Summary of Opinion: Peggy R. Hammond v. Margaret M. Heckler, No. 84-2185 (4th Cir. June 24, 1985)

Factual and Procedural Background

Peggy Hammond, age forty-four at the time of the incident, completed high school and received training as a hospital technician. While assisting in the movement of a bedridden patient at Pitt Memorial Hospital on May 29, 1980, Hammond sprained her back. She thereafter alleged an inability to perform substantial gainful activity and applied for Social Security disability insurance benefits and supplemental security income.

The Social Security Administration denied Hammond's claims in October 1982 and again on reconsideration in December 1982. Hammond requested a hearing. In April 1983 an administrative law judge (ALJ) heard testimony from Hammond and received medical records from Pitt Memorial Hospital, treating physician Dr. Andrew Best, and consultative examiner Dr. Richard Rawl. The ALJ found Hammond unable to return to her work as a hospital technician but concluded she retained the residual functional capacity to perform a full range of sedentary work. The ALJ applied the Department of Health and Human Services' medical-vocational "grid" (Rule 201.21, Table No. 1 of Appendix 2, 20 C.F.R. § 404, Subpart P) and denied benefits. The Appeals Council declined review, and the district court affirmed the Secretary's denial. Hammond appealed to the United States Court of Appeals for the Fourth Circuit.

Legal Issues Presented

Whether the ALJ properly classified Hammond's residual functional capacity as the full range of sedentary work and therefore permissibly relied on the Department of Health and Human Services' medical-vocational grid to deny benefits.
Whether the ALJ erred by failing to account for nonexertional limitations (in particular, chronic pain) and by failing to make adequate credibility findings regarding Hammond's allegations of pain.
Whether, given the ALJ's use of the grid and the record evidence, the Secretary satisfied the burden of producing vocational evidence showing that the national economy offers employment opportunities to Hammond.

Arguments of the Parties

The opinion does not contain a detailed account of the parties' legal arguments.

Table of Precedents Cited

Precedent	Rule or Principle Cited For	Application by the Court
Gordon v. Schweiker, 725 F.2d 231 (4th Cir. 1984)	The most important finding when an ALJ uses the grid is what kind of physical activity the claimant can sustain.	The court relied on Gordon to emphasize the ALJ's duty to determine accurately the claimant's sustained physical capabilities before applying the grid.
Heckler v. Campbell, 461 U.S. 458 (1984)	Describes the special ALJ "duty of inquiry" and cautions that regulations require individual attention for cases differing from the official matrices.	The court invoked Heckler v. Campbell to support the proposition that ALJs must exercise care in classifying claimants and must give individual consideration where the grids are not fully descriptive.
Hall v. Harris, 658 F.2d 260 (4th Cir. 1981)	Identifies two types of claimants the grids inadequately describe: (1) those with disabilities present in the absence of physical exertion and (2) those with exertional disabilities that restrict them from performing the full range of a category.	The court used Hall to categorize Hammond as falling into both types of claimants who cannot be adequately described by the grids alone.
Grant v. Schweiker, 699 F.2d 189 (4th Cir. 1983)	Where grids are inadequate, the ALJ may not give them preclusive effect and must produce specific vocational evidence showing available jobs for the claimant.	The court cited Grant to explain that the Secretary retains the burden to produce vocational evidence when the grids do not alone support denial.
Wilson v. Heckler, 743 F.2d 218 (4th Cir. 1984)	Illustrates that a claimant who cannot perform the full range of sedentary work cannot be denied benefits solely by applying the grids; specific vocational evidence is required.	The court compared Hammond's limitations to the plaintiff in Wilson and concluded Hammond likewise cannot perform the full range of sedentary work, making reliance on the grids inappropriate without further evidence.
DeLoatche v. Heckler, 715 F.2d 148 (4th Cir. 1983)	A treating physician's opinion is entitled to great weight.	The court cited DeLoatche to support giving substantial weight to Dr. Best's opinion that Hammond was 50–55% disabled from performing the job.
Smith v. Schweiker, 719 F.2d 723 (4th Cir. 1984)	Affirms that the ALJ is required to make credibility determinations concerning allegations of pain or other nonexertional disabilities, and such determinations sometimes must be negative.	The court relied on Smith to explain that while the ALJ may reject subjective allegations of pain, the ALJ must make specific findings and refer to the evidence supporting the credibility determination.
Van Huss v. Heckler, 572 F. Supp. 160 (W.D. Va. 1983)	Notes that ALJs are somewhat constricted in choosing a decisional process and underscores the importance of explanation in credibility evaluations.	The court cited Van Huss to stress that the ALJ's duty of explanation is especially important in evaluating pain claims.

Court's Reasoning and Analysis

The Fourth Circuit examined whether the ALJ properly applied the HHS medical-vocational grid to deny Hammond's benefits. The court's analysis proceeded as follows, based strictly on the opinion's text:

The ALJ found that Hammond was too impaired to return to her prior job as a hospital technician but concluded she retained the residual functional capacity to perform the full range of sedentary work. The ALJ then relied on Rule 201.21 of the HHS grid to deny benefits, a largely mechanical application.
The court reiterated that when an ALJ uses the grid, the critical factual finding is what kind of physical activity the claimant can sustain (citing Gordon v. Schweiker). Because the grids compress many factual situations into a few categories, the ALJ has a heightened duty of inquiry and must give individual attention to cases that differ materially from the grid categories (citing Heckler v. Campbell and the regulations).
Relying on Hall v. Harris, the court explained two types of claimants for whom the grids are inadequate: those with disabilities independent of exertion and those whose exertional limitations prevent them from performing the full range of activity within a grid category. If a claimant falls into either category, the ALJ may not give the grids preclusive effect and must produce specific vocational evidence showing jobs that exist in the national economy for that claimant (citing Grant and Wilson).
Applying these principles to the record, the court found uncontradicted evidence that Hammond could not perform the full range of sedentary work as defined in 20 C.F.R. § 404.1567(a). The medical record showed chronic lumbar strain requiring a back brace, oral and injected analgesics, and frequent visits to Dr. Best. Hammond testified she could not sit or stand for a full hour, could not bend, stoop, lift, or climb, and could not walk more than a few hundred yards twice a week. Dr. Best concluded Hammond would be fifty to fifty-five percent disabled from performing the job. Dr. Rawl's consultative report confirmed back strain with tenderness.
Because the medical evidence and Hammond's testimony uniformly indicated she cannot perform the full range of sedentary work (similar to the plaintiff in Wilson v. Heckler), the court concluded the grids alone could not support denial.
Separately, the court addressed the ALJ's rejection of Hammond's subjective complaints of constant pain. The ALJ's statement that he did not find Hammond's subjective symptoms credible was insufficient because, given the apparent consensus among Hammond, Dr. Best, and Dr. Rawl that Hammond suffered steady pain, the ALJ needed to identify the evidence supporting his credibility determination. The court emphasized that credibility findings — particularly regarding pain — require specific reference to evidence and explanation.
Given that the grids may not alone support denial and that the ALJ's credibility finding lacked adequate support in the record, the court held that the Secretary retained the burden of producing vocational evidence that employment opportunities exist for Hammond in the national economy.

Holding and Implications

HOLDING: The judgment of the district court affirming the Secretary's denial of benefits is VACATED AND REMANDED.

Implications and direct consequences (as stated in the opinion):

The case is vacated and remanded to the district court with instructions to remand to the Secretary for further proceedings consistent with the opinion.
If the Secretary presents additional evidence on remand, Hammond's claim must be reconsidered in light of that evidence and any further evidence the plaintiff may present.
If no additional evidence is presented by the Secretary on remand, the judgment shall go for the plaintiff.

Note: The opinion also observes that the case was decided prior to enactment of 42 U.S.C. § 423(d)(5)(A) (a statutory requirement of medical corroboration for pain allegations) and states that the findings of "pain" and "tenderness" by the treating and consultative physicians satisfy the burden of production imposed by that statute; therefore the opinion did not examine application of that statutory provision in detail.

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PEGGY R. HAMMOND, APPELLANT, v. MARGARET M. HECKLER, SECRETARY OF HEALTH AND HUMAN SERVICES, APPELLEE.

PER CURIAM:

Peggy Hammond appeals from a judgment of the district court affirming the Secretary's decision to deny Hammond's applications for social security disability insurance benefits and supplemental security income. Because we find that the Secretary improperly compressed Hammond's claim to fit within one of the Department of Health and Human Services' recognized medical-vocational categories, we vacate the denial of benefits and remand for further individualized proceedings.

Hammond, forty-four years old at the time of the incident precipitating this case, has graduated from high school and has received training as a hospital technician. This training prepared her to work at Pitt Memorial Hospital in Greenville, North Carolina, where her duties included assistance in the movement of bed-ridden patients. On May 29, 1980, Hammond sprained her back while lifting one such patient whom she later estimated to weigh two hundred thirty-five to two hundred forty pounds. Hammond found that the injury left her unable to perform substantial gainful activity, and she applied for social security benefits.

The Social Security Administration denied the claims in October 1982 and again on reconsideration in December 1982, upon which Hammond sought a hearing in her case. In April 1983, an administrative law judge listened to Hammond's testimony and received in evidence the medical records made at the time of the injury by Pitt Memorial Hospital and the medical reports made subsequently by Hammond's physician, Dr. Andrew Best, and by a consultative examiner, Dr. Richard Rawl. The ALJ concluded from this information that Hammond was too severely impaired to return to her position as a hospital technician but that she retained the residual functional capacity to perform a full range of sedentary work. After that step, the adjudicative process was entirely mechanical. The ALJ simply referred to a "grid" published by the Department of Health and Human Services which stated that the national economy provides employment opportunities for a person of Hammond's age and experience who can perform sedentary work. See Rule 201.21, Table No. 1 of Appendix 2, 20 C.F.R. § 404, Subpart P. On the basis of that reading, the ALJ rejected Hammond's benefits claims. The decision became the final action of the Secretary when the Appeals Council declined Hammond's request for review.

This court has recently remarked that "when an ALJ uses the grid, the most important finding that the ALJ must make is what kind of physical activity the claimant can sustain." Gordon v. Schweiker, 725 F.2d 231, 235 (4th Cir. 1984). Given the obvious difficulties in encompassing a very large number of cases within a few general categories, the questions of whether and how to classify claimants raise to a high level the special ALJ "duty of inquiry" described by Justice Brennan in Heckler v. Campbell, 461 U.S. 458, 470-473, 103 S.Ct. 1952, 1959-1960, 76 L.Ed.2d 66 (1984). The regulations themselves accordingly require that individual attention be devoted to cases with parameters different from those in the official matrices. See Heckler v. Campbell, 461 U.S. at 462 n. 5, 103 S.Ct. at 1955 n. 5. In applying this principle of caution, we have discussed two types of claimants that the grids inadequately describe; the claimant who suffers a disability present in the absence of physical exertion and the claimant who suffers in exertion a disability that restricts her from performing the full range of activity covered by a category. Hall v. Harris, 658 F.2d 260, 265 (4th Cir. 1981). In these types of cases, the ALJ may not give preclusive effect to the grids and must produce specific vocational evidence showing that the national economy offers employment opportunities to the claimant. See respectively Grant v. Schweiker, 699 F.2d 189, 192 (4th Cir. 1983); Wilson v. Heckler, 743 F.2d 218, 221-222 (4th Cir. 1984).

Hammond's claim illustrates both of the limitations to the grid that are explained in Hall v. Harris. First, uncontradicted evidence shows that Hammond cannot perform the full range of sedentary work as defined by 20 C.F.R. § 404.1567(a). Hammond suffers from chronic lumbar strain that requires her to wear a back brace, to take both oral and injected analgesics, and to return several times each week to her treating physician, Dr. Best. She testified that she can neither sit nor stand for a full hour, cannot bend, stoop, lift, or climb, and cannot walk more than a few hundred yards twice a week. Dr. Best, whose opinion is entitled to great weight, DeLoatche v. Heckler, 715 F.2d 148, 150 n. 1 (4th Cir. 1983), concluded that Hammond — even if she could find a position that required none of these prescribed activities — would be fifty to fifty-five percent disabled from performing the job. Hammond's testimony and Best's opinion are completely consistent with the consultative report of Dr. Rawl, which merely confirmed the presence of back strain with associated tenderness and noted the absence of arthritis and scoliosis. The evidence thus unanimously indicates that Hammond is in the same position as the plaintiff in Wilson v. Heckler: she cannot perform the full range of sedentary work because she cannot bend or squat or sit for six hours in an eight-hour day, even if she could perform the walking and standing that might be necessary. Cf. Wilson, 743 F.2d 221-222.

Apart from Hammond's imperfect correspondence to the sedentary listing in the Health and Human Services' grid, reliance on the exertional table is inappropriate in this case because the Secretary has not adequately accounted for the nonexertional limitation suggested by Hammond's claim that she is constantly in pain. The ALJ simply stated that "In view of the objective medical evidence of record, the undersigned does not find credible the claimant's subjective symptoms including pain of a level of severity as to preclude sedentary work activity." In light of the apparent consensus among Hammond, Best, and Rawl that Hammond suffers steady pain, this statement may not stand without some support. The ALJ is required to make credibility determinations — and therefore sometimes must make negative determinations — about allegations of pain or other nonexertional disabilities. Smith v. Schweiker, 719 F.2d 723, 725 n. 2 (4th Cir. 1984). But such decisions should refer specifically to the evidence informing the ALJ's conclusion. This duty of explanation is always an important aspect of the administrative charge, see Gordon v. Schweiker, 725 F.2d at 235-236 (citing cases), and it is especially crucial in evaluating pain, in part because the judgment is often a difficult one, and in part because the ALJ is somewhat constricted in choosing a decisional process, Van Huss v. Heckler, 572 F. Supp. 160, 167 (W.D.Va. 1983).

This case was decided prior to the enactment of 42 U.S.C. § 423(d)(5)(A), which created a requirement of medical corroboration for a claimant's allegations of pain. As the findings of "pain" and "tenderness" by Best and Rawl satisfy the burden of production imposed by the statute, we need not consider the application of the provision in detail.

As the grids may not alone support a denial of Hammond's disability claim, the Secretary retains the burden of producing evidence that the national economy offers employment opportunities to Hammond. The judgment of the district court is therefore vacated and the case is remanded to the district court with instructions to remand to the Secretary. If the Secretary offers additional evidence, Hammond's claim should be reconsidered in light of that evidence and any additional evidence that the plaintiff may choose to advance. If no additional evidence is presented, the judgment shall go for the plaintiff.

VACATED AND REMANDED.

HAMMOND v. HECKLER