Francisco PEREZ TORRES, Plaintiff, Appellant, v. SECRETARY OF HEALTH AND HUMAN SERVICES, Defendant, Appellee

890 F.2d 1251, 1989 U.S. App. LEXIS 18521, 1989 WL 146953
CourtCourt of Appeals for the First Circuit
DecidedSeptember 15, 1989
Docket89-1116
StatusPublished
Cited by46 cases

This text of 890 F.2d 1251 (Francisco PEREZ TORRES, Plaintiff, Appellant, v. SECRETARY OF HEALTH AND HUMAN SERVICES, Defendant, Appellee) is published on Counsel Stack Legal Research, covering Court of Appeals for the First Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Francisco PEREZ TORRES, Plaintiff, Appellant, v. SECRETARY OF HEALTH AND HUMAN SERVICES, Defendant, Appellee, 890 F.2d 1251, 1989 U.S. App. LEXIS 18521, 1989 WL 146953 (1st Cir. 1989).

Opinion

PER CURIAM.

This is an appeal from the denial of social security disability benefits. The district court found that substantial evidence supported the Secretary’s decision, at step five of the sequential evaluation process, that the claimant, Francisco Perez, retained the functional capacity to perform the full range of sedentary work. We affirm.

Perez applied for benefits in March 1986 alleging a disabling leg condition and arthritis. In subsequent submissions, Perez also alleged acute lower back pain and an emotional condition. At the July 1987 hearing Perez testified that he had worked *1252 as a salesman in the men’s clothing department of Sears, Roebuck and Co. for sixteen years until December 1985. Earlier problems with the nerves and tendons of both feet had necessitated foot surgery in 1984. After about seven months of recuperation and therapy, he had returned to Sears for another year before stopping work due to foot pain and leg cramps which prevented him from walking around and standing. He also complained that he could no longer bend and carry, lift or move the merchandise for display. He described his difficulty in walking, the inability to walk or stand for long periods, sitting for long periods was also compromised due to back and neck pain from an automobile accident injury suffered after the operation on his feet. Perez stated that medication relieved but did not eliminate the pain caused by both conditions.

After leaving his job, Perez had a second operation on his left foot in January 1986. In August 1986 he began seeing a psychiatrist, Dr. Rivera Polanco, on a monthly basis for insecurity, nervousness, violent reactiveness and problems at home. His daily activities included watching television and reading the newspapers, limited driving due to leg numbness, and rare social contacts except for seeing cock fights. Perez has a twelfth-grade education and was 46 years old at the time of the hearing.

The medical evidence submitted by Perez falls into two categories: hospitals and State Insurance Fund (SIF) records for the two-year period from May 1984 to April 1986, and reports from four treating and evaluating physicians.

Hospital records document the two foot surgeries in 1984 and 1986. His admitting diagnosis in 1984 was bilateral tarsal tunnel syndrome and hypertension. Upon continued complaints of left foot pain, Perez was admitted for treatment of hallux val-gus and underwent bunion and bunionette excision in January 1986. His prognosis was good upon discharge. These records also show an emergency room visit in May 1985 after a motor vehicle accident. A cervical spine x-ray performed at that time revealed degenerative spondylosis at C4 and C5 vertebrae but no fracture. An April 1986 lumbar spine x-ray was read to show degenerative joint disease. The last hospital report of April 1986 notes claimant’s complaints of left foot and low back pain for which medication was prescribed. Concurrently, Perez was seen at the SIF for a six-month period from October 1985 to April 1986 and, according to his statements, thereafter for the purpose of receiving medication.

Dr. Mendez, a rheumatologist, submitted an August 1986 evaluation which indicated that he had seen Perez once in April 1984 and had referred him for possible foot surgery at that time. Perez’ chief complaints in 1986 were severe pain in both legs and feet which persisted despite rest, physical therapy and medication. At the examination, Perez walked with a stiff, uncertain gait. His mental status was found to be alert, of normal intellect, well-orientated, able to concentrate and with adequate recent and remote memory. Based upon an April 1986 x-ray of the lumbar spine, an electromyograph (E.M.G.) and nerve conduction studies of the lower extremities, Mendez’ final diagnosis was: 1) radiculopa-thy, left leg, SI by E.M.G., 2) degenerative joint disease of the lumbar spine and 3) status post tarsal tunnel syndrome. Regarding treatment for the back condition, Mendez’ records that Perez has been advised to sleep on a firm bed, to promote self-care and to undertake physical therapy. Without comment as to the efficacy of any modality, Mendez also notes that the claimant had been treated with muscle relaxants, analgesics and tranquilizers. Mendez’ assessment of Perez’ functional capacity was that he could not stand, walk or sit for long periods of time and was unable to carry even small loads. The prognosis was poor.

In June 1986 Dr. Llompart evaluated Perez who complained of low back pain, pain in both feet and weakness in both ankles. Dr. Llompart’s orthopedic exam records that Perez walked with a mild degree of low back protection and showed some midline back tenderness, but was otherwise essentially normal. X-rays taken of the lumbar spine, right ankle and left foot *1253 showed slight spurring. Dr. Llompart assessed Perez’ present condition: he should avoid activities that require more than minimal standing or walking; he should not carry or lift more than mild weights; he should climb stairs or bend his back only occasionally.

In September 1987 the claimant was evaluated by Dr. Fontanez, a neurosurgeon. Perez’ chief complaints were pain in both feet, especially the left lower extremity, lumbar pain and difficulty in waist movements. Dr. Fontanez’ exam noted lumbar muscle spasm and tenderness to palpitation, reduced reflex and muscle tone of the left leg and weak hand grasps. In summary, Fontanez diagnosed: myositis, radiculo-pathy, lumbar spondyloarthritis, status post tarsal tunnel release surgery and chronic benign pain. He assessed these conditions to impose a permanent disability to engage in any type of gainful activity.

In August 1986 Perez began seeing Dr. Rivera, a psychiatrist, who completed two mental impairment evidence reports indicating fifteen visits through July 1987. Perez’ chief complaints were feeling anxious, uneasy and unable to sleep well. Dr. Rivera noted an inability to relax, anxiety, recurrent suicidal ideation, a depressed affect, some disorientation, and diminished memory, intellectual function judgment, insight and self-esteem. The diagnosis was severe dysthymic disorder and medication was prescribed. Dr. Rivera noted, however, that Perez did not tolerate medication well, was intensely preoccupied with staying invalid in his two legs and should continue to put muscle tone on both legs. Regarding his ability to function, Rivera found that Perez could not adapt to work stress or concentrate adequately to perform productive labor, that he had difficulty with interpersonal relations and often became irritable, hostile and tearful.

The agency sent Perez to three consulting physicians. Dr. Lugo performed a psychiatric evaluation in October 1986 and offered a clinical diagnosis of dysthymic disorder — moderate depression, for which Perez had received medication with no reported secondary effects. The mental examination revealed logical, coherent and relevant thought content, good contact with reality, adequate mental process, but slight to moderate psychomotor retardation. Perez was found to be oriented in three spheres, with good memory and the ability to concentrate without distraction. His insight, judgment and intellectual functions were intact. Dr. Lugo noted, however, that Perez’ physical condition, to the extent that it worsened, complicated the prognosis which he characterized as very dismal. He recommended neurological and vascular examinations.

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890 F.2d 1251, 1989 U.S. App. LEXIS 18521, 1989 WL 146953, Counsel Stack Legal Research, https://law.counselstack.com/opinion/francisco-perez-torres-plaintiff-appellant-v-secretary-of-health-and-ca1-1989.