Mary E. Thomas appeals a judgment of the district court affirming the Secretary of Health and Human Services determination that she is ineligible for supplemental security income benefits. Thomas has no quarrel with the Secretary's conclusion that, despite her illnesses, she has the strength to perform sustained sedentary work. She asserts that the Secretary's error was in failing to appreciate that her respiratory affliction precludes her from taking those sedentary jobs which demand a tolerance for dust, heat, and fumes. We agree with Thomas. Accordingly, we reverse the judgment of the district court and remand this case with instructions that it be returned to the Secretary for further proceedings consistent with this opinion.
There is no dispute over the essential facts. Thomas is forty-eight years old, has a sixth grade education, and no vocational skills. Though in years past she was employed as a domestic, she has since mid-1979 not engaged in work beyond maintaining a home for her two minor children. Her ailments are tied to her obesity — at 5'2" she weighs in excess of 240 pounds — and her smoking habit. Thomas has been hospitalized at least twice since July 1979; her attending physicians have consistently diagnosed chronic respiratory impairments. Thomas first applied for supplemental security income disability benefits in August 1979.
Thomas sought review of the ALJ's recommended decision before the Appeals Council. Review was denied, making the decision of the ALJ the final ruling of the Secretary of Health and Human Services. On appeal to the district court under section 205(g) of the Social Security Act, 42 U.S.C. § 405(g), the Secretary's decision was upheld as supported by substantial evidence. This appeal followed.
We note at the outset the confined sphere within which we may conduct our review. Section 205(g) restricts our review, as it restricted that of the district court,
As limited as the statutory scope of review may be, the parties have in this case narrowed it still further. Thomas raises only a single issue on appeal. She claims that the same proof which showed her inability to return to her previous employment, because of a reduced capacity for sustained exertion, also shows that she is unable to do certain types of work within her exertional capacity because she cannot tolerate the environment in which the work must be performed. She argues, in essence, that the Secretary failed to meet his burden of proving that there is other substantial gainful employment activity in the economy which she can perform.
At her hearing, Thomas testified that she has difficulty in breathing, coughs and chokes often, and has asthmatic attacks of five to fifteen minutes duration several times a day. She cooks, grocery shops, and does housework, all the while interspersing her periods of activity with frequent rest breaks, and at one point attempted to paint her apartment. The latter effort resulted in her January 1980 hospitalization for asthmatic bronchitis aggravated by toxic fumes. Medical evidence was also introduced at the hearing. In substance, it indicated that three physicians had found Thomas to be afflicted with chest pains, shortness of breath, a nonproductive cough, and bilateral and symmetric inspiratory and expiratory wheezes. Two of the doctors diagnosed chronic asthmatic bronchitis; the third found aggravated emphysema. Certain clinical findings pointed to the possibility of an incipient heart impairment; those symptoms did not regularly appear, however, and only one of the three doctors diagnosed pulmonary disease.
The ALJ found that Thomas is afflicted with asthmatic bronchitis, obstructive pulmonary disease, and obesity. He found not wholly credible her testimony as to the severity of her pain and functional limitations; it appears that this discreditation rested at least in part on Thomas' concurrent testimony that she is able to keep house, albeit at a slow pace. The ALJ concluded that, despite the opinions of two of Thomas' treating physicians that she is completely disabled, both the clinical findings underlying the medical opinions and Thomas' own testimony indicated that while Thomas cannot return to her previous employment as a domestic, she is capable of maintaining sustained exertion equivalent to that required of sedentary work.
The conclusion that Thomas is capable of sedentary work did not, of itself, dictate a determination that she is not disabled within the meaning of the Social Security
The Medical-Vocational Guidelines set forth rules governing disability determinations in commonly-encountered patterns of functional and vocational limitations. The rules are organized in three Tables, each dealing with a different level of residual exertional capacity. The separate rules consider varying combinations of age ranges, educational levels attained, and job skills exemplified by previous employment, and direct, based on those four factors, a finding of disability or nondisability. See Salinas v. Schweiker, 662 F.2d 345 (5th Cir. 1981); Perez v. Schweiker, 653 F.2d 997 (5th Cir. 1981). Table 1 provides the rules for claimants found capable of performing sedentary work as defined by 20 C.F.R. § 404.1510(b). Based on his findings that Thomas, under fifty years of age, was a younger individual as defined by 20 C.F.R. § 404.1506(b), that she had a limited education as defined by 20 C.F.R. § 404.1507(d) and that she had been an unskilled worker as defined by 20 C.F.R. § 404.1511(b), the ALJ determined that Rule 201.18 of Table 1 applied and directed a conclusion of "not disabled."
Thomas does not dispute the four findings of residual exertional capacity, age, education, and job skill level on which the ALJ's finding of nondisability was predicated. Nor does she argue that reliance on the guidelines is insufficient to satisfy the Secretary's burden of proof where the four factors on which they are based coincide precisely with the considerations relevant to disability presented by the claimant's situation.
Recent opinions of this Court establish that use of the Guidelines is inappropriate where their evidentiary underpinnings do not coincide exactly with the evidence of disability appearing on the record. Millet at 1204; Perez at 1001; accord Ferguson v. Schweiker, 641 F.2d 243, 247 (5th Cir. 1981). The Secretary's regulations directing proper use of the Guidelines explicitly state that the Guidelines do not take into consideration nonexertional limitations on the type of work which the claimant could perform, and caution that the guidelines should not be considered determinative in, inter alia, situations where the nature of the claimant's ailment manifests itself in intolerance of dust and fumes. 20 C.F.R. Subpart P, App. 2 § 200.00(E) states
Evidence submitted at the hearing before the ALJ indicated that Thomas' disabling symptoms appear or are intensified by exposure to dust, fumes, and excessive heat. The ALJ failed to address the question raised by this evidence of whether it supports a finding that Thomas' ability to work is restricted by an environmental, as well as an exertional, limitation. The hearings must be reopened and a determination must be made on this issue. If such a restriction is found to exist, the Secretary's proof of available alternate employment must take this restriction into consideration. Because the Guidelines do not include consideration of this factor, it will be necessary, if dual exertional and environmental limitations are proved, for the Secretary to offer testimony by a vocational expert on whether there exists jobs in the national economy which the claimant is capable of performing.
Ferguson at 248.
The case is remanded to the Secretary for development of findings on the extent of the environmental limitation, if any, under which Thomas would labor. If such a limitation is found, it is incumbent on the Secretary to show, through the testimony of a vocational expert, that there exists in the national economy substantial gainful employment which Thomas is capable of performing in light of all the factors contributing to her disability.
REVERSED AND REMANDED.
The ALJ found, on examination of Thomas' employment records, that she last met the insured status requirement on December 31, 1978. Because she claimed that her disability began on July 12, 1979, after her insured status had lapsed, the ALJ denied her claim for a period of disability and disability insurance benefits. Thomas did not appeal this determination.
Thomas' ineligibility for benefits under Title II does not affect her eligibility for supplemental security income disability benefits. The latter, authorized by Title XVI of the Social Security Act, 42 U.S.C. § 1381 et seq., provide assistance to the disabled needy, without regard to the claimant's history of coverage under the Act. Its qualifying financial tests are, rather, income and resource tests. Section 1611(a), 42 U.S.C. § 1382(a). Rosario v. Harris, 492 F.Supp. 414 (D.N.J.1980); Patterson v. Califano, 475 F.Supp. 578 (E.D.Va.1979).
42 U.S.C. § 1382c(a)(3)(A), and if
42 U.S.C. § 1382c(a)(3)(B).
Table No. 1 — Residual Functional Capacity: Maximum Sustained Work Capability Limited to Sedentary Work as a
Result of Severe Medically Determinable Impairment(s)Previous Rule Age Educ. Work Exper. Decision201.18 [Younger Limited [Unskilled Not individual or less or none] Disabled age 45-49] — at least literate and able to communicate in English
20 C.F.R. Subpart P, App. 2, § 201.00(a). Machine trades and bench work by their nature often involve exposure to dust, fumes, and other suspended particulates irritating or intolerable to persons afflicted with respiratory ailments.