Opinion
Civ. No. 99-3391 (DRD).
February 20, 2001
Vasiliki Pagidas, Esq., Freeman Bass, P.A., Newark, N.J., Attorney for Plaintiff.
Anthony J. Labruna, Esq., Assistant United States Attorney, Newark, N.J., Attorney for Defendant.
O P I N I O N
Plaintiff Margaret Jackson appeals from a final determination of the Commissioner of Social Security ("the Commissioner"), denying her application for Disability Insurance Benefits ("DI") and Supplemental Security Income Benefits ("SSI") under the Social Security Act. Plaintiff alleges that the Commissioner's determination is not supported by substantial evidence. For the reasons set forth below, the Commissioner's determination is affirmed.
Statement of Facts and Procedural History On May 29, 1996, plaintiff applied for DI and SSI benefits, alleging disability due to obesity, hypertension, and complications arising therefrom. (Tr. 75-78, 88-95). Her application was denied initially and again upon reconsideration. (Tr. 55-62, 65-67, 309-16). Plaintiff requested a hearing before an Administrative Law Judge ("ALJ"), which was held on October 27, 1997, before ALJ Gordon Mahley. (Tr. 27-54). Plaintiff was represented by counsel at that hearing. (Tr. 27). On February 12, 1998, the ALJ issued his decision, finding that although plaintiff was severely impaired, she retained the functional capacity to return to the work she performed in the past and therefore was not under a disability as that term is defined in the Act. (Tr. 14-23). Plaintiff requested that the Appeals Council review the ALJ's determination and submitted additional medical reports in support of her claim. (Tr. 9, 10, 13). In a letter to plaintiff dated May 25, 1999, the Appeals Council denied plaintiff's request for review and stated that the new evidence, to the extent it was relevant to the period through the date of the ALJ's decision, did not justify granting review of the ALJ's decision. (Tr. 6-8). Plaintiff now seeks review of those determinations. Administrative Findings
ALJ Mahley made the following findings:
1. The claimant met the disability insured status requirements of the Act on May 15, 1996, the date the claimant stated she became unable to work, and has acquired sufficient quarters of coverage to remain insured through at least December 31, 2000.
2. The claimant has not engaged in substantial gainful activity since May 1996.
3. The medical evidence establishes that the claimant has atypical chest pain, pulmonary hypertension by history and obesity, impairments that are severe but which do not meet or equal the criteria of any of the impairments listed in Appendix 1, Subpart P, Regulations No. 4.
4. The claimant's statements concerning her impairments and their impact on her ability to work are not entirely credible in light of the claimants own description of her activities and life style and the reports of the treating and examining practitioners.
5. The claimant lacks the residual functional capacity to lift and carry more than ten pounds.
6. In her past work as a secretary, the claimant was not required to lift up to ten pounds.
7. The claimant's past relevant work as a secretary did not require the performance of work functions precluded by her medically determinable impairments.
8. The claimant's impairments do not prevent her from performing her past relevant work as a secretary.
9. The claimant has not been under a disability, as defined in the Social Security Act, at any time through the date of the decision.
(Tr. 6).
Evidence Before the ALJ
ALJ Mahley had several items of documentary evidence before him, primarily plaintiff's medical and hospital records. (TR. 79-318). Hospital records indicated that plaintiff made six hospital visits (and was admitted four times) over the course of three years. (Tr. 124, 163, 197, 249, 286).
In late 1995, plaintiff was admitted to the hospital and was diagnosed with chest pain, a pulmonary embolism, bronchial asthma and hypertension. She was treated with Coumadin and Heparin. (Tr. 123-168). Prior to her hospital admission, plaintiff weighed 243 pounds. (Tr. 121).
In early 1996, plaintiff was treated at the hospital for complaints of chest pain. (Tr. 170-195). She was treated with Coumadin and Cardizem.
In early summer 1996, plaintiff was admitted to the hospital because of chest pain. (Tr. 196-247). Records indicate that plaintiff also experienced shortness of breath and had high cholesterol. (Tr. 204, 246). Plaintiff complained that she could walk only one block before experiencing shortness of breath and that she had been experiencing chest pain with increasing intensity. (Tr. 204).
In late summer 1996, plaintiff was admitted to the hospital because of shortness of breath and chest pain. (Tr. 248-65). Plaintiff was diagnosed with sleep apnea, obesity, high cholesterol and triglyceride levels, anemia and hypertension. (Tr. 248). Plaintiff was treated with Heparin and Coumadin. (Tr. 250).
A report signed by Dr. Frank Barbara on behalf of the New Jersey Department of Labor states that as of September 13, 1996, plaintiff had a history of controlled hypertension, pulmonary hypertension, anemia, and peripheral vascular disease. (Tr. 271-273). The report states that plaintiff stated she was unable to work due to chest pain and shortness of breath. The report states that plaintiff was not in acute distress. The report further states that plaintiff was 64 inches tall and weighed 236 pounds.
A report signed by Dr. I. Ahmad, M.D., states that as of February 14, 1997, plaintiff was totally disabled "as a physiological unit." (Tr. 277-78). A report signed by Dr. Samuel Pollock, M.D., states that as of February 19, 1997, "as a physiological industrial unit, regardless of cause, [plaintiff] appears to be 100% disabled." (Tr. 279-80). A report signed by Dr. Sidney E. Friedman, M.D., states that as of May 28, 1997, plaintiff was "totally disabled as a physiological industrial unit from all causes." (Tr. 281-84). Drs. Ahmad, Pollock and Friedman are members of a team of doctors repeatedly retained by plaintiff's attorneys to examine their clients. As is his usual practice Dr. Ahmad recited that the person being examined while employed "was exposed to dust, dirt, fumes, gases, noises, bending, lifting, stress and strain." (Tr. 277). As is his usual practice Dr. Pollock recited that the person being examined had a number of jobs over a period of years "which involved varying exposures to dusts, gases, fumes, noise, repeated bending, lifting, repeated manipulations, exposure to noxious elements, stress and strain." (Tr. 279). As is his usual practice, Dr. Friedman recited that the person being examined had a number of jobs over a period of years and was "exposed to dust, dirt, fumes, noise, stress and strain." (Tr. 281). Apparently the doctors believed these conditions existed even though plaintiff was a secretary or administrative assistant required to lift no more than ten pounds.
In addition to those reports, plaintiff appeared at her administrative hearing on October 27, 1997, represented by counsel. (Tr. 27). ALJ Mahley received testimony from plaintiff. (Tr. 34-54).
Plaintiff testified that she was 5 feet 3 inches tall and weighed 248 pounds. (Tr. 35). The ALJ noted that plaintiff wore a brace on her arm, which plaintiff stated she had worn for two months because of carpal tunnel syndrome. (Tr. 36). Plaintiff testified that she made numerous visits to the hospital complaining of shortness of breath, chest pain, and dizziness, and that she received medical treatment at a clinic every four to six weeks. (Tr. 39-43). At the time of the hearing, plaintiff was taking the following medications: Naproxen, Cardizem, Pepcid, Diphenhydramine, Ultram, Nitrostat, Acetaminophen with Codeine and Propulsid. Plaintiff testified that she had started using a cane the previous week because she felt dizzy and her legs felt weak. (Tr. 49). She also testified that she had a pinched nerve in her back that caused pain, difficulty walking, and difficulty sitting for extended periods of time. (Tr. 49-50).
Plaintiff testified that she had a high-school education and worked as an administrative assistant for fifteen years. (Tr. 37-38). She testified that she would not be able to return to work because of her "overall condition" and carpal tunnel syndrome. (Tr. 36, 39). Additionally, plaintiff testified that she could not return to work because she had difficulty focusing and following directions. (Tr. 47). Plaintiff testified that she attended religious services five times per week, tried to do her own housework and cook (but with difficulty), and that she did not go grocery shopping alone. (Tr. 37, 51-52).
At the close of the hearing, ALJ Mahley stated that the record would be held open for the submission of additional medical reports. (Tr. 54). Counsel for plaintiff submitted the results of plaintiff's stress test, which was performed shortly after the hearing. (Tr. 17, 308). The results were unremarkable. (Tr. 308). Counsel for plaintiff submitted reports from plaintiff's March 1997 hospital admission for throat pain and difficulty breathing. (Tr. 286-296). She was diagnosed with epiglottitis and peritonsillitis. (Tr. 287). Additionally, counsel submitted reports from plaintiff's October 1997 emergency room visit for shortness of breath and chest pain. (Tr. 297-307). ALJ Mahley issued his decision three months later. (Tr. 14-23).
Additional Evidence before the Appeals Council
Following the denial of plaintiff's claim by the ALJ, plaintiff submitted additional items of evidence to the Appeals Council. (Tr. 9). Those additional items included medical reports completed by Dr. Chidi Anukwuem, M.D. on December 12, 1997 (which stated that plaintiff's conditions were "fairly serious and progressive") (Tr. 318), August 6, 1998, July 8, 1998, November 6, 1998, (Tr. 338-43, 346-55) and November 12, 1998 (which stated that "[d]ue to the nature of her medical conditions, she may not be able to work at this time. I consider her permanently disabled."). (Tr. 356). Additionally, plaintiff submitted treatment records from Irvington General Hospital and an MRI report dated September 23, 1998, both relating to plaintiff's complaints of knee pain. (Tr. 319-37, 344-45).
DETERMINATION OF DISABILITY AND BURDENS OF PROOF
Under the Social Security Act, the term "disability" is defined as "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). The statute further states:
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).
Social Security regulations provide a five-step procedure for evaluating disability claims. See 20 C.F.R. § 404.1520 and 416.920. The Commissioner first determines whether the claimant is currently engaged in substantial gainful activity. 20 C.F.R. § 404.1520(a). If the claimant is employed in substantial gainful activity, his application for disability benefits is automatically denied. 20 C.F.R. § 404.1520(b).
The second step determines whether the claimant has a "severe impairment," defined as "any impairment or combination of impairments which significantly limits [the claimant's] physical or mental ability to do basic work activities . . ." 20 C.F.R. § 404.1520(c). A claimant who does not have a severe impairment is not disabled. Id.
If the claimant has a severe impairment, the Commissioner next determines whether the impairment is listed in 20 C.F.R. Part 404, Subpart P, Appendix 1. See 20 C.F.R. § 404.1520(d). If so, the claimant is conclusively presumed to be disabled, without consideration of the claimant's age, education and work experience. See id.
Fourth, the Commissioner determines whether the claimant can return to his previous type of employment. See 20 C.F.R. § 404.1520(e). The claimant bears the burden of proving that he is unable to return to his former occupation. Rossi v. Califano, 602 F.2d 55, 57 (3d Cir. 1979). TheRosssi court noted that a "[c]laimant satisfies her initial burden of showing that she is unable to return to her previous employment when her doctor substantiates her subjective claims." Id.
For the fifth step, "the burden of proof shifts to the [Commissioner] to show that the claimant, given her age, education, and work experience, has the capacity to perform specific jobs that exist in the national economy." Id. at 57. Entitlement to disability benefits is dependent on a finding that the claimant is incapable of performing some other type of work in the national economy. See 20 C.F.R. § 404.1520 (f).
STANDARD OF REVIEW
A district court must accept the Commissioner's findings of fact as conclusive if they are supported by "substantial evidence." 42 U.S.C. § 405(g), Plummer v. Apfel, 186 F.3d 422, 427 (3d Cir. 1999), Cotter v. Harris, 642 F.2d 700 (3d Cir. 1981). 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, 186 F.3d at 427. The administrative decision "should be accompanied by a clear and satisfactory explication of the basis on which it rests." Cotter, 642 F.2d at 704. Additionally, an "examiner's findings should be as comprehensive and analytical as feasible." Baerga v. Richardson, 500 F.2d 309, 312 (3d Cir. 1974)).
DISCUSSION
Applying the standard articulated above, the Commissioner's determination is supported by substantial evidence. The ALJ undertook a thorough examination of plaintiff's medical records and concluded that plaintiff's chest pain, hypertension, and obesity, although severe, did not meet or equal any of the impairments listed in Appendix 1, Subpart P, Regulations No. 4. The fact that at various times after the ALJ issued his decision plaintiff's weight exceeded 250 pounds (an impairment listed in Appendix 1, Subpart P, Regulations No. 4 prior to October 1999) could not have been relied upon by the ALJ in rendering his February 12, 1998 decision. Plaintiff did not meet the weight requirement during the relevant time period considered by the ALJ. The ALJ evaluated plaintiff's testimony and, in light of the medical records and reports discussed above, concluded that plaintiff's subjective complaints were not credible to the extent plaintiff alleged. There is substantial evidence to support that finding. The ALJ adequately explained his reasons for rejecting the reports of Drs. Ahmad, Friedman and Pollock. In addition to the reduced credibility of those doctors due to the fact that they repeatedly prepared strikingly similar reports in support of Social Security claims, the reports in this case did not appear to reflect plaintiff's individual situation, as discussed supra.
Similarly, other changes to plaintiff's medical condition after the issuance of the ALJ's determination do not form the basis upon which to review that determination. Plaintiff argues that her submission of new evidence warrants a remand. However, the reports submitted by plaintiff post-date the ALJ's decision and do not relate to the relevant time period. Because plaintiff's condition changed, she filed a new application for a subsequent period of disability (commencing on March 1, 1998) and received a Fully Favorable Decision from Administrative Law Judge Robert J. Lazarus on January 18, 2001.
The Appeals Council considered the additional evidence submitted to the extent that it was relevant to the period through the date of the ALJ's decision, evaluated the entire record, and found no reason to grant review of the ALJ's decision. See 20 C.F.R. § 404.970(b). Thus, the ALJ's decision is the Commissioner's final decision and it is the ALJ's decision — not the Appeals Council's decision to deny review — that is subject to district court review. See Matthews v. Apfel, No. 00-1151, slip op. at 7, 10 (3d Cir. Feb. 8, 2001) (citing Sims v. Apfel, 530 U.S. 103 (2000)). Further, there is no reason to remand to the Commissioner because there has been no showing that the new evidence submitted to the Appeals Council is material and that there is good cause for the failure to incorporate it into the record before the ALJ. Id. at 7-8.
CONCLUSION
For the foregoing reasons, the final determination of the Commissioner is affirmed. An appropriate order shall be entered.