It was serious error to compare his report on equal footing with that of Plaintiff's long-time treating physician.
IV. THE ALJ'S CONCLUSION THAT PLAINTIFF'S DIABETES, HYPERTENSION, AND ALCOHOLISM WERE EITHER NON-EXISTENT, MILD, OR WELL CONTROLLED, WAS NOT BASED UPON SUBSTANTIAL EVIDENCE
It is well settled that if the Secretary's decision regarding Plaintiff's disability is supported by substantial evidence, it must be affirmed by this Court. 42 U.S.C. § 405(g). Richardson v. Perales, 402 U.S. 389, 28 L. Ed. 2d 842, 91 S. Ct. 1420 (1971). "Substantial evidence" is "such relevant evidence as a reasonable mind might accept to support a conclusion." Id. at 401 (quoting Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229, 83 L. Ed. 126, 59 S. Ct. 206 (1938)).
Doctors' reports and hospital records show that Mr. Fulwood's diabetes is not well controlled. (See, e.g., R. 213, 220, 270, 285, 348, 320). Numerous abnormal glucose readings appear in laboratory reports of Plaintiff's blood test results. (See, e.g., R. 224, 238, 239, 276, 307, 322, 323, 346, 347). Indeed, Plaintiff was noted to have experienced hypoglycemic reactions requiring an adjustment of insulin in November, 1982. (R. 344).
Dr. R. Sion, a public health doctor to whom the Plaintiff was referred when he could no longer afford the private services of Dr. Chase (R. 62, 80), has treated Plaintiff for diabetes, and on March 8, 1983, Dr. Sion diagnosed this condition as "uncontrolled" (R. 320). Although the ALJ cited a 1981 consultative report by Dr. Jerome Putnam in which Dr. Putnam stated that Plaintiff's diabetes was well controlled (R. 36), this report must be outweighed by that of Dr. Sion which was made at a much later date and by a doctor who was, again, a long-time personal treating physician. Perez, supra, Gold, supra.
With respect to Plaintiff's hypertension, hospital records and reports show that it too is uncontrolled. (R. 258, 264). Even Dr. Putnam -- the consultative doctor who examined Plaintiff at the behest of the Social Security Administration and whose report the ALJ cited (R. 36) -- stated that Plaintiff's hypertension is under "poor control." (R. 36).
Furthermore, it appears that the ALJ dismissed the possibility that Mr. Fulwood was disabled by reason of alcoholism. This conclusion appears to rest solely upon the basis that Mr. Fulwood underwent a detoxification program in 1979 (R. 353) and upon Plaintiff's testimony that he had quit drinking in 1980 (R. 36, 37) and is now a member of Alcoholics Anonymous (R. 61). In McShea v. Schweiker, 700 F.2d 117 (3d Cir. 1983), however, where the claimant had also denied his alcoholism, the Court held that the ALJ erred in not going beyond the claimant's own testimony, stating that denial is a common phenomenon of the disease. Id. at 119. Similarly, in Ferguson v. Schweiker, 641 F.2d 243 (5th Cir. 1981), the Court held that the ALJ erred in finding that the claimant had the voluntary ability to control the use of alcohol where the only evidence was that the claimant had once undergone detoxification and had testified that he only drank "once in a while" and had quit once. Id. at 249. As in McShea and Ferguson, the ALJ here should have, but did not, look beyond Plaintiff's testimony.
The record in this case is replete with evidence tending to show that Plaintiff suffers from chronic alcoholism. Mr. Fulwood suffers from such indicative symptoms as cirrhosis of the liver (R. 182, 284, 285, 314, 329), chronic renal failure (R. 224-244, 266, 276, 314, 322-323, 347), liver and kidney dysfunction (R. 186, 198, 199, 201, 202, 204, 211, 216, 217, 224-244, 256, 266, 268, 270, 271, 276, 314, 319, 321, 322-323, 343, 347, 348), alcoholic anemia (R. 184, 185, 213, 271, 332), and alcoholic hepatitis (R. 184, 185, 201, 202, 314). Along these lines it is important to note that Plaintiff's most recent emergency room treatment for alcohol abuse was only ten days prior to the ALJ's hearing (R. 348). It is well settled that a claimant's inability to voluntarily control the use of alcohol is a disabling disease within the meaning of the Act. McShea, supra, at 118-19, Ferguson, supra, at 248, Griffis v. Weinberger, 509 F.2d 837, 838 (9th Cir. 1975).
Once evidence of the claimant's alcoholism has been introduced, the ALJ has an affirmative duty to order further inquiry or a consultative examination. Hicks v. Califano, 600 F.2d 1048, 1051 (4th Cir. 1979), McShea, supra, at 119. Furthermore, the ALJ is obliged to reconcile relevant probative evidence that conflicts with his conclusions. Milazzo v. Schweiker, 528 F. Supp. 1099, 1102 (E.D. Penn. 1981). In the instant case, the ALJ simply failed to carry out either of these duties.
V. THE ALJ VIOLATED HIS DUTY TO CONSIDER ALL OF PLAINTIFF'S IMPAIRMENTS OF WHICH HE BECAME AWARE
The ALJ has an affirmative duty to explore all of Plaintiff's impairments of which he becomes aware. Narrol v. Heckler, 727 F.2d 1303, 1306 (D.C. Cir. 1984). As noted above, only Dr. Chase rendered an opinion which was based on a combination of all of Plaintiff's ailments. Nevertheless, the ALJ appears to have discounted Dr. Chase's report. In addition, it appears that the ALJ impermissibly discounted the evidence of Plaintiff's alcoholism. Finally, the ALJ did not even implicitly, let alone explicitly, note Plaintiff's psychological ailments in his decision. Such psychological impairments were clearly laid out in the medical report of Dr. Behrman, which is part of the record now on review (R. 352, 317-318). Under relevant law, the ALJ must consider both physical and psychological impairments in determining a claimant's eligibility for disability benefits. See, e.g., Poe v. Harris, 644 F.2d 721, 723 (8th Cir. 1981). It is clear that in this case, the ALJ failed to properly consider and explore that which the law required him to.
VI. PLAINTIFF WAS DENIED A FAIR HEARING IN THAT THE ALJ INTERFERED WITH PLAINTIFF'S PRESENTATION OF HIS CASE IN A PARTISAN MANNER
A review of the transcript of the hearing before the ALJ in this case, reveals that the ALJ questioned Plaintiff in a brusque, bullying manner, answered questions for him when the answer did not come quickly enough, drew conclusions unwarranted by Plaintiff's actual answers, and interrupted questions put by Plaintiff's attorney. (See, e.g., R. 55, 64, 65, 66, 72, 78, 81-82, 87, 88). The following colloquys are indicative of the hearing as a whole:
RE-EXAMINATION BY ATTORNEY:
Q Mr. Fulwood, just a couple --
ALJ: Do you have some questions?
ATTORNEY: I just want a couple of clarifying questions.
ALJ: Okay. I don't want any repetition, and I don't want any argumentation type questions.
Q Mr. Fulwood, I would just like to clarify one point. You said you'd been as a -- deacon, you had visited the hospital once in the past year?
A I would say so.
Q Okay. I just wanted to -- to --
RE-EXAMINATION BY ALJ:
Q Well, while you're on that, once or more than once? Of course, you, if you're going to visit them at all, it would be at least one time.
A Well, I say at least once.
Q At least once?
Q It could have been more than once?
A It could have been.
Q It could have been several times.
A Well, that -- that -- you know, it --
ALJ: All right. That's an inconsequential point, I really think.
ATTORNEY: Okay. I --
ALJ: He gets around. Let's go. He has gotten around. Let's put it that way.
ATTORNEY: I don't have any --
ALJ: To church.
ATTORNEY: -- Further questions of him at this point.
ALJ: You don't have any, right?
ALJ: Very good. (R. 87, 88)
Q So you say you're without funds. Are you borrowing money from your friends?
A Yes, I am.
Q So you must visit your friends then, if you're going to borrow money from them. You certainly would want to go around and say, "Hello," to them from time to time.
A Oh, I certainly would.
Q I asked you if you did that, and you indicated you only saw them at church.
A I was only referring to the church people. I'm not talking --
Q I said friends.
A -- about relatives.
Q I said friends and relatives. All right. I'll put relatives into the question. You do visit friends and relatives then?
A Well, mostly relatives, yes.
Q Uh-huh. How do you get to seem them? Travel.
A Well, they come to see me, the same ones --
Q Do you - Do you ever go to see them?
A When I feel like it, when I'm up to it.
Q And how do you get there?
A (No response).
Q Bus? Walk?
A No, I have a car.
Q Oh, you have an --
A But I don't --
Q -- automobile?
A -- drive it most of the time.
Q Oh, I don't know whether I --
A No one's asked that question.
Q I see. I asked it now. You have a car. What kind is it?
A It's a 1973 Thunderbird.
A Yes. (R. 81, 82)
Initially the Court notes that the ALJ's mischaracterization of Plaintiff's testimony by skewing Plaintiff's answers in an unfavorable light makes the ALJ's findings questionable. Brown v. Secretary of HEW, Unemp. Ins. Reptr. (C.C.H.) para. 17,336 (E.D. Mich. 1980). The tenor of the ALJ's questions are clearly shown to be not that of a neutral fact-finder but one of an advocate with a predetermined mind destined to reach a predetermined result.
The ALJ's role in a disability benefits hearing is analogous to that of a trial judge, for whom it is clearly improper to interfere with the questioning of a witness, particularly when it is done in a partisan manner. See, Gomila v. United States, 146 F.2d 372, 374-75 (5th Cir. 1944); See also United States v. Hickman, 592 F.2d 931, 934 (6th Cir. 1979); United States v. D'Anna, 450 F.2d 1201, 1206 (2d Cir. 1971); Bursten v. United States, 395 F.2d 976, 983 (5th Cir. 1968). Such conduct constitutes a denial of a party's procedural due process right to a fair and impartial hearing, which is required in administrative proceedings under the Social Security Act. Richardson v. Peralis, 402 U.S. 389, 400, 91 S. Ct. 1420, 28 L. Ed. 2d 842 (1971). The Court concludes that the ALJ in this case, by constantly interrupting Plaintiff and his counsel, not permitting Plaintiff to present his case, and questioning Plaintiff in a partisan manner, transgressed the bounds of judicial propriety.
The Court is mindful that in reviewing the decision of the Secretary, its role is limited. The Court may not "decide the facts anew, reweigh the evidence, or substitute its judgment for that of the Secretary," Bloodsworth v. Heckler, 703 F.2d 1233, 1239 (11th. Cir. 1983), and the Court has not done so here. A close examination of the record in this case clearly shows that Plaintiff suffers from a number of ailments which, in combination, have rendered him disabled within the meaning of the Social Security Act. There is no other reasonable conclusion. Not only did the ALJ in this case fail to base his findings upon substantial evidence, but he also committed plain error in the application of several well-settled principles of law. For the foregoing reasons, this Court reverses the Secretary's decision. Judgment shall be entered in favor of the Plaintiff, granting Plaintiff retroactive Social Security Disability Insurance and Supplemental Security Income Benefits dating from May 10, 1982, the day on which Plaintiff's second application for disability benefits was filed. Accordingly, this case is remanded to the Defendant for a determination of the amount of benefits due, retroactive to May 10, 1982, and consistent with the judgment above. Meanwhile, the case will stand dismissed from the dockets of this Court.
[EDITOR'S NOTE: The following court-provided text does not appear at this cite in 594 F. Supp.]
For the reasons set forth in the Opinion of this Court of even date herewith, it is by the Court this 27th day of September, 1984,
ORDERED that the plaintiff is entitled to retroactive Social Security Disability Insurance and Supplemental Security Income Benefits dated from May 10, 1982, the day on which plaintiff's second application for disability benefits was filed; and it is
FURTHER ORDERED that this case is therefore remanded to the Defendant for a determination in accordance with this Court's Opinion of the amount of benefits due to the plaintiff; and it is
FURTHER ORDERED that this case shall stand dismissed from the dockets of this Court.
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