Sosa v. SHHS

USCA1 Opinion









March 13, 1995 [NOT FOR PUBLICATION]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.


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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.


____________________

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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.

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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.

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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,


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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


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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. _________






































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