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May 2, 1986

NANNIE B. HOWARD, Plaintiff,
OTIS R. BOWEN, Defendant

The opinion of the court was delivered by: PARKER

 Barrington D. Parker, Senior District Judge:

 Plaintiff Nannie B. Howard brings this action under 42 U.S.C. § 1383(c)(3) (1982), challenging the Secretary of Health and Human Services' final decision to deny her application for Supplementary Security Income ("SSI") benefits. She claims in a motion for a judgment of reversal that the Secretary's determination is not supported by substantial evidence and must therefore be overturned. The Secretary, moving for a judgment of affirmance, argues that his decision is adequately supported by the record. Having reviewed the administrative record *fn1" and the pleadings in support of the parties' cross-motions, the Court determines that the plaintiff's motion should be granted. Accordingly, an order will be entered directing the Secretary to award plaintiff SSI benefits retroactive to the date of her application.


 Plaintiff is a 56 year old woman, born in Burryville, Virginia. She has a seventh grade education and no vocational training. Her employment history consists entirely of cleaning and domestic jobs beginning when she was eight years old. She last worked in August 1983.

 Since 1979, plaintiff has been troubled by chest pains. See A.R. at 88. The pain was severe enough to require hospitalization twice in late 1981 and again in August 1983 and January 1984. A.R. at 88, 90, 111, 142. She has been diagnosed at different times as possibly suffering from ischemia, A.R. at 100, 199, coronary artery spasm, A.R. at 197, 205, or bilary gastritis, A.R. at 200. A variety of tests and examinations have not revealed with certainty the source of plaintiff's pain nor suggested treatment that gives her more than temporary relief.

 For approximately eight months ending in May 1981, plaintiff worked as a housekeeper at the Embassy Square Hotel in Washington, D.C. A.R. at 40-41, 213. Her next job was with D.C. Home Care Services and involved personal care and housekeeping for a senior citizen. This employment lasted approximately three months until chest pains forced her first hospitalization in November 1981. A.R. at 40, 88. In late July or early August 1983, plaintiff began work again, this time as an office cleaner. She worked for only two weeks before her chest pain while on the job became so severe that she went home and early the next morning was again hospitalized. A.R. 38-39, 111. Neither of her last two employers would rehire her after her hospitalizations. A.R. at 39, 40.

 On January 27, 1984, after yet another hospital stay, plaintiff filed an application for SSI disability benefits with the Social Security Administration ("Administration"). Her application was denied by a hearing examiner on March 13, 1984, and a request for reconsideration was denied on July 9, 1984. A hearing was held before an Administrative Law Judge ("ALJ") on October 25, 1984. In a decision issued on April 25, 1985, the ALJ, like the hearing examiner, determined that plaintiff was able to return to her previous occupation and denied her claim. The decision was affirmed by the Social Security Administration Appeals Council on August 18, 1985. This action was filed on October 11, 1985.



 42 U.S.C. § 1383(c)(3) allows for judicial review of a final agency decision on SSI benefits under the same standard as is provided in 42 U.S.C. § 405(g) for determinations of eligibility for standard social security insurance benefits. That is, "the findings of the Secretary as to any fact, if supported by substantial evidence, shall be conclusive." 42 U.S.C. § 405(g). The Court must thus decide if the Secretary's decision to deny plaintiff's application is supported by substantial evidence. Substantial evidence means "'such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.'" Richardson v. Perales, 402 U.S. 389, 401, 91 S. Ct. 1420, 28 L. Ed. 2d 842 (1971) (quoting Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229, 83 L. Ed. 126, 59 S. Ct. 206 (1938)). It is "more than a mere scintilla of evidence but may be less than a preponderance." Laws v. Celebrezze, 368 F.2d 640, 642 (4th Cir. 1966). The standard of review is therefore deferential to the Secretary, but the Court "is duty bound to give careful scrutiny to the entire record to assure that there is a sound foundation for the Secretary's findings and that his decision is rational." Hurst v. Mathews, 426 F. Supp. 245, 247 (E.D. Va. 1976). If the reasons supporting the Secretary's determination, as presented in the ALJ's written decision, are inadequate, and if that determination is otherwise unsupported by substantial evidence, it must be reversed. See Rossi v. Califano, 602 F.2d 55, 58-59 (3d Cir. 1979).


 To be considered "disabled" and therefore eligible for SSI benefits under 42 U.S.C. § 1382, a claimant must show that he suffers from a "medically determinable physical or mental impairment . . . of such severity that he is not only unable to do his previous work but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy." 42 U.S.C. § 1382c (a)(3)(A), (B). In the April 26, 1985 decision denying benefits, the ALJ found that

the medical evidence establishes that claimant has severe chest pain of an unknown etiology, but that she does not have any impairment or combination of impairments listed in, or medically ...

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