Perez v. Shalala

890 F. Supp. 218, 1995 U.S. Dist. LEXIS 4518, 1995 WL 367092
CourtDistrict Court, S.D. New York
DecidedApril 7, 1995
Docket93 Civ. 7262 (JFK)
StatusPublished
Cited by3 cases

This text of 890 F. Supp. 218 (Perez v. Shalala) is published on Counsel Stack Legal Research, covering District Court, S.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Perez v. Shalala, 890 F. Supp. 218, 1995 U.S. Dist. LEXIS 4518, 1995 WL 367092 (S.D.N.Y. 1995).

Opinion

OPINION AND ORDER

KEENAN, District Judge:

Before the Court is Plaintiffs motion for judgment on the pleadings, pursuant to 42 U.S.C. sections 405(g) and 1383(e)(3) of the Social Security Act (the “Act”), to reverse the administrative decision of the Secretary of Health and Human Services, or in the alternative, to remand the case to the Secretary for further evidentiary proceedings. Also before the Court is defendant’s cross-motion for judgment on the pleadings affirming the Secretary’s decision and dismissing the complaint. For the reasons that follow, Plaintiffs motion for judgment on the pleadings is denied. Defendant’s cross-motion is granted.

BACKGROUND

A. Current Status of Case

Plaintiff Ramona Perez, now 49 years of age, is appealing a decision by the Secretary of Health and Human Services (“Secretary”), that partially granted Plaintiffs application for Social Security Income (“SSI”) under Title XVI and Social Security Disability (“SSD”) under Title II of the Social Security Act. Plaintiff initially applied for disability insurance on March 15, 1990. That application was denied on May 29, 1990. After that denial Plaintiff sought no additional administrative review. Plaintiff then filed for SSD and SSI benefits on October 11, 1991 which were both denied initially and on reconsideration. Subsequently, Plaintiff requested a hearing to review the applications which was held on December 16, 1992 before an Administrative Law Judge (“ALJ”).

On January 28, 1993 the ALJ determined that as of February 13, 1992, Plaintiff was under a disability as defined in 20 C.F.R. sections 404.1520(f) and 416.920(f) of the Social Security Act for the purpose of receiving SSI benefits, but that Plaintiff was not disabled prior to that date. Consequently, the ALJ determined that Plaintiff is not entitled to receive SSD benefits because she was not disabled on or prior to December 31, 1989, the date on which her insured status expired.

In order to receive SSD, Plaintiff must prove she was disabled on or prior to December 31, 1989, the expiration date of her last insured status. See Arnone v. Bowen, 882 F.2d 34, 38 (2d Cir.1989). Plaintiff may not use evidence of a disability that developed after the expiration date in order to qualify for benefits. 1 However, qualification for SSI benefits is not related to the date of her last insurance, but will not be granted for any months prior to October 1991, the month in which she filed her application. See 20 C.F.R. §§ 416.330 and 416.355. The Appeals Council rejected Plaintiffs request for review on August 13,1993. Upon that rejection, the ALJ’s decision became the final decision of the Secretary and therefore this action is ripe for review.

B. Medical Evidence Prior to February 13, 1992

The only medical evidence presented to the ALJ for the period prior to December 31, 1991 was a report from Plaintiffs treating physician Dr. Andre Celestin dated May 16, 1990, covering the period of January 17,1988 through March 19, 1990. The report indicated that during that period Dr. Celestin saw Plaintiff eleven times for arthritis of the *221 knees. He noted that Plaintiff had tenderness in the knees, but no heat or effusion; that she had a normal range of bilateral motion; and that her gait and station were completely normal, thus precluding assistance of an orthotic device. Dr. Celestin also acknowledged that Plaintiffs arthritic pain was aggravated by her weight gain from 176 pounds to 190 pounds which occurred between January of 1988 and May of 1990.

Plaintiff also underwent a series of three tests, including a CAT scan, from February 26, 1991 to August 26, 1991 ordered by Dr. Raphael P. Gonzalez. 2 The CAT scan dated February 25, 1991 showed good visualization of the vertebral bodies which were all within normal limits. All other discs were normal except for a right sided disc herniation at disc level C4-5.

On August 24, 1991 an MRI indicated that there were minimal centrally bulging discs at the levels of C4-5, C5-6 and C6-7. There was no evidence of frank disc herniation, nerve root impingement, spinal stenosis, fracture, dislocation, neoplasm, inflammatory disease, hematoma, white matter plaque or congenital abnormality. The cervical spinal cord was also intact. The final test, an MRI dated August 26, 1991, found disc degeneration at the disc levels of T12-L1, Ll-2, L3-4, L4-5 and L5-S1. All other evidence indicated no abnormalities.

C. Medical Evidence After February 12, 1992

On February 20,1992 Dr. Agustín Sanchez reported that he examined Plaintiff on February 13, 1992 for complaints of cervical thorax and lower back pain, right hand numbness and decreased strength. Dr. Sanchez found that she had knee flexion-extension of 110 degrees on the right and 120 degrees on the left out of 120 degrees. Lateral flexion of her cervical spine was ten degrees to the right and fifteen to the left out of a possible forty-five degrees. Flexion of Plaintiffs cervical region was thirty degrees and extension was forty-five degrees out of forty-five degrees. Plaintiffs rotation of the cervical region was thirty degrees to the right and thirty-five degrees to the left out of forty-five degrees. Dr. Sanchez found Plaintiffs flex-ion-extension of the lumbar region was sixty degrees out of ninety degrees, and lateral flexion was ten degrees on the right and fifteen degrees on the left out of a possible thirty degrees. Dr. Sanchez concluded that Plaintiff was limited to occasionally carrying less than five pounds and frequently carrying less than two pounds. Plaintiff was unable to stand or walk for over two hours per day and to sit less than six hours per day. Finally, Dr. Sanchez found she had limited ability to push and pull. He prescribed Naprosyn, ultrasound treatments and hot pack treatments.

On May 1, 1992, Plaintiff was examined by Dr. Mario Mancheno who found she walked with a limp, favoring the left lower extremity with a cane. He observed that despite some difficulty in toe-heel walking, she did not need assistance of a cane. She had no difficulty getting on the examination table or lying down. An examination of her neck revealed some tenderness from C4-7 and mild paraspinal muscle spasm bilaterally. She had no gross deformity, and could flex 20 degrees, extend to 20 degrees, bend laterally to thirty-five degrees on each side and rotate to thirty degrees on each side. An examination of Plaintiffs upper extremities revealed full range of motion in both hands and no impairment of fine manipulation. Tests of her lower extremities revealed full range of motion in her hips with negative straight leg raises bilaterally. She had scars of arthroscopic surgery on her left knee with slight stiffness but no acute inflammation.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Cite This Page — Counsel Stack

Bluebook (online)
890 F. Supp. 218, 1995 U.S. Dist. LEXIS 4518, 1995 WL 367092, Counsel Stack Legal Research, https://law.counselstack.com/opinion/perez-v-shalala-nysd-1995.