Fargnoli v. Apfel ( 2001 )


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  •                                                                                                                            Opinions of the United
    2001 Decisions                                                                                                             States Court of Appeals
    for the Third Circuit
    4-11-2001
    Fargnoli v. Apfel
    Precedential or Non-Precedential:
    Docket 99-1989
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    Recommended Citation
    "Fargnoli v. Apfel" (2001). 2001 Decisions. Paper 73.
    http://digitalcommons.law.villanova.edu/thirdcircuit_2001/73
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    Filed April 11, 2001
    UNITED STATES COURT OF APPEALS
    FOR THE THIRD CIRCUIT
    No. 99-1989
    TOMMASO FARGNOLI,
    Appellant
    v.
    WILLIAM A. HALTER,* COMMISSIONER,
    SOCIAL SECURITY ADMINISTRATION
    Appeal from the United States District Court
    for the Eastern District of Pennsylvania
    (D.C. Civil Action No. 97-cv-6913)
    District Judge: Honorable Clarence C. Newcomer
    Argued: August 2, 2000
    Before: ALITO, ROTH and AMBRO, Circuit Judges
    (Filed April 11, 2001)
    _________________________________________________________________
    * Substituted for Kenneth S. Apfel pursuant to Rule 43(c)(2) of the
    Federal Rules of Appellate Procedure.
    INEZ A. DE BAPTISTE, ESQUIRE
    (Argued)
    Silver & Silver
    42 Lancaster Avenue
    Ardmore, PA 19003
    Counsel for Appellant
    ANDREW C. LYNCH, ESQUIRE
    (Argued)
    Office of the General Counsel
    Social Security Administration
    P.O. Box 41777
    Philadelphia, PA 19101
    Counsel for Appellee
    OPINION OF THE COURT
    AMBRO, Circuit Judge:
    This case arises from the denial of Tommaso Fargnoli's
    ("Fargnoli") application for disability insurance benefits
    under Title II of the Social Security Act, 42 U.S.C. SS 401-
    433 ("Act"). Fargnoli appeals the District Court's order
    granting summary judgment in favor of the Commissioner
    of the Social Security Administration (the "Commissioner").1
    The District Court exercised jurisdiction pursuant to 42
    U.S.C. S 405(g). Our jurisdiction arises under 28 U.S.C.
    S 1291. For the reasons set forth below, we will vacate the
    District Court's order and remand the case with instruction
    to return it to the Commissioner for further proceedings
    consistent with this opinion.
    I. Factual and Procedural History
    Fargnoli is an unskilled construction labor er with a fifth
    grade education. He was born in Italy and came to the
    United States in 1964 at the age of seventeen. Far gnoli
    applied for disability insurance benefits on October 29,
    1993, alleging that as of May 10, 1985, he was disabled
    _________________________________________________________________
    1. The Social Security Administration is her einafter referred to as the
    "SSA."
    2
    and unable to work due to a work-related back injury.
    Because of his limited work history, Fargnoli's date last
    insured was December 31, 1990. He was denied benefits
    initially and on reconsideration.2 At Fargnoli's request, a
    hearing before an administrative law judge (the"ALJ") was
    held on February 15, 1996.
    Fargnoli appeared at the hearing with his counsel and
    testified, with the assistance of an Italian interpreter, about
    his back impairment. Fargnoli testified that he suffers from
    severe low back pain and radicular pain primarily in the
    left leg but at times in the right leg. He also testified that
    he sometimes has problems with numbness in his left arm.
    When asked how his impairment affects his ability to work
    around the house, Fargnoli testified that he has difficulty
    going up and down the stairs and is unable to do any
    household chores. He also testified that he has difficulty
    dressing because he cannot bend over. W ith regard to work
    restrictions, he testified that his back injury limits him to
    lifting approximately five to ten pounds, sitting or standing
    for only ten to twenty minutes at a time, and walking the
    equivalent of only one to two blocks. Further , he testified
    that although he occasionally drives, doing so is painful
    because he cannot take his pain medication which makes
    him sleepy and dizzy. He testified that his medications at
    the time of the ALJ hearing were Daypro, a nonsteroid anti-
    inflammatory, and Ultram, a pain reliever .
    The medical evidence of record, as developed before the
    ALJ, reflects that Fargnoli had been continuously treated
    with two doctors since his May 1985 injury -- Dr . Dennis
    B. Zaslow, an orthopedic surgeon, and Dr . Max Karpin, a
    neurosurgeon. Dr. Zaslow saw Far gnoli approximately once
    a month from September 1985 until approximately July
    1995. At Fargnoli's initial visit in September 1985, Dr.
    Zaslow diagnosed Fargnoli with an acute lower dorsal and
    lumbar sprain and strain and lumbosacral somatic
    _________________________________________________________________
    2. The administrative review within the SSA of eligibility for disability
    insurance benefits involves a four-step pr ocedure, consisting of an
    initial
    determination, a request for reconsideration, a request for a hearing
    before an ALJ, and a request for r eview of the ALJ's decision by the
    Appeals Council. See 20 C.F.R. S 404.900.
    3
    dysfunction. He stated that Fargnoli's range of motion in
    his lower back was poor, his gait was labor ed and he
    favored his left leg. Further, he noted that Fargnoli's left
    shoulder was drooped lower than the right, his trunk was
    sidebent to the left and paravertebral spasms wer e seen in
    the lumbar muscles of the middle to lower back. Finally, he
    indicated that straight leg raising was causing radicular
    pain in Fargnoli's left leg. Based on his evaluations, Dr.
    Zaslow stated that Fargnoli could not work as of December
    31, 1990, his date last insured.
    Dr. Zaslow's treatment notes consistently document
    objective muscular symptoms associated with Far gnoli's
    back impairment, including his inability to perform or
    difficulty with squatting, bending, leg lifting, changing
    positions, sitting, standing and walking, his tender ness to
    palpitation and manipulation, and the often spastic
    condition of his low back. Dr. Zaslow's tr eatment notes also
    document the variability of Fargnoli's condition, which
    changed depending on various conditions, impr oved with
    prolonged periods of rest or immobilization and favorable
    weather, and worsened with periods of incr eased activity or
    occurrences of poor weather.
    In January 1986, Fargnoli began treatment with Dr.
    Karpin. At Fargnoli's initial visit, Dr . Karpin reported that
    Fargnoli had a labored gait, difficulty walking, was favoring
    the left lower extremity, and had limited flexion and
    paravertebral spasm. Dr. Karpin's diagnosis was post-
    traumatic status, low back syndrome, dorsolumbar sprain
    and strain and left lumbar radiculopathy. Dr . Karpin
    reported similar findings until approximately November 7,
    1986, when he noted that Fargnoli was showing gradual
    improvement. Dr. Karpin's later tr eatment notes reflect his
    opinion that Fargnoli suffered fr om chronic back pain that
    would improve and worsen periodically accor ding to factors
    such as activity and weather, but would neither improve
    nor worsen on a permanent basis from continued
    medication and physical therapy. Over the course of
    Fargnoli's treatment, Dr. Karpin prescribed numerous
    medications.
    The record reflects reports or mention of certain
    diagnostic tests, including an October 1985 EMG of
    4
    Fargnoli's left lower extremity, an October 1985 CT-scan of
    his lumbar spine, and a thermogram. In his November 17,
    1985 report, Dr. Zaslow states that the EMG was abnormal
    and notes that the findings were suggestive of
    radiculopathy at the L5 region. Further , he states that the
    CT-scan showed degeneration of the L3-L4 disc and a
    strong possibility of a fracture of the anterior edge of the
    superior plateau of L4. Finally, he notes that the
    thermogram was abnormal. A tomogram of the spine was
    performed in late 1985 to confir m the existence of a
    fracture. It indicated interosseous distal herniation of the
    lumbar spine, but no evidence of fracture. A February 1986
    MRI was performed that evidenced an abnormal disc
    intensity between L3-4 with a high degree of suspicion of
    herniation and abnormal discs between L1-2, L4-5 and L5-
    S1. A January 1986 bone scan was reported by Dr . Zaslow
    as being normal. Although strongly r ecommended by both
    Drs. Zaslow and Karpin to confirm disc her niation, Fargnoli
    would not agree to undergo a myelogram because of his
    fear of needles and invasive procedures.
    Additionally, the treatment notes of Dr . Zaslow and Dr.
    Karpin reflect that Fargnoli has under gone physical
    therapy, varying from three times a week to one time a
    week, from after his accident until appr oximately
    September 1991, although the treatment notes fr om his
    therapists are not included in the recor d.3
    On August 5, 1996, the ALJ issued an opinion denying
    Fargnoli's claim for disability insurance benefits, stating
    that "the evidence of record does not r eveal that the
    claimant's condition was sufficiently sever e to preclude him
    from performing at least light work. . . ." The Appeals
    Council of the SSA declined further review on October 4,
    _________________________________________________________________
    3. The record also includes the tr eatment notes and opinions of
    physicians treating or examining Fargnoli, or reviewing his medical
    records, after his date last insur ed (December 31, 1990). Because these
    treatment notes and opinions are for a time period after Fargnoli's last
    insured date and, with the exception of one tr eatment note from Dr.
    Karpin, were not mentioned in the ALJ's opinion, we do not know what
    significance, if any, they had in the ALJ's deter mination. On remand, the
    ALJ should discuss the significance of these r ecords and whether he is
    relying on any of them in reaching his determination.
    5
    1997, making the ALJ's determination the final decision of
    the Commissioner.
    Having exhausted his administrative remedies, Fargnoli
    filed an action in the United States District Court for the
    Eastern District of Pennsylvania seeking judicial review of
    the ALJ's decision. The parties filed cross-motions for
    summary judgment. The District Court granted the
    Commissioner's request for summary judgment and denied
    Fargnoli's request. Fargnoli appeals the District Court's
    decision.
    II. Discussion
    A. Standard of Review.
    Although our review of the District Court's or der for
    summary judgment is plenary, "our review of the ALJ's
    decision is more deferential as we deter mine whether there
    is substantial evidence to support the decision of the
    Commissioner." Knepp v. Apfel, 
    204 F.3d 78
    , 83 (3d Cir.
    2000). "Substantial evidence has been defined as `more
    than a mere scintilla. It means such relevant evidence as a
    reasonable mind might accept as adequate.' " Plummer v.
    Apfel, 
    186 F.3d 422
    , 427 (3d Cir. 1999) (quoting Ventura v.
    Shalala, 
    55 F.3d 900
    , 901 (3d Cir . 1995)). Where the ALJ's
    findings of fact are supported by substantial evidence, we
    are bound by those findings, even if we would have decided
    the factual inquiry differently. Hartranft v. Apfel, 
    181 F.3d 358
    , 360 (3d Cir. 1999). Thus, the general issue before us
    is whether the ALJ's finding that Fargnoli was not disabled,
    and thus not entitled to disability insurance benefits, is
    supported by substantial evidence.
    B. Determination of Disability
    Under the Social Security Act, a disability is established
    where the claimant demonstrates that ther e is some
    " `medically determinable basis for an impairment that
    prevents him from engaging in any `substantial gainful
    activity' for a statutory twelve-month period.' " 
    Plummer, 186 F.3d at 427
    (quoting Stunkard v. Sec. of Health &
    Human Servs., 
    841 F.2d 57
    , 59 (3d Cir . 1988)); see also 20
    C.F.R. S 404.1505(a). A claimant is considered unable to
    engage in any substantial gainful activity "only if his
    6
    physical or mental impairment or impair ments are of such
    severity that he is not only unable to do his pr evious work
    but cannot, considering his age, education, and work
    experience, engage in any other kind of substantial gainful
    work which exists in the national economy . . . ." 42 U.S.C.
    S 423(d)(2)(A). This disability determination is made by the
    Commissioner based on a five-step sequential evaluation
    process promulgated by the Social Security Administration
    ("SSA"). See 20 C.F.R. S 404.1520. In Plummer, this Court
    set out the relevant steps as follows:
    In step one, the Commissioner must determine
    whether the claimant is currently engaging in
    substantial gainful activity. 20 C.F.R. S [404.]1520(a). If
    a claimant is found to be engaged in substantial
    activity, the disability claim will be denied. Bowen v.
    Yuckert, 
    482 U.S. 137
    , 140, 
    107 S. Ct. 2287
    , 2290-91,
    
    96 L. Ed. 2d 119
    (1987). In step two, the Commissioner
    must determine whether the claimant is suf fering from
    a severe impairment. 20 C.F.R.S 404.1520(c). If the
    claimant fails to show that her impairments ar e
    "severe," she is ineligible for disability benefits.
    In step three, the Commissioner compar es the
    medical evidence of the claimant's impairment to a list
    of impairments presumed severe enough to preclude
    any gainful work. 20 C.F.R. S 404.1520(d). If a claimant
    does not suffer from a listed impair ment or its
    equivalent, the analysis proceeds to steps four and five.
    Step four requires the ALJ to consider whether the
    claimant retains the residual functional capacity to
    perform her past relevant work. 20 C.F.R.
    S 404.1520(d). The claimant bears the bur den of
    demonstrating an inability to return to her past
    relevant work. Adorno v. Shalala, 
    40 F.3d 43
    , 46 (3d
    Cir. 1994).
    If the claimant is unable to resume her for mer
    occupation, the evaluation moves to the final step. At
    this stage, the burden of production shifts to the
    Commissioner, who must demonstrate the claimant is
    capable of performing other available work in order to
    deny a claim of disability. 20 C.F.R. S 404.1520(f). The
    ALJ must show there are other jobs existing in
    7
    significant numbers in the national economy which the
    claimant can perform, consistent with her medical
    impairments, age, education, past work experience,
    and residual functional capacity. The ALJ must analyze
    the cumulative effect of all the claimant's impairments
    in determining whether she is capable of per forming
    work and is not disabled. See 20 C.F .R. S 404.1523.
    The ALJ will often seek the assistance of a vocational
    expert at this fifth step. See, [sic] Podedworny v.
    Harris, 
    745 F.2d 210
    , 218 (3d Cir . 
    1984). 186 F.3d at 428
    .
    In this case, the ALJ undertook the five-step sequential
    evaluation in determining that Fargnoli was not disabled.
    The ALJ made the following findings: (1) Far gnoli had not
    engaged in any substantial gainful activity since the alleged
    onset date of disability; (2) he suffers fr om a severe back
    impairment; (3) his back impairment, although severe, does
    not meet or equal the criteria of the Listing of Impairments
    set forth in 20 C.F.R. Pt. 404, Subpt. P , App. 1; (4) he
    retains the residual functional capacity to engage in light
    work, and therefore cannot retur n to his past relevant work
    as a construction laborer because it is heavy work; and (5)
    based on his age, educational background, work
    experience, and limitations, the medical vocational
    guidelines (the "Grids") direct a finding of not disabled. See
    20 C.F.R. Pt. 404, Subpt. P, App. 2,S 202.17. The ALJ
    erred, Fargnoli contends, at step four in determining that
    he retained the residual functional capacity to do light
    work. We agree.4
    _________________________________________________________________
    4. Although not raised by Fargnoli, and therefore not an issue in this
    appeal, we also note our concern with the conclusion reached by the ALJ
    at step three in the sequential evaluation pr ocess and the discussion
    thereof. The ALJ determined that Far gnoli's back impairment did not
    meet the Listing of Impairments at 20 C.F .R. Pt. 404, Subpt. P, App. 1.
    He stated that "[n]o treating or examining physician has mentioned
    findings equivalent in severity to the criteria of any listed impairment.
    Particular consideration was given to Listing 1.00 (musculoskeletal
    system)." First, we note that in reviewing the voluminous medical
    evidence for our discussion of step four of the pr ocess, we found
    treatment notes and diagnostic tests ar guably meeting the Listing of
    8
    C. Step Four Evaluation: Residual Functional Capacity
    " `Residual functional capacity is defined as that which an
    individual is still able to do despite the limitations caused
    by his or her impairment(s).' " Bur nett v. Comm'r of Soc.
    Sec. Admin., 
    220 F.3d 112
    , 121 (3d Cir . 2000) (quoting
    
    Hartranft, 181 F.3d at 359
    n.1); see also 20 C.F.R.
    S 404.1545(a). In this case, the ALJ deter mined that
    Fargnoli had the residual functional capacity to perform
    light work. The SSA defines work as "light" when it
    involves lifting no more than 20 pounds at a time with
    frequent lifting or carrying of objects weighing up to 10
    pounds. Even though the weight lifted may be very
    little, a job is in this category when it requires a good
    deal of walking or standing, or when it involves sitting
    most of the time with some pushing and pulling of ar m
    or leg controls. To be considered capable of performing
    a full or wide range or light work, you must have the
    ability to do substantially all of these activities.
    20 C.F.R. S 404.1567(b). The SSA has further explained
    that "light work generally requires the ability to stand and
    carry weight for approximately six hours of an eight hour
    day." Jesurum v. Sec. of Health & Human Servs., 
    48 F.3d 114
    , 119 (3d Cir. 1995) (citing Social Security Ruling 83-
    10).
    After reviewing the record, we find it impossible to
    determine whether the ALJ's finding that Far gnoli can
    perform light work is supported by substantial evidence.
    We are handicapped by the fact that the ALJ has (1) failed
    to evaluate adequately all relevant evidence and to explain
    the basis of his conclusions and (2) failed to explain his
    _________________________________________________________________
    Impairments in S 1.05 (disorders of the spine). Second, we note that this
    Court requires more than just a conclusory statement that a claimant
    does not meet the listings. See Burnett v. Comm'r of Soc. Sec. Admin.,
    
    220 F.3d 112
    , 119-20 (3d Cir. 2000) (r emanding where conclusory
    statement "is similarly beyond meaningful judicial review," with
    directions that ALJ should "fully develop the record and explain his
    findings at step three, including an analysis of whether and why [the
    claimant's] . . . impairments . . . ar e or are not equivalent in severity
    to
    one of the listed impairments").
    9
    assessment of the credibility of, and weight given to, the
    medical evidence and opinions from Fargnoli's treating
    physicians that contradict the ALJ's finding that Fargnoli
    can perform light work. We ther efore vacate the decision of
    the District Court and remand with instruction to remand
    to the ALJ for further proceedings.5
    1. The ALJ Must Evaluate All the Evidence and Explain
    the Basis for his Conclusions.
    The ALJ must consider all relevant evidence when
    determining an individual's residual functional capacity in
    step four. See 20 C.F.R. SS 404.1527(e)(2), 404.1545(a),
    404.1546; 
    Burnett, 220 F.3d at 121
    . That evidence includes
    medical records, observations made during formal medical
    examinations, descriptions of limitations by the claimant
    and others, and observations of the claimant's limitations
    by others. See 20 C.F.R. S 404.1545(a). Moreover, the ALJ's
    finding of residual functional capacity must"be
    accompanied by a clear and satisfactory explication of the
    basis on which it rests." Cotter v. Harris, 
    642 F.2d 700
    , 704
    (3d Cir. 1981). In Cotter, we explained that
    [i]n our view an examiner's findings should be as
    _________________________________________________________________
    5. Fargnoli urges us to conclude further that the ALJ improperly relied
    on Fargnoli's desire to retur n to work at a light exertional level and to
    take a trip to Europe as substantial evidence that he could perform light
    work. Although it is not the primary basis for our r emand, we agree. In
    this particular case, we believe that Fargnoli's expressed desire to
    return
    to work at a light duty job cannot support a finding that he is actually
    capable of such work when he later testified that he cannot perform light
    work and his testimony is consistent with restrictions imposed by his
    treating physician. See Talbot v. Heckler, 
    814 F.2d 1456
    , 1461 (10th Cir.
    1987) (claimant's application for vocational training did not create
    inference that "claimant thought he could work at a full range of light
    activity" as opposed to a "limited range of light or sedentary activity").
    Furthermore, Fargnoli's trip to Eur ope in 1988 cannot be the basis for
    a finding that he is capable of doing a light exertional job because
    sporadic and transitory activities cannot be used to show an ability to
    engage in substantial gainful activity. See 
    Jesurum, 48 F.3d at 119
    (claimant's trip to Rhode Island two years prior to hearing was a
    "sporadic and transitory activity that cannot be used to show an ability
    to engage in substantial gainful activity").
    10
    comprehensive and analytical as feasible and, where
    appropriate, should include a statement of subordinate
    factual foundations on which ultimate factual
    conclusions are based, so that a reviewing court may
    know the basis for the decision. This is necessary so
    that the court may properly exercise its r esponsibility
    under 42 U.S.C. S 405(g) to determine if the Secretary's
    decision is supported by substantial evidence.
    
    Id. at 705
    (quoting Baerga v. Richardson, 
    500 F.2d 309
    ,
    312 (3d Cir. 1974)).
    The ALJ's discussion of the relevant medical evidence in
    Fargnoli's case was limited to the following four paragraphs:
    A medical report from [Dr. Zaslow], doctor of
    osteopathy, dated December 16, 1995, revealed that
    the claimant complained of increasing pain since his
    work-related accident in May 1985. Dr. Zaslow stated
    a computerized tomography scan of the lumbar spine,
    done on October 19, 1985, indicated degeneration of
    the L3-4 disc. A thermogram done on October 24, 1985
    was reported as normal and showed L4-L5 nerve fiber
    involvement on the left side. An electromyography
    performed on October 30, 1985 showed evidence of
    radiculopathy. A medical report from Dr . Zaslow, dated
    December 5, 1986, stated that a bone scan per formed
    on January 22, 1986 was completely normal. The
    claimant stated that he was able to stand for an hour
    and sit for several hours.
    A report by [Dr. Karpin], dated December 12, 1986,
    stated that a magnetic resonance imaging showed
    abnormal disc intensity between L3-4, and abnormal
    disc between L-1 and L-2, and to a lesser extent
    between L-4, 5 and L5-S1. It was reported that the
    claimant refused to undergo a myelogram to confirm
    the findings and chose to continue with the
    conservative treatments for a while longer . Dr. Karpin
    stated that the claimant has to maintain a 1,000
    calorie [diet] to lose weight in order to reduce the
    pressure on his back.
    A report by Dr. Zaslow, dated December 4, 1987,
    stated that the claimant complained about pain over
    11
    the midline. There was considerable spasm of the back
    with the inability to flex forward. The claimant stated
    that he wanted a light duty job, but no light duty work
    was available for him.
    A medical report by Dr. Karpin, dated February 22,
    1991, stated that the claimant was still having
    difficulty with his lower back, but was able to cope
    with the pain and discomfort as long as he took his
    muscle relaxant and non-steroidal anti-inflammatory.
    The claimant was maintained on Robaxin, Feldene and
    physical therapy.6
    In the passages quoted above, the ALJ describes four
    diagnostic tests and five treatment notes. Y et our review of
    the record reflects over 115 pages of relevant, probative
    treatment notes from Drs. Zaslow and Karpin detailing
    Fargnoli's medical condition and progr ess. The disparity
    between the actual record and the ALJ's sparse synopsis of
    it makes it impossible for us to review the ALJ's decision,
    for we "cannot tell if significant probative evidence was not
    credited or simply ignored." Bur 
    nett, 220 F.3d at 121
    (quoting 
    Cotter, 642 F.2d at 705
    ).
    Although we do not expect the ALJ to make refer ence to
    every relevant treatment note in a case where the claimant,
    such as Fargnoli, has voluminous medical r ecords, we do
    expect the ALJ, as the factfinder, to consider and evaluate
    the medical evidence in the record consistent with his
    responsibilities under the regulations and case law. His
    failure to do so here leaves us little choice but to remand
    for a more comprehensive analysis of the evidence
    _________________________________________________________________
    6. The Commissioner argues that the ALJ'sfinding is further supported
    by a workers' compensation commutation enter ed into by Fargnoli in
    1995, in which he stipulates that he has an agr eed earning power of a
    certain sum, and the opinions of three doctors examining Fargnoli after
    his date last insured for disability benefits (December 31, 1990). See
    Appellee's Br. at 3-4. Although this infor mation may have been in the
    file
    before the ALJ, there is no evidence in the record that any of it was
    considered by him. Furthermore, after reviewing the record, we cannot
    find two of the opinions relied on by the Commissioner. We therefore
    cannot consider them as a basis for finding that the ALJ's decision is
    supported by substantial evidence.
    12
    consistent with the requirements of applicable regulations
    and the law of this Circuit, both as discussed in more detail
    below.
    2. The ALJ Must Assess the Credibility of, and Explain
    the Weight Given To, Conflicting Medical Evidence by
    the Claimant's Treating Physicians.
    This Court has long been concerned with ALJ opinions
    that fail properly to consider, discuss and weigh relevant
    medical evidence. See Dobrowolsky v. Califano, 
    606 F.2d 403
    , 406-07 (3d Cir. 1979) ("This Court has repeatedly
    emphasized that the special nature of pr oceedings for
    disability benefits dictates care on the part of the agency in
    developing an administrative record and in explicitly
    weighing all evidence."). Where ther e is conflicting probative
    evidence in the record, we recognize a particularly acute
    need for an explanation of the reasoning behind the ALJ's
    conclusions, and will vacate or remand a case where such
    an explanation is not provided. See Cotter , 642 F.2d at 706
    (listing cases remanded for ALJ's failur e to provide
    explanation of reason for rejecting or not addressing
    relevant probative evidence).
    In his opinion the ALJ finds Fargnoli to have a severe
    back impairment, but not so severe that it prevents him
    from performing light work that includes frequently lifting
    ten pounds, occasionally lifting twenty pounds, and
    standing and walking for six hours out of an eight-hour
    day. In reaching this finding, the ALJ does not mention the
    contradictory finding of Dr. Zaslow, nor does he explain his
    assessment of the credibility of Drs. Zaslow and Karpin or
    the weight given to their treatment notes and opinions.
    Under applicable regulations and the law of this Court,
    opinions of a claimant's treating physician ar e entitled to
    substantial and at times even controlling weight. See 20
    C.F.R. S 404.1527(d)(2); 
    Cotter, 642 F.2d at 704
    . The
    regulations explain that more weight is given to a
    claimant's treating physician because
    these sources are likely to be the medical professionals
    most able to provide a detailed, longitudinal picture of
    [the claimant's] medical impairment(s) and may bring a
    13
    unique perspective to the medical evidence that cannot
    be obtained from the objective medical findings alone
    or from reports of individual examinations, such as
    consultative examinations or brief hospitalizations.
    20 C.F.R. S 404.1527(d)(2). Wher e a treating source's
    opinion on the nature and severity of a claimant's
    impairment is "well-supported by medically acceptable
    clinical and laboratory diagnostic techniques and is not
    inconsistent with the other substantial evidence in[the
    claimant's] case record," it will be given "controlling weight."
    
    Id. Although the
    ALJ may weigh the credibility of the
    evidence, he must give some indication of the evidence that
    he rejects and his reason(s) for discounting that evidence.
    See 
    Burnett, 220 F.3d at 121
    ; 
    Cotter, 642 F.2d at 705
    . In
    Burnett, we determined that the ALJ had not met his
    responsibilities because he "fail[ed] to consider and explain
    his reasons for discounting all of the pertinent evidence
    before him in making his residual functional capacity
    
    determination." 220 F.3d at 121
    . W e therefore remanded
    the case to the ALJ with instructions to "r eview all of the
    pertinent medical evidence, explaining any conciliations
    and rejections." 
    Id. at 122.
    The record reflects that thr oughout his treating history
    Dr. Zaslow consistently found Fargnoli to suffer from a
    severe and dehabilitating chronic back condition that often
    requires bed rest or immobilization. Countless treatment
    notes document Fargnoli's spastic condition, the immobility
    of his lower back, the radicular pain to his legs and his
    tenderness to palpitation and manipulation. Fargnoli points
    out that Dr. Zaslow has opined on twenty-thr ee separate
    occasions that he is disabled. Dr. Zaslow has restricted
    Fargnoli to only seven to ten pounds of lifting, no prolonged
    periods of walking and no climbing, bending or squatting.
    He has also opined that Fargnoli is incapable of even
    sedentary work.
    Although never opining on Fargnoli's vocational
    restrictions or limitations, Dr. Karpin's clinical findings are
    consistent with Fargnoli's complaints. Dr . Karpin found
    that Fargnoli suffers from r educed mobility, spasms and
    14
    tenderness to palpitation. Further, Dr . Karpin's treatment
    notes document the sensitivity of Fargnoli's back
    impairment to changes in the weather and his activity level.
    Finally, Dr. Karpin noted that, although Far gnoli's chronic
    condition can be maintained at status quo with continued
    medication and physical therapy, he will continue to suffer
    symptoms associated with his back impairment.
    The ALJ makes no mention of any of these significant
    contradictory findings, leaving us to wonder whether he
    considered and rejected them, consider ed and discounted
    them, or failed to consider them at all. "The ALJ's failure to
    explain his implicit rejection of this evidence or even to
    acknowledge its presence was error." 
    Cotter, 642 F.2d at 707
    .7
    We therefore cannot conclude that his findings at step four
    were supported by substantial evidence. Mor eover, we
    cannot affirm the ALJ's determination that Fargnoli was not
    disabled under the Grids because that determination
    requires that Fargnoli be capable of light exertional work.
    III. Conclusion
    For the foregoing reasons, the District Court's order
    granting summary judgment to the Commissioner will be
    vacated and remanded to the District Court with
    instructions to remand to the Commissioner for additional
    proceedings consistent with this opinion. On r emand, the
    ALJ must consider and make specific findings as to all of
    the relevant probative medical evidence, including
    assessing the credibility of the evidence and weighing that
    evidence. Further, to the extent that the ALJ reaches a
    finding contradictory to that of Fargnoli's treating
    physicians, he must explain the reasoning behind such a
    _________________________________________________________________
    7. The District Court, apparently recognizing the ALJ's failure to
    consider
    all of the relevant and probative evidence, attempted to rectify this
    error
    by relying on medical records found in its own independent analysis,
    and which were not mentioned by the ALJ. This runs counter to the
    teaching of SEC v. Chenery Corporation, 
    318 U.S. 80
    (1943), that "[t]he
    grounds upon which an administrative or der must be judged are those
    upon which the record discloses that its action was based." 
    Id. at 87;
    see
    also Healtheast Bethesda Lutheran Hosp. & Rehab. Ctr . v. Shalala, 
    164 F.3d 415
    , 418 (8th Cir. 1998) (r ecognizing Chenery in case deciding
    claim for Social Security disability insurance benefits).
    15
    finding, including reconciling conflicts and discussing how
    and why probative evidence supporting Far gnoli's claim was
    discounted and/or rejected.
    16
    ROTH, Circuit Judge, dissenting:
    I respectfully dissent. This case presents the not
    uncommon conflict between treating physician and
    independent medical examiner. The treating physician has
    determined that the petitioner is unable to work. The
    independent medical examiner finds that the objective tests
    do not substantiate the subjective complaints and that the
    petitioner is exaggerating. In view of the fact that the
    Administrative Law Judge credited the testimony of the
    latter, rather than the former, I am persuaded that the
    decision is supported by sufficient evidence. I am also
    concerned by the petitioner's refusal to permit tests and
    treatment that would alleviate a ruptur ed disc if that is
    indeed his problem. For these reasons, I would affirm the
    decision of the District Court, upholding the deter mination
    of the Administrative Law Judge.
    A True Copy:
    Teste:
    Clerk of the United States Court of Appeals
    for the Third Circuit
    17