Garnet Morse v. Donna E. Shalala, 1 Secretary of Health and Human Services of the United States

MAGILL, Circuit Judge,

dissenting.

I dissent. The majority has reversed the district court based upon a physician’s legal opinion and, in the process, mischaracterizes the use of medical-opinion evidence. Basing its reversal largely on the conclusory statement of a physician, the majority also exceeds its permissible scope of review in finding that the hypothetical posed to the vocational expert was unsupported by substantial evidence in the record.

I. Medical-Opinion Evidence

The majority misconstrues both the proper scope and the proper application of medical-opinion evidence. Medical opinions are relevant evidence to a determination of a claimant’s impairments; medical opinions are not conclusive evidence of whether a claimant can perform substantial gainful work. Nelson v. Sullivan, 946 F.2d 1314, 1316-17 (8th Cir.1991). The majority’s assertion regarding Dr. Davis’s statement, ante, at 871 (“the Secretary presented no evidence that contradicts Dr. Davis’s opinion regarding the claimant’s disability”), incorrectly frames the disability analysis. An ALJ need not contradict a treating physician’s statement to find a claimant to be not disabled. Cf. 20 C.F.R. § 416.927(d)(3) (1993) (“The better an explanation a treating source gives for an opinion, the more weight we will give that opinion.”).

Dr. Davis’s statement that Ms. Morse is disabled, however, is not a medical opinion.1 Regardless of the label, a physician’s statement on the ultimate issue of disability is not binding on the Secretary. 20 C.F.R. § 416.-927(e)(1) (“A statement by a medical source that you are ‘disabled’ or ‘unable to work’ does not mean that we will determine that you are disabled.”); accord Janka v. Secretary of Health, Educ., & Welfare, 589 F.2d 365, 369 (8th Cir.1978). Under the Social Security Act, a treating physician’s medical opinions are given great weight. 20 C.F.R. § 416.927(d)(2); see also Nelson v. Sullivan, 966 F.2d 363, 367 (8th Cir.1992) (20 C.F.R. § 416.927 is a codification of the Eighth Circuit’s treating-physician rule). “Medical opinions are statements from physicians ... that reflect judgments about the nature and severity of [the claimant’s] impairment(s), including [the claimant’s] symptoms, diagnosis, and prognosis, what [the claimant] can still do despite impairments, and [the claimant’s] physical or mental limitations.” 20 C.F.R. § 416.927(a)(2). When a physician renders an evaluation of a claimant’s ability either to do prior work or to perform other positions based upon her physical or mental impairments, that evidence should be carefully considered by the Secretary. See Turpin v. Bowen, 813 F.2d 165, 172 (8th Cir.1987). However, the Secretary need not give great or controlling weight to the conclusions of a medical physician regarding a claimant’s ability to do work if that conclusion is not supported by evidence in the record or is merely conclusory. 20 C.F.R. § 416.927(d)(2); accord Janka, 589 F.2d at 369 (medical opinion unsupported by the record); Ward v. Heckler, 786 F.2d 844, 846 (8th Cir.1986) (treating physician’s statements were conclusory).

Dr. Davis’s “findings” to which the majority refers are neither medical findings, nor medical conclusions. Dr. Davis made a broad conclusory statement that Ms. Morse “is disabled as far as regular work is concerned.” App. at 990. This statement is a legal conclusion. See 20 C.F.R. § 416.-927(e)(1) (“We are responsible for making the determination or decision about whether you meet the statutory definition of disability.”). Moreover, specifically how this conclusion affects the fifth step of the sequential analysis is a quandary. The record does not indicate that Dr. Davis’s statement that Ms. Morse is disabled was based on an opinion that Ms. Morse could not perform any sub-' stantial gainful work existing in significant *877numbers in the national economy; nor does the majority make such an assertion.

II. The Fifth Step of the Sequential Analysis

The majority states that “[i]n formulating the hypotheticals and reaching the conclusion that Ms. Morse is not disabled, the ALJ discredited Dr. Davis’s findings.” Ante, at 871; see also id. at 872 (“The ALJ rejects Dr. Davis’s findings regarding the degree of Ms. Morse’s impairments.”). The ALJ did not discredit Dr. Davis’s findings regarding the degree of Ms. Morse’s impairments. In fact, the limitations articulated by Dr. Davis2 are essentially the same limitations underlying the vocational expert’s conclusion that the hypothetical individual could perform substantial gainful work existing in the national economy.3 The ALJ properly rejected Dr. Davis’s final conclusion that Ms. Morse was disabled because this conclusion was unsupported by the evidence and not based upon a finding that Ms. Morse could not do any substantial gainful activity existing in significant numbers in the national economy.

The majority finds that the ALJ erred when he discredited Ms. Morse’s subjective complaints of pain. I disagree. The record amply supports the ALJ’s finding. The ALJ notes that he considered all the Polaski factors,4 and an examination of the ALJ’s decision supports his statement. The majority’s digression regarding Ms. Morse’s work history and daily living routine begs the question of whether the vocational expert’s testimony was supported by substantial evidence. I fail to perceive any association between these issues and the validity of the vocational expert’s hypothetical.

The only substantive issues raised by the majority regarding the hypothetical posed to the vocational expert are refuted by the record. The majority states “[tjhere is no psychological test in evidence to support” the ALJ’s stress level of six on a scale of one to ten. Ante, at 874. There is, however, a psychological assessment to support the ALJ’s stress level determination. Ms. Morse was evaluated by a clinical psychologist who opined that her “[w]ork related activities [are] somewhat restricted by stress.” App. at 995 (emphasis added).5 A stress level of *878six on a scale of one to ten appears to fairly represent, if not overly represent in Ms. Morse’s favor, the psychologist’s assessment.

The majority finds farther error in the ALJ’s decision because the ALJ discredited portions of Ms. Morse’s testimony and didn’t include Ms. Morse’s “constant medical care,” ante, at 875, in the hypothetical. Regarding the first finding, the majority overlooks that as the trier of fact, the ALJ makes the credibility assessments, not the courts. Richardson v. Perales, 402 U.S. 389, 399, 91 S.Ct. 1420, 1426, 28 L.Ed.2d 842 (1970). As to frequent medical care, the majority points to no evidence in the record to establish that Ms. Morse’s medical care will make her miss work on a regular basis, and, instead, the majority assumes that frequent medical care is synonymous with frequent work absences. See ante, at 875-76.6

I dissent because the majority has effectively nullified the Secretary’s regulation, 20 C.F.R. § 416.927, and this circuit’s precedents defining the scope and application of medical-opinion evidence. Furthermore, I am bound by the limitations accorded by Congress when reviewing this record, see 42 U.S.C. § 405(g) (1988), and find that substantial evidence in the record supports the decision of the Secretary.

ORDER

April 5, 1994.

On the court’s own motion petition for rehearing by the court en banc is granted. The opinion and judgment of this court entered on March 3, 1994, are vacated.

The argument date will be fixed by a later order of this court.

. When Dr. Davis states that Ms. Morse must avoid fumes, that is a medical opinion. When Dr. Davis states that Ms. Morse must avoid lifting more than 20 pounds, that is a medical opinion. A statement that an individual is disabled under the Social Security Act is a legal conclusion.

. In relevant part, Dr. Davis’s letter reads:

I believe Mrs. Morse is disabled as far as regular work is concerned. She would be restricted from lifting more than perhaps 20 pounds and would be unable to carry even smaller amounts more than a few feet at a time. She does not appear to be restricted as far as standing, moving about and sitting but would be limited as far as walking because of her mitral valvular disease and her congestive heart failure. She would have considerably limited stooping, climbing, kneeling and crawling and could not be expected to do this in a job situation because of her lumbar disc disease which causes continuous pain even when she is resting.
I do not believe that Mrs. Morse has difficulty with handling objects, seeing, hearing, speaking, or traveling. She could not be exposed to environments involving fumes, high or low temperatures or hazards such as climbing or being in high places because of her heart disease.

App. at 990.

. The initial hypothetical included the following limitations: a maximum weight limit of 20 pounds; standing, walking or climbing no more than occasionally; no repetitive pushing or pulling; no arm work above shoulder level; no prolonged work in extremes of’temperature, fumes, or high humidily; no work around unprotected heights or dangerous moving machinery; no work in an environment with a stress level over six on a scale of one to ten; only occasional contact with the public; no work requiring close attention to detail; and no very complex or technical work. App. at 87-88.

In the second hypothetical, the ALJ asked the vocational expert to assume the following limitations in addition to those previously enumerated: no repetitive bending; no stooping, climbing, kneeling or crawling; and alternating positions between standing and sitting at least every 45 minutes. App. at 89.

. See Polaski v. Heckler, 739 F.2d 1320, 1322, supplemented, 751 F.2d 943 (8th Cir.1984), vacated, 476 U.S. 1167, 106 S.Ct. 2885, 90 L.Ed.2d 974, adhered to on remand, 804 F.2d 456 (8th Cir.1986), cert. denied, 482 U.S. 927, 107 S.Ct. 3211, 96 L.Ed.2d 698 (1987).

. On September 19, 1990, Robert L. Notch, Ph. D., opined the following:

Claimant has a chronic depression and personality disorder by history. She has been restricted to sedentary work physically. Depression appears reactive to physical problems. ADL’s [activities of daily living] not significantly restricted by mental problems. Work related activities somewhat restricted by stress, though most restriction appears physical. *878From a psychiatric standpoint no significant new evidence is noted that would change this review from earlier reviews. Simple routine work.

App. at 995.

. The majority identifies another purported problem with the fifth step in the disability analysis: the categorization of the reviewer, sorter, and checker positions as unskilled sedentary clerical positions. The majority has not suggested, nor does the record indicate, that Ms. Morse could not perform these positions. Hence, I cannot perceive how a change in the Dictionary of Occupational Titles category affects the validity of the Secretary’s decision.