Chamberlain v. SSA CV-98-029-M 07/08/99 UNITED STATES DISTRICT COURT
DISTRICT OF NEW HAMPSHIRE
Thomas Chamberlain, Plaintiff
v. Civil No. 98-29-M
Kenneth S. Apfel, Commissioner Social Security Administration, Defendant
O R D E R
Pursuant to 42 U.S.C. § 405(g), claimant, Thomas
Chamberlain, moves to reverse the Commissioner's decision denying
his application for Social Security Disability Insurance Benefits
under Title II of the Social Security Act, 42 U.S.C. § 423, and
Supplemental Security Income benefits under Title XVI of the
Social Security Act, 42 U.S.C. § 1381, et seg. (the "Act").
Defendant objects and moves for an order affirming the decision
of the Commissioner.
Factual Background
I. Procedural History.
On January 19, 1995, claimant filed an application for
disability insurance benefits and supplemental security income
under Titles II and XVI of the Act, alleging that he had been
unable to work since August 2, 1994. The Social Security
Administration denied his application initially and on
reconsideration. On August 8, 1995, claimant, his attorney, and a vocational expert appeared before an Administrative Law Judge,
who considered claimant's application de novo. On February 21,
1996, the ALJ issued his order, concluding that although claimant
was unable to perform his past relevant work, he retained the
residual functional capacity to perform a range of medium work.
Administrative transcript, at 20. And, although he concluded
that claimant's ability to secure gainful employment was further
limited by certain non-exertional limitations, the ALJ determined
that he was capable of performing a number of sedentary and light
jobs which exist in substantial numbers in the national economy.
Accordingly, the ALJ concluded that claimant was not disabled, as
that term is defined in the Act, at any time through the date of
his decision.
Claimant then sought review of the ALJ's decision by the
Appeals Council. On December 17, 1997, the Appeals Council
determined that the ALJ's decision was supported by substantial
evidence, thereby rendering it a final decision of the
Commissioner, subject to judicial review. On January 15, 1998,
claimant filed a timely action in this court, asserting that the
ALJ's decision was not supported by substantial evidence and
seeking a judicial determination that he is disabled within the
meaning of the Act. Subseguently, claimant filed a "Motion for
Order Reversing Decision of the Commissioner" (document no. 11).
The Commissioner objected and countered with a "Motion for Order
2 Affirming the Decision of the Commissioner" (document no. 16).
Those cross-motions are pending.
II. Stipulated Facts.
Pursuant to this court's Local Rule 9.1(d), theparties have
submitted a statement of stipulated facts which, because it is
part of the court's record (document no. 15), need not be
recounted in this opinion.
Standard of Review
I . Properly Supported Findings by the ALJ are _____ Entitled to Deference.
Pursuant to 42 U.S.C. § 405(g), the court is empowered "to
enter, upon the pleadings and transcript of the record, a
judgment affirming, modifying, or reversing the decision of the
Secretary [now, the "Commissioner"], with or without remanding
the cause for a rehearing." Factual findings of the Commissioner
are conclusive if supported by substantial evidence. See 42
U.S.C. §§ 405(g), 1383(c)(3); Irlanda Ortiz v. Secretary of
Health and Human Services, 955 F.2d 765, 769 (1st Cir. 1991) .1
Moreover, provided the ALJ's findings are supported by
substantial evidence, the court must sustain those findings even
1 Substantial evidence is "such relevant evidence as a reasonable mind might accept as adeguate to support a conclusion." Consolidated Edison Co. v. NLRB, 305 U.S. 197, 229 (1938). It is something less than the weight of the evidence, and the possibility of drawing two inconsistent conclusions from the evidence does not prevent an administrative agency's finding from being supported by substantial evidence. Consolo v. Federal Maritime Comm'n., 383 U.S. 607, 620 (1966).
3 when there may also be substantial evidence supporting the
claimant's position. See Gwathnev v. Chater, 104 F.3d 1043, 1045
(8th Cir. 1997) (The court "must consider both evidence that
supports and evidence that detracts from the [Commissioner's]
decision, but [the court] may not reverse merely because
substantial evidence exists for the opposite decision."). See
also Andrews v. Shalala, 53 F.3d 1035, 1039-40 (9th Cir. 1995)
(The court "must uphold the ALJ's decision where the evidence is
susceptible to more than one rational interpretation."); Tsarelka
v. Secretary of Health & Human Services, 842 F.2d 529, 535 (1st
Cir. 1988) ("[W]e must uphold the [Commissioner's] conclusion,
even if the record arguably could justify a different conclusion,
so long as it is supported by substantial evidence.").
In making factual findings, the Commissioner must weigh and
resolve conflicts in the evidence. See Burgos Lopez v. Secretary
of Health & Human Services, 747 F.2d 37, 40 (1st Cir. 1984)
(citing Sitar v. Schweiker, 671 F.2d 19, 22 (1st Cir. 1982)). It
is "the responsibility of the [Commissioner] to determine issues
of credibility and to draw inferences from the record evidence.
Indeed, the resolution of conflicts in the evidence is for the
[Commissioner] not the courts." Irlanda Ortiz, 955 F.2d at 769.
Accordingly, the court will give deference to the ALJ's
credibility determinations, particularly where those
determinations are supported by specific findings. See
Frustaalia v. Secretary of Health & Human Services, 829 F.2d 192,
4 195 (1st Cir. 1987) (citing Da Rosa v. Secretary of Health and
Human Services, 803 F.2d 24, 26 (1st Cir. 1986)).
II. The Parties' Respective Burdens.
An individual seeking Social Security disability benefits is
disabled under the Act if he or she is unable "to engage in any
substantial gainful activity by reason of any medically
determinable physical or mental impairment which can be expected
to result in death or has lasted or can be expected to last for a
continuous period of not less than 12 months." 42 U.S.C.
§ 416(1)(1)(A). See also 42 U.S.C. § 1382c(a)(3). The Act
places a heavy initial burden on the claimant to establish the
existence of a disabling impairment. See Bowen v. Yuckert, 482
U.S. 137, 146-47 (1987); Santiago v. Secretary of Health and
Human Services, 944 F.2d 1, 5 (1st Cir. 1991). To satisfy that
burden, the claimant must prove that his impairment prevents him
from performing his former type of work. See Gray v. Heckler,
760 F.2d 369, 371 (1st Cir. 1985) (citing Goodermote v. Secretary
of Health and Human Services, 690 F.2d 5, 7 (1st Cir. 1982)).
Nevertheless, the claimant is not reguired to establish a doubt-
free claim. The initial burden is satisfied by the usual civil
standard: a "preponderance of the evidence." See Paone v.
Schweiker, 530 F. Supp. 808, 810-11 (D. Mass. 1982).
In assessing a disability claim, the Commissioner considers
objective and subjective factors, including: (1) objective
5 medical facts; (2) the claimant's subjective claims of pain and
disability as supported by the testimony of the claimant or other
witnesses; and (3) the claimant's educational background, age,
and work experience. See, e.g., Avery v. Secretary of Health and
Human Services, 797 F.2d 19, 23 (1st Cir. 1986); Goodermote, 690
F.2d at 6. Provided the claimant has shown an inability to
perform his previous work, the burden shifts to the Commissioner
to show that there are other jobs in the national economy that he
can perform. See Vazquez v. Secretary of Health and Human
Services, 683 F.2d 1, 2 (1st Cir. 1982). If the Commissioner
shows the existence of other jobs which the claimant can perform,
then the overall burden to demonstrate disability remains with
the claimant. See Hernandez v. Weinberger, 493 F.2d 1120, 1123
(1st Cir. 1974); Benko v. Schweiker, 551 F. Supp. 698, 701
(D.N.H. 1982) .
When determining whether a claimant is disabled, the ALJ is
reguired to make the following five inguiries:
(1) whether the claimant is engaged in substantial gainful activity;
(2) whether the claimant has a severe impairment;
(3) whether the impairment meets or eguals a listed impairment;
(4) whether the impairment prevents the claimant from performing past relevant work; and
(5) whether the impairment prevents the claimant from doing any other work.
6 20 C.F.R. § 404.1520. See also 20 C.F.R. § 416.902. Ultimately,
a claimant is disabled only if his:
physical or mental impairment or impairments are of such severity that he is not only unable to do his previous work but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy, regardless of whether such work exists in the immediate area in which he lives, or whether a specific job vacancy exists for him, or whether he would be hired if he applied for work.
42 U.S.C. § 423(d)(2)(A). See also 42 U.S.C. § 1382c(a)(3)(B).
With those principles in mind, the court reviews claimant's
motion to reverse and the Commissioner's motion to affirm his
decision.
Discussion
I. Background - The ALJ's Findings.
In concluding that Mr. Chamberlain was not disabled within
the meaning of the Act, the ALJ properly employed the mandatory
five-step seguential evaluation process described in 20 C.F.R. §§
404.1520 and 416.920. Accordingly, he first determined that
claimant had not been engaged in substantial gainful employment
since August 2, 1994. Next, he considered whether any of
claimant's impairments were severe. In that regard, the ALJ
concluded that "the medical evidence shows severe impairments of
7 impaired hearing, anxiety, depression and varicose veins."
Transcript at 17.2
The ALJ also concluded, however, that claimant's high blood
pressure (which is controlled by medication), his avoidant
personality disorder, low-average intelligence, and history of
tinea versicolor did not impose any substantial work limitations
and were not severe under the Act. Id. Assessing claimant's
impairments, both alone and in combination, the ALJ determined
that "there is no combination of impairments so severe that the
reguirements of any section of the Listings are met and no
condition of medical eguivalence." Id.
Next, the ALJ concluded that claimant is able to perform the
exertional reguirements of at least medium work (which
necessarily includes the finding that claimant could also perform
the exertional reguirements of light and sedentary work). He
also held that claimant's non-exertional limitations imposed only
"a moderate decrease in his ability to complete detailed or
complex work as well as to cope with high-stress work."
Transcript at 18. Conseguently, the ALJ determined that
claimant:
2 It is worth noting that the ALJ's conclusion that claimant's hearing impairment is "sever" is based upon an evaluation of claimant's uncorrected hearing (that is, his ability to hear without the use of a hearing aid). needs a job with little contact with the public and co workers. I find him unable to perform jobs where average production quotas are required or where he is closely supervised. In combination with his hearing impairment, he heeds to have job functions demonstrated one or two times.
Id.
Finally, after considering claimant's residual functional
capacity, including both his exertional and non-exertional
limitations, and relying, at least in part, upon the testimony of
the vocational expert, the ALJ concluded that there is a
substantial number of jobs in the national economy which claimant
is capable of performing. Accordingly, he held that claimant was
not disabled within the meaning of the Act.
II Use of the Grid in Combination with V.E. Testimony.
In light of the ALJ's conclusion that claimant retained the
RFC to perform the exertional requirements of a range of medium
work, the Medical-Vocational Guidelines, 20 C.F.R Part 404,
Subpart P, Appendix 2 (the Grid"), would direct a conclusion that
claimant is not disabled. However, because claimant also suffers
from non-exertional limitations, direct application of the Grid -
which takes into account only exertional limitations - is not
appropriate.
Nevertheless, the Court of Appeals for the First Circuit has
recognized that there are circumstances under which an ALJ may
use the Grid as a "framework for consideration of how much the individual's work capability is further diminished." Ortiz, 890
F.2d at 524 (quoting 20 C.F.R Part 404, Subpart P, Ap p . 2, §
200.00(e)(2)). Here, the ALJ did just that:
Although the claimant's limitations do not allow him to perform the full range of medium work, using the above cited rule as a framework for decision-making there is a significant number of jobs which the claimant can perform.
Transcript at 21.
Additionally, it is important to note that the ALJ did not
simply use the Grid in a vacuum. Instead, he solicited the
expertise of a vocational expert. In presenting his hypothetical
questions to the vocational expert, the ALJ asked her to assume
that an individual suffered from each of the exertional and non-
exertional limitations which, when viewed as a whole, claimant
says render him disabled: (1) an ability to lift no more than 50
pounds occasionally and 25 pounds frequently; (2) an inability to
perform repetitive bending and stooping; (3) an inability to
reach, handle, finger, and feel; (4) an inability to tolerate
environments characterized by dust or chemical fumes; (5) an
inability to work at heights; (6) a moderate decrease in the
ability to perform detailed or complex work; (7) an inability to
have more than limited supervision and contact with the public;
(8) a decreased ability to cope with high stress work; and (9) an
ability to meet only limited production quotas. Those
hypothetical limitations are consistent with claimant's
10 limitations, as disclosed in the medical records as well as
claimant's description of his daily activities and hobbies. They
are also consistent with the ALJ's conclusion that claimant
"requires no regular medical attention; he has not followed
through with suggested medical advice, including securing hearing
aids; and, he requires no significant medications or treatment
modalities for his condition." Transcript at 19.
Notwithstanding those limitations, the vocational expert
testified that there is a substantial number of jobs in the
national economy which an individual with those limitations could
perform. Transcript at 53-80. The ALJ accepted the vocational
expert's testimony and relied upon it in reaching his
determination that claimant was not disabled.
Claimant says that he is incapable of performing any of the
jobs identified by the vocational expert. While the court does
not necessarily agree with claimant's assessment of his ability
to perform many of those jobs, a detailed discussion of
claimant's views on that issue is not necessary. Among other
things, the vocational expert opined, and the ALJ concluded, that
claimant could perform sedentary and light security jobs, which
exist in significant numbers in the national economy. As to that
conclusion, claimant raises two objections.
A. Effect of Claimant's Hearing Impairment.
11 Claimant asserts that his hearing impairment substantially
reduces the number of such jobs he can actually perform. The
vocational expert testified, however, that while the ability to
hear well is important to someone working as a security guard, it
is far less important one working as a surveillance system
monitor. Transcript at 66. Perhaps more importantly, however,
the ALJ could have determined that, although claimant's
uncorrected hearing creates a "severe impairment," that
impairment lends itself to rather simple correction through
amplification. The medical records (see, e.g., transcript at
179-81; 198-99) and plaintiff's own statements regarding his
daily activities (e.g., his use of an audio amplifier on his
television set) support that conclusion. In fact, the ALJ
specifically noted in his decision that claimant has not followed
medical advice he has received regarding the purchase of a
hearing aid. Transcript at 19.
Implicit in any finding of disability is the conclusion that
a claimant's impairment(s) cannot be readily corrected by
reasonable methods of treatment. Accordingly, the pertinent
regulations specifically instruct claimants that "[i]n order to
get benefits, you must follow treatment prescribed by your
physician if this treatment can restore your ability to work."
20 C.F.R §§ 404.1530(a), 416.930(a). Plainly, this regulation is
rooted in reason and logic: a claimant is not disabled if his or
her disabling limitation lends itself to reasonable and readily
12 accessible correction. The pertinent regulations go on to
provide that "[i]f you do not follow the prescribed treatment
without a good reason, we will not find you disabled." 20 C.F.R
§§ 404.1530(b), 416.930 (b). See also Tsarelka, 842 F.2d at 534.
The Court of Appeals for the Tenth Circuit has elaborated
upon those regulations and articulated four factors, each of
which must be present in order for the ALJ to conclude that a
claimant's failure to follow prescribed treatment precludes the
recovery of disability benefits. Although the court of appeals
for this circuit has yet to expressly adopt the Tenth Circuit's
test, it still provides useful guidance. Under that test, a
failure to follow prescribed treatment will preclude a finding of
disability if each of the following factors is present:
(1) the treatment at issue should be expected to restore the claimant's ability to work; (2) the treatment must have been prescribed; (3) the treatment must have been refused; (4) the refusal must have been without justifiable excuse.
Pacheco v. Sullivan, 931 F.2d 695, 697-98 (10th Cir. 1991)
(guoting Teter v. Heckler, 775 F.2d 1104, 1107 (10th Cir. 1985)).
Here, the record certainly supports the conclusion that each
of those four factors was present and the ALJ properly concluded
that claimant's impaired hearing did not limit his ability to
secure gainful employment. First, the medical evidence
establishes that claimant's hearing impairment lends itself to,
13 at a minimum, partial correction through amplification. See
Report of Hamden Moody, Jr., M.D., transcript at 198-99. In a
subsequent letter from Dr. Moody to claimant's attorney. Dr.
Moody explained:
Mr. Chamberlain's audiogram shows a moderate-to-severe volume loss, and on testing the clarity, which is the speech discrimination score, he scores 100% in both ears. This indicates that as long as the volume is increased the hearing clarity should be in the normal range. With the 100% discrimination score this usually indicates that the patient should do well with amplification from hearing aids. . . . Mainly based on this test, the patient should be a good candidate for hearing aids. The only simple solution would be to have the patient get a hearing aid trial and see what the improvement is. However, the tests indicate that he should do well with amplification.
Transcript at 229.
Nothing in the record suggests that amplification would not
likely restore claimant's hearing to the normal range. In fact,
the record shows that each treating expert who expressed an
opinion on the matter informed plaintiff that use of a hearing
aid would likely benefit him substantially. It is equally clear
that, notwithstanding the medical advice that he received,
claimant did not obtain a hearing aid. The only reason suggested
in the record for plaintiff's failure to obtain a hearing aid is
his concern that he could not afford the required batteries. See
Transcript at 53 (claimant testified that he could not afford
batteries for the amplifier he used) and 58 (in posing his
hypothetical to the vocational expert, the ALJ noted that, "The
14 amplification helped him. He just doesn't have the money to buy
batteries."). Absent further evidence suggesting that claimant's
concern about the cost of batteries was a legitimate basis upon
which to rest his refusal to obtain a hearing aid, the court must
view his conduct as "without justifiable excuse."
Additionally, claimant's failure to follow the advice of his
physicians and obtain a hearing aid suggests that his hearing
loss has had little effect on his ability to effectively
communicate with others; if his uncorrected hearing did, in fact,
adversely affect his ability to communicate with others, it is
reasonable to assume that he would have, at a minimum, more fully
explored the possibility of obtaining a hearing aid. His failure
to do so certainly undermines his claim that his impaired hearing
is a factor which substantially limits his ability to secure
gainful employment. See, e.g., Audiologist's report, transcript
at 17 9 ("When speech stimuli were presented at a sensation level
of 40dB, discrimination ability was excellent for both ears.");
Report of Scott Diehl, M.D., transcript at 190 ("Assessment: The
patient can understand spoken language guite easily. It does
reguire one to speak loudly and clearly, but he can [understand]
guite easily.") .
Conseguently, to the extent that the positions of security
guard and/or surveillance system monitor actually demand auditory
acuity, the ALJ could have reasonably concluded that claimant was
15 capable of performing those jobs. He certainly could have
concluded that plaintiff could (and probably should) have heeded
the advice of treating experts and, at a minimum, explored the
possibility of acguiring a hearing aid, which the medical
evidence of record suggests would have enabled him to perform
those jobs without any problem. See transcript at 58 (in his
hypothetical to the vocational expert, the ALJ assumed that
claimant would acguire and use a hearing aid and, therefore,
decreased capacity to hear was not a factor which he asked the
vocational expert to assume).
B. Claimant's Inability to Handle Stress.
Claimant also asserts that the ALJ failed to adeguately
account for his claims that he cannot handle stressful situations
and suffers periodic episodes of anxiety attacks. The court
disagrees. In his hypothetical, the ALJ adeguately accounted for
those factors by describing an individual who must have limited
contact with the public and whose work would not involve
substantial production guotas, complex assembly tasks, or close
supervision. Based upon the evidence presented by claimant
relating to his low tolerance for stress and his anxiety attacks,
the ALJ's hypothetical was more than adeguate.
Although he claims that the interaction of his inability to
cope with stressful situations and his anxiety attacks renders
him disabled, plaintiff produced little evidence describing the
16 nature of those impairments. When asked by examining experts, he
could provide little insight into what triggered his anxiety
attacks, nor could he describe what caused him to perceive
stress. See, e.g.. Report of James Claiborn, Ph.D., transcript
at 194. All claimant could say was that he had difficulty
meeting demanding production guotas at his last job and, since
leaving that job, concerns over obtaining future employment
caused him anxiety. With little information to guide him in that
regard, the ALJ posed a reasonable hypothetical to the vocational
expert which was properly based (to the extent possible) on the
facts of record concerning claimant's limitations.
Stated somewhat differently, it is not enough for a claimant
to simply say that he is unable to tolerate stressful situations
and suffers from freguent anxiety attacks without elaboration and
then challenge as insufficient an ALJ's hypothetical which
attempts, to the extent possible based upon the limited record,
to account for those limitations. Nor can such a claimant
reasonably claim that the ALJ failed to fully develop the factual
record, when it is clear that plaintiff himself was unable to
describe the circumstances or situations which precipitated his
anxiety attacks. And, if claimant had additional (and previously
undisclosed) evidence or testimony concerning the nature or
debilitating effects of those limitations or the circumstances
that precipitated his anxiety attacks, the time to present it was
at the hearing, when the ALJ (or claimant's counsel) would have
17 had the opportunity to fashion an appropriately detailed
hypothetical.
Conclusion
At step five of the sequential analysis, the Commissioner
bore the burden of proving that there were jobs in the national
economy which claimant was capable of performing. He carried
that burden. Accordingly, claimant's motion to reverse the
decision of the Commissioner (document no. 11) is denied, and the
Commissioner's motion to affirm his decision (document no. 16) is
granted. The Clerk of the Court shall enter judgment in favor of
the Commissioner and close the case.
SO ORDERED.
Steven J. McAuliffe United States District Judge
July 8, 1999
cc: Raymond J. Kelly, Esq. David L. Broderick, Esq.