March 13, 1995 [NOT FOR PUBLICATION]
UNITED STATES COURT OF APPEALS
FOR THE FIRST CIRCUIT
No. 94-1618
MILAGROS SOSA,
Plaintiff, Appellant,
v.
SECRETARY OF HEALTH AND HUMAN SERVICES,
Defendant, Appellee.
APPEAL FROM THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF PUERTO RICO
[Hon. Hector M. Laffitte, U.S. District Judge]
Before
Selya, Circuit Judge,
Campbell, Senior Circuit Judge, and
Boudin, Circuit Judge.
Aurelio Saliva Mattei on brief for appellant.
Guillermo Gil, United States Attorney, Maria Hortensia Rios,
Assistant United States Attorney, and Nancy B. Salafia, Assistant
Regional Counsel, Department of Health and Human Services, on brief
for appellee.
Per Curiam. Milagros Sosa (claimant) appeals from a
district court judgment affirming the decision of the
Secretary of Health and Human Services to deny her
application for disability benefits. For the reasons
outlined below (and enumerated at greater length in the
magistrate-judge's report), we find substantial evidence in
support of the Secretary's decision and therefore affirm.
Claimant is a married, 38-year-old mother of two who was
employed as a bank teller and loan clerk until December
1987. She alleges that she has been disabled since that
date due to the following series of ailments: (1) vascular
insufficiency and thrombophlebitis of the legs; (2) painful
fibromyositis and arthritis of the back; (3) vertigo; and
(4) nervous depression. Following a hearing, the
administrative law judge (ALJ) found that claimant's leg
condition, while restricting her ability to stand for
extended periods and thus precluding a return to her past
job, did not prevent her from performing sedentary work. In
turn, the ALJ determined that claimant's remaining ailments
imposed only minimal functional restrictions, such that her
ability to perform the full range of sedentary work was not
significantly compromised. Applying Rule 201.29 of the
Grid, see 20 C.F.R. Part 404, Subpart P, App. 2, the ALJ
reached a finding of not disabled. Claimant now argues that
such findings were unsupported by substantial evidence and,
more specifically, that it was error not to hear from a
vocational expert. We disagree.
Abundant record evidence supports the conclusion that the
exertional restrictions imposed by claimant's leg condition
did not preclude performance of sedentary work.1 Claimant
has had two episodes of thrombophlebitis2: in February 1987
(three weeks after the birth of her first child) and again
in September 1988 (in the midst of her second pregnancy).
Both episodes were successfully treated over a period of
days. Otherwise, she has suffered from chronic venous
insufficiency with recurrent edema3 and pain (consistent
with a post-phlebitic syndrome)--for which medication and
the use of elastic socks have been prescribed. The
physician who treated claimant between January and July 1988
(Dr. Munoz) specifically reported that she was capable of
sedentary activity, identifying her only functional
limitation as an inability to stand or walk for extended
periods. Much of the other evidence was to the same effect.
For example, a neurologist (Dr. Scarano Garcia) in August
1988 described claimant's ability to walk on heels or toes
1. Sedentary work involves lifting no more than ten pounds
at a time and "occasional" walking and standing. 20 C.F.R.
404.1567(a).
2. Thrombophlebitis is the inflammation of a vein associated
with blood clot formation.
3. Venous insufficiency involves the inadequate drainage of
venous blood. Edema is the accumulation of excessive fluid
in cells or tissues.
-3-
as being within normal limits. In December 1988, three
months after claimant's second bout of thrombophlebitis, a
non-examining physician (Dr. Arzola) completed a residual
functional capacity assessment noting only minor limitations
in this regard. And in October 1989, a vascular surgeon
(Dr. Ramirez Ferrer) found some swelling in claimant's legs
but no other complications. Notwithstanding the contrary
indications in the record,4 such evidence provides ample
support for the ALJ's conclusion.
In turn, we think the ALJ was warranted in finding that
the functional restrictions imposed by claimant's remaining
ailments were minimal. As to her complaints of back pain,
the ALJ found that claimant suffered from impairments
capable of producing pain, but then proceeded to discount
the severity of those complaints. The record reveals that
claimant experienced a back sprain in 1982, for which she
received physical therapy and was awarded a five percent
state disability. More recently, claimant was treated for
pain in the right shoulder in February 1988. Raising of the
arm was found to cause suppression of the subclavian artery,
but neurological testing was otherwise normal; the treating
4. Most notable among these was the evaluation of one
treating physician (Dr. Quinones Soto), who in December 1987
recommended bed rest for six months and, in April 1988,
reported that claimant was totally disabled. He stopped
treating claimant in December 1987, however, giving way to
Dr. Munoz. As mentioned, the latter described a more benign
condition.
-4-
physical therapist (Dr. Oms) reported an impression of
fibromyositis. Similarly, in August 1988, a neurologist
(Dr. Rodriguez Del Valle) diagnosed a painful syndrome in
the cervical and dorsal region, of unknown origin, when the
right arm was raised. Nonetheless, muscle strength,
reflexes and sensibility were all within normal limits.
That same month, another neurologist (Dr. Scarano Garcia)
reported normal range of motion in the cervical, thoracic
and lumbar regions, along with normal muscle tone in all
extremities. On the basis of such evidence, and on the
basis of his questioning of claimant in accordance with
Avery v. Secretary of HHS, 797 F.2d 19 (1st Cir. 1986), the
ALJ justifiably concluded that most of her pain was
effectively controlled through therapy and medication. And
any residual limitation on claimant's ability to raise her
right arm over her head would have little bearing on her
capacity to perform sedentary work.
Claimant first complained of vertigo in July 1988, during
the middle of her second pregnancy. Following a brief
hospitalization therefor (as well as for pregnancy-related
vomiting), she was treated over the next month by a
neurologist (Dr. Scarano Garcia). Results of extensive
neurological testing, including a brain scan and an EEG,
were normal except for a mild head tremor; no cause was
found for her vertigo. More important, there is no record
of any further treatment for this condition after August 9,
-5-
1988. Indeed, there is no evidence that claimant thereafter
made any further complaints in this regard to medical
personnel--apart from allegations voiced to a psychiatrist
in January 1990. The ALJ thus was warranted in regarding
claimant's vertigo as a short-lived affliction.
Finally, substantial evidence supports the ALJ's
conclusion that claimant's mental condition was of minimal
severity. Claimant alleges that she has suffered therefrom
since the age of thirteen. Yet she received no psychiatric
treatment from at least 1980 onwards, and made no mention of
such a condition to any of her treating physicians. A
psychiatrist (Dr. Toro) who examined claimant in January
1989, shortly before she delivered her second child,
diagnosed only a "mild" generalized anxiety disorder. In
particular, he reported that claimant cared for her son,
performed some housework with the help of others, attended
to her own personal needs without supervision, and was
capable of normal interpersonal relationships. It was
within the ALJ's prerogative to credit Dr. Toro's findings
over those reached one year later by a second psychiatrist
(Dr. Bocanegra). And even the latter, we note, recorded a
diagnosis of only "moderate" dysthymia.
We therefore find substantial evidentiary support for the
ALJ's conclusions. We likewise conclude that it was
unnecessary to hear vocational evidence. As explained, the
ALJ was warranted in finding that claimant's nonexertional
-6-
impairments had only a minimal impact on her ability to
perform the full range of sedentary work. Under such
circumstances, reliance on the Grid to yield a finding as to
disability was appropriate. See, e.g., Heggarty v.
Sullivan, 947 F.2d 990, 995-96 (1st Cir. 1991) (per curiam);
Ortiz v. Secretary of HHS, 890 F.2d 520, 524-25 (1st Cir.
1989) (per curiam).
Affirmed.
-7-