintiff would not be able to perform any job if he could only sit for a half hour before having to take medication and if he would have to lie down to alleviate his pain (Tr. 94-95).
A claimant satisfies his initial burden of proving entitlement to disability benefits by having his treating physician substantiate his subjective claims. Livingston v. Califano, 614 F.2d 342, 345 (3d Cir. 1980); Rossi v. Califano, 602 F.2d 55, 57 (3d Cir. 1979). The ALJ is not bound to accept the conclusion of claimant's physician without weighing it against other relevant evidence. Urgolites v. Finch, 316 F. Supp. 1168 (W.D.Pa.1970). However, if no contradictory evidence exists, the ALJ is bound by the expert opinions of claimant's treating physician regarding the existence of the disability. Rossi v. Califano, 602 F.2d at 57-58; Eiden v. Secretary of H.E.W., 616 F.2d 63, 64 (2d Cir. 1980); McLaughlin v. Secretary of H.E.W., 612 F.2d 701, 705 (2d Cir. 1980). The Secretary then must come forward with evidence showing that given claimant's age, education, and work experience, claimant can perform specific jobs in the national economy. If no finding exists regarding alternative employment, a denial of disability benefits can be upheld only if there is medical evidence of record that claimant's impairment did not prevent him from engaging in his former employment. Rossi, supra, at 57.
Section 205(g) of the Social Security Act provides that "the findings of the Secretary as to any fact, if supported by substantial evidence, shall be conclusive...." 42 U.S.C. 405(g). Judicial review of the Secretary's factual determinations is limited solely to ascertaining whether they are supported by substantial evidence, Richardson v. Perales, 402 U.S. 389, 91 S. Ct. 1420, 28 L. Ed. 2d 842 (1971). If so, the Secretary's decision must be affirmed even though the record may also support a contrary conclusion. DeNafo v. Finch, 436 F.2d 737 (3d Cir. 1971). However, the reviewing court has a duty to make a searching investigation of the record in order to determine whether the Secretary's decision is supported by substantial evidence and whether it was made in accordance with the proper legal standards. Gold v. Secretary of Health, Education and Welfare, 463 F.2d 38, 43 (2d Cir. 1972). See also Lincovich v. Secretary of Health, Education and Welfare, 403 F. Supp. 1307 (E.D.Pa.1975). The Supreme Court has characterized substantial evidence as "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Richardson v. Perales, supra 402 U.S. at 401, 91 S. Ct. at 1427.
The definition of disability set forth in the Social Security Act provides in pertinent part:
(d)(1) The term "disability" means
(A) inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months; ...