HEANEY, Circuit Judge.
This appeal raises the difficult question of whether May V. Stephens, a fifty-five-year-old female with an eighth grade education, who was a steady and dependable worker until she was injured in 1970, was properly denied disability insurance benefits by the Secretary of Health, Education and Welfare. The difficulty is compounded by the fact that here, as in many other similar cases, the medical testimony in the record is entirely in the form of written reports, a practice which may save the time of the doctors, the examiners and the administrative law judge but which complicates review by district and appellate courts. The difficulty is further compounded by the fact that the hypothetical questions posed to the vocational expert were so sketchy and incomplete that it is extremely difficult to give the answers to them little, if any, weight. We have no alternative but to reverse and remand for a further hearing, with the ardent hope that this time, the record will be completed in a way which will permit a final review.
Stephens was employed by McDonnell-Douglas Corporation on February 2, 1970, when she fell and sustained injury to her spine. As a result of that injury, the Workmen's Compensation Appeals Board of California awarded her a permanent disability of 35½%. Stephens attempted to return to work after her injury. Although she worked intermittently at McDonnell-Douglas, she was terminated in November, 1974, primarily because her injury prevented her from performing her assigned work.
On March 4, 1976, Stephens filed her application for disability insurance benefits. The application was denied by the Social Security Administration on June 23, 1976. The Disability Denial Notice to Stephens noted:
The application was reconsidered and again denied. Pursuant to Stephens' request, a hearing was held before an administrative law judge on March 10, 1977. The administrative law judge heard the testimony of Stephens and a vocational expert, as well as receiving in evidence numerous medical reports.
The medical reports substantially corroborated Stephens' testimony. Dr. Edward H. Boseker, in a report dated December 18, 1973, noted that her subjective complaints increased if she engaged in heavy lifting or repetitive bending, and concluded that Stephens "should be prophylactically precluded from [such] heavy lifting and repetitive bending." He estimated that Stephens had a 10% loss of motion in the lumbar spine. Dr. John S. Woodward examined Stephens on May 7, 1976. In his report, dated May 21, 1976, he noted that Stephens suffered from a generalized spinal immobility which he diagnosed as spinal arthritis with shoulder girdle myositis. His prognosis was poor for substantial improvement. Dr. Woodward concluded that she could not stand or walk for over six hours, occasionally lift or carry more than twenty pounds, or frequently lift or carry more than ten pounds. Considering these limitations, he reasoned that Stephens should avoid any strenuous activities.
Stephens was examined on October 27, 1976, by Dr. Martin E. Offenberger. His examination revealed a limited range of motion at the waist, coupled with moderately severe tenderness. Dr. Offenberger noted that the joints on Stephens' hands and wrists were painful and stiff, had a limited range of motion and were subject to frequent locking. Grip strength was very weak with mild deformities noted in the joints of all the fingers. Dr. Offenberger's diagnosis was: (1) chronic myofaschial ligamentous sprain and strain of joints of the fingers with chronic inflammatory changes of the joints, (2) chronic myofaschial ligamentous sprain and strain of the joints of the wrists and elbows of both upper extremities, (3) chronic myofaschial sprain and strain of the joints of the feet, toes, ankles and knees of both lower extremities, (4) chronic thoracic sprain, (5) chronic lumbar sprain, (6) chronic bronchitis, (7) chronic costochondritis, bilateral, secondary to bronchitis, (8) post-traumatic anxiety neurosis. He felt claimant's impairments precluded her from any type of work for which she had had any type of experience and training. He also indicated that she was 100% disabled and that her condition was permanent and stationary.
Stephens was examined on October 27, 1976, by Dr. Reubin Merliss. He felt that her lung disease was sufficient to permanently preclude her from heavy work or working in atmospheres containing pollutants. A report from Dr. Hassan M. Masri, dated July 19, 1977, concluded that Stephens had chronic bronchitis and osteoarthritis.
These medical reports, when considered as a whole, indicate without contradiction that Stephens was unable to return to her former job and conclusively support the finding that she was unable to do any work which subjected her to the type of air pollutants which would aggravate her bronchial condition, work which required her to do constant bending, twisting or occasional lifting in excess of twenty pounds, or frequent lifting in excess of ten pounds. They also show that she was unable to do any work which required significant finger dexterity because of the swelling and degeneration in the joints in her hands.
The administrative law judge, however, concluded that although Stephens had some
The vocational expert had given the following testimony at the hearing:
The Appeals Council affirmed the decision of the administrative law judge on December 9, 1977. On February 6, 1978, Stephens filed a complaint in the District Court for review of the administrative determination. When the matter was presented to the court, Stephens submitted a medical report from Dr. Earl M. Woodson, dated February 14, 1978. In that report, Dr. Woodson stated that Stephens suffered primarily from chronic bronchitis, emphysema, osteoarthritis of the lumbar spine, arthritis of the right and left shoulder and hypertension. He concluded that, in light of her physical condition and her limited background, she was unable to engage in any type of gainful employment. The District Court remanded the action to the Secretary of Health, Education and Welfare to consider the new medical evidence on February 27, 1978.
The matter was assigned to a new administrative law judge who conducted a hearing on May 17, 1978. The only witness at the hearing was Stephens whose testimony was essentially the same as at the first hearing. In addition to considering the record made at the first hearing, the administrative law judge also accepted three additional medical reports.
The first was Dr. Woodson's report. The second was a report from Dr. H. E. Jones, dated May 16, 1978. Dr. Jones found that Stephens suffered from osteoporosis of the spine, bronchial asthma, pulmonary emphysema and osteoarthritis. He concluded that Stephens was unable to gainfully compete in the labor market and was totally and permanently disabled. The third report, dated May 31, 1978, was from Dr. William Sherrill. Dr. Sherrill concluded that Stephens had a lumbosacral pain syndrome with aggravation by posture and obesity, but made no conclusions as to whether Stephens was disabled. There is no indication that he examined her for her bronchial condition or the degeneration in the joints of her hands, or that he had the other medical reports exploring these conditions in his possession. Instead, he concentrated his examination on her back.
The second administrative law judge also found that Stephens was not totally disabled within the meaning of the Social Security Act. He concluded that:
Our function when reviewing a disability insurance decision is to determine whether or not it is supported by substantial evidence on the record as a whole. 42 U.S.C. § 405(g). For purposes of the Social Security Act, substantial evidence is defined as more than a mere scintilla. It 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). See also Alexander v. Weinberger, 536 F.2d 779 (8th Cir. 1976); Timmerman v. Weinberger, 510 F.2d 439 (8th Cir. 1975); Yawitz v. Weinberger, 498 F.2d 956 (8th Cir. 1974).
A claimant has the burden of establishing the existence of a disability as defined by 42 U.S.C. § 423(d)(1)(A). To satisfy the statutory definition of disability, the claimant must show: (1) that there is a medically determinable impairment which has lasted or is expected to last twelve months; (2) that there is an inability to engage in any substantial gainful activity; and (3) that the inability is by reason of the impairment. Yawitz v. Weinberger, supra at 959; Brinker v. Weinberger, 522 F.2d 13, 17 (8th Cir. 1975); Timmerman v. Weinberger, supra at 442. When a claimant has demonstrated a medically determinable disability is so severe as to preclude him from performing his former work, however, the burden shifts and the Secretary must prove there is some other type of substantial gainful employment the claimant can perform. Boyer v. Califano, Jr., Secretary of Health, Education and Welfare, 598 F.2d 1117 at 1118 (8th Cir. 1979); Brinker v. Weinberger, supra at 17; Timmerman v. Weinberger, supra at 443.
It is uncontradicted that Stephens was precluded from performing her former work at McDonnell-Douglas; thus, the burden shifted to the Secretary to establish by a preponderance of the evidence that there was work available in the national economy that Stephens could perform in her disabled condition.
The only evidence in the record to support the administrative law judge's finding that Stephens could, in fact, engage in substantial gainful activity is the testimony of the vocational expert. Based on the hypothetical question, he found that Stephens was capable of substantial gainful activity. We conclude, however, that the vocational expert's testimony was fatally deficient in that the hypothetical question failed to precisely set out all of Stephens' impairments. See Behnen v. Califano, 588 F.2d 252, 255 (8th Cir. 1978); Lewis v. Califano, 574 F.2d 452, 456 (8th Cir. 1978); Daniels v. Mathews, 567 F.2d 845, 848 (8th Cir. 1977).
In Daniels v. Mathews, supra at 848, this Court held:
The administrative law judge failed to do so here. In the hypothetical question, he asked the expert to assume that Stephens could do "light or sedentary work with such limitations as are noted in the record." The exact nature of these "limitations" was undisclosed and, thus, we have no way of determining whether the vocational expert recognized all of Stephens' disabilities. At a minimum, the hypothetical question should have included a reference to Stephens' osteoarthritis, bronchial condition, limitations on her ability to bend, stoop, sit or stand for prolonged periods, the degenerative condition of her hands and her constant pain. We simply are unprepared to assume that the vocational expert had all of
While there is some justification for reversing outright,
The judgment is reversed and remanded to the District Court with direction to remand the claim to the Secretary of Health, Education and Welfare for further hearing.
LAY, Circuit Judge, dissenting.
I respectfully dissent.
The record clearly supports an award for the claimant. I fail to see the necessity of another remand.