The opinion of the court was delivered by: FISHER
This is an action under § 205(g) of the Social Security Act, as amended, 42 U.S.C. § 405(g), to review a final decision of the Secretary of Health and Human Services denying plaintiff's claim for disability insurance benefits.
An administrative decision to deny benefits will be upheld on review if supported by "substantial evidence." 42 U.S.C. § 405(g); Dobrowolsky v. Califano, 606 F.2d 403, 406 (3d Cir. 1979). Substantial evidence has been 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, 1427, 28 L. Ed. 2d 842 (1971). See also Lewis v. Califano, 616 F.2d 73, 76 (3d Cir. 1980). The conclusive effect of the substantial-evidence rule applies not only with respect to the Secretary's findings as to basic evidentiary facts, but also to inferences and conclusions drawn therefrom. Jolley v. Weinberger, 537 F.2d 1179, 1181 (4th Cir. 1976); Reyes v. Secretary of HEW, 155 U.S.App.D.C. 154, 476 F.2d 910, 914 (D.C.Cir.1973). Despite the deference to administrative decisions required by these standards, a reviewing court "retain(s) a responsibility to scrutinize the entire record and to reverse or remand if the Secretary's decision is not supported by substantial evidence." Smith v. Califano, 637 F.2d 968, at 970 (3d Cir. 1981); Baerga v. Richardson, 500 F.2d 309, 313 (3d Cir. 1974), cert. denied, 420 U.S. 931, 95 S. Ct. 1133, 43 L. Ed. 2d 403 (1975). Further, even if the Secretary's factual findings are supported by substantial evidence, this court may review whether the administrative determination was made upon correct legal standards. Strickland v. Harris, 615 F.2d 1103, 1108 (5th Cir. 1980); McCarty v. Richardson, 459 F.2d 3, 4 (5th Cir. 1972).
The term disability means inability to engage in any substantial gainful activity by reason of a physical or mental impairment that can be expected to result in death or that has lasted or can be expected to last for a continuous period of at least 12 months. 42 U.S.C. § 423(d)(1)(A). The existence of such impairment must be demonstrable by medically-acceptable clinical and laboratory diagnostic techniques. 42 U.S.C. § 423(d)(3). Where a finding of disability cannot be made based on medical evidence alone, other evidence must be considered. Such evidence may include information about:
(1) The individual's residual functional capacity;
(2) The individual's age, education, and work experience; and
(3) The kinds of substantial gainful activity (work) which exists in significant numbers in the national economy for someone who can do only what the individual can do.
20 C.F.R. § 404.1502(b). See 42 U.S.C. § 423(d)(2)(A). Further, the court must consider the (1) objective medical facts; (2) diagnoses and medical opinions of examining physicians; (3) subjective evidence of pain and disability as described by plaintiff and corroborated by others who have observed him; and (4) plaintiff's age, educational background and work history. Blalock v. Richardson, 483 F.2d 773, 776 (4th Cir. 1972); Gold v. Secretary of HEW, 463 F.2d 38, 41 n. 2 (2d Cir. 1972).
Plaintiff filed an application for disability insurance benefits on July 7, 1978 (Tr. 173-176), stating that she was unable to work beginning in February 1977 because of injuries to her neck, back, arms and shoulders. Her application was denied on August 10, 1978 (Tr. 177-178), as was her request for reconsideration (Tr. 180-181). On October 20, 1978 plaintiff requested a hearing before an administrative law judge (ALJ) (Tr. 56), and hearings in this matter were held on January 31, 1979 and March 12, 1979 (Tr. 58-172). The ALJ awarded plaintiff disability benefits for the period of February 19, 1977 to January 11, 1979, but not thereafter (Tr. 42-49). On November 19, 1979 the Appeals Council reviewed and vacated the decision of the ALJ and remanded the case for further development of the record to "clarify (plaintiff's) residual functional capacity" and resolve "the issue of pain" (Tr. 30). In his June 20, 1980 opinion, rendered subsequent to a hearing held on May 16, 1980, the ALJ again found that plaintiff's disability ceased on January 11, 1979 (Tr. 16-26). The decision of the ALJ became the final decision of the Secretary when it was approved by the Appeals Council on August 25, 1980 (Tr. 4-5).
In finding plaintiff not disabled, the ALJ relied on the reports of Drs. Cunningham, Goldfedder and Feldman. Plaintiff's claim for disability benefits arises out of a work-related accident on February 19, 1977 in which she injured her neck (herniated disc at C5-6). As a result, plaintiff underwent two surgical procedures an anterior discoidectomy at the C5-6 level and a spinal fusion at the C5-6 and C6-7 levels. As the ALJ indicated in his opinion, Dr. Cunningham, a treating neurosurgeon, found that plaintiff's post-operative objective neurologic exam was normal (Tr. 271, 273). However, Dr. Cunningham noted throughout all of his reports that plaintiff consistently complained of pain, and that her pain had regressed back to the point it was at prior to the spinal fusion (Tr. 273). Dr. Cunningham noted that the strongest evidence for persistent disability as a result of this pain "is (the) patient's word" (Tr. 289). From a mechanical and objective point of view, Dr. Cunningham had no further recommendations within the sphere of neurosurgery (Tr. 273). However, Dr. Cunningham noted that because of plaintiff's long-standing radiculopathy, irreversible changes in the nerves themselves may be responsible for her persistent pain (Tr. 273, 289).
Dr. Goldfedder similarly found no objective neurological findings to account for plaintiff's symptoms of radiculopathy and saw no indication for further diagnostic neurosurgical procedures or rehabilitative measures (Tr. 278). Dr. Goldfedder suggested that plaintiff become involved with psychiatric consultation and counselling or a pain clinic (Tr. 278). Despite Dr. Goldfedder's recognition of plaintiff's persistent pain, he concluded that plaintiff can lift frequently up to 50 lbs. (Tr. 279), in contrast to plaintiff's claim that she is only able to lift 5 lbs. (Tr. 156). Mr. Sofranko, a physical therapist, also corroborates plaintiff's persistent complaints of subscapular pain (Tr. 288).
Dr. Feldman, a psychiatrist to whom plaintiff was referred by the State of New Jersey, concluded that, in addition to plaintiff's physical problems, she has anxiety neurosis with depressive features. In his view, she has symptoms of anxiety and depression which ...