Rivera Garay v. SHHS ( 1995 )


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  • USCA1 Opinion



    [NOT FOR PUBLICATION]
    UNITED STATES COURT OF APPEALS
    FOR THE FIRST CIRCUIT



    ____________________


    No. 94-1515

    ANTONIO RIVERA GARAY,

    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

    Cyr, Boudin and Stahl, Circuit Judges. ______________

    ____________________

    Juan R. Requena Davila, Raymond Rivera Esteves and Juan A. _________________________ _______________________ ________
    Hernandez Rivera on brief for appellant. ________________
    Guillermo Gil, United States Attorney, Maria Hortensia Rios, _____________ ______________________
    Assistant United States Attorney, and Robert M. Peckrill, Assistant ___________________
    Regional Counsel, Department of Health & Human Services, on brief for
    appellee.


    ____________________

    ____________________






















    Per Curiam. Claimant Antonio Rivera Garay filed an __________

    application for social security disability benefits on

    January 9, 1990, alleging disability due to a back and leg

    condition, associated pain, and an anxiety disorder. After a

    hearing, the Administrative Law Judge (ALJ) conceded that

    claimant had a severe impairment or impairments, but

    concluded that claimant was not disabled at step 4 of the

    sequential evaluation process, 20 C.F.R. 404.1520(e), on

    the ground that claimant's impairments did not preclude his

    return to his former job as a lottery ticket vendor. The ALJ

    based this determination on the testimony of a vocational

    expert at the hearing that an individual with claimant's

    impairments, as described by the ALJ, could perform that job.



    After the Appeals Council denied claimant's request

    for review of the ALJ's decision, claimant appealed to the

    district court, which affirmed. On appeal to this court,

    claimant argues that the Secretary's decision is not

    supported by substantial evidence. We agree, and we direct a

    remand to the Secretary for the taking of additional

    vocational evidence.



    Background __________







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    We review the Secretary's decision under a

    "substantial evidence" standard; we will affirm that decision

    if it is supported by "such relevant evidence as a reasonable

    mind might accept as adequate to support a conclusion."

    Richardson v. Perales, 402 U.S. 389, 401 (1971). The ALJ's __________ _______

    determination that claimant could perform his past work was

    based on the vocational expert's answers to hypothetical

    questions posed by the ALJ. We must, therefore, examine the

    soundness of those questions' premises. If the premises are

    supported by substantial evidence in the record, then the

    vocational expert's responses constitute substantial evidence

    to support the ALJ's vocational determination that claimant's

    impairment do not preclude his former work. If the premises

    lack record support, then the vocational expert's responses

    are not substantial evidence. "[I]n order for a vocational

    expert's answer to a hypothetical question to be relevant,

    the inputs into that hypothetical must correspond to

    conclusions that are supported by the outputs from the

    medical authorities." Arocho v. Secretary of Health and ______ _________________________

    Human Services, 670 F.2d 374, 375 (1st Cir. 1982). ______________

    The ALJ described claimant's exertional impairment

    to the vocational expert as follows:

    [C]onsidering the claimant's age, education
    and working experience; considering that he
    can alternate positions, can perform fine and
    gross manipulation, he can push and pull up
    to 25 pounds, frequently. That he can
    occasionally lift more than 25 pounds. That


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    he would be limited in the use of foot
    controls, but that he could bend, squat, he
    could pull and push the weight mentioned
    before. If this is the situation, are there
    jobs in a significant number that a person
    like the one we have described before could
    do?

    The vocational expert responded that claimant could return to

    his former job as a lottery ticket vendor.

    The ALJ then added a hypothetical directed to

    claimant's mental impairment, asking, "And if we added a

    mental condition where the memory seems preserved, the

    recent, remote and immediate memory is present, there is good

    attention, concentration, mental capacity, good judgment,

    good introversion. Would your opinion vary at all?" The

    vocational expert responded that it would not.

    Finally, the ALJ asked, "And if we gave credibility

    to the claimant's complaints as indicated here today, that he

    feels pain in the leg, that the left leg gets numb, that the

    knee fails him, that he has to use a cane, that he has chest

    pains, that he likes to be alone, that he hears voices. If

    we gave credibility to these complaints, would your

    appreciation change at all?" The vocational expert responded

    that claimant could not perform his past job in that

    condition.



    Claimant's Exertional Impairment ________________________________





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    Substantial record evidence exists to support the

    ALJ's description of claimant's exertional impairment. Two

    non-examining physicians, Dr. Fragoso and Dr. Hernandez,

    reviewed the record and assessed claimant's residual

    functional capacity. Both found that claimant could lift and

    carry up to 50 pounds, 25 pounds frequently; could sit, walk,

    and stand up to six hours each day; could push and pull; had

    no manipulative limitations; and could climb, balance, stoop,

    kneel, crouch and crawl at least occasionally. These medical

    findings, which constituted the only medical assessments of

    claimant's residual exertional capacity in the record,

    adequately supported the ALJ's hypothetical.

    It is true that the weight to be given the residual

    functional capacity assessments of non-examining physicians

    "will vary with the circumstances, including the nature of

    the illness and the information provided the expert."

    Rodriguez v. Secretary of Health and Human Services, 647 F.2d _________ ______________________________________

    218, 223 (1st Cir. 1981). Claimant's benefits application,

    however, was denied at step 4, and at step 4 it is ordinarily

    claimant's burden, not the Secretary's, to produce evidence

    to demonstrate that he cannot return to his former work.

    Gray v. Heckler, 760 F.2d 369, 375 (1st Cir. 1985). Since ____ _______

    claimant was represented by counsel, there is no

    justification here for a departure from that rule. See ___

    Currier v. Secretary of Health, Education and Welfare, 612 _______ ____________________________________________



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    F.2d 594, 598 (1st Cir. 1980). The onus was on claimant,

    therefore, to introduce additional residual functional

    capacity assessments relevant to the step 4 determination.

    Claimant having failed to do so, the Secretary was entitled

    to rely on the assessments of these non-examining physicians.



    Claimant's Allegations of Pain ______________________________



    We also find no error in the ALJ's treatment of

    claimant's subjective complaints of pain. The exertional

    aspects of claimant's pain, associated with claimant's back

    and leg condition, are covered by our above remarks. It was

    partly because of claimant's "pain or discomfort related to

    back syndrome" that the ALJ concluded that claimant faced the

    exertional limitations the ALJ outlined in her hypothetical

    to the vocational expert.

    As for the non-exertional aspects of claimant's

    pain, we find that the ALJ conducted the kind of inquiry into

    claimant's allegations of pain required by Avery v. Secretary _____ _________

    of Health and Human Services, 797 F.2d 19 (1st Cir. 1986), _____________________________

    and that the ALJ's decision to discredit allegations of

    disabling pain was supported by substantial evidence. The

    record supports, and claimant has not challenged, the ALJ's

    findings that claimant "has been taking medication on his

    own, has not been going for treatment consistently and he



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    should complain to the treating sources so that corrective

    action may be undertaken such as prescribe a substitute

    medication, decreasing the frequency or the dosage of the

    medication or orienting the claimant in terms of taking

    medication consistently." The ALJ also permissibly relied on

    her own observations at the hearing that claimant "had a

    cane, but he did not appear to actually need it for support.

    He admitted that such cane was not prescribed by any medical

    source and that he bought it on his own. He was able to sit,

    stand up and exercise body control with no significant

    limitations." This evidence adequately supported the ALJ's

    finding, as reflected in her hypotheticals to the vocational

    expert, that claimant did not suffer from significant pain

    beyond that which contributed to his exertional limitations.



    Claimant's Mental Impairment ____________________________



    The deficiency in the Secretary's determination

    concerns the ALJ's description of claimant's mental

    impairment in the ALJ's hypothetical to the vocational

    expert. The hypothetical merely stated that claimant had a

    mental condition, without any description of any specific

    mental impairment or any specific functional consequences.

    The hypothetical then went on to list a number of areas in

    which claimant's mental capabilities were found to be normal.



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    As claimant argues in his brief on appeal, "the subject

    hypothetical having to do with appellant's mental condition

    poses no mental impairment at all."

    The medical evidence does not permit claimant's

    mental condition to be ignored in this manner. Even the

    psychological evaluation most favorable to the Secretary,

    that of Dr. Orlando Maldonado Rodriguez conducted on March 7,

    1990, found a "mild anxiety disorder." It did not discuss

    what, if any, functional limitations that disorder posed.

    The two assessments by non-examining agency review physicians

    of claimant's residual mental capacity, provided by Dr.

    Reboredo and Dr. Jeanette Maldonado, found that claimant had

    a severe anxiety-related disorder which imposed "moderate"

    limitations in various functional areas, including the

    following: maintaining attention and concentration for

    extended periods, performing within a schedule, maintaining

    regular attendance and punctuality, completing a normal work

    day or week without interruption from psychologically based

    symptoms, performing at a consistent pace without an

    unreasonable number and length of rest periods, interacting

    appropriately with the general public, getting along with co-

    workers without distracting them or exhibiting behavioral

    extremes, and responding appropriately to changes in a work

    setting. Of particular relevance, given claimant's past

    work as a lottery ticket salesman and the ALJ's denial of



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    benefits on the ground that claimant could still perform that

    job, Dr. Reboredor wrote that claimant "cannot relate to

    public . . . on a steady basis," and Dr. Jeanette Maldonado

    expressed a similar view.

    The ALJ herself specifically concluded in her

    decision that claimant has "some anxiety related disorder

    although it is mild to moderate in nature," and that he could

    not "perform . . . complex tasks with detailed instructions."

    The ALJ failed to address, however, what affect the moderate

    limitations on, for example, dealing with the public and

    completing a normal workday would have on claimant's ability

    to perform his past work as a salesman.

    Although we recognize that the medical evidence

    supported the ALJ's finding of a "mild to moderate" mental

    disorder, the hypothetical presented to the ALJ -- which

    effectively described no mental limitation at all -- was at

    odds with the medical evidence and with the ALJ's own

    finding. It may be that claimant's former job could be

    performed by an individual with claimant's "mild to moderate"

    mental impairment. This court is certainly not qualified to

    make that determination nor is it clear why the ALJ was

    entitled to do so in the absence of expert vocational

    testimony. Such was not obtained here and, if there is some

    basis on which the ALJ was justified in disregarding or





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    discounting the medical evidence as to mental disorder, that

    explanation is not set forth in the ALJ' decision.

    Conclusion __________

    For the reasons stated above, the judgment of the

    district court is vacated. We remand this case to the _______

    district court with instructions to remand to the Secretary

    for further proceedings, which may include the taking of

    additional vocational evidence, not inconsistent with this

    opinion.



































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