Appeal from a judgment of the United States District Court for the Eastern District of New York, Thomas C. Platt, Jr., Judge, dismissing complaint seeking reversal of Secretary's decision denying disability benefits. Reversed and remanded.
Feinberg, Chief Judge, and Van Graafeiland and Kearse, Circuit Judges.
Plaintiff Aurea Aponte appeals from a judgment of the United States District Court for the Eastern District of New York, Thomas C. Platt, Judge, dismissing her complaint for review of the denial by defendant Secretary of Health and Human Services ("Secretary") of Aponte's application for disability benefits under the Social Security Act ("Act"), 42 U.S.C. § 401 et seq. (1976 & Supp. V 1981). On appeal, Aponte contends that the Secretary gave insufficient weight to (1) the uncontradicted evidence that Aponte suffered from a disabling mental impairment, (2) Aponte's subjective complaints of pain, and (3) the views of Aponte's treating physicians. Although we conclude that the district court properly upheld the Secretary's determination that Aponte was not physically disabled, we reverse and remand to the Secretary because we are unable to fathom the Secretary's rationale for concluding that Aponte was not disabled by reason of a mental impairment.
Aponte applied for disability benefits in 1981, claiming that, due to "high blood pressure & chronic arthritis," she had become unable to work as of July 15, 1979. The Social Security Administration denied her application, and rejected her request for reconsideration. Aponte then requested and received a hearing before an administrative law judge ("ALJ").
The record before the ALJ consisted of the testimony of Aponte and her daughter-in-law, and the medical reports of several physicians. Aponte, who had been employed as a sewing machine operator until July 1979, testified to a variety of physical and mental symptoms. Her physical symptoms included pain in her knees, feet, back, hands, and neck. She testified that she was chronically exhausted; had lost twenty pounds due to a loss of appetite; and suffered from high blood pressure, dizziness, shortness of breath, and chest pains. Aponte testified that her condition had curtailed her daily activity. Her pain rendered her unable to walk for more than a few blocks, and she could no longer perform ordinary housework, including the use of her home sewing machine. Her only outside activity was to attend church twice a week, which she was able to do only because the pastor drove her to and from the church.
Aponte's mental symptoms included depression, weeping, and thoughts of suicide. She wept at one point during the hearing. The medication prescribed for and taken by Aponte included Indocin, Butazolidin, Motrin, Aldoril, Deprol, and Triavil.*fn1
Aponte's daughter-in-law testified that she did all of Aponte's general cleaning, dishwashing, mopping, and laundry, and helped Aponte to dress and comb her hair. The daughter-in-law stated that although Aponte sometimes did some light cooking for herself and her husband, the daughter-in-law did most of the cooking. The daughter-in-law testified that Aponte constantly complained of pain and exhaustion, frequently wept, and sometimes talked of suicide.
The medical evidence relating to Aponte's physical symptoms included the reports of Drs. Paolo Ottolenghi, and Jorge Rivera-Fernandez, who were Aponte's treating physicians, and Drs. Harry Jackson and Barry Fisher, who examined Aponte on behalf of the Secretary. Dr. Ottolenghi diagnosed Aponte's condition as hypertension and progressive arthritis of the knees, elbows, and lower spine. He opined that she was totally disabled. Dr. Fernandez diagnosed arthritic pain in the lower back and both legs, loss of strength in the hands, and hypertension. He indicated that these conditions were not improving in response to treatment. Dr. Jackson diagnosed hypertension, inflammation of the cartillage around the ribs, osteoarthritis of the lower spine, and inflammation of the left elbow. He estimated that Aponte had the residual functional capability to sit for up to four hours, stand and walk for two out of eight hours, lift up to twenty pounds, and use both hands for repetitive tasks. Dr. Fisher's report indicated that, although Aponte suffered from mild osteoarthritis, the movement of her limbs was not restricted and she remained capable of sitting and standing for up to six hours out of eight, and walking up to four hours out of eight. He also found that she could use her hands for "fine manipulation."
Medical evidence relating to Aponte's mental condition appeared in the reports of Dr. Francisco Pereda, who was Aponte's treating psychiatrist, and Drs. Louis Locuratolo and Andreas Neophytides, a psychiatrist and a neurologist, respectively, who examined her on behalf of the Secretary. In a report dated October 2, 1981, Dr. Pereda described Aponte as very depressed and nervous, extremely tense and irritable, and suffering from "an acute depression," and diagnosed her condition as "Acute Depressive Neurosis." His report stated that
this patient has suicidal ideas and plan [sic] to jump out of a window, she has desire of going out and run away, has feeling of burning in her skull and all over her head. She is unable to remember what she read, with lost [sic] of concentration and lost [sic] of recent memory, with good remote memory. This patient has an acute depression episode since July 79, and in my opinion, she is in need of further psychiatric care and treatment.
He concluded that Aponte would be "unable to work for at least the next 2 years, due to her nervios [sic] condition. Her depression is so severe that she is unable to work even in an sedentary, light or low stress. [sic]"
Dr. Locuratolo, the psychiatrist who examined Aponte on behalf of the Secretary, reported that he had observed no disorientation, hallucinations or persecutory ideas. Nonetheless, he described her as weeping occasionally, sad, and tense, and he diagnosed her condition as an " adjustment disorder with mixed emotional features, (depression and anxiety)." (Emphasis in original.) He recommended psychotherapy, medications (minor tranquilizers and anti-depressants), and vocational rehabilitation. Dr. Neophytides reported that he found no evidence of neurological disease, but he described Aponte as "a depressed appearing lady . . . tearing during the interview, in moderate psychic distress." His report noted that Aponte had ...