*2 WINTER, Circuit Judge: appeals Lewis Robert L. from the district court’s affirmance of the Secretary of H.E. of disability W.’s denial benefits under the Security Act. Social He claims to be dis- the meaning abled within of 42 U.S.C. 416(i), 423(d), due to a §§ severe chronic anxiety state tension and moderately severe hypochondriacal neurosis. The Secretary Lewis admits that suffers from these condi- tions, but contends that there is substantial evidence to his determination Lewis can nevertheless and therefore is not disabled. We are convinced that there is a firm base evidentiary to show that Lewis is dis- impairment, abled due to mental and there is not substantial evidence to refute it. We therefore reverse and direct order entry requiring of an the Secretary to grant the claimed benefits.
I. August 7, 1922, Lewis born was and com- pleted only years nine of schooling, but has the equivalent high of a school on education testing. basis of GED He has worked driver, as a truck forklift operator, and salesman. He claimed that he had been August 8, 1971, unable to work since be- prostatitis cause of chronic and ten- anxiety sion state.
The evidence showed that was Lewis urologist 18, 1970, treated on by May prior thereto he had had pros- chronic a number years tatitis for which partially by been controlled In medication. June, 1970, he underwent a transurethral Charleston, Green, Va., W. Dale W. for prostate. per- resection of Because of appellant. perineal sistent discomfort and infection, prostatic residual he was hospital- Marinucci, Regional Fred Atty. Asst. December, again ized physical His Field, III, Charleston, (John A. Atty., U.S. responded temporarily to medical Va., Jarrett, Jr., W. and H. Marshall Asst. management, but when he resumed nor- his Va., Atty., Charleston, brief), U.S. W. on mal and attempted work, they activities appellee. Beginning May, 1971, recurred. he be- BRYAN, Judge, gan Before to be treated for an anxiety Senior Circuit tension BUTZNER, and WINTER Circuit state in addition treatment for chronic Judges. prostatitis. Lewis was also examined Kitch- November, again Lewis hos- was ing, psychiatrist the Secretary, selected prostato- a radical and underwent
pitalized 5,1973. January Kitching diagnosed in an performed was vesiculectomy which suffering “hypochondriacal as perineal his discomfort to resolve effort neurosis, moderately severe, chronic operation While the infection. prostatic by preoccupation manifested with the body controlling was successful apparently *3 presumed diseases various organs and of relieving persistent in not infection —but from ordinary and withdrawal activities of to pain continued lower abdominal —he By impotence and physical life.” reason of anxiety ten- with chronic problem have a ills, Kitching Dr. Lewis stated that Kiser, treating physi- his Dr. sion state. regressed and “concomitantly withdrew April, in that cian, the view expressed moderately life in a responsibility from and disabled totally permanently and Lewis was hypochondriacal adjustment severe neurotic to unlikely he would return it was and that . .” not flatly, He stated “I do think thought Dr. Kiser employment. gainful gainful he can or will do sustained work. August existed since condition had that this might He in see and make a psychotherapy 7, 1971. adjustment, would healthier but there have 12, 1972, Dr. Kiser motivating dated June strong In a letter forces which I do . . major problem, present chron- not see at . even to enter Lewis’s outlined that therapy.” by only partially was controlled anxiety, ic medi- therapy tranquilizing with constant Judge, Administrative Law whose The. of complained Lewis noted that cation. He findings accepted by were region which perineal in the pain continued court, and sustained the district conclud- Dr. activity. by physical aggravated was ed that Lewis was not disabled within the that thought unlikely it Lewis meaning Kiser of Act. He called attention to labor, but heavy hearing manual the fact that at the Lewis to did not be able any exhibit and jobs physical handicaps in did not occupation other suggested that suffering any to or appear pain be in diffi- cope Lewis if could might be considered recognized that psycho- culties. While Kiser problems. Dr. emotional with his logical testing showed “marked conversa- view, in his let- expressed the subsequently overlay significant hypo- reaction and tion 2,1972, was that Lewis November ter dated chondriasis,” Kitching and that Dr. diag- and was permanently disabled totally and “moderately hypochondriacal nosed severe any gainful substantial to resume unable neurosis,” Dr. Kitching he stressed that or in the foreseea- at that time occupation considered the illness “mild for industrial ble future. Overall, adaptability.” the Administrative psy- made a Rodgers, psychologist, Dr. Judge thought Law that the evidence es- Septem- Lewis in evaluation of chological physical impairment togeth- tablished some ber, led to sus- His evaluation him anxiety with a severe er chronic tension overlay conversion reaction pect “marked moderately hypochondria- state severe hypochondriasis, probably significant neurosis, that to cal but it failed indicate aspects, to neurosis compensation with degree severity that of which would inca- may present, physiopathology whatever all pacitate Lewis for forms of substantial to repressive, mildly generally in a rather gainful activity. man.” depressed and anxious
moderately II. urged to more Rodgers Lewis undertake work or an involve- return to activity case, which, we if As view the it is one —a part-time consistent any kind of ment “disability” found, disability is to be stems Lewis Rodgers has, noted that activity, course, but mental illness. of from added, Rodg- “resistant,” “I completely physical was solved his [Dr. to stemming history prostatitis, much effective his of that I have doubt ers] even does not but contend offer.” justify prima alone would an award of a out a facie condition case of disability made, disability benefit to him. therefore di- due to mental impairment when she showed (1) men- principal rect our attention to Lewis’s that her own doctor considered her “dis- psychological nerves,” tal or difficulties. abled from a standpoint (2) of her past history subjective medical and the Security is clear the Social It testimony of herself and her husband were Both psychological Act covers disabilities. physician’s conclusion, consistent with her 416(i)(l)(A) and 42 U.S.C. § U.S.C. (3) diagnosis psychiatrist 423(d)(1)(A) “disability” define as “inabili § she consulted was also consistent with a engage substantial ty any to finding disability. This any medically reason activity determi showing was require deemed sufficient physical impairment nable or mental the Secretary go produce forward and added.) addition, .” (Emphasis . the claimant had 423(d)(3) states: *4 sufficient capacity residual she that could subsection, purposes “physi- For of this a perform job a in the national economy. impair- mental impairment” cal or is an Here, the record shows regard to Lewis anatomical, phy- ment that results from (1) treating that his physician, Kiser, Dr. siological, or abnormalities totally considered him disabled when his medically are which demonstrable ac- problem emotional account, was taken into ceptable laboratory diagnos- clinical and (2) subjective that Lewis’s testimony was techniques. added.) tic (Emphasis conclusion, (3) consistent with this that a upholding Secretary, In the the dis psychiatrist, Kitching, Dr. who examined appendix trict court relied on the to the him, expressed the view that he could not regulations, 20 Secretary’s Subpart C.F.R. do (4) sustained that a 12.04, P, App. which describes certain disa psychologist confirmed the existence of bling The mental conditions. court district “marked overlay conversion reaction was of the view that was necessary it significant hypochondriasis, probably with Lewis’s condition within fall one of the compensation aspects neurosis . . . categories listed for him order to recover. The case stronger for Lewis is even than This was error. the case the claimant in Wyatt. The regulation handy guide lay is a to [T]he record thus requires the conclusion that examiners to disability advise them when Lewis is disabled and entitled to benefits resulted, unquestionably has unless there is substantial to show regulation but the cannot be to construed not severely is so disabled that cannot the establish exclusive means which perform job. some showing may the made. be H.E.W., Secretary Martin v. F.2d 492 IV. (4 1974). 910 Cir. The Judge Administrative Law found Rather, the test appropriate is whether that Lewis could jobs the of “sales- impairment the claimant’s “mental or im- man, light driver, light truck delivery man pairments are severity of such that he sedentary and similar to light work engage any . cannot . . . .” The “sedentary limitation to which gainful work light necessary work” was because of the economy exists in the national . . . persistence physical symptoms which, de- 423(d)(2)(A). 42 We the think that spite prostate Lewis’s surgery, prevented supports only record the conclusion performing him from heavy manual labor. met. test was there Since was no direct evidence that was capable any of performing of the III. specific jobs, enumerated the Administra- (4 Wyatt Weinberger, Judge’s F.2d 1285 tive Law conclusion must have been 1975), Cir. we held that a on finding claimant based a that Lewis’s mental im- VI. sufficiently severe as to pairment was We turn to what is disabling. totally therefore that conclude on the support for such record asserted to be us, record before the overwhelming evi finding. totally dence shows that Lewis is disabled there is not substantial evidence to principally upon Secretary relies contrary remand, conclusion. On reports of the two from the passages three the district enter an Kiser, court should order di Dr. psychologist. the physicians recting the grant discussing after claimed treating physician, difficulties, benefits. stated Lewis’s emotional con- [light] jobs might be
“occupation in REVERSED AND REMANDED. with the adequately cope sidered if he can This statement is con- problem.” emotional BRYAN, ALBERT V. Senior Circuit Moreover, begs question. ditional and Judge (dissenting): of other statements in the context it comes The District has found Court that, considering the emotional by Dr. Kiser record, whole, when considered as a sup- Lewis was disabled. problem, ports finding Secretary. of the Like- Next, Secretary points to the state- wise, I say cannot the administrative Rodgers, psycholo- the clinical ment decision is without substantial evidence to . Lewis, that he “sus- gist who examined it. sustain I would affirm. Whiten v. be much better off pected] patient Finch, 1971). (4 Cir. F.2d 73 situation . . . kind of work in some However, Rodgers immediately added *5 quite sure how to accom- was “not work, and noted
plish” a return are difficult to resolve
“these context, Thus, taken
. .” Rodgers relied on by Dr.
statement can no evidence
Secretary is might to show that he only tends but LYTLE, Appellee, Robert therapeutic proce- by appropriate be aided they were available.
dures if argues Secretary COMMISSIONERS OF Finally, ELECTION OF al., Appellants. Secretary’s Kitching, UNION diagnosis of Dr. COUNTY et impair- that Lewis’s examining psychiatrist, No. 75-1327. adaptability for industrial ment was “mild Appeals, United States Court personal adapta- social and and severe for Fourth Circuit. bility” that Lewis can do sub- is evidence accept gainful work. cannot stantial 12, Argued Nov. 1975. Kitching goes argument, Decided Feb. “I do flatly not think to conclude can or will do sustained [Lewis]
work.” attempts rely also Judge’s Law obser Administrative
on the appear Lewis did not
vation that alleged In cases of
pain testifying. while disability, lay such observa and, no weight to little or
tion is entitled alone, evi
standing cannot Secretary’s decision.
dence to