The opinion of the court was delivered by: WEINSTEIN
This case is troubling in view of the dilemmas with respect to protection of the disabled not yet comprehensively addressed by our legal system. On the one hand, there are now greater opportunities for employment under laws protecting the disabled, new technologies allowing work at home and in other non-traditional work places, and statutes requiring removal of obstacles facing disabled persons who wish to work. On the other hand, there is a need to provide necessary income under the Social Security laws for the disabled. See Part V, infra, "The Disabled, Work at Home, the SSA, and the ADA." How do these two related lines of protection interact?
Plaintiff, Stephen Harris, thirty-five years old with a high school equivalency diploma, suffers from severe Crohn's disease. He has severe diarrhea, abdominal pain, nausea, cramps, and other symptoms. He also suffers from gouty arthritis, depression, and malabsorption of nutrients.
Until about 1985, he worked at a variety of sedentary and non-sedentary jobs. For some time he has been unable to work because of his disease.
In early 1984, plaintiff began seeing doctors because of endemic diarrhea with blood in his stool. The diagnosis was ulcerative colitis.
Plaintiff was treated by Doctor Mark Shaffer, a general practitioner, and Doctor John C. Kaufman, a specialist in gastoenterology. Under Doctor Kaufman's care plaintiff was diagnosed as having extensive small bowel Crohn's disease and placed on medication. Doctor Kaufman saw plaintiff on many occasions, beginning in 1986. While at times plaintiff appeared "to be doing well," he had persistent diarrhea, difficulty properly absorbing certain vitamins and minerals, and at times blood in his stool. Plaintiff's weight fluctuated widely. During this period he was also seen by other treating physicians for episodes of arthritis and acute gout, frequent headaches, and recurrent cysts in his ears.
In 1989, plaintiff applied for disability insurance benefits under the Social Security Act because of his Crohn's disease, chronic arthritis, and gout. His request for benefits was denied and a series of hearings ensued.
The evidence included various medical records including a number of letters written by plaintiff's treating physicians. For instance, an April 17, 1990 letter from Doctor Kaufman stated:
In my best medical opinion, I hereby state that, since my report of October 3, 1989 the condition of the above-named patient/claimant remains unchanged, he is still disabled . . . .
A February 9, 1990 letter from Doctor Richard Robbins, who treated plaintiff for cysts in his ears, explained:
Mr. Harris has a chronic illness and with his Crohn's disease would not be able to tolerate the stressors of a work environment. His symptoms will last for at least a year and as his problems are ongoing, he needs constant treatment. As he has bouts of diarrhea almost daily and his problems keep coming back, he would not be a reliable candidate for gainful employment.
In addition, Doctor Ralph S. Bell, who examined plaintiff for treatment because of "recurrent diarrhea, difficulty absorbing vitamin B-12, abdominal pain, cramps, nausea, and polyps in his left ear," wrote a letter on October 30, 1990 that stated:
Since the symptoms of Mr. Harris' illness are recurrent, and have been for several years, he would be an [unlikely] candidate for a work environment. Due to the seriousness of his present condition, he requires constant treatment and regular check ups.
Reports from Doctor Hyman Miller, who examined plaintiff on behalf of the Social Security Administration, were also part of the record. This doctor was of the opinion that plaintiff's ability to lift and carry were impaired by his frequent diarrhea episodes. In addition, the doctor's records stated that plaintiff could stand and walk for a total of four hours a day, depending, however, on the number of bowel movements he experienced. Doctor Miller expressed doubt about the credibility of plaintiff's reported bowel movements.
Plaintiff testified. He explained that he had uncontrollable bowel movements many times a day that made even traveling to work by public transportation; which he would be forced to use, impossible. He recounted a loss in strength and a fluctuation in his weight because of his illness.
On June 27, 1991, an Administrative Law Judge found that plaintiff could not perform his past relevant work. The ALJ held, however, that the claimant was not disabled because he could perform a full range of ...