Opinion
Civil Action No. 98-5334 (NHP).
June 12, 2000
Patricia M. Franklin, Esq., Newark, N.J., Attorney for Plaintiff.
Barbara L. Spivak, Chief Counsel, Sheena V. Barr, Assistant Regional Counsel, Office of the General Counsel, SOCIAL SECURITY ADMINISTRATION ROBERT J. CLEARY, UNITED STATES ATTORNEY, Newark, N.J., Attorneys for Defendant.
THE ORIGINAL OF THIS LETTER OPINION IS ON FILE WITH THE CLERK OF THE COURT
Dear Counsel:
Edith Watson, wife of deceased claimant, Walter L. Watson, brings this action before the Court seeking to overturn the final determination of the Commissioner of Social Security denying claimant's request for disability insurance benefits. This matter was resolved without oral argument pursuant to Federal Rule of Civil Procedure 78. For the following reasons, the Commissioner's decision is hereby AFFIRMED.
STATEMENT OF FACTS
The deceased claimant, Walter L. Watson (hereinafter "claimant"), had completed a high school education and prior to this action had been employed by the United States Marine Corps. (hereinafter "Marines"). On June 1970, claimant ceased working as a result of injuries sustained in an automobile accident while on leave from the Marines. As a result of the accident, claimant suffered severe injuries and was declared disabled. His injuries included a dislocated and fractured right pelvis with mal-union, comminuted fracture of the left femur, tibia and fibula with mal-union, partial ankylosis of the hips, left knee and left ankle injuries, and suffered neuropathy, cerebral concussion and urinary tract damage. See Transcript (hereinafter "Tr.") at 12. He received a period of disability and disability insurance benefits from June 15, 1970 through February 1982. See Tr. at 12. Claimant also was insured for Social Security disability benefits from June 15, 1970 through June 30, 1986.See Tr. at 11.A hearing was held on October 29, 1982, before the Administrative Law Judge, Newton Greenberg. (hereinafter "ALJ"). In November 1982, the ALJ found that, as of February 1982, claimant was not disabled. Prior to February 1982, the ALJ determined that claimant was unable to engage in sedentary work and therefore was found disabled. The ALJ concluded that by February 1982, however, claimant had regained the ability to perform a broad range of sedentary work and therefore was no longer disabled.
In April 1982, claimant began monthly treatments with a chiropractor because he complained of pain in his knees, right hip, lower back, and pelvis. The chiropractor diagnosed him with acute sciatic neuropathy and lumbar spine scoliosis. The chiropractor found positive results on the orthopedic lower back tests. See Tr. at 13; see also Exhibit 18. In addition, a physician observed in August 1982 that both muscle strength and sensation in his lower extremities were only mildly decreased, but he was grossly intact from a neurological and musculoskeletal view. See Tr. at 13; see also Exhibit 15.
In 1982, claimant's doctor noted that he suffered from intermittent hematuria since 1970 due to urethral damage. Blood was present in claimant's urine, but no treatment for this condition was documented. Claimant was hospitalized for an evaluation and treatment of recurrent urinary tract infections. Prompt removal of the calculus was recommended but he left the hospital contrary to medical advice. Subsequently, the calculus fragmented and all of the stones were not removed. As a result, a stone dislodged and obstructed the UP junction, causing an abscess, which required treatment in June 1984. He then developed fascitis and another abscess, which became stabilized after administration of antibiotics.
Claimant's second documented urinary tract infection was discovered during testing for possible diabetes. He was placed on antibiotics in order to control the urinary tract infection. Although he required periodic urethral dilatation and antibiotics to control his urinary tract infections, the dilatation was minimal and no further abscesses were documented. Eventually, after 1990, he developed chronic renal failure and was placed on dialysis.
Claimant developed hypertension and was placed on medication. Although he had Grade II hypertensive changes of his fundi, his hypertension was well controlled throughout 1985 and 1986. The record also showed that claimant complained of occasional blurry vision in January 1986. His blood pressure was moderately elevated because he had run out of medication.
In June 1985, claimant was hospitalized and treated for diabetes mellitus as a result of obesity. Although the doctor recommended a low calorie diet, the claimant refused to adhere to the diet. As a result, the doctor prescribed insulin to control claimant's diabetes. The diabetes was controlled when he took his insulin as directed.
Claimant alleged that he suffered from sleep disturbance and nightmares. Previously, however, he had denied any psychiatric symptoms at his examinations and had no history of medication for any mental problems. He was prescribed anti-depressants, sleep aid, and various psychotropic medications. In January 1987, claimant was diagnosed with dysthymic disorder. There is no evidence that he was treated for alcoholism or drug use.
Claimant's treating physicians did not offer opinions regarding claimant's residual functional capacity. The treating chiropractor did state that the claimant was unable to do heavy lifting, excessive sitting, or standing. The chiropractor further stated that claimant could perform very light work on a part-time basis. See Tr. at 15; see also Exhibit 18. The orthopedic consultant reported that claimant could perform work- related activities except for bending, stooping, working on his knees and substantial weight bearing. Specifically, the orthopedic consultant indicated that claimant could take a relatively light job which did not stress the lower extremities. See Tr. at 15; see also Exhibit 18.
Moreover, the non-examining physicians who reviewed the medical evidence found that claimant had nephrolithiasis, a renal abscess in 1984, recurrent urinary tract obstructions due to kidney stones, urinary tract infections, hypertension, and diabetes mellitus.
Claimant alleged an inability to work after an automobile accident in 1970. He further alleged that he remained disabled and was entitled to a continued period of disability and disability insurance benefits from February 1982 through June 30, 1986. On October 16, 1996, a second hearing was held before the ALJ. At trial, claimant alleged that all of his prior symptoms persist and expressed feelings of discouragement with his life and pessimism about his future. In an opinion dated July 24, 1997, the ALJ found lack of treatment for any of the impairments in 1981 and 1982, normal hand and upper body findings, sufficient flexibility to bring the finger tips within 12 inches of the floor, and no stones or urinary difficulties. Moreover, the ALJ concluded that there was no evidence of heavy drinking or limitations attributable to alcoholism.
The ALJ then determined that claimant did have a severe impairment, but that the impairment did not meet, or equal in severity, the impairments listed in 20 C.F.R. § 404, App. 1, Subpt. P, Regulation No. 4. In addition, the ALJ found that a conflict existed between what the claimant alleged and what was revealed in the medical findings. The ALJ further decided that claimant was capable of performing his past relevant work, since claimant's allegations were not supported by the medical findings. The ALJ therefore concluded that the claimant was not disabled and not entitled to disability insurance benefits during the period of February 1982 through June 30, 1986.
DISCUSSION
Title 42 U.S.C. § 405(g) sets forth the standard of review to be applied by this Court. According to Section 405(g), this Court must affirm the ALJ's findings of fact if supported by substantial evidence. Substantial evidence has been defined as "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 (1981)). The decision "should be accompanied by a clear and satisfactory explanation of the basis on which it rests." Cotter v. Harris, 642 F.2d 700, 704 (3d Cir. 1981).
Moreover, the ALJ must analyze all evidence and explain why some evidence is supported while other evidence is dismissed. See Gober v. Matthews, 574 F.2d 772, 776 (3d cir. 1978). Although administrative decisions are accorded a certain level of deference, it is the responsibility of this Court to examine all evidence and determine whether the ALJ's ruling is supported by substantial evidence. See id.
In order to qualify for benefits, the claimant must demonstrate that he is disabled. A "disability" under the Social Security Act is defined as the "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)(2)(A). Under Section 423(d)(2)(A), "a person is disabled if they are unable to do their previous work, but also cannot, considering their 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).
The Social Security Act sets forth a five-step process for an ALJ's evaluation of a claimant's disability. See 20 C.F.R. § 404.1520. If the ALJ can make a finding of disability or non- disability at any point in the analysis, the ALJ will not review the claim further. First, the ALJ must ascertain whether the claimant has currently engaged in "substantial gainful activity." See 20 C.F.R. § 404.1520(a). Once the claimant proves he has not engaged in substantial gainful activity, the ALJ must next determine whether the claimant has a "severe impairment" or "combination of impairments." See 20 C.F.R. § 404.1520(c). If the impairment is severe, the third inquiry is whether the severe impairment is listed in 20 C.F.R. § 404, App. 1, Subpt. P, Regulation No. 4.
Where the claimant's impairment meets or equals a listed impairment, then the claimant is declared disabled. However, if the impairment does not meet or equal a listed impairment, it must then be determined whether the impairment prevents the claimant from performing any of his past relevant work. See 20 C.F.R. § 404.1520(e). Upon a finding that the claimant can perform any of his past relevant work, the analysis is concluded. Where the claimant cannot perform any of his past relevant work, the burden of proof then shifts to the Commissioner to show, in step five, that the claimant is able to perform any work in the national economy. In making that determination the ALJ considers the claimant's age, education, and past work experience. See 20 C.F.R. § 404.1520(f).
I. Substantial Gainful Activity and Severe Impairment
First, the ALJ must ascertain whether the claimant has currently engaged in "substantial gainful activity." See 20 C.F.R. § 404.1520(a). Here, claimant stopped working for the Marines on June 15, 1970, as a result of injuries sustained in an automobile accident. Thus, he was not engaged in substantial gainful activity during the relevant period and has satisfied step one.
In step two it must be determined whether claimant had a "severe impairment" or "combination of impairments" between February 1982 and June 30, 1986. See 20 C.F.R. § 404.1520(c). Here, the medical evidence establishes that claimant had impairments which could reasonably cause pain and limit claimant's activities. Since claimant's functional capacity was limited to sedentary level activity, a severe impairment existed. See Tr. at 13.
II. Impairment Listed In Appendix 1, Subpart P, Regulation No. 4 .
In step three, it must be determined whether the impairment is listed in 20 C.F.R. § 404, App. 1, Subpt. P, Regulation No. 4. If the impairment is found on the list, the claimant is conclusively presumed to be disabled, and the evaluation ceases. See 20 C.F.R. § 404.1520(d). If the impairment does not meet or equal a listed impairment, the ALJ proceeds to step four.
In order for the claimant to meet the impairments which are on the list, the impairments must be severe and affect the claimant's residual functional capacity. Here, the medical evidence establishes that the claimant had severe residuals of fractures of his right pelvis and left femur, tibia and fibula with mal-union, partial ankylosis of his hips, left knee and left ankle impairments, neuropathy, cerebral concussion and urinary tract damage. See Tr. at 12. There was bone mal-union as opposed to non-union of the fractures by 1982. In addition, he was able to withstand weight and ambulate short distances. Furthermore, claimant did not have chronic renal dysfunction, significant end-organ damage from diabetes mellitus, hypertension, or significant mental dysfunction that persisted in spite of medication. See Tr. at 20. These impairments are severe, but they do not meet, or equal in severity, the impairments listed in 20 C.R.F. § 404, App. 1, Subpt. P, Regulation No. 4.
Claimant did suffer from chronic renal failure after the relevant time period at issue in this case.
III. Retention of Residual Functional Capacity
The fourth step requires a determination of whether the impairment prevents the claimant from returning to the work the claimant previously performed. See 20 C.F.R. § 404.1520(e). If a claimant is found capable of performing his previous work, then the claimant is not disabled. See id.
Here, claimant was not capable of returning to his former job with the Marines. Although by February 1982 claimant had regained the ability to perform a broad range of sedentary work, he was still limited in his residual functional capacity. Therefore, he was not capable of returning to military service between 1982 and June 30, 1986, which is his only past relevant work.
IV. Jobs in the National Economy
In the fifth step, where the burden of proof shifts to the Commissioner, there must be a determination of whether the impairment prevents the claimant from 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, whether a specific job vacancy exists for him, or whether he would be hired if he applied for work. See 42 U.S.C. § 423(d)(2)(A). In making that determination the ALJ considers the claimant's age, education, and past work experience. See 20 C.F.R. § 404.1520(f). Whether an employer desires or would be willing to hire a particular claimant is irrelevant. See Gentile v. Finch, 423 F.2d 244, 246 (3rd Cir. 1970). Furthermore, guidelines have been promulgated in Appendix 2, Subpart P, Part 404, Title 20 of the Code of Federal Regulations to assist the Social Security Administration in determining whether jobs exist in significant numbers.
Here, the claimant was only thirty-nine years old when his disability insured status expired on June 30, 1986. He achieved a high school education and had a vocational history. The ALJ applied the Social Security guidelines and found that considering claimant's young age, education, residual functional capacity, and work experience, claimant was able to obtain work in the national economy during the relevant time period between February 1982 and June 30, 1986. See Tr. at 21-22.
The ALJ further considered claimant's residual functional capacity, which consists of a broad range of sedentary work, and relied upon Rule 201.27 201.29 to conclude that claimant was not disabled. Moreover, the issue of transferability of work skills was not material because of claimant's young age, high school education, and vocational history. See Tr. at 22. The substantial evidence supports the ALJ's conclusion that claimant's impairments did not interfere significantly with the performance of a full range of sedentary work, that claimant was capable of finding a job in the national economy, and that claimant was not disabled.
The ALJ also analyzed claimant's exertional impairment. Exertional impairments involve limitations on a claimant's ability to meet certain strength requirements of a job such as lifting, pushing, or pulling. See 20 C.F.R. § 404.1545(b).
The chiropractor and the orthopedic consultant agreed that, during the relevant period at issue, claimant's musculoskeletal impairments did not prevent the claimant from performing work- related activities which required lifting and/or carrying very light objects. See Tr. at 16. There was also evidence that claimant could lift ten pounds. See Tr. at 18.
In addition, the medical records show that claimant suffers from a non-exertional limitation. Non-exertional 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). The chiropractor and the orthopedic consultant agreed that claimant's musculoskeletal impairments did not prevent the claimant from performing work-related activities except for doing more than occasional standing and/or walking, sitting without customary breaks, bending or stooping frequently, climbing a lot of stairs, and kneeling or crawling. See Tr. at 16. These opinions are consistent with the objective documentation, and also tend to support the ALJ's findings.
The non-examining physicians who reviewed the medical evidence found that claimant had nephrolithiasis, a renal abscess in 1984, recurrent urinary tract obstructions due to kidney stones, urinary tract infections, hypertension, and diabetes mellitus. However, there was no evidence of any impairment that had more than a minimal impact upon claimant's ability to perform work-related activities. See Tr. at 15;see also Exhibits 4 and 6.
The record reflects that although claimant walked with a limp, he was generally able to ambulate short distances fairly well. He also could stand for an hour to an hour and a half at a time, walk approximately a block without resting, and sit for an hour at a time. Moreover, claimant walked twice a week to a corner candy shop and moved to a second floor apartment, even though he found it difficult to walk up and down the stairs.
The record also demonstrates that claimant had persistent urethral stricture, recurrent urinary tract obstructions due to kidney stones, recurrent right renal dysfunction, two abscesses, and repeated urinary tract infections between 1970 and June 30, 1986. See Tr. at 16. Nonetheless, most of his infections were discovered and treated before becoming symptomatic. Although one of his urinary infections did become symptomatic, he stabilized rapidly with relatively non-invasive treatments and he did not complain to the doctors of persistent severe pain or malaise. His urinary condition was possibly exacerbated by his decision not to follow his doctor's recommendation to have the calculus of his right kidney promptly removed.
Claimant also alleged disability as a result of diabetes mellitus and hypertension. His diabetes, however, was controlled when insulin was taken as directed by his doctor. The lapses in control occurred because the claimant did not follow the doctor's recommendations carefully. Similarly, his hypertension was controlled so long as he complied with his medication. The only end-organ damage was Grade II hypertensive changes of his fundi, which was only associated with occasional blurred vision.
Claimant further alleged that he suffered from sleep disturbance and nightmares. Nevertheless, in all of his examinations he denied any psychiatric symptoms and had no history of medication for any mental problems. He was not diagnosed with major depression or post-traumatic stress disorder. Claimant was only diagnosed with dysthymic disorder in January 1987, after the relevant period at issue in this case. The prescriptions for psychotropic medications were based on his subjective complaints since no clinical signs of altered mental status were observed by the numerous physicians who examined him through June 30, 1986. The only evidence of a possible diminished mental condition was found in a letter. In the letter claimant stated that the reason why he left the hospital rather than staying to have his renal calculus removed was that the patient next to him had died and he thought that he would also die.See Tr. at 18-19.
Moreover, the hospital record shows that myocardial infarction was unlikely, and it contains no mention of any flashbacks. It also notes that claimant was acutely intoxicated with alcohol at the time and states that he gave the impression that he was going home to take care of urgent business. See Tr. at 19. In addition, claimant argued that the determination by the Veterans Administration that he was one-hundred percent disabled should influence the decision to find him disabled. That decision, of course, is not binding on the ALJ.
Likewise, claimant asserted that he suffered from forgetfulness as a result of his medications, yet the medical records submitted do not mention any adverse side-effects from medications or any clinical signs of forgetfulness prior to June 30, 1986. He was able to testify in detail at the hearing in regards to his medical history and daily activities. He also watched television for four hours at a time, listened to gospel music on Sundays, and watched the news, sports, and quiz shows.
In evaluating the existence of a disability, a claimant's statements about pain alone will not establish disability. There must be medical signs and laboratory findings which support the claimant's statement about his or her pain. See Brown v. Schweiker, 562 F. Supp. 284, 287 (E.D.Pa. 1983) (quoting Bolton v. Secretary of HHS, 504 F. Supp. 288 (E.D.N.Y. 1980)). It is in the ALJ's discretion to grant less weight to subjective complaints of pain when such complaints conflict with the medical evidence. See id. Nonetheless, the claimant's pain and other subjective symptoms must also be considered pursuant to 20 C.F.R. § 404.1529, 416.929, S.S.R. 96-7p. See Tr. at 19.
Claimant complained of pain in his knees, right hip, lower back, and pelvis. However, there is no information from his treating doctor, Dr. Costa, to show the frequency with which potent medications were required prior to June 30, 1986. The doctors who treated the claimant at the Veterans Administration Medical Center were not aware of any potent medications. In fact, claimant did not mention any back impairment or recent chiropractic treatment when he applied for benefits in August 1995. See Tr. at 13; see also Exhibit 10. Prior to June 30, 1986, claimant did not use minor anti-inflammatory or potent medications on a regular basis.
The record reveals bone deformities in the fractured regions, one-half inch of shortening of the left leg, reduced ankle motion, leg muscle atrophy, right hip tenderness, a limp, lower back pain, history of kidney problems, history of stress incontinence and slightly elevated blood calcium level. During the relevant time period of February 1982 to June 30, 1986, however, claimant had normal hand and upper body findings, sufficient forward bending to bring the finger tips within twelve inches from the floor, no evidence of a diagnosed mental disorder or mental limitations, and no stones or urinary difficulties. The ALJ also considered claimant's age and determined that he was a very young man who was able to work. All of the above evidence tends to support the ALJ's determination to deny claimant's request for benefits for the relevant time period.
Based on the aforementioned evidence, claimant's assertions are less credible in light of the degree of medical treatment required and the findings made on examination. The ALJ correctly granted less weight to claimant's subjective complaints in light of the lack of medical evidence. Therefore, based upon the record, and after careful review of the relevant evidence, this Court finds that the ALJ's decision to deny claimant's request for benefits for the period of February 1982 to June 30, 1986 is supported by substantial evidence. Consequently, the ALJ's decision is AFFIRMED.
CONCLUSION
Based on the foregoing, the ALJ's decision to deny claimant's request for Social Security disability insurance benefits is hereby AFFIRMED.
An appropriate Final Order accompanies this Letter Opinion.
_________________________ NICHOLAS H. POLITAN U.S.D.J.