testimony. The Secretary's finding regarding the medical evidence for Moyer's disability was not supported by substantial evidence.
B. Evidence of Moyer's Pain
A claimant's testimony as to subjective pain is entitled to great weight, particularly where such testimony is supported by competent medical evidence. Boyd v. Bowen, 710 F. Supp. 1046, 1047 (E.D.Pa. 1989) (Katz, J.) (citing Dobrowolsky v. Califano, 606 F.2d 403, 409 (3d Cir. 1979). The ALJ cannot decide that pain does not constitute a disability when no medical evidence refutes other evidence indicating that the pain is real. See Smith v. Califano, 637 F.2d 968, 972 (3d Cir. 1981). An ALJ must have corroborating medical testimony to draw an inference of lack of pain. Id. The ALJ should give serious consideration to subjective complaints of pain, even though such complaints are not fully confirmed by objective evidence. Id.
Even though Moyer's complaints are fully confirmed by x-rays, a CAT scan, physical examination and repeated surgery, no such serious consideration was given in this case. See Record at 394, 147-49, 173-86, 242, 187-97. Moyer has clinical and laboratory data which reveal painful low back and right hand conditions. Id. Every doctor who examined Moyer noted he was in pain, including Dr. Toland who was consulted by the Administration. Id. at 187-91. Furthermore, Moyer has made attempts to resolve his chronic pain problem in his right hand and wrist, including multiple surgeries. The only condition for which he has not had surgery was his back, and Moyer testified that he has declined that surgery because he was given information of only a 30 percent success rate, with a high rate of complications possible. Id. at 35.
The use of pain medicine is significant in determining credibility. Moyer testified and his various medical records document his continual use of xylocaine injections, Flexeril and Motrin in its various forms to help relieve his pain.
During Moyer's hearing, there was no medical evidence presented refuting either Moyer's pain or his medical condition. The ALJ, however, dismissed Moyer's complaints as not credible in finding that "the claimant's testimony with regard to . . . pain is credible to the extent that he retains the functional capacity to perform sedentary to light work activity." See Record at 16, Finding 6. Moyer's complaints cannot be discredited or limited in this way without evidence of record to support a determination that the claimant is not credible. No such evidence exists in this record. Therefore, the finding that Moyer's complaints of pain were not credible are not based on substantial evidence.
C. Capacity to Perform Light or Sedentary Work
The ALJ found that Moyer had the capacity to perform light or sedentary work. Sedentary work requires lifting no more than 10 pounds at a time and occasionally lifting or carrying articles; it involves primarily sitting along with a certain amount of walking or standing. 20 C.F.R. § 404.1567(a). Light work requires the ability to perform sedentary work, along with the ability to lift no more than 20 pounds at a time with frequent lifting or carrying of objects weighing up to ten pounds; it also requires a good deal of walking or standing. 20 C.F.R. § 404.1567(b). This finding that Moyer is capable of such work is not based on substantial evidence upon examination of the record and the relevant legal standards.
Moyer has a long and continuous history of work dating back to high school, in addition to a history of returning to work after injury during an explosion in 1984. Record 95, 98. On this basis the ALJ should have given Moyer's testimony greater deference. See Taybron v. Harris, 667 F.2d 412, 415 (3d Cir. 1981) ("When the claimant has worked for a long period of time, his testimony about his work capabilities should be afforded substantial credibility."). Furthermore, in evaluating disability, a claimant's illnesses must be considered in combination and must not be fragmented. Beecher v. Heckler, 756 F.2d 693 (9th Cir. 1985); Smith, 720 F. Supp. at 64. The ALJ must analyze the cumulative or synergistic effect of all impairments in combination. There is no evidence in this record that either the ALJ or the vocational expert considered the combined effect of Moyer's conditions.
Moyer suffers severe pain on a daily basis from the injury to his right hand as well as his back problems. While it is true that Moyer may be able to use his right hand in a helping manner on an occasional basis, there is no evidence that he would be able to do this on a consistent basis. See Record at 191 (Dr. Toland states that he does not envision Moyer being able to use his right arm for any gainful occupation). In this case, it is the combination of injuries sustained by Moyer that makes substantial gainful activity impossible on a consistent basis.
From the vocational testimony presented, it is unclear how Moyer could be expected to do work listed by the vocational expert (such as a coding clerk, dispatcher of maintenance, compiler, telephone solicitor, inspector of components or work order clerk), when as Moyer testified, his right hand is useless, anything written with his left hand is illegible and he cannot sit, stand or walk for 8 hours at a stretch due to his back condition. See also Record at 187-97 (Dr. Toland finds that Moyer can stand or walk less than two hours a day and sit less than six hours, which would amount to less than an eight-hour work day).
Furthermore, Moyer cannot be expected to be a tool-crib attendant when he cannot write legibly with his left hand and he cannot lift the tools to hand them to the workmen as required. While it is true that the vocational expert stated it might be possible to modify the job to allow the workmen into the crib to retrieve the tools, the vocational expert was not able to say how many, if any, positions so-modified existed in the national or local economy. The decision that Moyer could find such a Position so modified was based on just speculation and not substantial evidence, therefore, this job cannot be found to be available to Moyer.
On cross-examination, the vocational expert further conceded that the job as a sales clerk was similarly not available to Moyer if he could not stand for an entire shift, as documented by Dr. Toland's findings. See Record at 54.
In this case, there is no evidence that Moyer is capable of performing any of these activities on a sustained basis. No doctor, treating or consulting, found Moyer capable of lifting more than ten pounds; Moyer himself testified that lifting with his right hand is impossible and in addition it hurts his lower back. No doctor found Moyer capable of standing or sitting for a substantial period of time. Dr. Toland, the Administration's doctor, found Moyer restricted in his ability to stand or walk to only two hours a day and found he could sit less than six hours a day. None of these restrictions place Moyer in the category of being able to perform sedentary or light work. The ALJ's findings are not based upon substantial evidence in the record.
The ALJ's decision is not supported by the evidence of record nor by substantial evidence. The ALJ's finding that Moyer's complaints of pain are not credible is contrary to the medical reports of the treating physicians and no medical testimony was presented refuting these opinions. The ALJ failed to properly credit and consider Moyer's complaints, either individually or in concert, in concluding that Moyer had the ability to perform light or sedentary work. Given the fact that the ALJ's decision that Moyer retained the capacity to perform light or sedentary work is not supported by substantial evidence, this court finds that Moyer is disabled for purposes of collecting disability insurance benefits.
For the foregoing reasons, the decision of the Secretary is reversed and this case is remanded to the Secretary for the calculation and award of benefits.
BY THE COURT:
MARVIN KATZ, J.
AND NOW, this 29th day of July, 1993, upon consideration of Plaintiff's Motion for Summary Judgment and the Defendant's Motion for Summary Judgment, it is hereby ORDERED that JUDGMENT is entered on behalf of the plaintiff and against the Defendant. The Secretary's decision is REVERSED. The matter is REMANDED to the Secretary for the calculation and payment of benefits. Summary judgment is entered in favor of the Plaintiff for the reasons stated in this court's order of the same date.
BY THE COURT:
MARVIN KATZ, J.