Oyola Rosa v. SHHS ( 1992 )


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  • USCA1 Opinion




    December 30, 1992 [NOT FOR PUBLICATION]


    UNITED STATES COURT OF APPEALS
    FOR THE FIRST CIRCUIT

    ____________________


    No. 92-1810

    CARLOS OYOLA-ROSA,

    Plaintiff, Appellant,

    v.

    SECRETARY OF HEALTH AND HUMAN SERVICES,

    Defendant, Appellee.


    ____________________

    APPEAL FROM THE UNITED STATES DISTRICT COURT

    FOR THE DISTRICT OF PUERTO RICO


    [Hon. Gilberto Gierbolini, U.S. District Judge]
    ___________________

    ____________________

    Before

    Breyer, Chief Judge,
    ___________
    Torruella and Selya, Circuit Judges.
    ______________

    ____________________

    Raymond Rivera Esteves and Juan A. Hernandez Rivera on brief for
    ______________________ _________________________
    appellant.
    Daniel F. Lopez Romo, United States Attorney, Jose Vazquez
    _______________________ _____________
    Garcia, Assistant United States Attorney, and Paul Germanotta,
    ______ ________________
    Assistant Regional Counsel, Department of Health and Human Services,
    on brief for appellee.


    ____________________


    ____________________






















    Per Curiam. In 1989, Carlos Oyola filed an
    ___________

    application for Social Security disability benefits, alleging

    disability due to epilepsy, a nervous condition and back and

    neck pain. After a hearing, the Administrative Law Judge

    (ALJ) found that Oyola was not disabled at step five of the

    sequential evaluation process set out in 20 C.F.R.

    404.1520(f). The ALJ determined that Oyola's epilepsy was a

    severe impairment which precluded him from returning to his

    previous employment, but that Oyola did not have a disabling

    emotional or mental condition. He credited Oyola's

    allegations of pain to the extent that his pain would reduce

    his residual functional capacity from heavy to medium work.

    (Thus, he treated Oyola's pain as an exertional impairment.)

    Although the ALJ found that Oyola could not engage in work in

    which he would have to climb or balance,1 drive, or be

    exposed to unprotected heights and moving machinery, he

    concluded that those nonexertional impairments did not

    significantly compromise Oyola's capacity for the full range

    of medium work. Using Rule 203.25 of the Medical-Vocational

    Guidelines (the Grid) in Appendix 2 of the regulations as a

    framework for his decision, he determined that Oyola was not


    ____________________

    1. The ALJ did not resolve certain slight differences in the
    staff physicians' assessments of Oyola's climbing and
    balancing abilities. For purposes of our analysis in this
    opinion, we adopt the more restrictive assessment offered by
    Dr. Hernandez, which would be more favorable to Oyola, that
    Oyola should never engage in work requiring any climbing or
    balancing.

    -2-















    disabled before his coverage expired. Oyola appealed the

    ALJ's denial of benefits to the district court, which

    affirmed the ALJ's decision, and then sought review in this

    court. We affirm.

    I. Severity of Alleged Disabilities
    ________________________________

    Oyola does not challenge the ALJ's determination

    that his epilepsy did not meet or equal the criteria in the

    Listing of Impairments in Appendix 1 of the regulations. He

    claims, however, that the ALJ failed to consider adequately

    his allegations of disabling pain, and argues that his

    medical record shows that he "constantly and persistently"

    complained of "severe disabling pain" to his examining

    physicians. In fact, the medical record shows that Oyola

    only occasionally complained of pain or of other medical

    problems that might have caused him pain. In 1978, he

    reported that he had cervical muscle spasms and foot lesions,

    and he was advised to rest for a week. In 1983, he

    complained of pain in his feet, in his muscles and joints,

    and specifically in his neck and back or shoulder, but no

    medication or course of treatment was prescribed. In 1984,

    he reported pain in his left anterior thorax, and, being

    diagnosed provisionally as having angina pectoris and

    muscular spasm, was prescribed medicine. He was reported

    stable when he left the hospital. Pain in his thorax

    recurred once again in mid-1985. Although the 1985 medical



    -3-















    report is practically unreadable, it appears to indicate that

    medication was prescribed for Oyola's pain. Between mid-1985

    and December 31, 1988, the expiration date of Oyola's

    coverage, the record contains no further report by Oyola of

    any kind of pain. In early 1988, Oyola reported that he felt

    "allright for now."

    The ALJ did not specifically refer to this evidence

    of pain in his decision, but his failure to do so was not

    error under the circumstances. First, the medical records

    evidencing Oyola's reports of pain are not very probative.

    They indicate that Oyola complained of pain only sporadically

    and not at all after the middle of 1985. The reports of pain

    for 1984 and 1985 relate to chest pains which Oyola has not

    asserted is or was disabling, and which he does not claim

    arose out of his primary medical impairment, epilepsy.

    Second, the ALJ made clear at the outset of his decision that

    his task was to adjudicate only whether Oyola had a

    disability between February 26, 1988 and December 31, 1988.2

    (Two prior applications of Oyola relating to time periods

    between 1983 and early 1988 were denied and not appealed.)

    The evidence relating to pain suffered in prior periods was

    useful background for determining whether the pain suffered

    in the following period of time was disabling, Frustaglia v.
    __________


    ____________________

    2. The ALJ gives 1989 as the year ending the adjudicatory
    period, but it is clear that he meant to say 1988 because
    that is the year Oyola's coverage expired.

    -4-















    Secretary of Health and Human Services, 829 F.2d 192, 193
    ________________________________________

    (1st Cir. 1987), but was not itself dispositive.

    Furthermore, the ALJ considered thoroughly Oyola's

    testimony at a hearing in 1990 as to the severity of his

    pain. At the hearing, Oyola testified that severe pain

    caused by injuries suffered during a seizure and by bone

    spurs and arthritis had caused him to stop working. The ALJ

    noted, correctly, that the record showed that Oyola's

    osteoarthritis and musculoskeletal complaints arose after

    expiration of his coverage. He also noted that Oyola

    appeared to be healthy and strong at the hearing.

    Nevertheless, he evaluated Oyola's subjective complaints of

    back pain and epilepsy-related pain under the factors listed

    in Avery v. Secretary of Health and Human Services, 797 F.2d
    _____ ______________________________________

    19 (1st Cir. 1986). Specifically stating that he was giving

    Oyola the benefit of the doubt, he credited those

    allegations, but only to the extent that he found that

    Oyola's alleged pain reduced his exertional capability from

    heavy to medium work. He did not find Oyola totally disabled

    by pain because the medical record showed that Oyola did not

    seek or follow consistent medical treatment for his epilepsy,

    nor did the record indicate that the medications he received

    were ineffective to control his epilepsy, that they should be

    changed, or that there were adverse side effects. His

    conclusion shows that the ALJ reviewed Oyola's medical



    -5-















    records thoroughly, even if he did not specifically discuss

    the records evidencing Oyola's complaints in 1978, 1983,

    1984, and 1985. On the basis of all of the above factors, we

    conclude that the ALJ properly reviewed the evidence relating

    to Oyola's alleged pain, and that his findings relating to

    pain were supported by substantial evidence.

    Oyola alleges further that the ALJ cited only

    evidence favorable to the Secretary, disregarded the medical

    evidence of Oyola's disability, and based the disability

    determination on his own medical opinion. He provides no

    detail as to what evidence the ALJ allegedly disregarded, and

    does not describe in what respect the ALJ ignored the

    opinions of examining or consulting physicians, or based his

    disability determination on his own medical opinion. We have

    reviewed the ALJ's decision and the record and find no error

    of the kind Oyola has alleged. The ALJ considered carefully

    the evidence in the record which was favorable to Oyola,

    reviewing even medical conditions suggested by the record

    which Oyola himself did not claim were disabling. He

    determined that Oyola's epilepsy and pain constituted a

    "severe impairment" which imposed both exertional and

    nonexertional limitations on Oyola. His determination is

    supported by Oyola's testimony of pain and by the residual

    functional capacity assessments of Drs. Marxuach and

    Hernandez. There is no other relevant medical assessment of



    -6-















    residual functional capacity in the record which would

    support further restrictions on Oyola's ability to work, or

    which would support a conclusion that Oyola was totally

    disabled. The functional capacity assessment by Dr. Rivera,

    upon which Oyola relies and which the ALJ excluded from his

    consideration, relates to Oyola's condition in 1989, after

    his coverage had expired, and the ALJ was fully justified in

    discounting that assessment.3 In any event, the ultimate

    conclusion in Dr. Rivera's assessment agrees broadly with the

    assessments of Drs. Marxuach and Hernandez. Although Dr.

    Rivera states that, as of 1989, Oyola was an "[u]ncontrolled

    patient who comes frequently due to convulsions, receiving

    occasional traumas," and Dr. Hernandez had concluded that, as

    of December 1988, his seizures "had no frequency," Dr. Rivera

    did not find Oyola to be totally disabled or prohibit him

    from all work. She recommended only that Oyola "never[] [be]

    alone or engage[] in work where he might be exposed to danger

    due to convulsions."





    ____________________

    3. The English translation of Dr. Rivera's assessment, which
    had been written in Spanish, gives 1985 as the date of her
    report, and for that reason Oyola cites it as evidence of his
    disability prior to expiration of his coverage. The original
    document appears to give 1989 as the date it was prepared,
    although the final numeral was hastily written and cannot be
    said definitively to be a "9". Nevertheless, the record
    shows that Dr. Rivera did not begin to treat Oyola for
    epilepsy until 1989, and so the date on her assessment of his
    condition could not have been 1985 as Oyola suggests.

    -7-















    The record also supports the ALJ's conclusion that

    Oyola did not have a disabling mental condition. In February

    1985, he was referred to the Bayamon Mental Health Center in

    connection with his application for social security benefits.

    The referral stated that Oyola was "going through an intense

    depressive episode that began five months ago," and that he

    was not sleeping well and had been sleepwalking.

    Nevertheless, Oyola was not admitted because he was found not

    to have a "mental disorder." The report of his visit records

    as a "diagnostic impression" that a neurological disorder

    could be ruled out. Although the report of a visit in August

    1985 states that he had previously been diagnosed tentatively

    as having a "personality disorder" (the record does not

    include any report stating this diagnosis), at the date of

    the August visit he was found to be "in contact with reality"

    and "oriented." He was not admitted for treatment because

    "no major psych. pathology" was found. In October 1986, he

    visited the Mental Health Center again, complaining of

    sleeplessness and hallucinations. Although he was admitted

    to receive treatment at the Center as an outpatient and the

    examiner's "diagnostic impression" was that Oyola might have

    an "adjustment disorder" and a "histrionic personality," the

    record of his visit stated that he was "logical, coherent,

    [and] oriented." At what appears to be his next appointment,

    in January 1987, he was reported as not mentioning "anything



    -8-















    that calls our attention." Records for the same day from the

    Department of Mental Health state that he missed his

    appointment there. Some days later he visited the Bayamon

    Mental Health Center without an appointment, complaining that

    he had had hallucinations, heard voices, and had memory

    problems. He stated that his medication helped him "but not

    enough." The record states that he was "logical, coherent,

    oriented, approachable, communicative", and does not appear

    to make any change in medication. Although the record of

    that visit shows that an appointment for April 1987 was made,

    the record contains no report of that visit or any subsequent

    visit by Oyola to the Center, nor is there any other record

    of any other treatment of Oyola for mental or emotional

    problems. Accordingly, it appears that Oyola did not receive

    treatment at the Mental Health Center or at any other

    facility after January 1987. Thus, for approximately the

    last two years of the coverage period (and the entire period

    to be adjudicated here), he received no treatment for his

    alleged nervous condition. Therefore, the record provides

    substantial evidence for the ALJ's conclusion that Oyola did

    not suffer from a disabling mental condition.

    II. Reliance on the Grid
    ____________________

    After determining that Oyola could perform medium,

    unskilled work in which he would not have to climb or

    balance, drive or be exposed to unprotected heights or moving



    -9-















    machinery, the ALJ concluded that Oyola could not perform his

    previous heavy work which exposed him to a "hazardous

    environment."4 Accordingly, the ALJ noted that the burden

    of proof shifted to the Secretary to show that there were

    other jobs existing in significant numbers in the national

    economy which he could perform, given his exertional and

    nonexertional impairments, age, education and work

    experience. He found that Rule 203.25 of the Grid indicated

    that Oyola could make a successful vocational adjustment

    because he was a younger individual with marginal education

    who could readjust to medium unskilled work activities.5


    ____________________

    4. The ALJ does not explain what hazards Oyola encountered
    in his previous jobs, but the record shows that his most
    recent job involved work with a machine called a "stacker"
    and that an earlier job may have entailed some driving of the
    trucks which it was his job to load.

    5. The ALJ's finding that Oyola met those criteria was
    supported by substantial evidence. Based on Oyola's
    testimony as to his age at the hearing, Oyola would have been
    40 years old or younger when his coverage expired, and thus
    was a "younger individual." See 20 C.F.R. 404.1563(b)
    ___
    ("[i]f you are under age 50, we generally do not consider
    that your age will seriously affect your ability to adapt to
    a new work situation."). Since Oyola had finished fifth
    grade, his education was "limited or less." See id.
    ________
    404.1564(b)(2), (3) (a limited education is one between the
    seventh and eleventh grades; a marginal education would be
    formal schooling to the sixth grade level). In his previous
    jobs, Oyola loaded and unloaded pipes and helped dig holes in
    which to lay them; he cleaned gasoline tanks, washed trucks,
    painted gasoline pipes, and stacked drums; and he lifted,
    moved and stacked blocks, using his hands, wheelbarrows and a
    stacking machine, and also performed maintenance work. This
    work would appear to be unskilled work, as found by the ALJ.
    Cf. id. 404.1568(a) (unskilled work requires little or no
    ________
    judgment to do simple duties that can be learned in a short
    time on the job, e.g., handling, feeding and offbearing, and

    -10-















    Without the aid of vocational testimony, the ALJ used Rule

    203.25 as a "framework" for his decision and concluded that

    Oyola was not disabled because his "capacity for the full

    range of medium work was not significantly compromised by his

    nonexertional conditions prior to the expiration of his

    coverage." As we noted in Ortiz v. Secretary of Health and
    _____ ________________________

    Human Services, 890 F.2d 520, 524 n.4 (1st Cir. 1989) (per
    _______________

    curiam), because the ALJ failed to take vocational testimony,

    he is deemed to have relied exclusively on the Grid to show

    that jobs that Oyola could perform existed in significant

    numbers in the national economy.

    Oyola contends that the ALJ erred in relying

    exclusively on the Grid. He argues that his nonexertional

    limitations significantly compromised his ability to engage

    in the full range of medium work, so that the ALJ should have

    consulted a vocational expert before finding that he was not

    disabled. Although Oyola's argument has merit and this issue

    is a close one, we find that, under the circumstances of this

    case, it is not necessary to remand to the ALJ to take the

    testimony of a vocational expert.




    ____________________

    machine tending). Although the ALJ found that Oyola could
    not speak English and the inability to speak English may
    point to disability for some individuals at some exertional
    levels, an ability to speak English is not relevant to the
    disability determination in Table 3 of the Grid, in which
    Rule 203.25 is located. See 20 C.F.R. Pt. 404, Supbt. P,
    ___
    App. 2, 203.00 & Table 3.

    -11-















    In Ortiz, supra, we stated that an ALJ need not
    _____ _____

    consult vocational experts if he determines that

    nonexertional limitations, even significant ones, do not

    significantly compromise the full range of work a claimant

    may be expected to perform at the relevant exertional level.

    See id. at 524 ("If a non-strength impairment, even though
    ___ ___

    considered significant, has the effect only of reducing [a

    claimant's] occupational base marginally, the Grid remains

    highly relevant and can be relied on exclusively to yield a

    finding as to disability.") (footnote omitted). At the same

    time, we stated that "the more that occupational base is

    reduced by a nonexertional impairment, the less applicable

    are the factual predicates underlying the Grid rules, and the

    greater is the need for vocational evidence." Id. at 524-25.
    ___

    In determining whether a nonexertional limitation

    significantly compromises the occupational base, we have

    sometimes analyzed the severity of the medical condition

    causing the nonexertional limitation.6 See, e.g., Perez
    ___ ____ _____

    Torres v. Secretary of Health and Human Services, 890 F.2d
    ______ ________________________________________

    1251, 1254-55 (1st Cir. 1989) (per curiam). If we use this

    same analysis here, we would conclude that Oyola's


    ____________________

    6. The ALJ appears to have taken this approach. On the
    basis of his discussion of the severity of Oyola's alleged
    impairments, he concluded, without further support, that
    Oyola's "capacity for the full range of medium work was not
    significantly compromised by his non-exertional conditions
    prior to the expiration of his coverage." See Finding No.
    ___
    12.

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    nonexertional impairments did not significantly diminish his

    ability to perform the full range of work at the medium

    exertional level. Before his coverage expired, Oyola

    apparently received emergency treatment for symptoms of a

    possible seizure disorder only twice -- in October 1983,

    where the provisional diagnosis ruled out an epileptic

    seizure, and in September 1987, where epilepsy was

    provisionally diagnosed. Although Oyola had reported that he

    had suffered epileptic seizures since childhood and that he

    had been "suspended" from work due to the seizures, he had

    also reported that he had never been treated for the

    seizures. In October 1985 Oyola's seizures were reported to

    be under control, although he had lost his anticonvulsant

    medication and had not been taking it. Lay statements by

    Oyola's sister and sister-in-law in 1989 indicated that Oyola

    suffered seizures once a month, but that the seizures could

    be controlled for periods of up to four months, and that the

    most recent seizures observed were in April, August and

    September of 1989. The medical records and lay statements

    show that Oyola's epileptic condition did not meet or equal

    the criteria in the Listings, and Oyola has conceded that

    fact. See 20 C.F.R., Pt. 404, Subpt. P, App. 1, 11.02,
    ___

    11.03 (to be presumptively disabled under the Listings, a

    claimant must suffer major seizures more frequently than once

    a month, and minor seizures more frequently than once weekly,



    -13-















    despite following prescribed treatment for at least three

    months). Based on the record of treatment alone, and

    emphasizing that Oyola received no treatment for epilepsy at

    all in 1988, the period to be adjudicated here, we would have

    to conclude that Oyola's epilepsy did not manifest itself

    frequently enough to significantly compromise his ability to

    engage in the full range of medium work during the

    adjudicatory period.

    Given the nature of the nonexertional limitations

    in this case, however, we are reluctant to rely on that kind

    of analysis. In Perez Torres and other cases, see, e.g.,
    _____________ ___ ____

    Heggarty v. Sullivan, 947 F.2d 990, 996-97 (1st Cir. 1991)
    ________ ________

    (per curiam) (evaluating the claimant's poor manual dexterity

    in light of the importance of fine motor skills to jobs at

    the sedentary exertional level); Ortiz, supra, 890 F.2d at
    _____ _____

    525 (evaluating the claimant's bending restriction in light

    of the bending requirements for light work), the specific

    nonexertional limitations in question diminished the

    claimant's ability to perform certain kinds of physical or

    mental tasks. As a result, analyzing the severity of the

    physical or mental condition giving rise to the nonexertional

    limitation truly captured the degree to which the

    nonexertional limitation affected the claimant's ability to

    perform the full range of work at the requisite exertional

    level. In contrast, Oyola's nonexertional limitations



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    consist of environmental restrictions which preclude him from

    performing whole categories of jobs -- he cannot perform any

    job that requires him to drive, to be near moving machinery,

    or to be exposed to unprotected heights (which, for purposes

    of our discussion here, we find subsumes Oyola's climbing and

    balancing limitations).7

    Under these circumstances, we believe that the

    better way to determine whether Oyola's nonexertional

    limitations significantly reduce his occupational base would

    be to attempt to quantify in some way the reduction in

    Oyola's occupational base caused by his environmental

    limitations. See, e.g., Gagnon v. Secretary of Health and
    ___ ____ ______ ________________________

    Human Services, 666 F.2d 662, 666 (1st Cir. 1981) (remanding
    ______________

    because the ALJ failed to consider whether Gagnon's

    nonexertional limitations, which included environmental

    restrictions, limited the number of jobs he could perform).



    ____________________

    7. Oyola's climbing and balancing limitations are
    essentially equivalent to the environmental restriction that
    he not be exposed to unprotected heights. The conclusions of
    Drs. Marxuach and Hernandez regarding those limitations are
    supported by the record only to the extent that they are held
    to derive from Oyola's epileptic condition. That is, there
    is no evidence in the record that, physically, Oyola cannot
    climb or balance. Oyola's epileptic condition would create a
    problem for him in climbing and balancing terms only when he
    actually suffers a seizure while climbing to or balancing at
    heights. Consequently, we treat those limitations as
    subsumed in the requirement that Oyola not be exposed to
    unprotected heights. If only climbing and balancing
    restrictions based on Oyola's physical capacities were
    present here, the Perez Torres type of analysis would be
    _____ ______
    adequate.

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    This approach basically reflects the approach taken in the

    Social Security Rulings discussed below, which consider

    specific nonexertional limitations and, at least for some

    restrictions, state whether few or many jobs at a given

    exertional level are affected by those limitations. Other

    circuits also appear to take a more quantitative approach in

    determining the effect of environmental restrictions on a

    claimant's occupational base. See, e.g., Allen v. Secretary
    ___ ____ _____ _________

    of Health and Human Services, 726 F.2d 1470, 1472 (9th Cir.
    _____________________________

    1984) (remanding because there was no evidence in the record

    that there were a "significant number of sedentary jobs"

    which the claimant could perform despite his ability to work

    only in environments free of respiratory irritants); Asher v.
    _____

    Bowen, 837 F.2d 825, 827-28 (8th Cir. 1988) (remanding
    _____

    because the ALJ could not assume that the majority of

    unskilled sedentary jobs took place in a pollution-free

    environment in light of regulations and caselaw suggesting

    that 85% of such jobs are in machine trades and benchwork

    categories often involving exposure to respiratory

    irritants); Ellison v. Sullivan, 921 F.2d 816, 820 (8th Cir.
    _______ ________

    1990) (the reduction in the claimant's functional capacity

    for sedentary work because of his environmental restriction

    was significant because it rendered the claimant able to

    perform only half the jobs in the occupational base);

    Zalewski v. Heckler, 760 F.2d 160, 165 (7th Cir. 1985) (the
    ________ _______



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    claimant's antisocial personality did not significantly

    affect his capacity to do sedentary work because regulations

    indicated that 85% of such jobs were in machine trades and

    benchwork categories that would not require much interaction

    with others).

    In the absence of other helpful measures of the

    number of jobs Oyola is precluded from performing given his

    restrictions, we turn to the assessments offered in the

    Social Security Rulings. Ruling 83-14 is the most applicable

    because it discusses cases like this one in which both

    exertional and nonexertional limitations exist. The Ruling

    states that "[r]elatively few jobs in the national economy

    require ascending or descending ladders and scaffolding."

    See SSR 83-14, reprinted in [Rulings 1983-91] West's Social
    ___ ____________

    Security Reprinting Service, at 43.8 Although that

    statement applies to the larger job base existing for work at

    all exertional levels, the Ruling also makes clear that the
    ___

    effect of that restriction on the occupational base at the

    medium exertional level is insignificant:

    In jobs at the medium level of exertion,
    there is more likelihood than in light
    work that such factors as the ability to
    ascend or descend ladders and
    scaffolding, kneel, and crawl will be a


    ____________________

    8. The "ascending or descending ladders and scaffolding"
    restriction reflects the climbing restriction placed on
    Oyola. The residual functional capacity forms filled out by
    Drs. Marxuach and Hernandez show climbing to involve
    "ramp/stairs" and "ladder/rope/scaffolds."

    -17-















    part of the work requirement. However,
    limitations of these activities would not
    significantly affect the occupational
    base.

    Thus, the Ruling suggests that a climbing restriction would

    not affect a significant number of jobs, and so we assume

    that Oyola would not be precluded from performing a

    significant number of jobs by the unprotected heights

    restriction. Since it is unclear, however, how Oyola's

    additional restrictions against driving and being near moving

    machinery would affect his occupational base, ultimately the

    Ruling does not substantiate the ALJ's conclusion that

    Oyola's restrictions did not significantly reduce his

    occupational base.9



    ____________________

    9. Ruling 85-15, discussed next, also discusses a climbing
    and balancing restriction, stating that: "Limitations on
    climbing and balancing can have varying effects on the
    occupational base, depending on the degree of limitation and
    the type of job. . . . These activities are required more in
    some jobs than in others, and they may be critical in some
    occupations. Where a person has some limitation in climbing
    ________________
    and balancing and it is the only limitation, it would not
    _______________
    ordinarily have a significant impact on the broad world of
    work." (Emphasis added.) Like Ruling 83-14, this Ruling
    suggests that Oyola's restriction against climbing and
    balancing -- equated here with the unprotected heights
    restriction -- would not significantly diminish Oyola's
    occupational base, but it is not dispositive. First, Oyola
    does not just have "some limitation" in his ability to climb
    and balance, but is completely prohibited from those
    activities. Second, Ruling 85-15 applies only to claimants
    with no exertional impairments. Thus, its starting point is
    __ __________ ___________
    the larger universe of jobs existing at all exertional
    levels. A prohibition against climbing and balancing may
    well implicate a smaller percentage of that occupational base
    than it would the smaller initial base of jobs comprising
    work at the medium level of exertion.

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    The Secretary points to Social Security Ruling 85-

    15 as substantial evidence for the ALJ's finding that Oyola's

    nonexertional limitations do not significantly diminish his

    occupational base. That Ruling states that "[a] person with

    a seizure disorder who is restricted only from being on

    unprotected elevations and near dangerous moving machinery is

    an example of someone whose environmental restriction does

    not have a significant effect on work that exists at all

    exertional levels." See SSR 85-15, reprinted in [Rulings
    ___ _________ __

    1983-91] West's Social Security Reporting Service, at 351.

    As Oyola points out, this statement does not take into

    account his additional restriction against driving.10 In

    this connection, however, Ruling 83-10, which discusses the

    Grid, is relevant. That Ruling defines medium work in part

    as follows:

    A full range of medium work requires
    standing or walking, off and on, for a
    total of approximately 6 hours in an 8-
    hour workday in order to meet the
    requirements of frequent lifting or
    carrying objects weighing up to 25
    pounds. As in light work, sitting may
    occur intermittently during the remaining
    time. . . . However, there are relatively
    few occupations in the national economy
    which require exertion in terms of


    ____________________

    10. And, as noted in the preceding footnote, the Ruling
    applies to the larger base of jobs existing at all exertional
    levels, rather than the smaller base of jobs existing at the
    medium exertional level, so that the effect of a restriction
    on unprotected elevations and moving machinery might be
    insignificant for jobs existing at all levels, yet
    significant for jobs only at the medium exertional level.

    -19-















    weights that must be lifted at times . .
    . but are performed primarily in a
    sitting position, e.g., taxi driver, bus
    driver, and tank-truck driver
    (semiskilled jobs). In most medium jobs,
    being on one's feet for most of the
    workday is critical.

    SSR 83-10, reprinted in [Ruling 1983-91] West's Social
    _________ __

    Security Reporting Service, at 30. Thus, this Ruling

    indicates that there are fairly few jobs at the medium

    exertional level which require the worker to drive, and that

    most medium jobs entail standing for most of the workday.

    Moreover, the examples the Ruling gives of driving jobs that

    exist at the medium exertional level are all semiskilled jobs
    ___________

    which would not be included in Oyola's occupational base in

    any event since the Grid Rule in question applies only to

    unskilled work.11 Once again, however, although this

    Ruling suggests that the driving restriction by itself would

    reduce Oyola's occupational base only marginally, if at all,

    it gives no indication what effect that restriction has when

    combined with Oyola's other environmental restrictions.

    Therefore, we conclude that the Rulings indicate or strongly

    suggest only that Oyola's environmental restrictions,

    individually, would not significantly reduce his occupational

    base. However, they do not support the ALJ's conclusion that


    ____________________

    11. See SSR 83-10, supra, at 27 ("The RFC addressed in a
    ___ _____
    [Grid] rule establishes the presence of an occupational base
    that is limited to and includes a full range (all or
    substantially all) of the unskilled occupations existing at
    _________
    the exertional level in question.") (Emphasis added.)

    -20-















    Oyola's combined limitations would not significantly reduce

    his occupational base.

    Our conclusion means that the ALJ could not rely

    exclusively on the Grid to support his decision that Oyola's

    nonexertional impairments did not significantly erode his

    occupational base. It does not mean, however, that the ALJ

    was required to consult a vocational expert to obtain

    evidence on that point. The Rulings make clear that, in

    "relatively simple" cases, an ALJ may consult the vocational

    publications listed at 20 C.F.R. 404.1566 and 416.966 to

    determine the extent to which additional nonexertional

    limitations not considered in the Rulings affect a person's

    occupational base. See SSR 83-14, supra, at 45; SSR 85-15,
    ___ _____

    supra, at 346; SSR 83-12, supra, at 37; see also SSR 85-15,
    _____ _____ ___ ____

    supra, at 352 (where the environmental restriction falls
    _____

    between "very little" and "excessive," an ALJ would usually

    need to consult occupational reference materials or the
    __

    services of a vocational specialist) (emphasis added); cf.
    ___

    Gray v. Heckler, 760 F.2d 369, 371-72 (1st Cir. 1985) (per
    ____ _______

    curiam) (although the court notes that it would be

    "preferable" to elicit vocational testimony to show that the

    claimant could return to the "type" of work he had previously

    performed, the court approved the ALJ's reliance on

    vocational publications to establish that fact).





    -21-















    We think that this case is a "relatively simple"

    case for two reasons. First, although we do not know the

    combined effect which Oyola's particular nonexertional

    limitations have on his occupational base, the Rulings

    indicate or strongly suggest that, individually, they would

    not significantly reduce that base. Moreover, the

    unprotected heights and driving limitations would probably

    have very little effect at all on the number of jobs Oyola
    ______

    could perform at the medium exertional level. See SSR 83-14,
    ___

    supra, at 43 ("relatively few jobs . . . require ascending or
    _____ __________ ___ ____

    descending ladders and scaffolding") (emphasis added); SSR

    83-10, supra, at 30 ("relatively few occupations . . .
    _____ __________ ___ ___________

    require exertion [at the medium level] . . . but are

    performed primarily in a sitting position, e.g., taxi driver,
    ____

    etc.") (emphasis added). Accordingly, it seems more likely

    than not that, when combined with the moving machinery

    restriction, those nonexertional impairments would not

    significantly erode Oyola's occupational base, suggesting

    that this case should be classified as a "simple" case under

    the Rulings.

    Second, apart from the question of Oyola's

    nonexertional impairments, Rule 203.25 of the Grid would have

    directed a conclusion of not disabled because Oyola could be
    ________

    expected to make a vocational adjustment to medium work.

    That is to say, Oyola's vocational attributes fit precisely



    -22-















    the vocational criteria of the Rule -- that the persons as to

    whom it would direct a finding of not disabled are "younger

    individuals" whose education is "limited or less" and whose

    previous work experience was "unskilled". Consequently, this

    case is certainly a "simpler" one than a case in which a Grid

    Rule should not be applied both because nonexertional
    ____

    limitations exist and because the claimant's vocational
    ___

    profile is different than that assumed by the Rule. Cf.
    ___

    Ortiz, supra, at 890 F.2d at 524 ("Whether by so invoking the
    _____ _____

    Grid as a 'framework,' the Secretary can satisfy his burden

    under step five without resorting to vocational evidence

    depends on how closely the claimant's characteristics and the
    ___ _______

    Grid criteria overlap.") (emphasis added). In this

    connection, we note that Oyola's characteristics did not

    place him near the disabled/not disabled dividing line under

    the Grid rules. See id. at 528; Rule 203.25.
    ___ ___

    Accordingly, we think that this case is a

    relatively simple case, and that the vocational publications

    listed in the regulations may substitute for vocational

    expert testimony to establish that specific jobs exist in

    significant numbers in the national economy which Oyola could

    perform given his restrictions. The vocational publication

    relevant to this case is the Dictionary of Occupational
    ___________________________

    Titles published by the Department of Labor, which is listed
    ______

    at 20 C.F.R. 404.1566(d)(1), 416.966(d)(1).



    -23-















    The record contains "Supplemental Rationale"

    reports by two disability examiners -- Belen Sampayo, who

    denied Oyola's application initially, and Salvador Toro, who

    denied Oyola's application upon reconsideration. Although

    concluding apparently that Oyola could perform heavy

    work,12 an assumption that does not affect our analysis

    here, Sampayo and Toro each listed three jobs described in

    the Dictionary of Occupational Titles which could be
    _____________________________________

    performed by Oyola and which they stated were available in

    the national economy, for a total of six such jobs:

    229.587-018 Ticketer (textile)
    369.687-018 Folder (laundry)
    795.687-014 Sample mounter (any
    industry)13
    920.687-126 Marker (any industry)
    920.687-166 Shoe Packer (boot and shoe)
    920.687-178 Stenciler (any industry)



    ____________________

    12. Sampayo and Toro both used Grid Rule 204.00 as a frame
    of reference for their decision. That Rule applies to
    persons who can perform heavy work despite their severe
    medically determinable impairments. We see no problem
    arising out of Sampayo's and Toro's and the ALJ's different
    evaluations of Oyola's exertional capacity. The ALJ
    determined that Oyola's alleged pain constituted an
    exertional impairment that reduced his functional capacity to
    the medium exertional level. In doing so, he relied upon
    Oyola's testimony at the hearing, evidence which was not
    before Sampayo or Toro, who made their decisions before the
    hearing on the basis of the medical records alone. As
    already noted, those records would have supported a
    conclusion that Oyola did not suffer pain between February
    ___
    and December 1988 to a degree that would have affected his
    exertional abilities.

    13. The title given in the Dictionary of Occupational Titles
    _________________________________
    under this number is "gluer," but "sample mounter" is given
    as an alternate title.

    -24-















    The descriptions of those jobs in the Dictionary of
    _____________

    Occupational Titles are consistent with work which Oyola
    ___________________

    could perform given his exertional and nonexertional

    restrictions. See U.S. Department of Labor, I Dictionary of
    ___ ______________

    Occupational Titles (rev. ed. 1991), at 205, 266, 267; II
    ___________________

    Dictionary, at 842, 937, 938; App. B, C. The jobs are all at
    __________

    the "light" exertional level, and thus within Oyola's

    exertional capacity. See 20 C.F.R., Pt. 404, Subpt. P, App.
    ___

    2, Rule 203.00(a) ("The functional capacity to perform medium

    work includes the functional capacity to perform sedentary,

    light, and medium work."). The general educational

    development required to perform the jobs is low, and would

    appear to be appropriate in light of Oyola's fifth grade

    education.14 All of the jobs require minimal retraining,


    ____________________

    14. The second lowest reasoning level is assigned to the
    ticketer, folder, marker, and shoe packer jobs. That level
    would require Oyola to "[a]pply commonsense understanding to
    carry out detailed but uninvolved written or oral
    instructions" and to "[d]eal with problems involving a few
    concrete variables in or from standardized situations." The
    lowest reasoning level applies to the sample mounter and
    stenciler jobs, and requires application of "commonsense
    understanding to carry out simple one- or -two-step
    instructions" and the ability to deal with "standardized
    situations with occasional or no variables . . . ." The
    lowest language level is assigned to all but the ticketer
    job, and would require Oyola to "[p]rint simple sentences
    containing subject, verb, and object, and series of numbers,
    names, and addresses", and to "[s]peak simple sentences,
    using normal word order, and present and past tenses." The
    second lowest language level applies to the ticketer
    position, and would require Oyola to be able to read
    "adventure stories and comic books, . . . [and] instructions
    for assembling model cars and airplanes", to "[w]rite
    compound and complex sentences," and to "[s]peak clearly and

    -25-















    i.e., instruction beyond a short demonstration, but lasting
    ____

    no more than one month. None of the jobs requires climbing

    and balancing or exposure to any hazards.15

    Only one aspect of the job descriptions in the

    Dictionary of Occupational Titles requires further
    _______________________________________

    discussion. The description for the folder, sample mounter

    and marker positions appear to require work with machines: a

    folder "[m]ay" use a "button-sewing-" or "button-attaching

    machine"; a sample mounter may apply adhesives by "holding

    material against [a] rotating saturated brush, or feeding


    ____________________

    distinctly with . . . correct pronunciation, . . . using
    present, perfect, and future tenses." All of the jobs
    require only the most rudimentary mathematical skills, e.g.,
    the ability to add and subtract only two digit numbers, to
    perform some multiplication and division, to use money and to
    measure with units like the cup, pint, quart, inch, foot,
    yard, ounce and pound.

    15. The Guide for Occupational Exploration ("GOE") numbers
    given the jobs in the Dictionary of Occupational Titles are
    __________________________________
    cross-indexed in a companion volume prepared by the
    Department of Labor entitled Selected Characteristics of
    _____________________________
    Occupations Defined in the Dictionary of Occupational Titles
    _____________________________________________________________
    (1981), the use of which we approved in Gray, supra. That
    ____ _____
    volume classifies the physical demands of jobs (sedentary,
    light, medium, etc.), and breaks jobs down into the types of
    physical activities they entail. All of the jobs listed
    above are coded as "4", meaning that they require "reaching,
    handling, fingering, and/or feeling." Selected
    ________
    Characteristics, at 75, 210, 212-14; App. A, at 465-66. (A
    _______________
    sample mounter is also required to have good visual
    abilities.) Id. at 210; App. A, at 466. None of the jobs is
    ___
    characterized as requiring climbing or balancing. The
    Selected Characteristics volume also describes environmental
    ________________________
    restrictions associated with certain jobs. Of all the jobs
    listed above, only the folder position has an environmental
    restriction. Coded as "4", it involves work in a wet and
    humid environment, an environment in which Oyola could work.
    Id. at 212, 467, 479.
    ___

    -26-















    part between saturated rollers"; and a marker "[m]ay" use a

    "tag dispensing machine" to attached gummed labels to

    merchandise. However, these "machines" do not appear to be

    the kinds of dangerous moving machines which Oyola must

    avoid. The sixth number in each of the title numbers given

    in the above list is "7". According to Appendix B of the

    Dictionary of Occupational Titles, that number means that
    ___________________________________

    those jobs require workers to use "body members, handtools,

    and/or special devices to work, move, or carry objects or

    materials," whereas jobs involving "machines or equipment"

    carry other numbers in the sixth place. See II Dictionary,
    ___ __________

    App. B, at 1005-07. Consequently, the machines used in the

    folder, sample mounter and marker jobs appear to be hand-or

    foot-operated (e.g., like a household sewing machine or a
    ____

    grocery store price tag dispenser). Thus, a worker suffering

    a seizure would not only not be endangered by the machine,

    but most likely the machine itself would stop operating once

    the worker suffers a seizure because his hand or foot would

    be removed from the controls. Cf. also Lizotte v. Secretary
    ________________ _________

    of Health and Human Services, 654 F.2d 127, 130 (1st Cir.
    _____________________________

    1981) (the ALJ determined that the claimant could not work

    around hazardous machinery, but would be able to perform the

    job of "marker machine operator in a shoe factory").

    Lest there be any doubt, however, that the folder,

    sample mounter or marker positions would be appropriate for



    -27-















    Oyola, we do not rely on those positions in rendering our

    decision. The remaining three jobs -- ticketer, shoe packer

    and stenciler -- do not involve any machinery, and would

    provide ample evidence that specific jobs exist in

    significant numbers in the national economy which Oyola could

    perform. See, e.g., Lizotte, supra, 654 F.2d at 130
    __________ _______ _____

    (affirming an ALJ decision that the claimant could engage in

    substantial gainful activity where the decision was based on

    vocational expert testimony that the claimant could perform

    three named jobs); see also Arce Crespo v. Secretary of
    ___ ____ ___________ ____________

    Health and Human Services, 831 F.2d 1, 3, 5 (1st Cir. 1987)
    __________________________

    (per curiam) (affirming an ALJ decision denying benefits

    where the decision was based on vocational expert testimony

    as to four jobs which the claimant could perform; the

    vocational expert relied in part on the description of the

    jobs found in the Dictionary of Occupational Titles).
    _________________________________

    Although the ALJ did not specifically refer to the

    jobs listed by disability examiners Sampayo and Toro to

    support his decision, at the outset of his opinion he stated

    that he had "carefully considered all the documents

    identified in the record as exhibits, . . . ." Exhibit C-8

    includes the "Supplemental Rationale" reports listing those

    jobs. In Geoffrey v. Secretary of Health and Human Services,
    ________ ______________________________________

    663 F.2d 315 (1st Cir. 1981), we considered an argument that

    the ALJ should have listed specific jobs to show that the



    -28-















    claimant could perform substantial gainful work. In dictum,

    we noted that the record contained the names of several

    occupations which the claimant could perform. Under the

    circumstances, we saw no need for the ALJ to repeat those

    occupations in his decision, but we also said that they

    represented "a fair example of the type of light work the

    records show Geoffrey can engage in" and that the listing

    "demonstrate[d] . . . that the record is not entirely devoid

    of evidence in this respect." Id. at 319 & n. 8. Thus, we
    ___

    suggested that evidence of specific jobs in the record could

    be given some weight upon appeal even if the ALJ had not

    relied upon, or even mentioned, that evidence in his

    decision. Here, at least, the ALJ made clear that he had

    reviewed the disability examiners' reports, and may also have

    been influenced by them in finding that Oyola was not

    disabled from engaging in substantial gainful work, even if

    he did not refer to them specifically.

    Obviously, it would be preferable to require an ALJ

    to describe specifically all evidence which supports his

    decision that a claimant is not disabled from engaging in

    substantial gainful employment. Nevertheless, under the

    circumstances present here,16 it makes no sense to remand


    ____________________

    16. Given the evidence in this case we would have sustained
    a decision by the ALJ rendered consistent with the regulation
    at 20 C.F.R., Pt. 404, Subpt. P, App. 2, 200.00(e)(2). In
    that regulation the Secretary provides for the following
    analytical procedure for determining whether an individual

    -29-















    solely to call a vocational expert to testify as to the

    existence of jobs that Oyola may perform when at least three

    appropriate jobs are already named in the record. Therefore,

    we find that the Secretary has met his burden of proving that

    Oyola's exertional and nonexertional impairments did not





    ____________________

    with both exertional and nonexertional impairments is
    disabled: (1) The decisionmaker is to see whether the
    individual is disabled based on strength limitations alone.
    Here, Oyola was not disabled because he retained the ability
    to do medium work. (2) The decisionmaker is to consider the
    relevant Grid Rule as a "framework." Rule 203.25 being used
    as a framework, Oyola's residual functional capacity, age,
    education and work experience all indicated that he was not
    disabled. (3) Finally, the decisionmaker is to consider "all
    of the relevant facts in the case" as described in the
    regulations, including the adjudicative weight accorded such
    factors. Here, the evidence showed that only Oyola's
    epilepsy and pain could be characterized as medically
    determinable severe impairments, but that his epilepsy did
    not meet the criteria of the Listings, indicating that he was
    not per se disabled from engaging in substantial gainful
    employment. See 20 C.F.R. 404.1525(a). The evidence also
    ___
    showed that he had not sought or followed consistent
    treatment for his conditions, important failures under the
    regulations and case law. See id. 404.1530; Irlanda Ortiz
    _______ _____________
    v. Secretary of Health and Human Services, 955 F.2d 765, 770
    ______________________________________
    (1st Cir. 1991) (per curiam) (lack of sustained treatment
    bolsters decision that the claimant was not disabled);
    Tsarelka v. Secretary of Health and Human Services, 842 F.2d
    ________ _______________________________________
    529, 534 (1st Cir. 1988) (per curiam) (the claimant should
    have secured treatment to show that her ability to work could
    not be restored). In addition, the Rulings indicate or
    strongly suggest that, individually, Oyola's nonexertional
    limitations would not significantly affect the full range of
    medium work he could perform. Those Rulings further
    indicated that, here, the Secretary could rely on the
    Dictionary of Occupational Titles for vocational evidence
    ___________________________________
    that specific jobs which Oyola could perform existed in
    significant numbers in the national economy, and the record
    contained specific job titles, whose descriptions matched
    Oyola's exertional and nonexertional limitations.

    -30-















    disable him from engaging in substantial gainful employment.

    The decision of the district court is affirmed.
    ________

















































    -31-







Document Info

Docket Number: 92-1810

Filed Date: 12/30/1992

Precedential Status: Precedential

Modified Date: 9/21/2015

Authorities (16)

14 soc.sec.rep.ser. 301, unempl.ins.rep. Cch 16,883 Ernest ... , 797 F.2d 19 ( 1986 )

Lisa TSARELKA, Plaintiff, Appellant, v. SECRETARY OF HEALTH ... , 842 F.2d 529 ( 1988 )

Victor M. ORTIZ, Plaintiff, Appellant, v. SECRETARY OF ... , 890 F.2d 520 ( 1989 )

John M. ZALEWSKI, Plaintiff-Appellant, v. Margaret HECKLER, ... , 760 F.2d 160 ( 1985 )

Elaine GRAY, Plaintiff, Appellant, v. Margaret HECKLER, ... , 760 F.2d 369 ( 1985 )

Edmond P. Lizotte v. Secretary of Health and Human Services , 654 F.2d 127 ( 1981 )

Victor J. Irlanda Ortiz v. Secretary of Health and Human ... , 955 F.2d 765 ( 1991 )

Roger Gagnon v. Secretary of Health and Human Services , 666 F.2d 662 ( 1981 )

Joseph T. FRUSTAGLIA, Plaintiff, Appellant, v. SECRETARY OF ... , 829 F.2d 192 ( 1987 )

David HEGGARTY, Plaintiff, Appellant, v. Louis W. SULLIVAN, ... , 947 F.2d 990 ( 1991 )

William P. Geoffroy v. Secretary of Health and Human ... , 663 F.2d 315 ( 1981 )

Edwin Paul ALLEN, Jr., Plaintiff-Appellant, v. SECRETARY OF ... , 726 F.2d 1470 ( 1984 )

Francisco PEREZ TORRES, Plaintiff, Appellant, v. SECRETARY ... , 890 F.2d 1251 ( 1989 )

unempl.ins.rep. Cch 17,623 Jose Arce Crespo v. Secretary of ... , 831 F.2d 1 ( 1987 )

Jimmy ASHER, Appellant, v. Dr. Otis BOWEN, Appellee , 837 F.2d 825 ( 1988 )

Francis ELLISON, Appellant, v. Louis W. SULLIVAN, Secretary ... , 921 F.2d 816 ( 1990 )

View All Authorities »