Rios Vazquez v. SHHS ( 1995 )


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  • USCA1 Opinion











    January 23, 1995 [NOT FOR PUBLICATION]
    UNITED STATES COURT OF APPEALS
    FOR THE FIRST CIRCUIT





    ____________________


    No. 94-1793



    LUIS A. RIOS VAZQUEZ,

    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. Jaime Pieras, II, Senior U.S. District Judge] __________________________

    ____________________

    Before

    Selya, Circuit Judge, _____________
    Campbell, Senior Circuit Judge, and ____________________
    Boudin, Circuit Judge. _____________

    ____________________

    Juan R. Requena Davila and Juan A. Hernandez Rivera on brief for _______________________ _________________________
    appellant.
    Guillermo Gil, United States Attorney, Maria Hortensia Rios, ______________ _____________________
    Assistant United States Attorney, and Eileen M. Cedrone, Assistant __________________









    Regional Counsel, Region I, Department of Health and Human Services,
    on brief for appellee.


    ____________________

    ____________________
    Per Curiam. Luis A. Rios-Vazquez (claimant) appeals __________

    from a district court judgment affirming the decision of the

    Secretary of Health and Human Services denying his

    application for disability benefits. For the reasons stated

    below, we affirm.

    I.

    Claimant was born on May 23, 1945, and applied for

    benefits when he was forty-four years old. He has an eighth

    grade education. In 1977, while working in Chicago as a

    crane operator, he lifted a steel object and became "stiff."

    After two more similar episodes, he was diagnosed in 1979 as

    having a herniated disc and underwent surgery on April 18,

    1979. He was allowed to return to work on September 24,

    1979, although he continued to experience some leg and back

    pain. In 1981, claimant returned to Puerto Rico and began

    working as a truck driver. His back pain worsened from time

    to time, especially when he drove for long periods of time.

    He also suffered pain and numbness in the legs. Claimant

    ceased working on February 26, 1989, and he has not worked

    since then. He is insured at least through March 11, 1991.

    On February 28, 1990, claimant filed an application for

    disability benefits alleging disability since February 26,

    1989 due to back pain and "frequent loss of balance." He

    claimed that his doctors had prohibited him from lifting

    anything heavy. Asked to describe his daily activities, he

    stated that he kept the area surrounding his home clean.














    Other activities included driving his car, reading the bible,

    visiting relatives, and going to church. The Social Security

    Administration denied claimant's application initially. On

    June 25, 1990, claimant requested reconsideration stating

    that his pain had worsened and that his nerves had been

    affected. Claimant's application was denied on

    reconsideration.

    Claimant obtained a hearing before an Administrative Law

    Judge (ALJ) on February 11, 1991. He was represented by an

    attorney. At the hearing, claimant testified that he ceased

    working as a truck driver because of his back or waist pain.

    He described the pain as pretty severe, sometimes causing him

    to loose control of his leg. Although he takes pain

    medication, it does not provide full relief. He testified

    that he can take of his personal needs, and that he attempts

    to help his wife with the wash. In addition, he visits with

    company, reads a little, and goes to church. He also

    testified that he began seeking mental health treatment in

    July 1990 because he "felt nervous."

    The ALJ found that although claimant has discogenic

    disease at L4-L5, he does not have an impairment or

    combination of impairments equivalent to one of the listed

    impairments. He also found that claimant is unable to

    perform his past relevant work, which required heavy lifting,

    but that claimant has the residual functional capacity for



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    the full range of light work. With respect to claimant's

    alleged mental condition, the ALJ found that claimant has not

    presented a severe mental impairment which can be expected to

    last at least twelve months. Finally, the ALJ ruled that

    based on claimant's capacity for light work, as well as his

    age, education, and work experience, the Grid directs a

    conclusion of not disabled. The Appeals Council denied

    review. An appeal was taken to the district court, where a

    magistrate-judge (magistrate) concluded that the Secretary's

    decision was supported by substantial evidence. The district

    court adopted the magistrate's report and recommendation.

    This appeal followed.

    II.

    The medical record is well-summarized in the ALJ's and

    the magistrate's reports, and we need only provide a brief

    overview here. On April 18, 1979, claimant underwent a

    partial hemilaminectomy of L4 on the left with excision of

    L4-5 disc. Approximately five months later, he was

    sufficiently improved to return to work, although he was

    limited temporarily to lifting thirty pounds. He continued

    to feel back pain and was fitted with a flexion jacket. He

    was also advised to continue light work and exercise.

    There is a gap in the medical record between August 1980

    and August 1988. On August 26, 1988, claimant began





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    treatment with Dr. Victor Burgos for lower back pain.1 Dr.

    Burgos diagnosed claimant as suffering from discogenic

    disease, osteoarthritis, and muscle spasms. He prescribed

    various medications for claimant, including meclomen,

    voltaren, and norflex.

    Between January 1989 and June 1990, claimant underwent

    physical therapy with Dr. Oscar Arroyo-Nieves. He diagnosed

    claimant as suffering from lumbar radiculopathy, status post

    laminectomy, degenerative joint disease, and chronic lower

    back pain.

    On May 6, 1990, claimant was examined by a consulting

    neurologist, Dr. Nilda De Jesus Pla. The motor examination

    revealed that claimant walks dragging his right leg, but has

    good strength in the upper and lower extremities. Dr. De

    Jesus Pla did not observe atrophy or abnormal movements. Her

    examination of claimant's vertebral column revealed marked

    spasms in the paravertebral region, as well as mild spasms in

    the posterior region of the right thigh. A range of motion

    examination disclosed that claimant's forward bending is

    limited to forty-five degrees. An x-ray report showed a


    ____________________

    1. A C.T. scan of claimant's spine, reported by Dr. Burgos,
    showed degenerative changes at the lumbo sacral spine with
    decreased intervertebral disc space at L4-L5 and bulging of
    the annulus fibrosus at L4-L5. It also revealed segmental
    calcifications at the outer annulus at the right
    posterolateral aspect L5-S1, as well as sclerosis and
    hypertrophic changes at the articular facets at L5-S1 at the
    right side causing narrowing of the neural foramina.

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    lumbar spondylolysis and myositis with disc disease at L5-L4.

    Dr. De Jesus Pla concluded that claimant's condition

    precludes him from returning to his past work as a truck

    driver.

    Dr. Tomas Hernandez, a neurologist, evaluated claimant

    on June 11, 1990 and diagnosed him as suffering from a

    pinched nerve root in the right side. Dr. Hernandez opined

    that this condition, as well as the C.T. lumbar findings and

    claimant's symptomatology, disabled claimant totally and

    permanently from working.

    Two residual physical functional capacity assessments,

    prepared by non-examining medical consultants, are consistent

    with the ALJ's finding that claimant has the capacity for

    light work. The latter assessment, dated August 26, 1990 and

    prepared by a consulting neurologist, concludes that "[t]here

    is no motor, sensory, or reflex deficit to account for [the]

    statement of inability to work."

    Mental health records reveal that claimant sought

    treatment on June 6, 1990, complaining of bad humor, an upset

    stomach, difficulty sleeping, and a tight feeling in his

    chest. Claimant was diagnosed with anxiety disorder and

    prescribed xanax. He was otherwise found to be cooperative,

    coherent, relevant, and somewhat oriented. On July 31, 1990,

    claimant reported feeling better. On September 20, 1990,

    claimant stated that he felt frightened. He was continued on



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    xanax. On December 20, 1990, claimant reported feeling

    better with medication.

    III.

    Claimant contends that the ALJ erred in relying on the

    Grid to reach a conclusion of not disabled. In particular,

    he argues that his restricted ability to bend from the waist,

    as well as the pain he suffers, constitute non-exertional

    impairments. Under the circumstances, he contends, the

    testimony of a vocational expert was required to evaluate his

    claim.

    Where a claimant's impairments involve only exertional

    limitations, the Grid provides a "streamlined" method by

    which the Secretary can make a determination whether there

    are jobs in the economy which the claimant can perform. See, ___

    e.g., Heggarty v. Sullivan, 947 F.2d 990, 995 (1st Cir. ____ ________ ________

    1991); Ortiz v. Secretary of Health & Human Servs., 890 F.2d _____ __________________________________

    520, 524 (1st Cir. 1989) (per curiam). However, where a

    claimant has non-exertional impairments in addition to

    exertional limitations, the Grid may not be fully applicable.

    See 20 C.F.R. Part 404, Subpart P, App. 2, 200(e). The ___

    appropriateness of relying of the Grid in such a situation

    "depends on whether claimant's nonexertional impairment

    ``significantly affects [a] claimant's ability to perform the

    full range of jobs' at the appropriate strength level."

    Heggarty v. Sullivan, 947 F.2d at 996 (quoting Lugo v. ________ ________ ____



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    Secretary of Health & Human Servs., 794 F.2d 14, 17 (1st Cir. __________________________________

    1986) (per curiam)).

    With respect to claimant's restricted ability to bend

    from the waist, we note that both residual functional

    capacity assessments reported that claimant is capable of

    occasional bending. This is all that "light" work requires.

    Ortiz, 890 F.2d at 525; see also SSR 85-15 at 97 (CE 1985) _____ _________

    ("If a person can stoop occasionally (from very little up to

    one-third of the time) in order to lift objects, the

    sedentary and light occupational base is virtually intact.").

    Under the circumstances, claimant's bending restriction did

    not preclude reliance on the Grid. See Ortiz, 890 F.2d at ___ _____

    525.

    With respect to claimant's pain, we observe that the ALJ

    concluded that claimant's back pain "does not constitute a

    disabling factor upon his ability to perform tasks that do

    not exceed light exertional demands." The ALJ evaluated

    claimant's allegations of pain in accord with our decision in

    Avery v. Secretary of Health & Human Servs., 797 F.2d 19 (1st _____ __________________________________

    Cir. 1986). Claimant was questioned concerning his daily

    activities, functional restrictions, medication, frequency

    and duration of pain, and precipitating and aggravating

    factors. See id. at 28-29. The ALJ also reviewed the ___ ___

    objective medical evidence. He found that apart from marked

    lumbar muscle spasms and some flexion difficulties, "claimant



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    did not present gross neurological deficits or limited

    movements as to impose significant restriction at all

    exertional levels." The ALJ further noted that claimant

    performed full body movements at the hearing and was not

    distracted due to pain. We are persuaded that substantial

    evidence supports the ALJ's conclusion that claimant's pain

    does not impair his ability to perform light work. See ___

    Frustaglia v. Secretary of Health & Human Servs., 829 F.2d __________ ____________________________________

    192, 195 (1st Cir. 1987). Under the circumstances, there was

    no error in relying on the Grid.

    Claimant also contends that the ALJ gave undue weight to

    the opinions of the Secretary's consulting physicians and too

    little weight to the opinions of his treating physicians.

    This is an apparent reference to recently promulgated

    regulations which describe how the Secretary will weigh

    medical opinions, and provide that, in general, the Secretary

    will give more weight to opinions from treating sources. See ___

    20 C.F.R. 404.1502 (1991) (defining treating source),

    404.1527(d) (1991) (explaining how the Secretary weighs

    medical opinions).2 Assuming, without deciding, that these

    regulations are applicable here, we find no fault with the

    ALJ's decision on this score.



    ____________________

    2. These regulations were promulgated after the ALJ issued
    his decision, but while the case was pending before the
    Appeals Council.

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    For the most part, the reports of claimant's physicians

    are fully consistent with those of the Secretary's

    physicians. The one exception is Dr. Hernandez' conclusory

    statement that claimant is totally and permanently disabled

    from working. However, the Secretary was not bound to accept

    this statement. First, it is by no means obvious that Dr.

    Hernandez should be considered a treating source. Claimant

    did not consult Dr. Hernandez until after the initial

    determination of no disability and apparently saw him on only

    two occasions. See 20 C.F.R. 404.1502 (1991) (defining ___

    treating source as a physician with whom claimant has had an

    "ongoing" relationship based on the need for treatment and

    not solely on the need to obtain a favorable report).

    Second, and more importantly, the determination of disability

    is reserved to the Secretary. See 20 C.F.R. 404.1527(e) ___

    (1991). There is ample evidence in the record as a whole to

    support the ALJ's conclusion that claimant retains the

    functional capacity for light work.

    Claimant's remaining argument is that the Secretary

    erred in finding that he does not have a severe mental

    impairment that can be expected to last at least twelve

    months. This issue was not encompassed in claimant's

    objection to the magistrate's report and, thus, is waived.

    See Thomas v. Arn, 474 U.S. 140, 147-48 (1985); Keating v. ___ ______ ___ _______

    Secretary of Health & Human Servs., 848 F.2d 271, 275 (1st ____________________________________



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    Cir. 1988) (per curiam). We add that the record portrays a

    relatively mild mental impairment, which has responded well

    to medication. Moreover, claimant has never clarified how it

    allegedly limits his ability to work. In such circumstances,

    the Secretary could properly conclude that claimant's mental

    impairment is "non-severe." See 20 C.F.R. 404.1521 ___

    (defining "non-severe" impairment as one that does not

    significantly limit a claimant's ability to do basic work

    activities); Rodriguez v. Secretary of Health & Human _________ ______________________________

    Servs., 893 F.2d 401, 403-04 (1st Cir. 1989). ______

    The judgment of the district court is affirmed. ________































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