Opinion
01 Civ. 10961 (SAS)
December 26, 2002
Fanny Ognunugafor, Yonkers, New York, Plaintiff, Pro Se.
John E. Gura, Jr., Assistant United States Attorney, Office of the United States Attorney for the Southern District of New York. New York, New York, For Defendant.
MEMORANDUM OPINION AND ORDER
Pro se plaintiff Fanny Ogbunugafor brings this action pursuant to Section 205(g) of the Social Security Act (the "Act"), 42 U.S.C. § 405 (g), seeking judicial review of a final decision by the Commissioner of the Social Security Administration (the "Commissioner") denying her claim for disability insurance benefits ("DIB" or "benefits"). The Commissioner moves for judgment on The pleadings under Rule 12(c) of the Federal Rules of Civil Procedure. For the reasons set forth below, the Commissioner's motion is granted and her determination is affirmed.
I. BACKGROUND
A. Procedural Background
Plaintiff filed an application with the Social Security Administration ("SSA") for benefits on April 6, 1998, alleging an inability to work due to difficulty walking and standing related to multiple sclerosis ("MS").See Transcript of Administrative Record filed as part of Commissioner's Answer ("Tr.") 11, 91-93. She claims her disability began on September 15, 1994, the date she first experienced difficulty walking. Tr. 11. This was approximately two-and-a-half months before December 31, 1994, the date on which her insured status expired. Tr. 8-14. Her application was denied initially and on reconsideration. Tr. 62, 76-77. Plaintiff then requested a hearing, which took place before an Administrative Law Judge ("ALJ") on January 24, 2000. Tr. 18-60, 79. At the hearing, plaintiff was represented by counsel. On July 7, 2000, the ALJ found that plaintiff was not disabled prior to December 31, 1994. Tr. 8-14. Plaintiff's request for review was denied by the Appeals Council on September 19, 2001, making the ALJ's decision the final decision of the Commissioner. Tr. 4-5.
B. Personal Background
Plaintiff is a 59-year-old woman with a Bachelor's degree in history and a Master's degrees in education. Tr. 34. Plaintiff was a college instructor from 1983 until 1990. Tr. 102. She was also a substitute high school teacher from 1980 until 1990. Plaintiff last worked in 1990. Tr. 47.
At present, Plaintiff has great difficulty walking. At the outset of the hearing, the ALJ remarked that she walked in "a very disjointed fashion". Tr. 20. Plaintiff claims that she cannot perform any housework and is "totally dependent on family for [her] care." Tr. 103. Her hobbies are limited to listening to music and occasionally writing. Tr. 103.
C. Medical Evidence
In addition to multiple sclerosis, plaintiff has suffered from a roster of ailments including thyroid disease, goiters, hypertension and seizures. Tr. 13. Plaintiff received treatment for these disorders at the Westchester County Medical Center ("WCMC") from September 1992 through November 1994. In 1993, she began treatment for seizures which abated in 1995 after several regimens of Dilantin. Tr. 136, 288, 322.
Plaintiff first complained of numbness in her right leg on June 2, 1993, when she was examined by Dr. Arcilla in the WCMC emergency room. On June 7, 1993, plaintiff returned to WCMC for a follow-up visit. Upon examination, plaintiff's motor and sensory functions were found to be intact. Tr. 318. She was found, however, to have a mildly ataxic tandem gait. Id.
Plaintiff's next follow-up visit at WCMC took place on September 20, 1993, when she was again examined by Dr. Arcilla. At this exam, plaintiff's motor strength was graded 5 in all extremities. Tr. 316. Her reflexes and sensory function were found to be "grossly intact." Id. She displayed good coordination. Id.
Motor and sensory functions are assessed on a scale of 0 (no function) to 5 (normal function). See Defendant's Memorandum of Law in Support of Her Motion for Judgment on the Pleadings ("Def. Mem.") at 4, n. 3.
Plaintiff's visits to WCMC of October 13, 1993, March 30, 1994, and April 20, 1994 were unremarkable. On July 20, 1994, a palpable node was found on plaintiff's right thyroid, and thyroid function tests ordered. Tr. 123, 308. Further examination at the follow-up visit on August 22, 1994 led Dr. Arcilla to suspect hypertension, but he noted that it was "controlled." Tr. 119, 307.
During these visits, plaintiff was treated for a number of problems. She received Dilantin for her seizure disorder. Tr. 317. For stomach discomfort, Dr. Arcilla instructed her to take Zantac. Tr. 310. Dr. Arcilla also prescribed, and subsequently increased the dosage of, plaintiff's Dyazinde for hypertension. Tr. 310, 314, 320.
In 1998, pursuant to the filing of plaintiff's claim, Dr. L. Marasigan and Dr. W.H. Wells, consulting physicians for the SSA, reviewed the medical record and found that plaintiff had no exertional, postural, manipulative, visual, communicative, or environmental limitations as of December 31, 1994. Tr. 163-181.
II. LEGAL STANDARD
The Act applies a five-step test to determine whether an applicant is disabled. See 20 C.F.R. § 416.920. In Perez v. Chater, 77 F.3d 41, 46 (2d Cir. 1996), the Second Circuit summarized the disability test as follows:
The first step of this process requires the Secretary to determine whether the claimant is presently employed. If the claimant is not employed, the Secretary then determines whether the claimant has a "severe impairment" that limits her capacity to work. If the claimant has such an impairment, the Secretary next considers whether the claimant has an impairment that is listed in Appendix 1 of the regulations. When the claimant has such an impairment, the Secretary will find the claimant disabled. However, if the claimant does not have a listed impairment, the Secretary must determine, under the fourth step, whether the claimant possesses the residual functional capacity to perform her past relevant work. Finally, if the claimant is unable to perform her past relevant work, the Secretary determines whether the claimant is capable of performing any other work. If the claimant satisfies her burden of proving the requirements in the first four steps, the burden then shifts to the Secretary to prove in the fifth step that the claimant is capable of working.
Here, the ALJ found that plaintiff was not engaged in substantial gainful activity on September 15, 1994 or any time thereafter. Tr. 12. Thus, the ALJ evaluated the severity of her impairment, concluding that "[t]he medical record fails to reflect debilitating severity referable to the claimant's impairments prior to her date last insured on December 31, 1994." Id. Therefore, the ALJ held that that claimant was capable of substantial gainful activity during the time she claimed disability and after the expiration of her insured status. On this basis, the ALJ rejected claimant's request for benefits.
"The findings of the Secretary are conclusive if they are supported by substantial evidence." 42 U.S.C. § 405 (g) Substantial evidence is "`more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.'"Richardson v. Perales, 402 U.S. 389, 401 (1971) (quoting Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229 (1938)). This Court must determine if the ALJ's decision was based on substantial evidence.
Despite the substantial evidence standard, the Second Circuit has instructed courts to interpret the Act as a remedial statute to be broadly construed and liberally applied. See Bastien v. Califano, 572 F.2d 908 (2d Cir. 1978). I analyze this case in that spirit.
III. DISCUSSION
Although the record contains medical records from 1992 through 2000, a claim under Title II of the Act for disability benefits requires the claimant to show that she was disabled at the time she last met Title II's special insured status requirement. 42 U.S.C. § 423. Claimant last met this requirement on December 31, 1994. Therefore, the ALJ must find that plaintiff was disabled on or before December 31, 1994, in order for her to qualify for disability benefits.
Some of the medical records suggest that plaintiff developed MS before she filed in 1998. However, there is scant evidence that this condition prevented plaintiff from working in 1994.
Since she filed her claim for DIB, plaintiff has successfully filed for Supplemental Security Income ("SSI") and has been receiving benefits since July of 2000. See Def. Mem. at 2.
Plaintiff's argument focuses on the fact that she had MS in 1994, although no diagnosis of MS was made until 1999. Tr. 12. But a diagnosis alone does not qualify a claimant for disability benefits. See 42 U.S.C. § 423 (d)(2)(A). The Act requires that "an individual shall be determined to be under a disability only if [her] physical or mental impairment or impairments are of such severity that [s]he is not only unable to do [her] previous work but cannot, considering [her] age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy." 42 U.S.C. § 423 (d)(2)(A).
Plaintiff claims she was misdiagnosed. See, e.g., Tr. 38, 41. There is some evidence in the record that she may be correct. On February 18, 1997, Dr. Michael Weintraub of New York Medical College performed a neurological examination on plaintiff. His impression, based on a brain MRI from June, 1995, was that plaintiff was suffering from demyelinating disease, a degenerative nerve condition similar to MS. Tr. 220.
Section 423(d)(1)(A) of the Act defines "disability" as the "inability to engage in any substantial gainful activity by reason of a medically determinable physical or mental impairment which can be expected to result in death or which has lasted or which can be expected to last for a continuous period of not less than 12 months." 42 U.S.C. § 423 (d)(1)(A).
Importantly, the five-step test used by an ALJ to determine whether a claimant is disabled examines the severity of the impairment (step two of the above mentioned five-step test) before ascertaining whether the claimant has an impairment listed in 20 C.F.R. § 404, Appendix 1, Subpart P (the "Listings"). In the context of MS, a listed impairment, an ALJ must first determine whether the severity of the claimant's impairment is such that her capacity to work is limited. "It is the disability, and not just the impairment, that must have existed before the person's insured status expired." Kelly v. Chater, 108 F.3d 329 (2d Cir. 1997) (citing Arnone v. Bowen, 882 F.2d 34, 38 (2d Cir. 1989)). Therefore, even if the ALJ concluded that plaintiff had MS prior to December 31, 1994, the impairment must have been severe enough at that time to significantly impede her ability to engage in substantial gainful employment. See 20 C.F.R. § 404.1520. However, the record, consisting primarily of WCMC treatment notes dating from September 1992 through November 1995, contains substantial evidence to support a finding that plaintiff was not disabled on December 31, 1994.
In Kelly, the claimant filed for disability insurance benefits in 1992, alleging that she became disabled fourteen years earlier, in 1978. A diagnosis of MS made in 1976 was not in dispute. What was "at issue is whether, for purposes of the [Social Security] Act, Kelly became `disabled' by multiple sclerosis on or before the date she was last insured." 108 F.3d at 329. The ALJ found that appellant failed to satisfy her burden. Id.
The five step test dictates that absent a documented finding of an Appendix 1 impairment, the presence of a physical or mental impairment requires the ALJ to evaluate whether the hardship is severe enough to warrant a finding of disability. See 20 C.F.R. § 404.1520.
None of the relevant WCMC medical reports indicate a functional restriction severe enough to preclude substantial gainful activity. On July 6, 1995, after the expiration of plaintiff's insured status, plaintiff did display a right leg limp and an MRI did reveal a brain lesion and degenerative changes at the US-S1 vertebrae of the spine. Tr. 293. However, plaintiff's patellar and ankle jerks were symmetrical, and plaintiff was not found to have any other difficulty walking or standing. Tr. 292-293. Although plaintiff may have experienced some pain and discomfort, there is nevertheless a reasonable basis for the ALJ's conclusion that on December 31, 1994, plaintiff had the ability to perform light work and perform substantial gainful work as a teacher, her previous profession. Tr. 13-14.
Although plaintiff may have been suffering from MS all along, the delay in diagnosis until 1999 illustrates why a successful disability claimant must first and foremost manifest a severe disability and cannot rely solely on the Listings. People with MS, a listed impairment, can nevertheless retain the ability to work if their symptoms do not impede their ability to engage in substantial gainful employment. See, e.g.,Taylor v. Apfel, No. 99-3584, 2001 WL 13292 at *1 (8th Cir. Jan 8, 2001); Darland v. Shalala, 52 F.3d 337 (10th Cir. 1995). Successful applicants for disability benefits must therefore first manifest severe symptoms that significantly limit their capacity to perform even sedentary work. See 42 U.S.C. § 423 (d)(2)(A) and (B).
On December 31, 1994, and for at least some time thereafter, plaintiff retained the ability to engage in light work, which entails standing or walking for up to six hours per day and lifting up to twenty pounds occasionally. Tr. 12. Plaintiff, a highly educated woman with a Master's degree in education, Tr. 11, was capable of continuing her past relevant work as a college instructor and substitute high school teacher. Tr. 12.
Finally, plaintiff's own statements to her treating physicians contradict a finding of disability in 1994. According to Dr. David Dickoff's letter of November 13, 1996, Tr. 184, plaintiff indicated that she had stopped working in 1994 not because of disability, but because she wanted to write a book. Tr. 184. According to Dr. Leona Borchert's records dated September 28, 1995, Tr. 289, plaintiff finished the book sometime in 1995. Tr. 289. Dr. Dickoff's 1996 letter also states that plaintiff felt that she could return to work. Tr. 184. Given these statements, coupled with the lack of medical evidence supporting a severe disability that existed in 1994, the ALJ's decision denying benefits is supported by substantial evidence.
IV. CONCLUSIONS
For the reasons above, the decision of the ALJ to deny disability insurance benefits is affirmed. The Clerk of the sedentary work. See 42 U.S.C. § 423 (d)(2)(A) and (B).
On December 31, 1994, and for at least some time thereafter, plaintiff retained the ability to engage in light work, which entails standing or walking for up to six hours per day and lifting up to twenty pounds occasionally. Tr. 12. Plaintiff, a highly educated woman with a Master's degree in education, Tr. 11, was capable of continuing her past relevant work as a college instructor and substitute high school teacher. Tr. 12.
Finally, plaintiff's own statements to her treating physicians contradict a finding of disability in 1994. According to Dr. David Dickoff's letter of November 13, 1996, Tr. 184, plaintiff indicated that she had stopped working in 1994 not because of disability, but because she wanted to write a book. Tr. 184. According to Dr. Leona Borchert's records dated September 28, 1995, Tr. 289, plaintiff finished the book sometime in 1995. Tr. 289. Dr. Dickoff's 1996 letter also states that plaintiff felt that she could return to work. Tr. 184. Given these statements, coupled with the lack of medical evidence supporting a severe disability that existed in 1994, the ALJ's decision denying benefits is supported by substantial evidence.
IV. CONCLUSION
For the reasons above, the decision of the ALJ to deny disability insurance benefits is affirmed. The Clerk of the Court is directed to close this case.