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Groves v. Apfel

United States Court of Appeals, Seventh Circuit
Jun 30, 1998
148 F.3d 809 (7th Cir. 1998)

Summary

holding that district judge erred in refusing to look at medical evidence submitted in connection with earlier application and noting that "although the final judgment denying that application was res judicata, this did not render evidence submitted in support of the application inadmissible to establish, though only in combination with later evidence, that she had become disabled after the period covered by the first proceeding"

Summary of this case from Boeck v. Berryhill

Opinion

No. 97-3688

ARGUED June 9, 1998

DECIDED June 30, 1998

Appeal from the United States District Court for the Western District of Wisconsin.

No. 97 C 304.

John C. Shabaz, Chief Judge.

Jason W. Whitley (argued), Notitzke, Gust Sempf, Amery, WI, for Plaintiff-Appellant.

Peggy A. Lautenschlager, Office of the United States Attorney, Madison, WI, John Lee (Argued), Social Security Administration, Office of the General Counsel, Region V, Chicago, IL, for Defendant-Appellee.

Before Posner, Chief Judge, and Cudahy and Eschbach, Circuit Judges.


This is an appeal from a decision by the district court affirming the denial of social security disability benefits to Kathryn Groves. Groves is a middle-aged woman who has chronic degenerative disc disease in several of her spinal discs and has had two operations on her spine. After working for many years as an x-ray technician, she quit in 1990 allegedly because of the pain caused by her spinal condition. The following year she applied for disability benefits. The application was denied, and rather than appealing the denial she filed a second application alleging a later date (November 14, 1994) for the onset of total disability.

Under the regulations governing the social security disability program, an applicant is deemed disabled, without regard to her actual ability to work, if she has a medical condition that appears on a list of per se disabling conditions. One item on this list, Listing 1.05C, is spinal disease expected to last at least twelve months that involves both "(1) pain, muscle spasm, and significant limitation of motion in the spine; and (2) appropriate radicular [i.e., resulting from pressure on a nerve originating in the spinal cord] distribution of significant motor loss with muscle weakness and sensory and reflex loss." Groves claims that the administrative law judge erred in failing to find that her disc disease fits the description in the listing.

She also argues, correctly but irrelevantly, that the district judge should not have refused to look at the medical evidence submitted in connection with her first application for benefits. The argument is correct because although the final judgment denying that application was res judicata, this did not render evidence submitted in support of the application inadmissible to establish, though only in combination with later evidence, that she had become disabled after the period covered by the first proceeding. Res judicata bars attempts to relitigate the same claim, but a claim that one became disabled in 1990 is not the same as a claim that one became disabled in 1994. Rucker v. Chater, 92 F.3d 492, 495 (7th Cir. 1996); Purter v. Heckler, 771 F.2d 682, 690-91 (3d Cir. 1985); cf. Peabody Coal Co. v. Spese, 117 F.3d 1001, 1007-08 (7th Cir. 1997) (en banc). What is true is that under the collateral estoppel branch of res judicata, the judgment denying the earlier claim may bar the relitigation of issues essential to the second claim as well. But it need not, especially when the disabling condition is progressive; for in that event there is no necessary inconsistency in finding an applicant not disabled at time t but disabled at t+1. There thus is no absolute bar to the admission in the second proceeding of evidence that had been introduced in the prior proceeding yet had not persuaded the agency to award benefits. The "readmission" of that evidence is barred only if a finding entitled to collateral estoppel effect establishes that the evidence provides no support for the current claim. Robbins v. HHS, 895 F.2d 1223, 1224 (8th Cir. 1990) (per curiam). That would be true if the earlier evidence had been found unworthy of belief. This is not what happened here. The earlier evidence just wasn't strong enough by itself to establish disability. It still might reinforce or illuminate or fill gaps in the evidence developed for the second proceeding. Robertson v. Sullivan, 979 F.2d 623, 625 (8th Cir. 1992) (per curiam); Frustaglia v. HHS, 829 F.2d 192, 193 (1st Cir. 1987) (per curiam).

But the district judge's error is irrelevant because our review of his decision is de novo, which means that we review the decision by the administrative law judge without giving any deference to the district judge's review of that decision. Griffith v. Callahan, 138 F.3d 1150, 1152 (7th Cir. 1998); Peterson v. Chater, 96 F.3d 1015, 1016 (7th Cir. 1996); Miles v. Chater, 84 F.3d 1397, 1400 (11th Cir. 1996). This raises the question why there should be two tiers of review of identical scope of the administrative decision, Kolman v. Shalala, 39 F.3d 173, 176 (7th Cir. 1994); 16 Charles Alan Wright, Arthur R. Miller Edward H. Cooper, Federal Practice and Procedure sec. 3943, p. 809 (2d ed. 1996), but that is a question properly addressed to Congress rather than to the courts.

The record contains conflicting evidence concerning the severity of Groves's back problem. The administrative law judge could have gone either way. But because his opinion fails to build a bridge from the evidence to the conclusion and is thus analytically inadequate — in a word, unreasoned — we cannot uphold his decision. J.C. Penney Co. v. NLRB, 123 F.3d 988, 996 (7th Cir. 1997); Sarchet v. Chater, 78 F.3d 305, 307 (7th Cir. 1996); Amax Coal Co. v. Franklin, 957 F.2d 355, 358-59 (7th Cir. 1992). In finding that Groves's condition did not fit Listing 1.05C, the administrative law judge relied entirely on the testimony of a Dr. Henke, whom the Social Security Administration had hired to review Groves's medical records. Dr. Henke did not examine Groves, and is not a neurologist or orthopedist. These are not disqualifications, 20 C.F.R. § 416.927(d); Books v. Chater, 91 F.3d 972, 979 (7th Cir. 1996), but they underscore the importance to a rational decision of taking account of the other medical evidence in the record, especially the evidence given by a specialist in the relevant disease who actually examined the applicant. See 20 C.F.R. §§ 416.927(d)(1), (5); Smolen v. Chater, 80 F.3d 1273, 1288 (9th Cir. 1996); Kelley v. Callahan, 133 F.3d 583, 589 (8th Cir. 1998). That is Dr. Cragg, and the administrative law judge did mention his report but only in connection with Cragg's description of Groves's functional capacity, and thus after the administrative law judge had decided that Groves's condition did not meet the criteria of Listing 1.05C and so had moved on to consider (and ultimately reject) an alternative ground for finding her disabled. Dr. Cragg had implied in one of his reports that Groves's condition met the criteria of Listing 1.05C by saying that "Mrs. Groves suffers from cervical and lumbar degenerative disc disease. . . . [I]t would appear to me that her lumbar spine disease falls under the category of 1.05C, which is vertebral disorders, including lumbar degenerative disc disease. Her cervical symptoms would also fall in the same category." The administrative law judge did not mention this evaluation, even though it was one that Dr. Cragg, a neurologist who had treated Groves for years, was entirely competent to offer. Nor did the administrative law judge mention any of the medical reports that were dated prior to her current application. Maybe he labored under the same misapprehension as the district judge regarding the admissibility of those reports. No matter; the failure so much as to mention the competent medical evidence that went contrary to Dr. Henke's opinion made the administrative law judge's explanation for his decision to deny benefits unacceptable. Herron v. Shalala, 19 F.3d 329, 333 (7th Cir. 1994); Zblewski v. Schweiker, 732 F.2d 75, 78-79 (7th Cir. 1984); Jones v. Chater, 65 F.3d 102, 103 (8th Cir. 1995); Prince v. Bowen, 894 F.2d 283, 285-86 (8th Cir. 1990).

It will be recalled, moreover, that Listing 1.05C requires pain. The administrative law judge incorrectly stated in his opinion that Groves takes no pain medicine (the list of pain medicine that she has taken is as long as her right arm). This may have led him to question Cragg's evaluation and give Henke's report more credit than it deserved.

The decision of the district court is reversed and the case remanded to the Social Security Administration for further proceedings consistent with this opinion.

Reversed and Remanded.


Summaries of

Groves v. Apfel

United States Court of Appeals, Seventh Circuit
Jun 30, 1998
148 F.3d 809 (7th Cir. 1998)

holding that district judge erred in refusing to look at medical evidence submitted in connection with earlier application and noting that "although the final judgment denying that application was res judicata, this did not render evidence submitted in support of the application inadmissible to establish, though only in combination with later evidence, that she had become disabled after the period covered by the first proceeding"

Summary of this case from Boeck v. Berryhill

explaining that evidence from previous denial of benefits cannot by itself establish disability in later case but "still might reinforce or illuminate or fill gaps in the evidence developed for the second proceeding"

Summary of this case from Spies v. Colvin

stating "there is no necessary inconsistency in finding [a claimant] not disabled at time t but disabled at t + 1," and thus, there is "no absolute bar to the admission in the second proceeding of evidence that had been introduced in the prior proceeding yet had not persuaded the agency to award benefits"

Summary of this case from Hillier v. Social Sec. Admin

opining that res judicata does not necessarily preclude relitigation of issues essential to a second claim for an unadjudicated period of time

Summary of this case from Seabolt v. Berryhill

stating that readmission of evidence from a prior claim is barred only if such evidence is found to provide no support for the current claim, and that such readmission would be permissible where the prior evidence merely wasn't strong enough by itself to establish disability, but might still reinforce, illuminate or fill gaps in the evidence developed for the second proceeding.

Summary of this case from Stowe v. Berryhill

noting that "a claim that one became disabled in 1990 is not the same as a claim that one became disabled in 1994"

Summary of this case from Boeck v. Berryhill

discussing the "collateral estoppel branch of res judicata" in social security cases

Summary of this case from Roy v. Comm'r of Soc. Sec.

discussing the "collateral estoppel branch of res judicata" in social security cases

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discussing the "collateral estoppel branch of res judicata" in social security cases

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discussing the "collateral estoppel branch of res judicata" in social security cases

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discussing the "collateral estoppel branch of res judicata" in social security cases

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discussing the "collateral estoppel branch of res judicata" in social security cases

Summary of this case from Albanna v. Comm'r of Soc. Sec.

discussing the "collateral estoppel branch of res judicata" in social security cases

Summary of this case from Dolder v. Comm'r of Soc. Sec.

discussing the "collateral estoppel branch of res judicata" in social security cases

Summary of this case from Downs v. Comm'r of Soc. Sec.

stating "there is no necessary inconsistency in finding [a claimant] not disabled at time t but disabled at t +1," and thus, there is "no absolute bar to the admission in the second proceeding of evidence that had been introduced in the prior proceeding yet had not persuaded the agency to award benefits"

Summary of this case from Thedford v. Colvin

discussing the "collateral estoppel branch of res judicata" in Social Security cases

Summary of this case from Erb v. Colvin

discussing the "collateral estoppel branch of res judicata" in Social Security cases

Summary of this case from McClain v. Colvin

discussing the "collateral estoppel branch of res judicata" in Social Security cases

Summary of this case from Osborn v. Colvin

In Groves, the Seventh Circuit held that the failure to even mention the opinion of competent medical evidence though contrary to state agency evidence "makes the ALJ explanation for denying benefits unacceptable."

Summary of this case from Wilson v. Astrue

In Groves, the ALJ relied on testimony provided by the SSA's expert, even though that doctor had not actually examined the applicant.

Summary of this case from Dodge v. Barnhart

In Groves v. Apfel, 148 F.3d 809, 811 (7th Cir. 1998), the court refused to uphold the ALJ's decision because "the opinion fail[ed] to build a bridge from the evidence to the conclusion and is thus analytically inadequate — in a word, unreasoned...."

Summary of this case from Halvorsen v. Barnhart

In Groves v. Apfel, 148 F.3d 809, 811 (7th Cir. 1998), the Court of Appeals for the Seventh Circuit held the Step 3 finding of the administrative law judge that the plaintiff did not meet Listing 1.05(C) "analytically inadequate — in a word, unreasoned" in view of his utter failure to discuss competing evidence by a treating physician implying that the plaintiff did meet the Listing.

Summary of this case from MacDonald v. Massanari
Case details for

Groves v. Apfel

Case Details

Full title:Kathryn K. Groves, Plaintiff-Appellant, v. Kenneth S. Apfel, Commissioner…

Court:United States Court of Appeals, Seventh Circuit

Date published: Jun 30, 1998

Citations

148 F.3d 809 (7th Cir. 1998)

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