Opinion
CIVIL NO. 02-2535 (SEC-JAC)
August 27, 2003
Louis A. DeMier-LeBlanc, Esq, San Juan, PR, for Plaintiff
Camille Vélez Rivé, AUSA, San Juan, PR, for Defendant
OPINION AND ORDER
Plaintiff filed an application for disability insurance benefits with the Social Security Administration which was initially denied. She was, at the time of her application, a forty six years old female, with GED high school education, and previous work experience as assembly line worker in the electronic industry. She requested benefits as of June 20, 1994, upon an inability to work because of allegations of cervical and upper back pain, carpal tunnel syndrome, high blood pressure, headaches, arms and neck limitations. She remained insured until June 30, 2000.
An administrative hearing was held on June 6, 2000, wherein claimant, in addition to a vocational expert, testified. The Administrative Law Judge (ALJ) issued an opinion finding that claimant should not be considered to be under disability, which findings were adopted as the final decision of the Commissioner of Social Security (the Commissioner). Plaintiff now seeks judicial review of this decision. Social Security Act, 42 U.S.C. § 405(g).
Section 2O5(g) provides: "[t]he court shall have power to enter, upon the pleadings and transcripts of record, a judgment affirming, modifying, or reversing the decision of the Commissioner, with or without remanding the cause for a rehearing".
To establish entitlement to benefits, claimant has the burden of proving that she became disabled within the meaning of the Social Security Act. Disability is determined in §§ 216(i)(1) and 223(d)(1), 42 U.S.C. § 416(i)(1) and 423(d)(1). See Bowen v. Yuckert, 482 U.S. 137, 107 S.Ct. 2287, 2294 n. 5 (1987); Deblois v. Secretary of Health Human Servs., 686 F.2d 76, 79 (1st Cir. 1982). Claimant may be considered disabled if she is unable to perform any substantial gainful employment because of a medical condition that is expected to last for a continuous period of at least twelve (12) months. The impairments imposed by the condition or combination of conditions must be so severe as to prevent her from working in her usual occupation and in any other substantial gainful employment further taking in consideration age, education, training, and work experience. Social Security Act, 42 U.S.C. § 423(d)(2)(A).
Once claimant has established she is unable to perform her previous work, then the burden shifts to the Commissioner to prove the existence of other jobs in significant numbers in the national economy that claimant is still able to perform. Goodermote v. Secretary of Health Human Servs., 690 F.2d 5 (1st Cir. 1982); Torres v. Secretary of Health Human Servs., 677 F.2d 167 (1st Cir. 1982). See Vázquez v. Secretary of Health Human Servs., 683 F.2d 1 (1st Cir. 1982): Geoffrey v. Secretary of Health Human Servs., 663 F.2d 315 (1st Cir. 1981).
The administrative decision indicated that plaintiff proved to suffer from cervical myositis, chronic low back pain, right L5 radiculopathy with superimposed mild axonal neuropathy, stiffness of the spine suggestive of degenerative joint disease of the lumbosacral spine and associated spondylosis, degenerative disc disease at L5-S1 level, minimal posterior right lateral disc protrusion at said level and mild concentric disc bulging at L4-L5 without significant impingement upon the spinal sac or neural root, degenerative joint disease of the knees, bilateral carpal tunnel syndrome and headaches. The musculoskeletal conditions were established by electrodiagnostic studies. The ALJ gave appropriate credit to the treating and consulting sources because the above were based on objective findings. Still, it was also determined that despite above described conditions, there were no significant limitation of motions nor evidence of disabling pain. In order to avoid exacerbation of symptoms imposed by above established conditions, she should avoid heavy and medium exertion and activities requiring fine hand movements.
The complaints of high blood pressure is not consistently established by the medical record, except for one reading, and confirmed by an absence of treatment. Additionally, although claimant suffered a motor vehicle accident, the medical record from the ACAA in the year 1993 was not submitted, and she had returned to her work throughout 1994 until she was lay-off upon closing of her work site. Any physical conditions thereinafter developed seemed amenable to treatment.
The ALJ explained the reasons not to give full credit to a medical report that was not grounded in objective medical evidence and controverted by the remaining evidence. Although claimant could not perform her previous work, which required fine hand manipulation, through the testimony of the medical expert, Mr. Paul Senior, and considering claimant's age, education, and work experience, the ALJ could identify significant light jobs in the national economy within her residual functional capacity. These included packer, inspector and repair in the electronic industry, and similar kind of jobs in the food chain industry and in assembly type of work in the pharmaceutical field.
An examination of the evidence and the record as a whole shows that at the administrative hearing plaintiff testified she developed a spinal column condition after her automobile accident. She was hospitalized for removal of a cervix tumor approximately in 1995. She has been at the emergency room on several occasions since 1994 because of dizziness, complaints of high blood pressure and, chest pain. She also complained of generalized body pain, although she remained working until the electronic plant was closed. She needs to do her house chores because there is no one else to do them, including laundry and making the beds. She attends religious services three to four times a week, listens to the radio, watches little television, takes care of her personal needs and reads the Bible. She has not tried to look for work because of her conditions and neither has she attended vocational rehabilitation.
The medical record shows evaluations and treatments by Dr. Ayala Rosa since 1994 and refers in one report to complaints of anxiety and depression imposing limitations in the year 1999, although the last examination of the patient is therein dated July of 1992. Sensory system and reflexes are within normal limits and likewise as to her gait and station. Another report by Dr. Ayala Rosa refers to pain in her back region. She was last examined in 1990. The pain radiates to her hands when she engages in physical exertion. The neurological examination is described as normal. There is a diagnosis of L/S radiculopathy, sprain, and a poor prognosis.
There is a neurological evaluation by Dr. De Jesus La Santa dated 1998. This report was not afforded full credibility by the ALJ as above indicated. The motor system is described as good, without atrophy or fasciculation, with adequate tone. Muscle strength was intact. A CT Scan showed straightening of the cervical spine suggestive of muscle spasm. The vertebral bodies and disc spaces appeared normal. The range of motion chart showed no limitation of movements.
Dr. Ricardo Rodriguez Navarro refers to complaints of knee pain and a whole body scan was compatible with degenerative joint disease of the knees. The imaging study performed in October 14, 1998, states an impression of mild early degenerative changes of the lumbo sacral spine, mild degenerative disc disease at L5-S1 level; minimal posterior right lateral disc protrusion at L5-S1 and mild concentric disc bulging at L4-L5 without significant impingement upon spinal sac or neural root. The lumbar spine MRI examination of August 21, 1998, found no significant degenerative disc disease with focal region of increased signal intensity at vertebral body L3.
Dr. Moisés Esquenazi, a neurologist, submitted an evaluation in March of 2000, after the patient made numerous complaints of body pains. She is described as alert, oriented in all spheres, her thought was logic and coherent. She had good memory and summarization and no gaps or hallucinations. There was no motor deficit. She presented good strength in both hands. Posture and gait were normal and she could walk on her heels and the ball of the foot. She had chephalea exacerbated by carpal tunnel. The range of motion chart was mostly normal, except for some limitation of motion in the lumbar region.
Due consideration was given to allegations of pain as an additional disabling factor. See Section 3(a)(1), which amended Section 223(d)(5) of the Social Security Act. The amendments to the Social Security Disability Benefits Act of 1984, Pub.L. No. 98-460, Section 3, 98 Stat. 1794 (1984), make clear there must be a medical impairment that can reasonably be expected to produce the pain alleged. Other evidence, including statements of claimant and/or his/her physician shall be considered.Avery v. Secretary of Health Human Servs., 797 F.2d 19 (1st Cir. 1986).
Where a potential basis for pain and restriction exists, the subjective symptoms must be evaluated with due consideration for credibility, motivation, and medical evidence of impairment. Gray v. Heckler, 760 F.2d 369, 374 (1st Cir. 1985); Alvarado v. Weinberger, 511 F.2d 1046, 1049 (1st Cir. 1975). When pain or restriction is shown to exist, the actual degree of pain plaintiff suffers is for the Commissioner to evaluate in light of the supporting evidence. Gagnon v. Secretary of Health and Human Services, 666 F.2d 662, 665 (1st Cir. 1981). Although pain is subjective, clinical techniques are appropriate to use in evaluating the probability of its existence, magnitude and disabling effects. Rico v. Secretary of Health, Education and Welfare, 593 F.2d 431, 433 (1st Cir. 1979).
The ALJ's opinion evaluated the issue of pain, but not to the extend alleged by plaintiff, upon considering her response to prescribed treatment, no adverse side effects, and the absence of persistent musculoskeletal pathology. Additionally, the evidence shows claimant had adequate motion, performed regular house chores, attended religious services regularly, and received no treatment for any mental condition.
To review the final decision of the Commissioner, courts must determine if the evidence of record meets the substantial evidence criteria to support the Commissioner's denial of plaintiffs disability claim. Substantial evidence is "more than a mere scintilla and such, as a reasonable mind might accept as adequate to support a conclusion".Richardson v. Perales. 402 U.S. 389 (1971), quoting Consolidated Edison Co. v. N.L.R.B., 305 U.S. 197 (1938). The findings of the Commissioner as to any fact are conclusive, if supported by the above-stated substantial evidence.
Falú v. Secretary of Health Human Servs., 703 F.2d 24 (1st Cir. 1983).
There is substantial evidence in the record as a whole to support the decision of the Commissioner, for which reason it is recommended that IT BE AFFIRMED. The Clerk's Office is to enter judgment accordingly.
IT IS SO ORDERED.