Opinion
CIVIL NO. 02-2025 (PG-JAC)
August 29, 2003
Rafael Colon Flores, Esq., Ponce, PR, for Plaintiff
Camille Vélez Rivé. AUSA, San Juan, PR, for Defendant
OPINION AND ORDER
This action seeks judicial review of the final decision of the Commissioner of Social Security (the Commissioner) denying plaintiffs application for a period of disability and ensuing benefits. Social Security Act, 42 U.S.C. § 405(g). The matter was referred to this magistrate and a consent to proceed was thereafter received.
Plaintiff filed an initial application for disability insurance benefits that was denied. Upon review, the Appeals Council remanded to the Administrative Law Judge (ALJ) for Further consideration. A second administrative hearing was held on August 29, 2000, where plaintiff and a vocational expert testified. Thereafter, the ALJ issued an opinion that was adopted by the Commissioner denying plaintiffs claim. It is from the latter final decision that above plaintiff has filed this civil action.
In his opinion the ALJ indicated the claimant alleged disability since March 27, 1995, because of cardiac disease, high blood pressure, chest pain, shortness of breath, edema, dizziness, and a mental condition. She meets the requirements for an insured status for disability purposes up through September 30, 2000.
The medical evidence shows uncontrolled arterial hypertension, cardiomyopathy unstable angina, mitral valve prolapse and major depression. She has been hospitalized on March 25, 1995, for chest pains. An echocardiogram showed mitral valve prolapse coronary regurgitation but no obstructive disease. Another similar test on December 22, 1995, described left axis deviation and the chest pain was retrosternal at left hemithorax on exertion and also at rest, lasting some ten minutes and relieved with rest. It was considered to be either from cardiac or musculoskeletal origin.
In regards to the mental condition, the ALJ found claimant initiated treatment on October 1995, with multiple symptoms and somatic complaints. Psychiatric treatment, notwithstanding severe symptomatology has been more limited as of 1997. There are physical and mental medically determined impairments that could reasonably be expected to produce pain and symptoms. Still, the ALJ concluded that the medical file and claimant's statement did not support the intensity and persistence of her subjective complaints nor the functional limitations to the extend alleged. The ALJ stated that although there is an assessment of markedly limited functional capacity, claimant is expected to improve if she follows through her prescribed treatment. The ALJ also considered that claimant's demeanor during the administrative hearing did not show additional limitations. She was observed well kept, thin, and with no signs of mental distress or physical pain.
The previous work experience as an office aid required claimant to use a typewriter, perform secretarial tasks, attend the switchboard, and interact with the public. She had Opinion and Order to lift up to twenty pounds and alternate positions, with frequent bending and reaching. The ALJ concluded she could not perform same because of inability to sit for skilled work activity. With the assistance of a vocational expert, Mr. Miguel Pellecier, considering her residual functional capacity for less than full range of light work, her age of 50 years old, and high school education, other available jobs were described. She could work as a bagger and as a clipper, which are light, unskilled, and allow to alternate positions. If credibility is afforded to her complaints of pain and symptoms, she would not be able to perform even the above.
On the above findings, the ALJ determined, adopted as the final decision of the Commissioner, that claimant was not disabled.
Courts are not to re-weight the evidence or substitute its judgment for that of the Commissioner when the record before the administrative agency has been comprehensive and thorough. Colón v. Secretary of Health Human Serv., 877 F.2d 148 (1st Cir. 1989). The issue to be considered by the Court in this kind of cases is whether the decision of the ALJ is supported by substantial evidence, which has been defined as "more than a mere scintilla" and "such as a reasonable mind might accept as adequate to support a conclusion". Richardson v. Perales, 402 U.S. 389, 401, 91 S.Ct. 1420 (1971).
At the administrative hearing, plaintiff indicated that she had problems with the public health plan to take care to her psychiatric condition. The medical evidence clearly shows a history of uncontrolled hypertension and complaints of chest pains and fatigue. The patient has lost some weight and presents at times a diagnosis of recurrent major affective depression, moderate to severe, with psychotic traits. She performs slight home chores activities. Although subject to numerous examinations for her heart ailment including cardiac catheterism, echocardiogram, and stress test; no definite cardiomegaly could be established. She was hospitalized for ten days and for another six days at the San Lucas Hospital where a cardiac catheterism was performed. The diagnosis refers to congestive heart disease, hypertensive cardiovascular disease, related cardiomyopathy, mitral valve prolapse, unstable angina, and a significant mental component. The patient has frequent treatment with a private cardiologist and with an internist. Medications includes Norvasc and Hyzaar daily.
Notes throughout the medical record indicates the patient complained of fatigue upon slight to moderate effort and dizzy spells. Chest pains are almost three times weekly.
Medication prescribed for her mental condition includes Xanax and Wellbutrin. She has received treatment consistently from April 1995, monthly in the year 1996, and in the first month of 1997. The patient is described as exhibiting states of depression, irritability, insomnia, anxiety, constant crying spells, tiredness, suicidal and paranoid ideas, with auditory and visual hallucinations. She exhibited social isolation, restlessness, agitation, and poor concentration.
A consultative evaluation for her physical ailments refers that the patient's chest pains were difficult to interpret, although did not negate their existence, because of negative coronary angiography. The pains could be related to her mitral valve prolapse and/or to her emotional condition. A consultative evaluation for her mental condition describes an individual in contact with reality, with appropriate affect and no evidence of disorganization of thought process, ideas of reference or delusions. The diagnosis was of dysthimic disorder, with a cardiac condition as stressor. The prognosis was guarded. She could not deal with work stress and was fair as to behaving in an emotionally stable manner. Another consultative psychiatric evaluation refers to a patient who spends much of her time at home taking care of her personal needs and her two minor children. She performs household chores and buys groceries. She maintains adequate interpersonal relations with neighbors, family, and friends and attends religious services regularly. Her speech was spontaneous, relevant, and logic. Mood was anxious and depressed. The thought process was well organized and goal oriented and there were no delusional, suicidal, or homicidal ideas. She was well oriented in all three spheres. Recent, remote, and immediate memory was preserved and so was her attention and concentration. The diagnosis was of depressive disorder. There are opposite psychiatric notes by Dr. Antonio Villanueva in the year 2000 with a diagnosis of major depression, single episode, moderate to severe.
Judicial review of social security claims is limited to determining whether the ALJ used proper legal standards and found facts upon the proper quantum of evidence. Ward v. Commissioner, 211 F.3d 652, 655 (1st Cir. 2000). The court would set aside a denial of Benefits only if it is not supported by substantial evidence or if it is based on a legal error. Seavey v. Barnhart, 276 F.3d 1, 9 (11 Cir. 2001. See Rodriguez v. Secretary of Health and Human Servs., 647 F.2d 218, 222 (1st Cir. 1981.
In the instant case, the ALJ have rejected the credibility of claimant's statements concerning the limiting effects of pain and other symptoms. Avery v. Secretary of Health Human Servs., 797 F.2d 19 (1st Cir. 1986). See Irlando Ortiz v. Secretary of Health Human Servs., 955 F.2d 765, 769 (1st Cir. 1991) ( per curiam) (explaining that it is the responsibility of the Secretary to determine issues of credibility). See also 20 C.F.R. § 404.1529 (explaining how the Secretary evaluates pain). Avery has been construed to mean that "complaints of pain need not be precisely corroborated by objective findings, but they must be consistent with medical findings." Dupuis v. Secretary of Health and Human Services, 869 F.2d 622, 623 (1st Cir. 1989). "`[I]f an impairment is reasonably expected to produce some pain, allegations of [disabling] pain emanating from that impairment are sufficiently consistent to require consideration of all relevant evidence.'" Harqis v. Sullivan, 945 F.2d 1482, 1489 (10th Cir. 1991) (emphasis in original; citation omitted).
The ALJ's credibility determination "is entitled to deference, especially when supported by specific findings." Frustaglia v. Secretary of Health and Human Services, 29 F.2d 192, 195 (1st Cir. 1987). In determining a claimant's residual functional capacity, he ALJ may rely on reports submitted by non-testifying, non-examining physicians. See generally Berrios Lopez v. Secretary of Health and Human Services, 951 F.2d 427, 429-32 1st Cir. 1991). This is not an absolute rule since a treating physician's conclusions regarding the ultimate question of disability is not binding to the ALJ.Rodríguez v Celebrezze, 349 F.2d 494, 496 (1st Cir. 1965). See Arroyo v. Secretary of Health and Human Services, 932 F.2d 82 (1st Cir. 1991). If the treating physicians' assessment are uncontroverted by substantial evidence in the record, and is well supported by medically acceptable clinical and laboratory diagnostic techniques, that is, not inconsistent with other substantial evidence, it should be given some controlling weight. In Tremblay v. Secretary of Health and Human Services, 676 F.2d 11, 13 (1st Cir. 1982), the emphasis being placed in the conclusory nature of a treating physician's opinion.
Upon an examination of the record as a whole, this Magistrate Judge finds that the decision of the Commissioner is supported by substantial evidence and is to BE AFFIRMED.
Judgment to be entered accordingly.
IT IS SO ORDERED.