Kalar v. SSA CV-95-330-B 05/16/96
UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW HAMPSHIRE
Janet M. Kalar
v. Civil No. 95-330-B
Shirley S. Chater, Commissioner of Social Security
O R D E R
Janet Kalar appeals the Commissioner's decision denying her
application for disability insurance benefits and asks that her
case be remanded for further proceedings. She contends that the
Administrative Law Judge ("ALJ") improperly determined that she
could return to her former work and that new and material
evidence exists which would change the outcome of her
application. For the reasons that follow, I reverse the
Commissioner's decision and remand for further proceedings.
I. BACKGROUND
Janet Kalar filed an application for disability insurance
benefits on October 14, 1993, on the grounds that her asthma had
prevented her from working since July 24, 1991. Her medical records show that in addition to her chronic asthma, she has
experienced a variety of other ailments requiring medical
attention including carpal tunnel syndrome affecting both hands.
Kalar's medical records from a visit to Frisbie Memorial
Hospital in January 1992 confirm her history of asthma and list
her medications as Albuterol, Intal, and Azmacort. In November
1992, her treating physician, Paul Friedrichs, wrote that he had
treated Kalar for asthma since early 1990 and that she required
daily medications, including nebulized medication (medication
administered through an atomizer). He stated that she takes
medications three or four times per day and that the medication
regime would add fifteen minutes to her preparation time before
work each morning. Dr. Friedrichs examined Kalar in June 1993
due to complaints of swollen glands, and Kalar reported that her
asthma was under good control. Similarly, when Dr. Friedrichs
saw her in January 1994 for a chest cold and impetigo on her
wrist, he determined that her asthma was stable.
Dr. Homer Lawrence reviewed Kalar's medical records and
assessed the severity of her impairments for the Disability
Determination Program in January 1994. He found that Kalar had
no exertional or postural limitations that would restrict her
work capacity but that her work environment could not include
2 fumes, odors, dust, gas, or poor ventilation. Dr. A. C. Campbell
reviewed Kalar's records in March 1994 and determined that Kalar
could lift and carry ten pounds frequently and twenty pounds
occasionally, and that she could stand, walk or sit for about six
hours in an eight hour day. He also included the environmental
limitations identified by Dr. Lawrence. Dr. Campbell concluded
that Kalar had a residual functional capacity ("RFC") for light
work with the noted environmental limitations.
Kalar was treated in April and May 1994 at the Lahey Clinic
for allergies. At that time, her chief complaints were asthma,
aching muscles, swelling with hives, swollen glands, and
headaches. She underwent a Pulmonary Function Test that was
interpreted to indicate "mild obstructive disease cannot rule out
restrictive disease." Her chest x-ray showed her lungs to be
clear.
Kalar complained of numbness in her hands and feet, an
aching right shoulder, and difficulty in holding her arms up
during her April 1994 neurology examination at the Lahey Clinic.
Her neurological examination was normal, and the recorded
impression was that she had symptoms without neurological
findings. An electromyogram on May 16, 1994, revealed moderately
severe bilateral carpal tunnel syndrome which causes burning or
3 tingling pain in the fingers and hands sometimes extending to the
elbows.
Kalar was treated in June 1994 by Dr. David J. Bryan, a hand
surgeon, for carpal tunnel syndrome. She reported numbness and
tingling in both hands and all fingers for the past two years,
intermittent bluish discoloration of her right hand in the past
six months, and some swelling in her arms and legs. From the
examination and the results of her previous testing. Dr. Bryan
concluded that Kalar had bilateral carpal syndrome, right greater
than left, that the pain in her arms was probably causalgia
caused by an injury to the peripheral nerve. He recommended
conservative treatment of her carpal tunnel syndrome and
suggested a rheumatology consultation to address her complaints
of hip and knee pain and general muscle soreness.
Dr. Bryan also completed a Medical Assessment of Ability to
Do Work-Related Physical Activities Form limited to an evaluation
of Kalar's hands. He showed no limits on her ability to lift or
carry, but indicated that her handling and feeling ability in her
right hand, more than her left hand, was affected by numbness and
diminished sensation in her fingers caused by neuropathy of the
median nerve. He noted that her impairment was worsened by
temperature extremes and vibrations.
4 Following Dr. Bryan's advice, Kalar underwent a
rheumatological evaluation in August 1994 by Dr. Jonathan Kay.
At that time, she described pain in her right shoulder and muscle
aches in her legs for the previous two years. Dr. Kay's
impression following examination was that Kalar had tendinitis in
her right biceps muscle and bilateral carpal tunnel syndrome but
showed no evidence of rheumatic disease. Kalar saw Dr. Kay again
in October 1994 due to a swelling under her chin. He was unable
to make a specific diagnosis and scheduled a follow-up
examination. Dr. Kay also completed a Medical Assessment of
Ability To Do Work-Related Physical Activities Form dated
November 14, 1994, and indicated no limitations on Kalar's
physical abilities.
At the ALJ hearing on November 14, 1994, Kalar testified
that she was forty-four years old, that she had completed three
years of college, and that she had previously worked as an
accounts payable clerk, a day care worker, a cashier, and an
office manager/executive assistant. She indicated that she was
terminated from her last employment because of her asthma and
that she had looked for work but was not hired for the same
reason. She explained that she used a nebulizer machine three to
four times each day to push the asthma medication into her lungs
5 and that each use lasted ten to fifteen minutes. She stated that
she had asthma attacks once or twice each day and that things in
the environment, such as chemicals, perfumes, and cigarette
odors, bothered her.
Kalar also testified that she had problems with her arms
which interfered with gripping things. She explained that when
she did bookkeeping, she constantly used calculators, adding
machines, and computers, and that she could no longer perform the
necessary fine manipulations with her hands. She explained that
her hands got tired too easily and developed "pins and needles"
so that she had to shake them and rest to restore circulation.
She also stated that she had muscle and back problems and that
her legs were useless for walking.
A vocational expert ("VE") also testified at the hearing.
The ALJ posed a hypothetical to the VE describing Kalar's age,
education, and past work experience, and the exertional
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Kalar v. SSA CV-95-330-B 05/16/96
UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW HAMPSHIRE
Janet M. Kalar
v. Civil No. 95-330-B
Shirley S. Chater, Commissioner of Social Security
O R D E R
Janet Kalar appeals the Commissioner's decision denying her
application for disability insurance benefits and asks that her
case be remanded for further proceedings. She contends that the
Administrative Law Judge ("ALJ") improperly determined that she
could return to her former work and that new and material
evidence exists which would change the outcome of her
application. For the reasons that follow, I reverse the
Commissioner's decision and remand for further proceedings.
I. BACKGROUND
Janet Kalar filed an application for disability insurance
benefits on October 14, 1993, on the grounds that her asthma had
prevented her from working since July 24, 1991. Her medical records show that in addition to her chronic asthma, she has
experienced a variety of other ailments requiring medical
attention including carpal tunnel syndrome affecting both hands.
Kalar's medical records from a visit to Frisbie Memorial
Hospital in January 1992 confirm her history of asthma and list
her medications as Albuterol, Intal, and Azmacort. In November
1992, her treating physician, Paul Friedrichs, wrote that he had
treated Kalar for asthma since early 1990 and that she required
daily medications, including nebulized medication (medication
administered through an atomizer). He stated that she takes
medications three or four times per day and that the medication
regime would add fifteen minutes to her preparation time before
work each morning. Dr. Friedrichs examined Kalar in June 1993
due to complaints of swollen glands, and Kalar reported that her
asthma was under good control. Similarly, when Dr. Friedrichs
saw her in January 1994 for a chest cold and impetigo on her
wrist, he determined that her asthma was stable.
Dr. Homer Lawrence reviewed Kalar's medical records and
assessed the severity of her impairments for the Disability
Determination Program in January 1994. He found that Kalar had
no exertional or postural limitations that would restrict her
work capacity but that her work environment could not include
2 fumes, odors, dust, gas, or poor ventilation. Dr. A. C. Campbell
reviewed Kalar's records in March 1994 and determined that Kalar
could lift and carry ten pounds frequently and twenty pounds
occasionally, and that she could stand, walk or sit for about six
hours in an eight hour day. He also included the environmental
limitations identified by Dr. Lawrence. Dr. Campbell concluded
that Kalar had a residual functional capacity ("RFC") for light
work with the noted environmental limitations.
Kalar was treated in April and May 1994 at the Lahey Clinic
for allergies. At that time, her chief complaints were asthma,
aching muscles, swelling with hives, swollen glands, and
headaches. She underwent a Pulmonary Function Test that was
interpreted to indicate "mild obstructive disease cannot rule out
restrictive disease." Her chest x-ray showed her lungs to be
clear.
Kalar complained of numbness in her hands and feet, an
aching right shoulder, and difficulty in holding her arms up
during her April 1994 neurology examination at the Lahey Clinic.
Her neurological examination was normal, and the recorded
impression was that she had symptoms without neurological
findings. An electromyogram on May 16, 1994, revealed moderately
severe bilateral carpal tunnel syndrome which causes burning or
3 tingling pain in the fingers and hands sometimes extending to the
elbows.
Kalar was treated in June 1994 by Dr. David J. Bryan, a hand
surgeon, for carpal tunnel syndrome. She reported numbness and
tingling in both hands and all fingers for the past two years,
intermittent bluish discoloration of her right hand in the past
six months, and some swelling in her arms and legs. From the
examination and the results of her previous testing. Dr. Bryan
concluded that Kalar had bilateral carpal syndrome, right greater
than left, that the pain in her arms was probably causalgia
caused by an injury to the peripheral nerve. He recommended
conservative treatment of her carpal tunnel syndrome and
suggested a rheumatology consultation to address her complaints
of hip and knee pain and general muscle soreness.
Dr. Bryan also completed a Medical Assessment of Ability to
Do Work-Related Physical Activities Form limited to an evaluation
of Kalar's hands. He showed no limits on her ability to lift or
carry, but indicated that her handling and feeling ability in her
right hand, more than her left hand, was affected by numbness and
diminished sensation in her fingers caused by neuropathy of the
median nerve. He noted that her impairment was worsened by
temperature extremes and vibrations.
4 Following Dr. Bryan's advice, Kalar underwent a
rheumatological evaluation in August 1994 by Dr. Jonathan Kay.
At that time, she described pain in her right shoulder and muscle
aches in her legs for the previous two years. Dr. Kay's
impression following examination was that Kalar had tendinitis in
her right biceps muscle and bilateral carpal tunnel syndrome but
showed no evidence of rheumatic disease. Kalar saw Dr. Kay again
in October 1994 due to a swelling under her chin. He was unable
to make a specific diagnosis and scheduled a follow-up
examination. Dr. Kay also completed a Medical Assessment of
Ability To Do Work-Related Physical Activities Form dated
November 14, 1994, and indicated no limitations on Kalar's
physical abilities.
At the ALJ hearing on November 14, 1994, Kalar testified
that she was forty-four years old, that she had completed three
years of college, and that she had previously worked as an
accounts payable clerk, a day care worker, a cashier, and an
office manager/executive assistant. She indicated that she was
terminated from her last employment because of her asthma and
that she had looked for work but was not hired for the same
reason. She explained that she used a nebulizer machine three to
four times each day to push the asthma medication into her lungs
5 and that each use lasted ten to fifteen minutes. She stated that
she had asthma attacks once or twice each day and that things in
the environment, such as chemicals, perfumes, and cigarette
odors, bothered her.
Kalar also testified that she had problems with her arms
which interfered with gripping things. She explained that when
she did bookkeeping, she constantly used calculators, adding
machines, and computers, and that she could no longer perform the
necessary fine manipulations with her hands. She explained that
her hands got tired too easily and developed "pins and needles"
so that she had to shake them and rest to restore circulation.
She also stated that she had muscle and back problems and that
her legs were useless for walking.
A vocational expert ("VE") also testified at the hearing.
The ALJ posed a hypothetical to the VE describing Kalar's age,
education, and past work experience, and the exertional
limitations indicated in the RFCs in the record and from Kalar's
testimony. Specifically, the hypothetical claimant was
restricted from doing "fine-finger hand tasks." The vocational
expert testified that based on the limitations posed by the ALJ,
the hypothetical claimant could return to work as an accounting
clerk because the necessary keyboard work was repetitive but did
6 not require fine-fingered manipulation. When the ALJ modified
the hypothetical to preclude any work with keyboards, the VE
testified that the hypothetical claimant could not work as an
accounting clerk. The ALJ then asked if there was other work
that Kalar could do, and the VE testified that she could work as
a surveillance monitor, a sedentary unskilled job, and that
52,987 of those positions existed in the national economy.
The ALJ issued his opinion on February 6, 1995, in which he
determined that the medical evidence supported Kalar's
impairments of lumbosacral strain, median neuropathy, bilateral
carpal tunnel syndrome, bilateral biceps tendinitis, and asthma.
He concluded, however, that her subjective complaints of pain and
other restrictions were not credible and that she was not
disabled from her past work as an accounting clerk by her
limitations. Therefore, he denied her benefits at the fourth
step of the sequential analysis.
Kalar then appealed the ALJ's decision to the Appeals
Council and submitted additional evidence. The Appeals Council
declined her request for review, and she then filed her appeal
here.
7 II. STANDARD OF REVIEW
After a final determination by the Commissioner and upon
request by a party, this court is authorized to review the
pleadings and the transcript of the record of the proceeding, and
enter a judgment affirming, modifying, or reversing the decision.
42 U.S.C.A. § 405(g) (West Supp. 1995). The court's review is
limited in scope, however, as the Commissioner's factual findings
are conclusive if they are supported by substantial evidence.
Id.; Irlanda Ortiz v. Secretary of Health & Human Servs., 955
F.2d 765, 769 (1st Cir. 1991). The Commissioner is responsible
for settling credibility issues, drawing inferences from the
record evidence, and resolving conflicting evidence. Id.
Therefore, the court must "'uphold the [Commissioner's] findings
. . . if a reasonable mind, reviewing the evidence in the record
as a whole, could accept it as adequate to support [the
Commissioner's] conclusion.'" Id. (quoting Rodriquez v.
Secretary of Health & Human Servs., 647 F.2d 218, 222 (1st Cir.
1981). However, if the Commissioner has misapplied the law or
has failed to provide a fair hearing, deference to the
Commissioner's decision is not appropriate, and remand for
further development of the record may be necessary. Carroll v. Secretary of Health & Human Servs., 705 F.2d 638, 644 (2d Cir.
1983). See also Slessinqer v. Secretary of Health & Human
Servs., 835 F.2d 937, 939 (1st Cir. 1987). I review Kalar's
appeal in light of the applicable standard.
III. DISCUSSION
Kalar argues that the record does not include substantial
evidence to support the ALJ's determination that she could return
to her previous work as an accounting clerk. Because I conclude
that remand is necessary on that ground, I do not address the two
additional grounds Kalar raises for remanding her case.
The ALJ concluded at the fourth step of the five step
disability determination analysis,1 that Kalar was not disabled
1 The ALJ is reguired to consider the following five steps when determining if a claimant is disabled: (1) whether the claimant is engaged in substantial gainful activity at the time of the claim; (2) whether the claimant has a severe impairment that has lasted for twelve months or had a severe impairment for a period of twelve months in the past; (3) whether the impairment meets or eguals a listed impairment; (4) whether the impairment prevents or prevented the claimant from performing past relevant work; (5) whether the impairment prevents or prevented the claimant from doing any other work. 20 C.F.R. § 404.1520 (1994) . because she could return to her previous work as an accounting
clerk. At Step Four, the ALJ must determine whether an
impairment, or combination of impairments, prevents the claimant
from performing her past relevant work. 20 C.F.R. § 404.1520(e).
To make the determination, "the ALJ must compare the physical and
mental demands of that past work with current functional
capability." Manso-Pizarro v. Secretary of Health and Human
Servs., 76 F.3d 15, 17 (1st Cir. 1996) (citing 20 C.F.R. §
404.1560(b)). Thus, a decision that a claimant can return to her
past work must be supported by factual findings concerning the
claimant's RFC and the physical and mental demands of the
claimant's previous work. Santiago v. Secretary of Health and
Human Servs., 944 F.2d 1, 5 n.l (1st Cir. 1991); see also SSR 82-
62, 1982 WL 31386 *4.
The initial burden is on the claimant to make a "reasonable
threshold showing that she cannot return to her former employment
because of her alleged disability." Santiago, 944 F.2d at 5;
accord Manso-Pizarro, 76 F.3d at 17. To carry her burden, the
claimant must produce evidence of the physical and mental demands
of her prior work and describe her limitations, indicating how
her current functional capacity precludes her from performing her
prior work. Santiago, 944 F.2d at 5. The ALJ may rely on the
10 claimant's own descriptions of her duties and her functional
limitations. Id. If the claimant can still perform her past
work, as she actually performed it when employed, she is not
disabled. Id. If the ALJ finds that the claimant cannot perform
her actual previous work, however, the claimant nevertheless is
not disabled if she "retains the capacity to perform the
functional demands and job duties of the job as ordinarily
required by employers throughout the national economy." SSR 82-
61, 1982 WL 31387 *2; accord Santiago, 944 F.2d at 5 n.l; Gray v.
Heckler, 760 F.2d 369, 372 (1st Cir. 1985).
Kalar testified at the hearing that she could no longer do
the fine hand manipulations necessary to use calculators, adding
machines, and computers in her job as an accounting clerk. The
VE testified that an accounting clerk job depended upon keyboard
work with repetitive motion and fingering although the job did
not require fine hand manipulations.2 The ALJ found that Kalar's
2 The parties dispute whether a V E 's opinion is appropriate at Step Four. In the second part of the analysis, when the nature of the job as it exists in the national economy is at issue, the ALJ may rely on supplementary or corroborative information from a variety of sources including a V E . See SSR 82-62, 1982 WL 31386 *3; but see Musqrave v. Sullivan, 966 F.2d 1371, 1376 (10th Cir. 1992) (ALJ not obligated to elicit opinion of VE to help claimant meet his burden of proof at Step Four); Smith v. Bowen, 837 F.2d 635, 637 (4th Cir. 1987) (improper to
11 RFC was limited by a variety of restrictions including that "she
cannot perform repetitive reaching and any handling, finqerinq or
feeling" (emphasis added). Nevertheless, the ALJ determined that
although Kalar was disabled from returning to most of her
previous work, she could work as an accounting clerk. The ALJ
did not explain the conflict between his finding that Kalar could
not do any fingering or handling and the record evidence that an
accounting clerk position reguires repetitive fingering and
keyboard work, as the VE testified, or that Kalar's previous
accounting job reguired fine hand manipulations, as she
testified. Nor does the record contain any evidence that would
support a finding that an accounting clerk position does not
reguire fingering, fine hand manipulations, or use of a keyboard.
Therefore, the ALJ's finding that Kalar could return to her job
as an accounting clerk in spite of her inability to perform
repetitive reaching, handling or fingering, is not supported by
substantial evidence.
Because the ALJ's determination at Step Four is not
supported by his factual findings or by substantial evidence in
the record, the decision is reversed. Although the hearing
rely on vocational expert's opinion until a claimant is found unable to do her past relevant work).
12 record includes evidence pertaining to a Step Five evaluation,
the ALJ did not make alternative findings to support a disability
determination at Step Five. Accordingly, the case is remanded to
the Commissioner for further proceedings at Step Four of the
seguential analysis to determine whether Kalar is disabled from
all previous work, and, if necessary, to proceed to Step Five.
CONCLUSION
For the foregoing reasons, the claimant's motion to reverse
(document no. 8) is granted, the government's motion to affirm
(document no. 12) is denied, and the case is remanded to the
Commissioner for further proceedings.
SO ORDERED.
Paul Barbadoro United States District Judge May 16, 1996
cc: Jeffrey A. Schapira, Esg. David L. Broderick, Esg.