Moreover, Mrs. Smith may black out as frequently as once a week, for five or six minutes at a time. She has difficulty breathing and suffers from chest pains. She has been diagnosed as having numerous ailments, including pulmonary sarcoidosis, arthralgia of multiple joints suggestive of degenerative joint disease, and lumbar and cervical strain. Because of her potential need for emergency care, Mrs. Smith's doctors have warned her that she is not to be left alone at any time.
The Secretary's decision that Mrs. Smith could perform her past work as a housemother for a college dormitory is not supported by substantial evidence. Substantial evidence is that which a reasonable mind might accept to support a conclusion. Perales, 402 U.S. 389, 28 L. Ed. 2d 842, 91 S. Ct. 1420. Given Mrs. Smith's treating physicians' opinions that her complaints were consistent with their medical findings, and the overall effects of her ailments, it was unreasonable to conclude that Mrs. Smith was not disabled.
The opinion of the treating physician is entitled to great weight by an ALJ who is determining medical impairment under the Social Security Act. Podedworny v. Harris, 745 F.2d 210, 217 (3d Cir. 1984). Absent persuasive contradictory evidence, the validity of the claimant's symptoms can be conclusively established by the opinion of the treating physician. Greene v. Weinberger, 391 F. Supp. 632 (E.D. Pa. 1975). The ALJ said that Dr. Sbarbaro's statement in 1987 that Mrs. Smith's condition was unimproved contradicted his 1985 assessment regarding her neck pain. (Exhibits 17 and 13). In fact, however, Dr. Sbarbaro's 1987 opinion acknowledged some improvement in her neck symptoms during 1984, but noted that she still suffered chronic, intransigent pain. His 1987 report also mentioned that Mrs. Smith had undergone three hospitalizations for her pulmonary sarcoidosis, a condition the ALJ did not take into account when evaluating the treating physician's opinion.
Given Dr. Sbarbaro's opinion that Mrs. Smith's pain was consistent with his medical examination of her (Exhibit 17), and Dr. Franklin's conclusion that Mrs. Smith was disabled by her impairments, the ALJ should have accorded these opinions the greater weight they deserve. The treating physician's report and finding that the plaintiff is unable to work are entitled to greater weight than is the report of a one-time consultative examiner. Jones v. Harris, 497 F. Supp. 161 (E.D. Pa. 1980). The ALJ's disregard of the treating physicians' findings, in favor of the opinion of the consulting doctor, Dr. Mercier, (Exhibit 12) which was based solely on one examination, indicates that his determination of "not disabled" is not supported by substantial evidence.
Further, the ALJ did not consider the total effect of Mrs. Smith's numerous ailments upon her ability to function as a dormitory housemother. The cumulative effect of all impairments must be analyzed when evaluating a claim of disability. Dobrowolsky v. Califano, 606 F.2d 403 (3d Cir. 1979). While the ALJ and Appeals Council found that Mrs. Smith's inability to bend and lift would not interfere with being a housemother, they failed to consider other evidence that would limit Mrs. Smith's ability to do such work. (Tr. 19). For example, the ALJ failed to explain why Mrs. Smith's shortness of breath, inability to climb stairs or walk more than half a block, proneness to blackouts and falls, chest pains and extreme drowsiness caused by her medication would not interfere with a housemother's tasks. Had the ALJ considered Mrs. Smith's ailments as a whole, he would have had to conclude that she was unable to work, and thus, disabled.
AND NOW, this 22nd day of September, 1989, upon consideration of plaintiff's and defendant's Motions for Summary Judgment, it is hereby ORDERED that plaintiff's motion is granted, defendant's motion is denied, and summary judgment is entered in favor of plaintiff and against defendant. This case is remanded to the Secretary for computation and award of benefits.
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