Stеphen R. Snead appeals from the district court’s decision affirming the Social Security Commissioner’s (“Commissioner”) revocation of disability insurance benefits under Title II of the Social Security Act. The Commissioner revoked Snead’s benefits to comply with statutory changes disallowing the award of benefits where alcoholism contributed as a material factor to the original finding of disability. Snead asserts that his other ailments, independent of his alcoholism, require an award of disability insurance benefits.
As we explain below, Snead presented evidence concerning his heart condition that should have prompted further investigation by the Administrative Law Judge (“ALJ”). Because the ALJ failed to develop the record sufficiently, we reverse the district court and remand for further proceedings.
I. Background
Snead first received disability insurance benefits based on alcoholism, starting on July 31, 1990. After a 1996 statute barred the Commissioner from awarding social security benefits based on alcohol or drug abuse, the Commissioner revoked Snead’s benefits.
See
42 U.S.C. § 423(d)(2)(C); 20 C.F.R. § 404.1535. To contest this revocation, Snead sought and received a hearing before an ALJ on April 29, 1997. At the hearing, Snead argued that his mеntal and physical impairments sufficed to render him disabled, even with the effects of his alcoholism excluded. Specifically, Snead complained of depression, irritability, lack of concentration, cerebral atrophy, and congestive heart failure. The ALJ rejected Snead’s claim on March 18, 1998, and denied him benefits from January 1, 1997, the effective date of the 1996 statute. Snead sought review in the Social Security Appeals Council, which affirmed the ALJ’s decision on May 24, 1999, resulting in a final agency decision against Snead. Snead appealed to the district сourt,
see
42 U.S.C. § 405(g), and that court affirmed the Commissioner’s final decision on February 21, 2001. Snead timely appealed,
1
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and now seeks the restoration of his benefits from January 1, 1997 to March 18, 1998. We reverse and remand to permit the Commissioner to develop the record fully regarding Snead’s physical cоndition.
See Nevland v. Apfel,
II. Discussion
We review the district court’s decision de novo.
See Hensley v. Barnhart,
In considering Snead’s claim, the ALJ followed the standard five-step procedure
2
relevant to the determination of disability in social security proceedings.
See
20 C.F.R. § 404.1520. The ALJ found that Snead met the first three steps and so qualified for an assessment of his residual functional capacity (RFC) at steр four of the determination. This assessment resulted in the ALJ’s decision that Snead could not perform his past relevant work. The ALJ went on to step five, where he determined that Snead could adjust to other work existing in substantial numbers in the economy, including jobs like janitor, machine feeder and tender, material handler, bench assembler, and light packer. While Snead bore the burden of proving his disability (independent of alcoholism) through step four, at step five the burden fell on the Commissioner to show that Snead’s non-alcohol related impairments would not prevent him from working in available jobs.
See Cox v. Apfel,
A. Snead’s Alleged Mental Impairments
At the March 18, 1998 hearing before the ALJ, Snead asserted that his mental impairments, including depression and uncontrollable anger, prevented him from working, independent of any symptoms of alcohol abuse. To establish Snead’s RFC, the ALJ inquired closely into both subjective and objective evidence of Snead’s mental conditions. The ALJ found Snead’s subjective complaints only partially credible because Snead’s testimo
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ny regarding his conditions aрpeared “evasive” and “self-serving.”
3
See Polaski v. Heckler,
Substantial evidence in the record supports the ALJ’s conclusion that Snead’s mental impairments, viewed in isolation, would not suffice to render him disabled. Consequently, we affirm the district court on that limited finding.
See Grebenick v. Chater,
B. Snead’s Heart Condition
In аddition to claims of mental illness, Snead presented evidence that he suffered a congestive heart failure in September, 1997 and again in February, 1998. Snead argued that the heart condition underlying these failures left him disabled, irrespective of his alcoholism. Congestive heart failure is аn acute disruption of the heart’s ability to deliver oxygen to the body, most commonly caused by “dilated cardiomyopa-thy,” a chronic disease in which “the walls of the heart chambers stretch (dilate) to hold a greater volume of blood than normal.” Jacqueline L. Longe, ed., 2 The Gale Encyclopedia of Medicine 896 (2d ed., 2002). In most cases, this incurable condition worsens over time until death results. Id. at 899. Only twenty-five percent of patients with dilated cardiomyopa-thy live for ten years after diagnosis, and men tend to die from the condition sooner than women. Id.
To support his claim, Snead presented the medical records of his two hospitalizations for congestive heart failure. Snead also presented a March 3, 1998 letter from his board-certified internist, Dr. T.K. Chaudhuri, which further supported his claim. Dr. Chaudhuri explained that “Snead is suffering from severe dilated cardiomyopathy [with] congestive heart failure and he is disabled from any job at this [particular] time.”
Even though Snead’s evidence showing his incurable cardiomyopathy went uncon-tradicted, the ALJ did not incorporate evidence of Snead’s heart condition in the hypothetical posed to the VE.
Cf. Frankl v. Shalala,
C. The ALJ’s Duty to Develop the Record
We begin our analysis of the ALJ’s duty to develop the record with a brief overview of the importance of this duty. Normally in Anglo-American legal practice, courts rely on the rigors of the adversarial process to reveal the true facts of a case.
See, e.g., Schaal v. Gammon,
In this case, the ALJ accepted as credible the evidence showing that Snead suffered from congestive heart failure due to dilated cardiomyopathy. Although Snead’s physicians did successfully resolve Snead’s acute heart failures, the underlying condition appears generally incurable. See Jacqueline L. Longe, ed., 2 The Gale Encyclopedia of Medicine 899 (2d ed., 2002). While quickly dismissing Snead’s two incidents of severe heart failure because they did not last for twelve months, *839 the ALJ gave no consideration to what effect this underlying heart condition might have on Snead’s ability to work.
Furthermore, no clinical findings existed on the record as developed by the ALJ that would undermine Dr. Chaudhuri’s report stating that Snead could do no work. Therefore, the ALJ’s decision to reject Dr. Chaudhuri’s opinion lacks support in the record. If the ALJ had conducted a further inquiry, he might have discovered clinical evidence supporting Dr. Chaudhu-ri’s opinion that Snead could not work. If Dr. Chaudhuri’s opinion found supрort in uneontradicted clinical evidence, then that opinion could potentially receive “controlling weight” under social security regulations as the opinion of Snead’s treating physician.
See
20 C.F.R. § 404.1527. At a minimum, Dr. Chaudhuri’s opinion, if properly supported, would undermine the Commissioner’s effort tо satisfy her burden at step five of the analysis. Because this evidence might have altered the outcome of the disability determination, the ALJ’s failure to elicit it prejudiced Snead in his pursuit of benefits.
See Shannon v. Chater,
Once aware of the crucial issue of Snead’s cardiomyopathy, the ALJ should have taken steps to develop the record sufficiently to determine whether Dr. Chaudhuri’s evidence deserved controlling weight. The ALJ should have understood that Snead’s heаrt condition, a condition that generally results in death, might be expected to seriously limit his ability to work for well beyond the twelve-month statutory period. With this central and potentially dispositive issue unexplored by the ALJ, we have no confidence in the reliability of the RFC upon which the ALJ based his dеcision. Dr. Chaudhuri’s opinion, on this record, stands as valid evidence that Snead may be totally disabled and unable to work because of a heart condition. Consequently, the ALJ’s conclusion to the contrary cannot stand. We must therefore reverse the district court and remand, with instructions to remand the case to the Commissioner for further development of the record.
See Boyd v. Sullivan,
III. Conclusion
Because the ALJ failed to develop the record fairly and fully, we reverse the district court and remand for further proceedings consistent with this opinion.
Notes
. Unfortunately, we must begin this decision with an explаnation for a delayed decision in this case. Docket records show that Snead properly appealed the district court’s decision on April 23, 2001. However, a communication failure between the district court and this court caused this case to sit in limbo for over two years, until it finally received an appellate docket number on June 3, 2003. Our decision today comes just over seven full years after Snead first lost his benefits. As the Third Circuit has recently stated, “It should go without saying, but apparently bears repeating, that claimants seeking Social Securi
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ty disability benefits deserve better.”
Cadillac v. Barnhart,
. The five steps consist of the following determinations: 1) whether the claimant conducts work for substantial gain, 2) whether the claimant has a severe impairment, 3) whether the impairment equals or exceeds a listed impаirment, 4) whether the claimant can perform his past relevant work, and 5) whether there exist other jobs in substantial numbers available for a person of the claimant's limitations. 20 C.F.R. § 404.1520(a)(4).
. The ALJ also noted that although Snead denied an ongoing alcohol problem, he admitted having drunk heavily the night before a consultative psychological examination and that the examining doctor noted the smell of alcohol on Snead’s breath. As this court has previously observed, active alcoholism does not preclude a finding of disability, so long as the claimant would still satisfy the regulatory requirements independent of the alcohol abuse.
See Brueggemann v. Barnhart,
. In
Shannon,
we affirmed the denial of benefits because the evidence the claimant felt should have been developed had only "minor importance” to the disability determination.
