Santiago-Santiago v. Secretary of Health & Human Services

756 F. Supp. 74, 1991 U.S. Dist. LEXIS 2007, 1991 WL 19270
CourtDistrict Court, D. Puerto Rico
DecidedFebruary 5, 1991
DocketCiv. No. 90-1440 (JAF)
StatusPublished

This text of 756 F. Supp. 74 (Santiago-Santiago v. Secretary of Health & Human Services) is published on Counsel Stack Legal Research, covering District Court, D. Puerto Rico primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Santiago-Santiago v. Secretary of Health & Human Services, 756 F. Supp. 74, 1991 U.S. Dist. LEXIS 2007, 1991 WL 19270 (prd 1991).

Opinion

REMAND ORDER

FUSTE, District Judge.

This is an action under section 205(g) of the Social Security Act (the “Act”), as amended, 42 U.S.C. § 405(g), to review a final decision of the Secretary of Health and Human Services (the “Secretary”) denying plaintiff’s application for disability benefits. Because we find that the Secretary’s decision is not based on substantial evidence, we REMAND for further proceedings.

Claimant Maria de Jesus Santiago-Santiago filed an application for disability bene[75]*75fits on August 19, 1988, alleging an inability to work since February 15, 1988. The claimant has been insured for purposes of the Act since the alleged onset date, and will continue to meet insured status through at least December 31, 1992. The application was denied initially and on reconsideration. The matter went to an administrative hearing, which resulted in a November 29, 1989 finding of not disabled. The Appeals Council denied the plaintiffs request for review on March 12, 1990, rendering the AU’s determination a final administrative decision ripe for our review.

Discussion

Claimant was born on August 18, 1948. She has a 12th grade education and a relevant past work history as a nurse’s aide. She considers herself to be disabled because of a combination of factors that include a bad back, an injured right hand, and “sinus bradycardia”, a condition which she claims results in biweekly dizzy spells and falls. The AU applied the five-step sequential analysis as prescribed by the Secretary. 20 C.F.R. § 404.1520; Bowen v. Yuckert, 482 U.S. 137, 107 S.Ct. 2287, 96 L.Ed.2d 119 (1987); Goodermote v. Secretary of Health and Human Services, 690 F.2d 5 (1st Cir.1982). We have no quarrel with the AU's disposition of the first four steps. The AU found that the claimant has not been employed since the alleged onset date (step one); that the claimant has a severe degenerative joint disease, a moderate impairment in fingering and handling in her right hand, and a mild limitation in bending (step two); but that no combination of her impairments is listed or medically equivalent to the conditions listed in Appendix 1, Subpt. P, 20 C.F.R. Part 404 (step three); and that exertional limitations alone would preclude the claimant’s ability to perform her past relevant work (step four).

In his analysis, the AU found that the claimant’s exertional limitations limited her Residual Functional Capacity (RFC) to light work, defined as the ability to work except for walking or standing for more than six hours in an eight hour day, lifting or carrying over 20 pounds at a time, with frequent lifting and carrying of objects weighing up to 10 pounds. 20 C.F.R. § 404.1567.

The AU’s findings as to claimant’s back condition is fully supported in the record. The degenerative joint disease in the back results in some limitation in movement of the spine, which limits the claimant’s ability to engage in certain postural activities such as climbing or stooping (Tr. 154). One diagnosis was of L5 root lesion (Tr. 151). Another generally described a lumbosacral strain (Tr. 115). One radiographic report of the lumbosacral spine indicated only minimal changes (Tr. 145). Another showed no evidence of osseous or joint pathology (Tr. 137). Two RFC’s were filed, both agreeing that claimant had some limitations due to her conditions, but that as to her ability to stand/walk, and lift/carry, she retained the capacity to perform light work.

Presumably on that basis, the AU found that the claimant could perform the full range of light work. This conclusion is unsupported by the very RFC’s themselves, in that it fails to account for the specific effect that claimant’s hand limitations would have on certain types of light work.

Hand Injury

Plaintiff’s right hand limitations are well documented in the file (Tr. 102, 126, 129, 142). The condition, right ulnar nerve palsy (Tr. 142), the result of a childhood accident, results in a contraction of the 4-5 fingers. Claimant testified, and the medical record shows, that she can only stretch these fingers out by applying force (Tr. 141). Her treating physician described the condition as a “paralysis of RT ulnar and ulnar side of the RT hand” (Tr. 127). Claimant testified, and the record supports the point, that the injury results in weakness in the right hand (Tr. 141). The hand is atrophied (Tr. 102). Residual weakness from the nerve damage is described (Tr. 151).

Both RFC’s in the record specifically refer to claimant’s right-hand condition as providing a significant limitation on certain types of handling and fingering. The RFC [76]*76filed by Dr. Marxuach states that there is “major loss of function [illegible] moderate impairment for handling & fingering” (Tr. 93). A second RFC concurs in this assessment (Tr. 98).

The record clearly describes an individual whose manual dexterity in her right hand is significantly limited. The ALJ himself refers to the “moderate impairment” in fingering and handling (Tr. 14). Despite all that, the ALJ determines that the claimant retains the capacity to perform sustained gainful employment as a “garment folder”, “sorter turner”, or “garment bagger”.

We do not believe that merely because Social Security cases involve a forest of regulations, reams of medical data, and the solemn testimony of esteemed experts, we are obliged to dispense with common sense. A person who must use her left hand to open the fingers of her right hand cannot be expected to perform work the very essence of which requires bilateral manual dexterity. The Secretary’s own regulations specifically state that a permanent injury of the right hand may limit the range of work to jobs where bilateral manual dexterity is not necessary. 20 C.F.R. Part 404, Subpt. P, App. 2, § 201.00(h) (forbidding use of GRID where hand injury limits work capacity even within “sedentary” range). All three jobs suggested by the vocational expert in this case are described in his testimony (Tr. 43-44). All three are performed at work tables, and all three seem to us to require the use of both hands. We do not need an expert to tell us that an employer who hires a “garment folder” will require that person to make multiple, accurate, uniform folds at a very high rate of speed for hours at a stretch.

We do note that the vocational expert did not ignore the hand condition completely in his testimony. He considered it relevant when opining that the claimant could not perform her prior relevant work, due to its effect on her ability to lift. However, he makes no reference to the hand in his assessment of the three jobs that he says claimant could perform. We do not think the finding of suitability for these highly hand-oriented jobs is saved by the passing observation by the vocational expert that the claimant was able to use her right hand to “pinch” with her thumb and index fingers.

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756 F. Supp. 74, 1991 U.S. Dist. LEXIS 2007, 1991 WL 19270, Counsel Stack Legal Research, https://law.counselstack.com/opinion/santiago-santiago-v-secretary-of-health-human-services-prd-1991.