Opinion
97 Civ. 4779 (AKH)
October, 2000
MEMORANDUM AND ORDER
Plaintiff pro se brings this action under 42 U.S.C. § 405(g), challenging the decision of the Commissioner of the SSA finding that Plaintiff was not disabled and denying her Title II disability insurance and Title XVI SSI benefits. Defendant, pursuant to Fed.R.Civ.P. 12(c), moves for judgment on the pleadings. I hold, despite medical evidence supporting Plaintiff's claim to a degree, that the Commissioner's decision is supported by substantial evidence, and I therefore grant the motion and dismiss the claim.
1. Prior Proceedings
Plaintiff filed applications for disability insurance and SSI benefits on March 10, 1995. Her applications were denied. On October 1, 1996, a hearing was held before an ALJ. The ALJ found that she was not disabled and therefore not entitled to either Title II or Title XVI benefits. On April 8, 1997, the Appeals Council denied Plaintiff's request for review and the ALJ's decision became final. Thereafter, Plaintiff commenced this action.
2. Legal Standards
A reviewing court should not decide a Social Security disability case de novo. 42 U.S.C. § 405(g). If the Court finds that there is substantial evidence for the determination, the Commissioner's decision must be upheld, even if there is substantial evidence for the Plaintiff's position as well. See Schauer v. Schweiker, 675 F.2d 55, 57 (2d Cir. 1982). Substantial evidence in this context has been defined as Amore 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) (citation omitted). The substantial evidence test applies not only to findings of basic evidentiary facts, but also to inferences and conclusions drawn from such facts. Rodriguez v. Califano, 431 F. Supp. 421, 423 (S.D.N.Y. 1977).
The Commissioner has established a five-step sequential evaluation for adjudication of disability claims, which the Second Circuit Court of Appeals has articulated as follows:
First, the [Commissioner] considers whether the claimant is currently engaged in substantial gainful activity. If he is not, the [Commissioner] next considers whether the claimant has a severe impairment which significantly limits his physical or mental abilities to do basic work activities. If the claimant suffers such an impairment, the third inquiry is whether, based solely on medical evidence, the claimant has an impairment which is listed in Appendix 1 of the regulations. If the claimant has such an impairment, the [Commissioner] will consider him disabled without considering vocational factors such as age, education, and work experience; the [Commissioner] presumes that a claimant who is afflicted with a listed impairment is unable to perform substantial gainful activity. Assuming the claimant does not have a listed impairment, the fourth inquiry is whether, despite the claimant's severe impairment, he has the residual functional capacity to perform his past work. Finally, if the claimant is unable to perform his past work, the [Commissioner] then determines whether there is other work which the claimant could perform.
DeChirico v. Callahan, 134 F.3d 1177, 1179-80 (2d Cir. 1998) (quoting Berry v. Schweiker, 675 F.2d 464, 467 (2d Cir. 1982)). The claimant has the burden of proof as to the first four steps. If she proves that she cannot return to her prior form of work, the Commissioner then considers whether work exists which she could perform. Schaal v. Apfel, 134 F.3d 496, 501 (2d Cir. 1998).
The Commissioner considers objective medical evidence, opinions of examining physicians, subjective evidence of pain and disability and a claimant's age, educational background, and work history in making those determinations. Mongeur v. Hackler, 722 F.2d 1033, 1037 (2d Cir. 1983).
3. Review of the Findings of the ALJ
Plaintiff alleges back pain commencing in 1988, resulting in numbness in her right leg and an inability to stand or sit for long periods. Tr. 25, 32-33. She alleges that she can walk only one block, stand for only 20 minutes at a time and sit for only 15 minutes at a time. Tr. 32-33. She described constant pain in her lower back down her right leg to her toes. Tr. 32-33. However, the ALJ found that the medical evidence did not substantiate a disabling condition. Tr. 16-17.
a. Title II Disability Insurance
For Title II purposes, Plaintiff must establish that she became disabled at a time when she met the insured status requirements under the SSA, that is, prior to December 31, 1993. 20 C.F.R. § 404.315(a); see Arnone v. Bowen, 882 F.2d 34, 37-38 (2d Cir. 1989). Plaintiff, therefore, must establish the existence of a disability on or before that date. Tr. 16.
Following the five-step sequential evaluation summarized in Berry, the ALJ determined that Plaintiff had a lower back disorder commencing May 1994, but that Plaintiff had not demonstrated a severe impairment as of December 31, 1993, as required for Title II purposes. Tr. 16. The ALJ further found that at no time, either prior to or since December 31, 1993, did Plaintiff have an impairment listed in Appendix 1 of the regulations, that is, an impairment that would justify an immediate finding of a disability. The ALJ thereafter considered Plaintiff's residual functional capacity and found that Plaintiff's former employment as a sewing machine operator involved exertion levels greater than those required for sedentary work. Under Rule 201.23 of the Medical Vocational Guidelines, 20 C.F.R. Part 404, Appendix 2, Subpart P, the ALJ found that Plaintiff was not capable of returning to her past relevant work, but retained the residual functional capacity to perform a full range of sedentary work activity. Tr. 17. The ALJ therefore concluded that for SSI purposes, since February 23, 1995, Plaintiff did not have a disabling condition.
The term "disability" means . . . inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months. 42 U.S.C. § 423(d)(1)(A). An individual shall be determined to be under a disability only if his physical or mental impairment or impairments are of such severity that he is not only unable to do his previous 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. § 423(d)(2)(A).
Despite Plaintiff's subjective complaints for the time period prior to December 31, 1993, the ALJ found no evidence of a disabling back condition for that time period. Tr. 17. Plaintiff had not been working since 1990, when she left her job in order to care for her one-year-old daughter, Tr. 31, but the record shows no complaint of a back condition for four years, until 1994. Plaintiff testified that she first sought medical treatment for her back pains in 1994. Tr. 25-26, 117. Tr. 31. Furthermore, the discharge summary for Plaintiff's November 1994 hospital admission states that she reported that her back problems started in May 1994. Tr. 107.
In a letter addressed to this Court dated January 5, 2000, Plaintiff submitted three letters from physicians attesting to the presence of a back condition prior to December 31, 1993. These letters contain no objective clinical findings, test results, or any indication as to whether her condition was disabling. The Second Circuit has devised a three-part test to determine whether a Social Security disability case should be remanded to consider new evidence. To introduce new evidence, a claimant must show that the evidence is
(1) new and not merely cumulative . . . (2) material, that is, both relevant to the claimant's condition during the time period for which benefits were denied and probative. . . . The concept of materiality requires, in addition, a reasonable possibility that the new evidence would have influenced the Secretary to decide claimant's application differently. . . . Finally, claimant must show (3) good cause for her failure to present the evidence earlier.
Jones v. Sullivan, 949 F.2d 57, 60 (2d Cir. 1991) (citations omitted). Plaintiff's correspondence does not include an explanation why this evidence was not presented at an earlier date. It also contradicts her own testimony in which she stated that she did not seek medical assistance prior to 1994. Tr. 25. It is therefore unlikely that these letters would have influenced the Secretary to evaluate her claim differently. The decision of the ALJ was supported by the substantial weight of the evidence, and it is affirmed.
b. Title XVI SSI Benefits
For Title XVI purposes, Plaintiff must show that a disabling condition existed on or after her application date of February 23, 1995. To show a disability under the SSA it is insufficient to establish the presence of an impairment alone; Plaintiff must show that the impairment caused functional limitations that precluded her from engaging in any substantial gainful activity. See Rivera v. Harris, 623 F.2d 212, 215-16 (2d Cir. 1980).
The ALJ found that, as of March 10, 1995, despite surgery in November 1994, Plaintiff was capable of performing sedentary work. In reaching her decision, the ALJ expressly considered the opinions of Plaintiff's treating physician, Dr. Jose A. Acevedo, and physicians' assistants Rodney C. Lawrence, R.P.A. and Gustavo Insignares, R.P.A., each of whom submitted a report stating, in effect, that Plaintiff was unable to perform even sedentary work. Tr. 14, 125, 130, 146-47. The ALJ found that Dr. Acevedo's restrictive assessment regarding Plaintiff's residual functional capacity was not consistent with his clinical findings. Tr. 14. The ALJ did not give weight to the other two reports, due to the absence of objective clinical findings or test results that supported their conclusions. Tr. 14.
Sedentary work involves lifting no more than 10 pounds at a time and occasionally lifting or carrying articles like docket files, ledgers, and small tools. Although a sedentary job is defined as one which involves sitting, a certain amount of walking and standing is often necessary in carrying out job duties. 20 C.F.R. § 416.967(a).
A treating physician's medical opinion is entitled to controlling weight only if that opinion is well supported and is not inconsistent with other substantial evidence. 20 C.F.R. § 416.927(d)(2). The ALJ relied primarily upon the consultative examination performed by Dr. Schwartz. Tr. 118-19. Dr. Schwartz concluded that Plaintiff can stand and sit in excess of eight hours per day, can perform dexterous activities bilaterally with her upper extremities, and can lift objects using normal lifting methods. Tr. 119. Dr. Schwartz gave Plaintiff an excellent prognosis, stating that her evaluation did not reveal any musculoskeletal or muscular deficits. Tr. 119. He concluded that Plaintiff should be able to perform normal work duties. Tr. 119. Based on Dr. Schwartz's report, the ALJ found that Plaintiff retained the residual functional capacity to perform sedentary work.
The ALJ considered Plaintiff's subjective complaints of disabling pain and discomfort, but found them unsupported by the medical record. Tr. 15. A claimant must demonstrate that she has a medically determinable impairment that could reasonably be expected to produce the alleged symptoms. 20 C.F.R. § 416.929(b). If objective medical evidence is not sufficient to support a claimant's allegations, the agency considers such factors as the claimant's daily activities, the intensity of her symptoms, any precipitating and aggravating factors, the type of medication prescribed and its side effects or any other measure which the claimant has used to relieve her symptoms. 20 C.F.R. § 416.929(c)(3). The ALJ has the capacity and the discretion to evaluate the credibility of a claimant and to arrive at an independent judgment, in light of medical findings and other evidence, regarding the true extent of pain alleged by the claimant. See Mimms v. Heckler, 750 F.2d 180, 186 (2d Cir. 1984). Taking all these factors into account, the ALJ found that Plaintiff's subjective complaints were not consistent with the objective medical evidence, and his finding in that respect is entitled to deference as substantially supported by the evidence. Tr. 15.
The record is conflicting regarding the medicine that Plaintiff has been taking to alleviate her back pain. The ALJ noted that Plaintiff reported that following surgery, her pain decreased, and she was able to cook, shop, and clean, and care for her two young children. Tr. 15, 86, 98. The ALJ observed that a nearly full bottle of pain medication (Methocarbonal) that Plaintiff produced at the hearing had been filled at the pharmacy three months earlier, and inferred that Plaintiff did not use prescription medication on a frequent basis. Tr. 15, 34-35. The ALJ ultimately determined that Plaintiff's subjective allegations of debilitating pain and discomfort were not supported by the evidence.
However, other evidence was consistent with an alternative view of the evidence. Plaintiff explained that she went shopping only once a month, that she needed other people to assist her with shopping and carrying her purchases, and that she needed the help of her niece to clean her apartment. Tr. 33, 98. As to the bottle of Methocarbonal pain medication that was nearly full and therefore appeared not to be used as prescribed, Plaintiff explained that she used a different medication, ARelafen. Tr. 34. When the ALJ asked if there were any other medications that she currently used, Plaintiff produced other bottles of medication, but was cut off from explaining her use. Tr. 34-35. This evidence provides some support for Plaintiff's position, but the ALJ determined that it was outweighed by evidence that Plaintiff was not disabled.
The ALJ concluded that Plaintiff had the functional capacity to perform sedentary work. Although some evidence exists supporting an alternative inference in Plaintiff's favor, the findings of the ALJ are supported by the substantial weight of the evidence. I therefore am compelled to affirm the decision below that Plaintiff was not disabled at any point during the critical period, that is, on or after February 23, 1995.
4. Conclusion
Accordingly, for the reasons stated, the decision of the Social Security Administration is affirmed and the complaint is dismissed.
The Clerk of the Court shall close this case.
SO ORDERED.