Opinion
Civil Action No. 97-443 (NHP).
July 19, 1999
Agnes S. Wladyka, Esq., ABROMSON CAREY, Newark, N.J., Attorneys for Plaintiff.
Peter G. O'Malley, Assistant, U.S. Attorney, FAITH S. HOCHBERG, UNITED STATES ATTORNEY, Newark, N.J., Attorneys for Defendant.
LETTER OPINION ORIGINAL ON FILE WITH CLERK OF THE COURT
Dear Counsel:
Plaintiff Gerald Munkacsy brings this action before the Court seeking to overturn the final determination of the Commissioner of Social Security denying plaintiff's claim for disability insurance benefits and Supplemental Security Income ("SSI"). For the following reasons, the Commissioner's decision is hereby AFFIRMED.
STATEMENT OF FACTS PROCEDURAL HISTORY
Plaintiff Gerald J. Munkacsy alleges that he has been disabled due to diabetes mellitus since March 2, 1990. (Transcript of Proceedings at pages 62-84.) Plaintiff was treated at the Chilton Memorial Hospital Clinic (hereafter "Chilton Memorial") from May 10, 1993 to May 20, 1996 and University of Medicine and Dentistry Clinic (hereafter "UMDNJ") from January 12, 1994 to May 29, 1996. Both hospitals' records indicate that the plaintiff has suffered from insulin dependent diabetes mellitus. (Tr. at p. 171, 193.) In addition, the records indicate that plaintiff has been a diabetic for over 30 years since age 13. (Tr. at p. 190, 297)
On July 8, 1994, Dr. Matthew C. Kartch noted hypoglycemia. (Tr. at p. 302.) Plaintiff was told of retinopathy in 1984 but had not been evaluated since then. See id. Plaintiff also learned at that time that his retinopathy was not proliferative. See id. Dr. Kartch noted that plaintiff's unaided visual acuity was 20/25+ in the right eye and 20/25 — in the left eye. See id. Plaintiff's corrected acuities were 20/20 in the right eye and 20/20-3 in the left eye. Both lenses showed nuclear sclerosis and early cataracts.
An abnormally low level of glucose in the blood. The Random House Dictionary of the English Language , 944 (2d ed. 1987).
Retinal changes occurring in diabetes of long duration, marked by hemorrhages, microaneurysms, and sharply defined waxy deposits, or by proliferative retinopathy. See Sedmans' Medical Dictionary , 1353 (25th ed. 1990).
Increased refractivity of the central portion of the lens of the eye. See Sedmans' Medical Dictionary , 1393 (25th ed. 1990).
Loss of transparency of the lens of the eye. See Sedmans' Medical Dictionary , 1393 (25th ed. 1990).
Plaintiff has had diabetic retinopathy for the past ten years and he has been told the back of his eyes are cloudy. (Tr. at pp. 54-55.) However, plaintiff does not have problems with his extremities. (Tr. at p. 56.)
On February 28, 1995, plaintiff's ability to control his condition was described as fair to poor in the UMDNJ's records. (Tr. at p. 371.) On June 19, 1995, it was noted that plaintiff had become a "brittle" diabetic with frequent highs and lows. (Tr. at p. 308.) Plaintiff's blood sugar fluctuated from 7200 to 38. (Tr. at p. 311.) On November 20, 1995, Chilton Memorial notes indicated that plaintiff experienced some cognitive dysfunction during decreased sugar spells. See id.
Diabetes in which there are marked fluctuations in blood glucose concentration which are difficult to control. See Sedmans' Medical Dictionary , 427 (25th ed. 1990).
From May 11, 1994 to November 23, 1994, the nutrition clinic at UMDNJ oversaw the plaintiff's condition because of his uncontrolled diabetes and hypoglycemia. (Tr. at pp. 366-68.) On January 31, 1996, plaintiff's blood sugar level was described as uncontrolled. (Tr. at p. 393.)
On January 28, 1996, Dr. Martin Fechner, a medical expert and board certified internist, reviewed the plaintiff's medical records at the request of the Administrative Law Judge (hereafter "ALJ") and answered interrogatories on January 28, 1996. Dr. Fechner noted that there were no episodes of symptoms which indicate hypoglycemia, such as numbness or pain in his feet or dizziness. The doctor further opined that the plaintiff's medical records indicate that the plaintiff is currently asymptomatic.
Plaintiff is a male who was born on August 19, 1949 and has a BS degree in biology. (Tr. at p. 61; 40.) Plaintiff had last worked for six months in 1990 doing maintenance work. (Tr. at pp. 38-39.) Plaintiff testified that he was fired because he had an insulin reaction. See id. Plaintiff had previously worked for two years as a house parent for a group home for children. (Tr. at p. 40.) Plaintiff worked for a year and one half as a house parent for mentally disabled adults. See id. Plaintiff also worked on an oil rig. See id.
Plaintiff filed applications for Social Security disability insurance benefits and SSI on February 14, 1994, alleging disability due to diabetes since March 2, 1990. (Tr. at pp. 62-64.) Plaintiff's claim for benefits was initially denied, and then denied upon reconsideration. (Tr. at pp. 66-68, 70-71, 77-78, 80-81.) Thereafter, plaintiff requested a hearing before the Administrative Law Judge. A hearing before Judge Muehling was held on February 21, 1996. (Tr. at pp. 35-60.)
On February 21, 1996, plaintiff testified at the hearing before the Honorable Ralph J. Muehling, ALJ, that his diabetes had become uncontrollable in the past five years and he is unable to work. (Tr. at p. 41.) Plaintiff has lived and eaten at his mother's and father's house for the past five years. (Tr. at pp. 48-49.) Plaintiff cares for his father who suffered a stroke. (Tr. at p. 50.) Plaintiff puts his father through a range of motion exercise and physically supports him so he can walk. See id. Plaintiff drives, does the shopping and mows the lawn. (Tr. at p. 51.) Plaintiff also breeds parrots, socializes with his friends and goes hunting with them. (Tr. at p. 52.)
On May 1, 1996, the ALJ determined that plaintiff was not disabled and thus not entitled to Social Security benefits. (Tr. at pp. 10-18.) The decision became final when Appeals Council denied plaintiff's request for review. (Tr. at pp. 5-6.) In ruling that plaintiff was not disabled, the ALJ found that the claimant met the disability insured status requirements of the Social Security Act on March 2, 1990, the date he alleges onset of disability, and that the claimant has not performed substantial gainful activity since his alleged onset date. The ALJ found that claimant's insulin dependent diabetes mellitus is considered to be a "severe" impairment. However, the ALJ determined that plaintiff's impairments were not contained in the "Listing of Impairments." See C.F.R. § 404, Subpt. at P, App.1 (1995). In addition, the ALJ decided that the plaintiff's subjective complaints were controverted by the medical evidence. Next, the ALJ found that the plaintiff has the residual functional capacity to perform his past relevant work as a maintenance worker or counselor. Accordingly, the ALJ concluded that plaintiff was not disabled, therefore, not entitled to benefits.
LEGAL DISCUSSION
Jurisdiction over this appeal is conferred upon this Court pursuant to 42 U.S.C. § 405(g) and 1383(c)(3). Based on § 405(g), this Court must affirm the Commissioner's findings of fact if supported by substantial evidence. It is settled that substantial evidence means any "`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). The fact that the record contains evidence which would have supported a different conclusion does not undermine the Commissioner's decision so long as there is substantial support for the decision in the record. See Blalock v. Richardson, 483 F.2d 773, 775 (4th Cir. 1972). Thus, the court's sole inquiry is whether the record, read as a whole, yields such evidence as would allow a reasonable mind to accept the conclusions reached by the Commissioner. Where evidence is susceptible of more than one rational interpretation, it is the Commissioner's conclusion which must be upheld. See Sample v. Schweiker, 694 F.2d 639, 642 (9th Cir. 1982). In addition, the ALJ's ruling should clearly explain the foundation upon which it rests. See Cotter v. Harris, 642 F.2d 700, 704 (3d Cir. 1981). Furthermore, it is clear that the ALJ is charged with the responsibility of analyzing all relevant evidence and explaining why certain evidence was considered relevant while other evidence was dismissed. See Gober v. Matthews, 574 F.2d 772, 776 (3d Cir. 1978). In sum, this Court must confine its inquiry to a determination of whether the Commissioner's decision is supported by substantial evidence.
In order for a claimant to be deemed disabled, and thus be entitled to benefits, he must comply with all relevant statutory requirements. To comply, the claimant must first meet the insured status requirements listed in 42 U.S.C. § 423(c) and the resource and income restrictions set forth in 42 U.S.C. § 1382(a) and (b). Secondly, the claimant must establish that he is not engaged in substantial gainful activity as defined in §§ 423(d)(1)(A) and 1382(c)(3)(A). Finally, the claimant must further show that he is disabled as defined by the statute.
In the instant case, the plaintiff has satisfied the first two of these requirements. Thus, the only determination at issue on appeal is whether plaintiff is disabled as defined by the statute. This Court must decide if the ALJ's ruling denying the plaintiff "disabled" status is supported by substantial evidence.
The Social Security Act prescribes a five-step sequential evaluation for an ALJ's evaluation of a claimant's disability. See 20 C.F.R. § 404.1520 (1998). In the first step, plaintiff has the burden of establishing that he is not currently employed or engaged in "substantial gainful activity." 20 C.F.R. § 404.1520(a) (1998); Bowen v. Yuckert, 482 U.S. 137, 146-47 n. 5 (1987). If the claimant is working and the work is substantial gainful activity, his application for disability benefits is automatically denied. See 20 C.F.R. § 404.1520(b) (1998). If the claimant is not employed, the ALJ proceeds to step two and determines whether the claimant has a "severe impairment" or "combination of impairments." 20 C.F.R. § 404.1520(c) (1998); Bowen v. Yuckert, 482 U.S. 137, 146-47 n. 5 (1987). A claimant who does not have a "severe impairment" is not disabled. Id. Third, if the impairment is found to be severe, the ALJ determines whether the impairment is listed in 20 C.F.R. § 404, Subpart P, Appendix 1 (1998). If so, the claimant is conclusively presumed to be disabled, and the evaluation ends there. See 20 C.F.R. § 404.1520(d) (1998). If the impairment does not meet or equal a listed impairment, the ALJ proceeds to step four.
The fourth step of the analysis requires a determination of whether the impairment prevents the claimant from returning to the work claimant performed in the past. See 20 C.F.R. § 404.1520(e) (1998); Bowen v. Yuckert, 482 U.S. 137, 146-47 n. 5 (1987). Failure to prove this requisite will result in a denial of benefits. See 20 C.F.R. § 404.1520(e) (1998). Finally, if the claimant has proven that he or she is unable to perform prior occupational duties, the evaluation must continue to the last step, where the burden then shifts to the Commissioner to establish that the claimant is able to work in some other occupation in the national economy. See 20 C.F.R. § 404.1520(f) (1998). In so doing, the ALJ considers the claimant's age, education and past work experience. See id. If the Commissioner is unable to carry this burden, the claimant is entitled to benefits. See id.
In the case sub judice, this Court finds that the ALJ's decision to deny the plaintiff's claim for benefits is supported by substantial evidence. First, there exists substantial medical evidence that plaintiff has the capability to engage in substantial gainful activity. Second, plaintiff fails to demonstrate the existence of a medically determinable impairment which prevents him from returning to his former occupation.See Doak v. Heckler, 790 F.2d 26, 28 (3d Cir. 1986).
The ALJ determined that plaintiff had insulin-dependent diabetes mellitus. However, the ALJ also found that substantial evidence indicated that plaintiff's diabetes was not serious enough to prevent him from working. In so deciding, the ALJ noted that there was no medical evidence that the plaintiff required hospitalization for treatment of any acute diabetic complications. In addition, there was no evidence of neuropathy. Furthermore, there was no evidence of diabetic neurosis or peripheral arterial disease requiring amputation. Although plaintiff gave a history of retinopathy, an eye examination performed on July 8, 1994 by Dr. Matthew C. Kartch revealed that plaintiff's unaided visual acuity was 20/25+ in each eye, which was nearly normal. Plaintiff's vision was improved with correction to 20/20 in the right eye, which was normal, and to 20/20-3 in the left eye. The macula and peripheral retina were normal with no hemorrhages seen. Although plaintiff's lenses showed nuclear sclerosis and early cataracts, these conditions were not serious enough to require corrective surgery or to significantly impair plaintiff's vision. Thus, Judge Muehling's determination is justified because there was no evidence of significant vision impairment or other conditions that would preclude all work activities. See 20 C.F.R. Part 404, Subpt. P, App. 1, part A § 9.08.
A combined sensory and motor disorder affecting any segment of the nervous system; seen frequently in older diabetic persons. See Sedmans' Medical Dictionary , 1048 (25th ed. 1990).
Furthermore, Judge Muehling found that plaintiff's diabetes can be controlled by good eating habits, although, according to the record plaintiff had some difficulty controlling his diabetes in the past. Plaintiff's blood sugar levels were moderately controllable according to the records, even though he was not always compliant with his diet. In addition, there were no reported episodes of hypoglycemia, dizziness or symptoms of foot neuropathy. Judge Muehling also noted the clinic records indicating that plaintiff's diabetes improved after he changed his diet habits. Thus, substantial evidence supports Judge Muehling's findings that plaintiff does not have a medically determinable impairment which prevents him from returning to his former occupation and engaging in any substantial gainful activity.
The plaintiff also claims that the ALJ did not consider the plaintiff's subjective complaints of pain. In evaluating the existence of a disability, "statements about [plaintiff's] pain or other symptoms will not alone establish that [plaintiff is] disabled; there must be medical signs and laboratory findings which show that [plaintiff has] a medical impairment(s) which could reasonably be expected to produce the pain or other symptoms alleged." 20 C.F.R. § 404.1529 (1998). Once it is established that a medically determinable impairment exists which reasonably can be expected to produce the pain, the intensity and persistence of symptoms must be evaluated to determine how they might limit a claimant's capacity to work. See 20 C.F.R. § 1529(c)(1) (1998). A determination of disability, however, requires "more than mere inability to work without pain" or discomfort. Dumas v. Schweiker, 712 F.2d 1545, 1552 (3d Cir. 1983). When a complaint of pain is not fully supported by the objective medical evidence in the record, the ALJ can give weight to factors such as reports from physicians, the frequency of complaints, evidence of any medication for pain, and the effect on the claimant's daily activities. See 20 C.F.R. § 404.1529(c)(3) and 416.929(c)(3) (1998).
The ALJ has discretion in evaluating the credibility of a claimant's subjective complaints of pain. See Brown v. Schweiker, 562 F. Supp. 284, 287 (E.D.Pa. 1983) (citing Bolton v. Secretary of HHS, 504 F. Supp. 288 (E.D.N.Y 1980)). In this case, the ALJ did not dismiss the plaintiff's subjective complaints of pain. Rather, the ALJ evaluated these complaints of pain in conjunction with the objective medical evidence. Judge Muehling gave little weight to plaintiff's subjective complaints of dizziness, neuropathy, and anxiety because plaintiff had never mentioned these concerns with his treating physicians. Additionally, there was no evidence that plaintiff's diabetes had caused psychiatric impairment and neuropathy. Moreover, the ALJ further noted that plaintiff is able to socialize, and even hunt. The ALJ thus found that the plaintiff's allegations that he is unable to engage in any work activity due to subjective complaints of dizziness, neuropathy and anxiety, are not entirely credible, nor consistent with plaintiff's record as a whole. It was within the ALJ's discretion to grant less weight to subjective complaints of pain when such evidence conflicted with the objective medical evidence.
Plaintiff further claims that the ALJ did not consider his complaints of poor vision, cognitive dysfunction, heart condition and uncontrolled diabetes as nonexertional limitations. However, there is substantial evidence that supports the ALJ's ruling that plaintiff does not suffer from a significant nonexertional impairment. Nonexertional impairments involve limitations such as postural, manipulative, or environmental impairments that do not affect a claimant's physical strength but may nevertheless prevent him from engaging in substantial gainful employment. See 20 C.F.R. § 404.1545(d) (1998). In the case at hand, the ALJ considered Dr. Martin Fechner's recommendation that plaintiff avoid exposure to unprotected heights, and working around moving machinery, due to the possibility of dizziness. However, the ALJ also noted Dr. Fechner's medical reports indicating that the medical records showed no reported dizziness.
More importantly, a claimant is not disabled if his impairments do not preclude him from performing his previous work, or if he is capable of engaging in any kind of substantial gainful work which exists in the national economy, "regardless of whether such work exists in the immediate area in which he lives, or whether a specific job vacancy exists for him, or whether he would be hired if he applied for work." 42 U.S.C. § 423(d)(2)(A) (1991). The ALJ indicated that plaintiff testified at the hearing that he is able to function in his activities of daily living. The ALJ also noted that plaintiff drives, shops, maintains his parent's house, and has significant responsibilities in taking care of his father who had a stroke in 1990. Plaintiff also testified that he sometimes goes hunting with his friends.
Significantly, Dr. Fechner estimated that plaintiff could sit for eight hours and stand and/or walk for six hours in an eight-hour day, and that he could lift fifty pounds occasionally and twenty-five pounds frequently. The ALJ noted plaintiff's description of his position as a wood worker as requiring him to lift up to 10 pounds, and walk 4 hours a day, or stand all day. Thus, plaintiff has the residual functional capacity to perform his past relevant work as a wood worker, maintenance worker, or counselor, which is described as light level work activity, based upon his residual functional capacity for medium level work activity.
CONCLUSION
For the foregoing reasons, and on the basis of the record as a whole, this Court finds that the Commissioner's determination that plaintiff is not entitled to disability insurance benefits or SSI under the Social Security Act is supported by substantial evidence and is hereby AFFIRMED.
An appropriate Final Order accompanies this Letter Opinion.
FINAL ORDER
This matter having come before the Court on the appeal of Gerald Munkacsy, pursuant to 42 U.S.C. § 405(g) and 1383(3) of the Social Security Act, seeking review of the final determination of the Commissioner of Social Security denying her claim for disability insurance benefits and Supplemental Security Income; and the Court having decided the matter without oral argument; and for the reasons set forth more fully in the accompanying Letter Opinion; and good cause having been shown;
IT IS on this day of July, 1999,
ORDERED that the Commissioner of Social Security's determination is AFFIRMED; and it is further
ORDERED that this case is CLOSED.