Sosa v. SHHS ( 1995 )


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  • USCA1 Opinion








    March 13, 1995 [NOT FOR PUBLICATION]
    UNITED STATES COURT OF APPEALS
    FOR THE FIRST CIRCUIT




    ____________________


    No. 94-1618

    MILAGROS SOSA,

    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. Hector M. Laffitte, U.S. District Judge] ___________________

    ____________________

    Before

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

    ____________________

    Aurelio Saliva Mattei on brief for appellant. _____________________
    Guillermo Gil, United States Attorney, Maria Hortensia Rios, ______________ _____________________
    Assistant United States Attorney, and Nancy B. Salafia, Assistant _________________
    Regional Counsel, Department of Health and Human Services, on brief
    for appellee.


    ____________________

    ____________________














    Per Curiam. Milagros Sosa (claimant) appeals from a ___________

    district court judgment affirming the decision of the

    Secretary of Health and Human Services to deny her

    application for disability benefits. For the reasons

    outlined below (and enumerated at greater length in the

    magistrate-judge's report), we find substantial evidence in

    support of the Secretary's decision and therefore affirm.

    Claimant is a married, 38-year-old mother of two who was

    employed as a bank teller and loan clerk until December

    1987. She alleges that she has been disabled since that

    date due to the following series of ailments: (1) vascular

    insufficiency and thrombophlebitis of the legs; (2) painful

    fibromyositis and arthritis of the back; (3) vertigo; and

    (4) nervous depression. Following a hearing, the

    administrative law judge (ALJ) found that claimant's leg

    condition, while restricting her ability to stand for

    extended periods and thus precluding a return to her past

    job, did not prevent her from performing sedentary work. In

    turn, the ALJ determined that claimant's remaining ailments

    imposed only minimal functional restrictions, such that her

    ability to perform the full range of sedentary work was not

    significantly compromised. Applying Rule 201.29 of the

    Grid, see 20 C.F.R. Part 404, Subpart P, App. 2, the ALJ ___

    reached a finding of not disabled. Claimant now argues that

    such findings were unsupported by substantial evidence and,

















    more specifically, that it was error not to hear from a

    vocational expert. We disagree.

    Abundant record evidence supports the conclusion that the

    exertional restrictions imposed by claimant's leg condition

    did not preclude performance of sedentary work.1 Claimant

    has had two episodes of thrombophlebitis2: in February 1987

    (three weeks after the birth of her first child) and again

    in September 1988 (in the midst of her second pregnancy).

    Both episodes were successfully treated over a period of

    days. Otherwise, she has suffered from chronic venous

    insufficiency with recurrent edema3 and pain (consistent

    with a post-phlebitic syndrome)--for which medication and

    the use of elastic socks have been prescribed. The

    physician who treated claimant between January and July 1988

    (Dr. Munoz) specifically reported that she was capable of

    sedentary activity, identifying her only functional

    limitation as an inability to stand or walk for extended

    periods. Much of the other evidence was to the same effect.

    For example, a neurologist (Dr. Scarano Garcia) in August

    1988 described claimant's ability to walk on heels or toes

    ____________________

    1. Sedentary work involves lifting no more than ten pounds
    at a time and "occasional" walking and standing. 20 C.F.R.
    404.1567(a).

    2. Thrombophlebitis is the inflammation of a vein associated
    with blood clot formation.

    3. Venous insufficiency involves the inadequate drainage of
    venous blood. Edema is the accumulation of excessive fluid
    in cells or tissues.

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    as being within normal limits. In December 1988, three

    months after claimant's second bout of thrombophlebitis, a

    non-examining physician (Dr. Arzola) completed a residual

    functional capacity assessment noting only minor limitations

    in this regard. And in October 1989, a vascular surgeon

    (Dr. Ramirez Ferrer) found some swelling in claimant's legs

    but no other complications. Notwithstanding the contrary

    indications in the record,4 such evidence provides ample

    support for the ALJ's conclusion.

    In turn, we think the ALJ was warranted in finding that

    the functional restrictions imposed by claimant's remaining

    ailments were minimal. As to her complaints of back pain,

    the ALJ found that claimant suffered from impairments

    capable of producing pain, but then proceeded to discount

    the severity of those complaints. The record reveals that

    claimant experienced a back sprain in 1982, for which she

    received physical therapy and was awarded a five percent

    state disability. More recently, claimant was treated for

    pain in the right shoulder in February 1988. Raising of the

    arm was found to cause suppression of the subclavian artery,

    but neurological testing was otherwise normal; the treating


    ____________________

    4. Most notable among these was the evaluation of one
    treating physician (Dr. Quinones Soto), who in December 1987
    recommended bed rest for six months and, in April 1988,
    reported that claimant was totally disabled. He stopped
    treating claimant in December 1987, however, giving way to
    Dr. Munoz. As mentioned, the latter described a more benign
    condition.

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    physical therapist (Dr. Oms) reported an impression of

    fibromyositis. Similarly, in August 1988, a neurologist

    (Dr. Rodriguez Del Valle) diagnosed a painful syndrome in

    the cervical and dorsal region, of unknown origin, when the

    right arm was raised. Nonetheless, muscle strength,

    reflexes and sensibility were all within normal limits.

    That same month, another neurologist (Dr. Scarano Garcia)

    reported normal range of motion in the cervical, thoracic

    and lumbar regions, along with normal muscle tone in all

    extremities. On the basis of such evidence, and on the

    basis of his questioning of claimant in accordance with

    Avery v. Secretary of HHS, 797 F.2d 19 (1st Cir. 1986), the _____ ________________

    ALJ justifiably concluded that most of her pain was

    effectively controlled through therapy and medication. And

    any residual limitation on claimant's ability to raise her

    right arm over her head would have little bearing on her

    capacity to perform sedentary work.

    Claimant first complained of vertigo in July 1988, during

    the middle of her second pregnancy. Following a brief

    hospitalization therefor (as well as for pregnancy-related

    vomiting), she was treated over the next month by a

    neurologist (Dr. Scarano Garcia). Results of extensive

    neurological testing, including a brain scan and an EEG,

    were normal except for a mild head tremor; no cause was

    found for her vertigo. More important, there is no record

    of any further treatment for this condition after August 9,


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    1988. Indeed, there is no evidence that claimant thereafter

    made any further complaints in this regard to medical

    personnel--apart from allegations voiced to a psychiatrist

    in January 1990. The ALJ thus was warranted in regarding

    claimant's vertigo as a short-lived affliction.

    Finally, substantial evidence supports the ALJ's

    conclusion that claimant's mental condition was of minimal

    severity. Claimant alleges that she has suffered therefrom

    since the age of thirteen. Yet she received no psychiatric

    treatment from at least 1980 onwards, and made no mention of

    such a condition to any of her treating physicians. A

    psychiatrist (Dr. Toro) who examined claimant in January

    1989, shortly before she delivered her second child,

    diagnosed only a "mild" generalized anxiety disorder. In

    particular, he reported that claimant cared for her son,

    performed some housework with the help of others, attended

    to her own personal needs without supervision, and was

    capable of normal interpersonal relationships. It was

    within the ALJ's prerogative to credit Dr. Toro's findings

    over those reached one year later by a second psychiatrist

    (Dr. Bocanegra). And even the latter, we note, recorded a

    diagnosis of only "moderate" dysthymia.

    We therefore find substantial evidentiary support for the

    ALJ's conclusions. We likewise conclude that it was

    unnecessary to hear vocational evidence. As explained, the

    ALJ was warranted in finding that claimant's nonexertional


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    impairments had only a minimal impact on her ability to

    perform the full range of sedentary work. Under such

    circumstances, reliance on the Grid to yield a finding as to

    disability was appropriate. See, e.g., Heggarty v. ___ ____ ________

    Sullivan, 947 F.2d 990, 995-96 (1st Cir. 1991) (per curiam); ________

    Ortiz v. Secretary of HHS, 890 F.2d 520, 524-25 (1st Cir. _____ _________________

    1989) (per curiam).

    Affirmed. _________






































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