USCA1 Opinion
March 23, 1994
[NOT FOR PUBLICATION]
UNITED STATES COURT OF APPEALS
FOR THE FIRST CIRCUIT
____________________
No. 93-1700
SONIA M. MORET RIVERA,
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. Carmen Consuelo Cerezo, U.S. District Judge] ___________________
____________________
Before
Breyer, Chief Judge, ___________
Torruella and Selya, Circuit Judges. ______________
____________________
Juan A. Hernandez Rivera and Raymond Rivera Esteves on brief for ________________________ _______________________
appellant.
Cuillermo Gil, United States Attorney, Maria Hortensia Rios, ______________ ______________________
Assistant United States Attorney, and Robert M. Peckrill, Assistant ___________________
Regional Counsel, Department of Health and Human Services, on brief
for appellee.
____________________
____________________
Per Curiam. Claimant Sonia Moret Rivera appeals a __________
district court judgment that affirmed the decision of the
Secretary of Health and Human Services denying claimant's
application for Social Security disability benefits. The
discrete question before us is whether substantial evidence
supports the Secretary's conclusion that claimant retained
the residual functional capacity (RFC) to perform her past
work as a secretary before her insured status expired.
Finding substantial evidence to support this conclusion, we
affirm.
I.
On October 18, 1990, at age 49, claimant filed an
initial application for disability benefits with a Florida
district office of the Social Security Administration (SSA).
Claimant alleged that she had been disabled from work since
December 15, 1985 due to the surgical removal of two left
ribs, left arm numbness and pain and back pains. (Tr. 61).
Claimant's insured status expired on December 31, 1989.
Claimant graduated from high school and received additional
training as a secretary around 1961. (Tr.65) Between 1963
and 1985, she worked as a secretary, receptionist, and office
clerk at various companies in her native Puerto Rico. (Tr.
66). Her responsibilities included typing letters, filing,
answering the telephone, using calculators, taking orders
from customers, and other office procedures. (Tr. 33, 66).1
The medical evidence discloses that claimant began
experiencing left wrist pain with paresthesias of the left
upper extremity in December, 1983. (Tr. 86). In early 1984,
claimant was evaluated by Dr. Jose Lozada-Roman for recurrent
anterior chest pain and numbness of the left arm. (Tr. 136).
X-rays of claimant's cervical spine taken on February 6, 1984
disclosed the presence of a left cervical rib and
osteophytosis (bony growths) of the mid-dorsal vertebrae.
(Tr. 85). Vascular studies from that period further revealed
that claimant experienced severe compression of the sub-
clavian artery with her arms overhead and mild vasospastic
flow with the arms at rest. (Tr. 83-84). Dr. Lozada-Roman
opined that claimant's evaluation, which included a positive
Adson's test, "was strongly suggestive of thoracic outlet
____________________
1. Claimant's disability report indicated that her past work
required her to perform the light exertional tasks of lifting
weights of up to 10 pounds frequently and 20 pounds
occasionally, sitting for four hours and walking and
standing, respectively, for two hours each. (Tr. 66). See ___
20 C.F.R. 404.1567(b).
-3-
syndrome." (Tr. 136).2 He referred claimant to a vascular
surgeon, Dr. Raul Garcia-Rinaldi.
On March 25, 1984, claimant was admitted to the Houston,
Texas Memorial Hospital under the care of Dr. Garcia-Rinaldi.
She again reported that in December 1983 she experienced the
onset of left wrist pain that radiated to her elbow and
associated numbness of the left hand. Her condition was
aggravated by physical activity. (Tr. 106). She also
complained of left-sided neck and shoulder pain with
paresthesias of the left upper extremity, tachycardia, light
headedness, palpitations, diaphoresis, neck, facial, and
anterior chest flushing, diarrhea, a sensation that there was
a lump in her throat, and generalized anxiety. Dr. Garcia-
Rinaldi found no increase of left wrist pain upon sustained
hyperextension of the wrist and that the distal pulses were
symmetrical at rest. (Tr. 107). His initial impression was
that claimant suffered from a left cervical rib, rule out
____________________
2. Thoracic outlet syndrome is "compression of the brachial
plexus nerve trunks, characterized by pain in arms,
paresthesia of fingers, vasomotor symptoms ... and weakness
and wasting of small muscles of the hand; it may be caused by
drooping shoulder girdle, a cervical rib or fibrous band, an
abnormal first rib, continual hyperabduction of the arm, or
(rarely) compression of the edge of the scalenus anterior
muscle." R. Sloane, The Sloane-Dorland Annotated Medical- ______________________________________
Legal Dictionary (1987), p. 697. Adson's test is one method _________________
of diagnosing thoracic outlet syndrome. Dorland's _________
Illustrated Medical Dictionary, (27th ed. 1988), p. 1674. ______________________________
-4-
thoracic outlet syndrome, and generalized anxiety with a
history of acute anxiety attacks. (Tr. 107.)3
On March 26, 1984, Dr. William Fleming evaluated
claimant as a consultant to Dr. Garcia-Rinaldi. Dr. Fleming
found that claimant exhibited a full range of motion of the
cervical spine, although she complained of a popping
sensation when she turned her neck. Tinel's sign was
positive at both wrists, the left greater than the right.4
There was moderate weakness of the left abductor pollicis
brevis muscle (i.e., the muscle between the wrist and the ____
first joint of the thumb) and decreased sensation in the
first three fingers of the left arm. Dr. Fleming's
impression was that claimant had left median neuropathy of
the wrist (carpal tunnel syndrome).5 Other possible
____________________
3. Claimant does not argue that she is disabled as a result
of anxiety or any other mental impairment.
4. Tinel's sign is "a tingling sensation in the distal end
of a limb when percussion is made over the site of a divided
nerve. It indicates a partial lesion or the beginning
regeneration of the nerve." Dorland's Illustrated Medical ______________________________
Dictionary, at 1526. "The sign is often present in the __________
abnormal tingling sensation in the fingers and the hand
(carpal tunnel syndrome)." The Mosby Medical Encyclopedia, _______________________________
(1985), p. 730.
5. Carpal tunnel syndrome is "a complex of symptoms
resulting from compression of the median nerve in the carpal
tunnel, with pain and burning or tingling paresthesias in the
fingers and hand, sometimes extending to the elbow."
Dorland's Illustrated Medical Dictionary, at 1632. "This __________________________________________
compression produces paresthesias in the radial-palmar aspect
of the hand plus pain in the wrist, in the palm, or sometimes
proximal to the compression site in the forearm and shoulder.
Sensory deficit in the first 3 digits and/or weakness and
-5-
conditions to be ruled out were thoracic outlet syndrome,
left brachial plexopathy, and cervical radiculopathy. (Tr.
103). Dr. Fleming recommended an electromyogram, nerve
conduction studies, and x-rays of both wrists and the
cervical spine.
A March 27, 1984 electromyogram was normal. (Tr. 86).
In addition, cervical spine films and x-rays of both wrists
were within normal limits except for the presence of the left
cervical rib that had been previously found. (Tr. 86). The
record suggests that no nerve conduction studies were done in
1984. On March 29, 1984, Dr. Garcia-Rinaldi diagnosed
claimant to be suffering from thoracic outlet syndrome due to
compression of the subclavian arteries caused by the left
cervical and first ribs. (Tr. 93). He performed a
transaxillary resection of these ribs. His operative report
indicates that when the rib sections were removed, "the
subclavian artery and its veins were released" and
"[e]xcellent distal pulsations were obtained in all
positions." (Tr. 93).6
____________________
atrophy in the muscles controlling thumb abduction and
apposition may follow." The Merck Manual, (Robert Berkow, ________________
M.D., et al., eds., 16th ed. 1992), p. 1519.
6. Dr. Garcia-Rinaldi later submitted a letter to the
Florida disability evaluation service in connection with
claimant's initial application. There he stated that the
diagnosis of thoracic outlet syndrome resulting from a left
cervical rib "was quite clear" and that, to the best of his
knowledge, claimant had satisfactory results following the
March 1984 surgery. (Tr. 132). During the course of
-6-
Claimant was discharged from the hospital on April 3,
1984. She returned to work after the surgery and continued
to work until December 1985. Claimant alleges that while she
experienced some improvement following the surgery, she
continued to experience arm pain and numbness that eventually
adversely affected her work performance and caused her to be
fired.7 Claimant has not worked since the alleged onset of
her disability on December 15, 1985.
There are no medical records from 1985, 1986, or 1987.
Between August 12, 1988 and April 1991, Dr. Tomas Jordan saw
claimant five times per year for various conditions. While
Dr. Jordan's office records are largely illegible, they
indicate that claimant had a history of thoracic outlet
syndrome that was treated with the surgical removal of a
cervical rib. (Tr. 108). Dr. Jordan treated claimant for
numbness of the left arm, cervical spasm and hematuria during
August and September 1988. He prescribed Decadron, an anti-
inflammatory drug, and other medications. (Tr. 124-27). X-
rays from that time disclosed mild straightening of the
____________________
claimant's 1984 hospitalization claimant also underwent
testing for chest pain and other problems. She was found to
have chronic esophagitis and bladder polyps, which were
removed. (Tr. 86, 89).
7. Claimant's disability report states that the operation,
which was performed under her left arm, caused "slow
movement" of her arm. Claimant reported that as a result,
she kept getting slower at work and that she did not perform
her work with accuracy. (Tr. 61).
-7-
cervical spine and mild osteophytes of the thoracic spine.
(Tr. 131). Dr. Jordan indicated that claimant's impairments
included carpal tunnel syndrome, cervical myositis, hiatal
hernia, microhematuria, gastritis, and irritable colon
syndrome. (Tr. 112). However, he did not specify when she
suffered from symptoms associated with these conditions, nor
did he state that any of these conditions were disabling
either during or after the insured period. Dr. Jordan
referred claimant to a physiatrist for her thoracic outlet
syndrome and prescribed medications, physical therapy, and
diet for her other symptoms. (Tr. 108, 112).
On December 17, 1990, claimant was examined by Dr.
Percival Tamayo, a Florida internist and SSA consultant. At
that time claimant reported that she could still do some
housework and lift weights less than ten pounds. Physical
examination disclosed that claimant's neck was supple and
that claimant exhibited no pain on hyperextension or
rotation. The back showed no significant paravertebral
muscle spasm and no spine deformity. Her lower extremities
were normal. There was no significant reduction in the range
of motion in claimant's cervical or lumbar spine, and no pain
was produced during the range of motion testing.
Neurological examination was grossly unremarkable. Palpation
of the chest wall elicited tenderness over the costochondral
junction at the second and third rib levels, especially on
-8-
the left side. Dr. Tamayo concluded that claimant suffered
from non-cardiac chest pain consistent with costochondritis
(an inflammation of the cartilage connecting the ribs to the
sternum) and that her residual left arm discomfort may be
secondary to her previous thoracic outlet syndrome. No other
significant abnormalities were noted. (Tr. 133-34).
Dr. Lozada-Roman also submitted a report dated 12/20/90.
In addition to the aforementioned history, he stated that
claimant was then experiencing "some discomfort" in the left
arm and difficulty writing and lifting objects. He
recommended that she again see a vascular surgeon and have a
neurological evaluation. (Tr. 136).
On January 2, 1991, claimant's initial application was
denied. She immediately filed a request for reconsideration
which was also denied. Claimant filed a request for a
hearing before an administrative law judge (ALJ) and
submitted additional medical evidence. On April 9, 1991,
claimant saw Dr. Victor Gonzalez, a specialist in physical
medicine and rehabilitation. (Tr. 137-38). His records are
also largely illegible. Nevertheless, Dr. Gonzalez reported
that claimant was experiencing pain in her chest and elbows
in 1991, as well as numbness of both arms, more so on the
left. Claimant also alleged that she had pain in her left
hip. Physical examination disclosed tenderness on palpation
of the cervical resection area. A 4/10/91 note suggests that
-9-
claimant's symptoms were consistent with carpal tunnel
syndrome and thoracic outlet syndrome. (Tr. 138).
An April 17, 1991 electromyogram of claimant's upper
limbs was normal. (Tr. 113). However, nerve conduction
studies from that date showed early signs of carpal tunnel
syndrome and entrapment neuropathy of the ulnar nerve at
Guyon's canal. April 1991 x-rays of claimant's lumbar spine
were normal. (Tr. 151-53). On May 24, 1991, claimant had
another vascular study. This disclosed mild compression of
the right subclavian artery with the arm to side and arm to
back maneuvers and severe compression with the arms overhead.
The left subclavian artery also exhibited mild compression
with the arms overhead. Claimant's circulation was normal
with her arms at rest, although she experienced mild
vasospastic flow in both hands. Dr. Ivette Matos Serrano,
a neurologist, began treating claimant around 1991. (Tr.
28). On June 20, 1991, one and one-half years after
claimant's insured status expired, Dr. Matos reported that
claimant was experiencing numbness in the posterior part of
the head, frequent headaches, paresthesias, cramps of both
upper extremities, and "an electric-like sensation along the
posterior aspect of the left upper extremity down to the
fingers[.]" The remainder of her report suggests that
claimant's condition was considerably more dire than that
described by Dr. Tamayo, the SSA's consultant. For example,
-10-
Dr. Matos indicated that claimant had muscle spasms in her
cervical, paravertebral, and trapezius muscles, that her
range of motion testing revealed significant limitations and
pain, and that claimant exhibited diminished sensation in her
left arm and leg and "slight weakness" of both handgrips.
Based on her examination and the 1991 vascular and nerve
conduction studies, Dr. Matos diagnosed claimant to be
suffering from severe bilateral thoracic outlet syndrome,
chronic cervical syndrome, bilateral carpal tunnel syndrome,
bilateral entrapment neuropathy of the ulnar nerves, and
chronic lumbar syndrome with clinical signs and symptoms
suggesting radicular involvement. She concluded that
claimant had suffered from bilateral thoracic outlet syndrome
since 1983, and that while she experienced some improvement
on her left side following surgery in 1984, her condition
became progressively aggravated. Dr. Matos opined that it
was understandable for claimant's symptoms to remain
following surgery as in many patients symptoms do recur. She
advised that claimant would continue to need treatment for an
indefinite time and that her labor prognosis was extremely
poor. However, Dr. Matos did not express an opinion on
whether claimant was disabled during the insured period.
(Tr. 142-47).
Claimant and her attorney appeared for a hearing before
an ALJ on August 1, 1991. Claimant testified that she could
-11-
no longer work as a result of her 1984 operation and
continuing pain and numbness. She explained that after her
operation, her "ability to work decreased" and she was fired
as a result. (Tr. 25).8 Claimant asserted that she did not
go back to work because she felt "ill" and "demoralized",
noting that she experienced "lots of pains in the neck,
muscular spasms which continued after the operation[, and
her] arms got numb." (Tr. 26). While claimant acknowledged
that she experienced some improvement after the operation,
pains and numbness of both arms continued. Claimant
testified that she is incapacitated because of the pain she
constantly feels. (Tr. 26, 32.)9
On August 27, 1991, the ALJ issued a decision denying
claimant's application for benefits. The ALJ specifically
found that during the relevant insured period, claimant
suffered from severe cervical myositis and status post trans-
axillary resection of her left cervical and first ribs.
Although these conditions did not meet or equal the SSA's
____________________
8. We note that claimant indicated that her employer did not
admit that her health problems cause her to be fired. (Tr.
61). Moreover, Dr. Matos reported that claimant was
dismissed from her job because of a nervous condition, not
because of her physical complaints. (Tr. 143).
9. Claimant also stated that she had problems swallowing
related to her esophagus and hiatal hernia, and cramps in her
arms and legs. (Tr. 26). She testified that she experienced
strong neck and back pain which is only temporarily relieved
with medication and that she can only sit and stand for 10
minutes at a time. (Tr. 34-37).
-12-
listings of impairments, the ALJ found that they imposed
significant limitations on claimant's ability to lift and
carry. With respect to claimant's complaints of pain and
numbness, the ALJ found:
... the claimant's neck pain is sustained
as being secondary to her cervical
myositis evidenced by mild straightening
of the cervical spine. However,
subsequent to the claimant's surgery on
March 29, 1984, she did not present
objective clinical findings in which to
sustain her allegations of chest pain or
left arm numbness until subsequent to the
critical period in issue. Through
December 31, 1989, the claimant was not
prescribed strong analgesics and there is
no evidence of significant restrictions
in her daily activities and social
functioning suggestive of her inability
to perform within all exertional levels.
Based on these findings, the ALJ concluded that claimant
retained the residual functional capacity to perform
sedentary work through December 31, 1989. (Tr. 15, 16). He
then went on to conclude that claimant's impairments did not
disable her from performing her past light work as a _____
secretary. (Tr. 15, 16).10 Consequently, the ALJ denied
____________________
10. The ALJ specifically found that claimant's past work
"involved sitting four hours, standing and walking two hours,
respectively, frequent bending and reaching and lifting and
carrying 10 pounds frequently and 20 pounds occasionally.
(Tr. 14). As noted above at n. 1, these exertional
requirements are consistent with light work. Moreover, the
ALJ also found that claimant has the RFC "to perform work
related activities except for work involving lifting and
carrying over 10 pounds frequently and 20 pounds ____
occasionally." (Tr. 16). Implicit in this statement is the
assertion that claimant can lift up to 10 pounds frequently
and 20 pounds occasionally.
-13-
benefits at step four of the sequential evaluation process.
See Goodermote v. Secretary of Health and Human Services, 690 ___ __________ ______________________________________
F. 2d 5, 6-7 (1st Cir. 1982). The Appeals Council denied
review, thus rendering the ALJ's decision final. Claimant
sought judicial review pursuant to 42 U.S.C. 405(g). The
district court summarily affirmed the Secretary. This appeal
followed.
II.
On appeal, claimant argues that the ALJ's decision is
not supported by substantial evidence on the record as a
whole because the ALJ ignored the uncontroverted evidence of
disability provided by Drs. Jordan, Tamayo, and Matos and
substituted his own, unqualified medical opinion in place of
the evidence provided by these physicians. Claimant says
that the medical evidence provided by these physicians
established that she is at least disabled from performing her
past secretarial work due to thoracic outlet syndrome, carpal
tunnel syndrome, left arm numbness, and pain. Claimant
further argues that the ALJ erred in concluding that she has
the residual functional capacity (RFC) to perform her past
relevant work absent an RFC assessment by a physician.
Finally, claimant contends that the ALJ failed to give
appropriate consideration to her complaints of disabling
pain.
-14-
We must affirm the Secretary's decision if it is
supported by substantial evidence on the record as a whole.
Rodriguez v. Secretary of Health and Human Services, 647 F.2d _________ ______________________________________
218, 222 (1st Cir. 1981). "Claimant is not entitled to
disability benefits unless [s]he can demonstrate that h[er]
disability existed prior to the expiration of h[er] insured
status." Cruz Rivera v. Secretary of Health and Human ____________ _________________________________
Services, 818 F.2d 96, 97 (1st Cir.), cert. denied, 497 U.S. ________ _____ ______
1042 (1987). It is not sufficient for a claimant to
establish that her impairment had its roots before the date
that her insured status expired. Rather, the claimant must
show that her impairment(s) reached a disabling level of
severity by that date. See, e.g., Deblois v. Secretary of ___ ____ _______ ____________
Health and Human Services, 686 F.2d 76, 79 (1st Cir. 1982); _________________________
Tremblay v. Secretary of Health and Human Services, 676 F.2d ________ ______________________________________
11, 13 (1st Cir. 1982). This does not mean, however, that
medical evidence from the post-insured period is always
wholly irrelevant. Medical evidence generated after a
claimant's insured status expires may be considered for what
light (if any) it sheds on the question whether claimant's
impairment(s) reached disabling severity before claimant's ______
insured status expired. See, e.g., Smith v. Bowen, 849 F.2d ___ ____ _____ _____
1222, 1225 (9th Cir. 1988); Basinger v. Heckler, 725 F.2d ________ _______
1166, 1169 (8th Cir. 1984)(collecting cases); Gonzalez v. ________
Secretary of Health and Human Services, 757 F. Supp. 130, 134 ______________________________________
-15-
(D.P.R. 1991); Alcaide v. Secretary of Health and Human _______ ________________________________
Services, 601 F. Supp. 669, 672-73 (D.P.R. 1985). ________
While we think claimant overstates the strength of the
evidence from Drs. Jordan, Tamayo, and Matos, we are troubled
by the ALJ's finding that claimant did not present objective
clinical findings to sustain her allegations of left arm
numbness until after her insured status expired in 1989. Dr.
Jordan recorded that claimant was experiencing left arm
numbness in connection with cervical spasm in August 1988.
(Tr. 127). And while claimant was not prescribed strong
analgesics through December 31 1989, Dr. Jordan did prescribe
Decadron, an anti-inflammatory medication, in August 1988.
(Tr. 126). The record as a whole suggests that claimant
suffered from symptoms associated with thoracic outlet
syndrome both before and after her insured status expired.
Arguably, the ALJ should have considered this condition in
evaluating claimant's RFC.
Nevertheless, we cannot say that the ALJ erred in
discounting the evidence from the post-insured period. The
record discloses that for at least three of the five years
after the alleged date of onset (i.e., 1985, 1986, and 1987),
claimant sought no medical treatment. A gap in the medical
evidence may itself be evidence that claimant's condition was
not as dire as alleged. See Irlanda Ortiz v. Secretary of ___ _____________ ____________
Health and Human Services, 955 F.2d 765, 769 (1st Cir. ___________________________
-16-
1991)(gaps in record supported conclusion that claimant's
pain was not as intense as alleged). Apart from one 1988
complaint of numbness and cervical spasm, which was treated
with Decadron, there is no evidence that claimant's condition
was particularly troubling during the insured period that
remained after her surgery, much less disabling. We think
that a single complaint of numbness and spasm does not
undermine the ALJ's conclusion that claimant retained the RFC
to perform sedentary work during the insured period. See ___
Gordils v. Secretary of Health and Human Services, 921 F.2d _______ _______________________________________
327, 329 (1st Cir. 1990)("if the only medical findings in the
record suggest that a claimant exhibited little in the way of
physical impairments, but nowhere in the record did any
physician state in functional terms that the claimant had the
exertional capacity to meet the requirements of sedentary
work, the ALJ would be permitted to reach that functional
conclusion himself"). This conclusion is further supported
by the ALJ's finding that there is no evidence of significant
restrictions in claimant's daily activities and social
functioning during the insured period.11 We recognize that
____________________
11. To be sure, claimant testified that she had not driven
in 3 or 4 years, that her daughter did most of the housework,
and that while she goes to church, she spends most of her
time lying down due to her various ailments. (Tr. 24, 33,
39). But it is clear that claimant was speaking of her
condition at the present, and did not focus on her condition
between 1985 and 1989. As it was claimant's burden to prove
that she was disabled before her insured status expired,
claimant was required to adduce evidence on her condition
-17-
the ALJ did not stop there, however, and went on to conclude
that claimant retained the RFC to perform her past light work _____
as a secretary. We expressly limited our holding in Gordils _______
to sedentary work, noting that the evidence that the claimant
had a "weaker back" was not sufficient to support the
conclusion that the claimant could do the more physically
demanding light work. See 921 F.2d at 329.12 Claimant ___
argues that the ALJ erred by concluding that claimant could
perform light work without an RFC from a physician. We have
repeatedly admonished that ALJs generally are not qualified
to assess RFC based on a bare medical record. See, e.g., ___ ____
Gordils, 921 F.2d at 329; Rivera-Torres v. Secretary of _______ _____________ _____________
Health and Human Services, 837 F.2d 4, 6-7 (1st Cir. 1988). _________________________
And while this principle does not preclude ALJs from
rendering "common sense judgments about functional capacity"
that do not overstep the bounds of a lay person's competence,
Gordils, 921 F.2d at 329, where significant exertional _______
____________________
during that period. And, in contrast to claimant's
testimony, the evidence in her 1990 disability report, which
was prepared only ten months after claimant's insured status
expired, indicated that claimant could drive, cook, do "some"
cleaning and shopping, and take care of flowers. (Tr. 64).
Given the gap in the medical evidence from the insured
period, this supports the ALJ's conclusion that the sedentary
base was intact during that time.
12. We note that in Gordils, a nonexamining physician had _______
indicated that claimant could do light work. We affirmed the
denial of benefits only on the ground that the record
supported the implicit conclusion that claimant also could
perform sedentary work. See 921 F.2d at 329. ___
-18-
limitations are present, an exertional RFC is required. See ___
Perez v. Secretary of Health and Human Services, 958 F.2d _____ ________________________________________
445, 446-47 (1st Cir. 1991). However, in order to trigger
this requirement, the claimant must first put her RFC in
issue. Thus, in Santiago v. Secretary of Health and Human ________ ______________________________
Services, 944 F.2d 1, 4 (1st Cir. 1992), we upheld an ALJ's ________
determination that a claimant retained the RFC to perform her
past, light work as a sewing machine operator absent an
expert's RFC because the record demonstrated that claimant
had "only relatively mild mental and physical impairments"
and claimant never clarified the particular respects in which
her impairments prevented her from performing her past work.
We emphasized that to meet the burden of proof at step 4, a
claimant must produce evidence of the physical and mental
demands of her prior work and describe how her impairment(s)
precluded the performance of that work "in the relevant ________________
period." Id. at 5. ______ ___
Here, while the claimant described both her duties and
her present impairments, neither her testimony nor the _______
medical evidence explained how her impairments precluded the
performance of work-related tasks during the insured period.
Rather, the record as a whole suggests that claimant
recovered from her surgery and did not seek treatment for the
three years that ensued (1985, 1986, and 1987). And while
claimant sought treatment again in 1988, there was no
-19-
evidence as to the frequency or duration of her symptoms
during the relevant period, nor did claimant explain how her
symptoms precluded the performance of the various tasks
associated with her past work during that time. Thus, where
claimant failed to focus her proof on the relevant insured
period, and the medical evidence from that time does not
suggest that claimant continuously suffered from disabling
symptoms, we think the ALJ supportably concluded that
claimant retained the RFC to perform her past work as a
secretary notwithstanding the absence of a physician's RFC.
Finally, claimant argues that the ALJ did not give
sufficient weight to her complaints of disabling pain. Once
again, this argument fails because the claimant did not
specify how her pain limited her functions during the insured
period. The ALJ supportably found that claimant was not
prescribed strong analgesics during the insured period
(indeed, we cannot discern that claimant was prescribed any ___
analgesics during this time). Claimant initially reported
that she could drive, shop, cook, tend flowers, and maintain
social contacts. Thus, the record does not suggest that
claimant's pain was disabling during the relevant period.
Judgment affirmed. _________________
-20-
-21-