Olmeda v. Commissioner of Social Security

Filing 21

OPINION AND ORDER dismissing re 1 SOCIAL SECURITY COMPLAINT, filed by Carlos A. Olmeda Signed by United States Magistrate Judge Justo Arenas on 4/15/2014.(Arenas, Justo)

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IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF PUERTO RICO 1 2 3 4 CARLOS A. OLMEDA, 5 Plaintiff 6 v. 7 8 9 CIVIL 12-1894 (JA) MICHAEL J. ASTRUE, COMMISSIONER OF SOCIAL SECURITY, Defendant 10 11 OPINION AND ORDER 12 I. PROCEDURAL BACKGROUND 13 On October 26, 2012, plaintiff filed this petition for judicial review of a final 14 decision of the Commissioner of Social Security which denied his application for a 15 period of disability and Social Security disability insurance benefits. (Docket No. 1). 16 He had filed an application for benefits on October 28, 2010 alleging disability due 17 to sleep apnea, depression, severe high blood pressure, a back injury, and early 18 stages of post traumatic stress disorder (PTSD). (Tr. at 237-39). 19 Pursuant to 42 U.S.C. § 405(g), the court is empowered to affirm, modify, 20 reverse or remand the decision of the Commissioner, based upon the pleadings and 21 transcript of the record. See 42 U.S.C. § 405(g). In reviewing a Social Security 22 decision, the factual findings of the Commissioner shall be conclusive if supported 23 by “substantial evidence” in the record. See Ortiz v. Sec’y of Health & Human 24 Servs., 955 F.2d 765, 769 (1st Cir. 1991) (quoting 42 U.S.C. § 405(g)). 25 “Substantial evidence” is more than a “mere scintilla,” see Richardson v. Perales, 26 402 U.S. 389, 401, 91 S. Ct. 1420 (1971), in other words, it is “such relevant 27 evidence as a reasonable mind might accept as adequate to support a conclusion.” 1 CIVIL NO. 12-1894 (JA) 2 2 3 See id.; also see Currier v. Sec’y of Health & Human Servs., 612 F.2d 594, 597 (1st 4 Cir. 1980); Taylor v. Astrue, 899 F. Supp. 2d 83, 85 (D. Mass. 2012). In reaching 5 the final decision, it is the Commissioner’s responsibility to determine issues of 6 credibility and to draw inferences from the evidence in the record. See Rodriguez 7 v. Sec’y of Health & Human Servs., 647 F.2d 218, 222 (1st Cir. 1981). 8 Plaintiff has the burden of proving that he has become disabled within the 9 meaning of the Social Security Act. See Bowen v. Yuckert, 482 U.S. 137, 146, 107 10 S. Ct. 2287 (1987); Rivera-Tufino v. Commissioner of Social Sec., 731 F. Supp. 2d 11 210, 212-13 (D.P.R. 2010). A finding of disability requires that plaintiff be unable 12 to perform any substantial gainful activity or work because of a medical condition 13 which has lasted or which can be expected to last for a continuous period of at least 14 twelve months. See 42 U.S.C. § 416(i)(1). In general terms, evidence of a physical 15 or mental impairment or a combination of both is insufficient for the Commissioner 16 to award benefits. There must be a causal relationship between such impairment 17 or impairments and plaintiff’s inability to perform substantial gainful activity. See 18 McDonald v. Sec’y of Health & Human Servs., 795 F.2d 1118, 1120 (1st Cir. 1986). 19 Partial disability does not qualify a claimant for benefits. 20 Celebrezze, 349 F.2d 494, 496 (1st Cir. 1965). See Rodríguez v. 21 The only issue for the court to determine is whether the final decision that 22 plaintiff is not under a disability is supported by substantial evidence in the record 23 when looking at such record as a whole. In order to be entitled to such benefits, 24 plaintiff must establish that he was disabled under the Act at any time on or before 25 June 28, 2012, the date of the Commissioner’s final decision. Plaintiff continues to 26 meet the earnings requirements for disability benefits under the Social Security Act 27 1 CIVIL NO. 12-1894 (JA) 3 2 3 until December 31, 2016 but not after that date. See Evangelista v. Sec’y of Health 4 & Human Servs., 826 F.2d 136, 140 n.3 (1st Cir. 1987). 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 After evaluating the evidence of record, Administrative Law Judge Harold Granville entered the following findings on June 28, 2012: 1. The claimant meets the insured status requirements of the Social Security Act through December 31, 2016. 2. The claimant has not engage in substantial gainful activity since July 1, 2010, the alleged disability onset date (20 CFR 404.1571 et seq.). 3. The claimant has the following severe impairments: cervical and lumbar degenerative disc disease, sleep apnea, high blood pressure, depression and post-traumatic stress disorder (20 CFR 404.1520(c)). 4. The claimant does not have an impairment or combination of impairments that meets or medically equals the severity of one of the listed impairments in 20 CFR Part 404, Subpart P, Appendix 1 (20 CFR 404.1520(d), 404.1525 and 404.1526). 5. After careful consideration of the entire record, the undersigned finds that the claimant has the residual functional capacity to perform light work as defined in 20 CFR 404.1567(b), except that he has to avoid skilled and semiskillled functions. He is capable of unskilled work avoiding environmental hazards and not dealing with the public. 6. The claimant is unable to perform his past relevant work (20 CFR 404.1565). 7. The claimant was born on September 1, 1966 and was 43 years old, which is defined as a younger individual age 1849, on the alleged disability onset date (20 CFR 404.1563). 8. The claimant has at least a high school education and is able to communicate in English (20 CFR 404.1564). 9. Transferability of skills is not material to the determination of disability because applying the Medical-Vocational Rules directly supports a finding of “not disabled,” whether or not the claimant has transferable job skills (See SSR 82-41 and 20 CFR Part 404, Subpart P, Appendix 2). 10. Considering the claimant’s age, education, work experience, and residual functional capacity, there are jobs that exist in significant numbers in the national economy that the claimant can perform (20 CFR 404.1569 and 404.1569(a)). 11. The claimant has not been under a disability, as defined in the Social Security Act, from July 1, 2010 through the date of this decision. (20 CFR 404.1520(g)). Tr. at 13-22. 1 CIVIL NO. 12-1894 (JA) 4 2 3 The administrative law judge ended the sequential inquiry at step five. 4 At this level, it has already been determined that the claimant cannot perform any 5 work he has performed in the past due to a severe impairment or combination of 6 impairments. 7 functional capacity as well as the claimant's age, education, and past work 8 experience to see if the claimant can do other work. If the claimant cannot, a 9 finding of disability will follow. See 20 C.F.R. § 404.1520(f). At step five, the 10 Commissioner bears the burden of determining that significant jobs exist in the 11 national economy which plaintiff can perform given the above factors. See Freeman 12 v. Barnhart, 274 F.2d 605, 608 (1st Cir. 2001); Nguyen v. Chater, 172 F.3d 31 (1st 13 Cir. 1999); Lancelotta v. Secretary of Health & Human Servs., 806 F.2d 284 (1st Cir. 14 1986); Vázquez v. Secretary of Health & Human Servs., 683 F.2d 1, 2 (1st Cir. 15 1982); Tassel v. Astrue, 882 F. Supp. 2d 143, 146 (D. Me. 2012); Rodriguez- 16 Gonzalez v. Astrue, 854 F. Supp. 2d 176, 180 (D.P.R. 2012). 17 18 19 20 The inquiry requires a consideration of the claimant's residual Plaintiff asked the Appeals Council to review the final decision. The Appeals Council denied such a request on September 1, 2012. (Tr. at 1-3). II. ARGUMENT On July 16, 2013, plaintiff filed a memorandum of law in the present case 21 seeking reversal of the final decision. (Docket No. 19). 22 memorandum in support of the final decision on August 15, 2013 (Docket No. 20). 23 Plaintiff argues in his memorandum of law that the administrative law judge 24 deployed the incorrect legal standard in reaching the final decision, disregarding his 25 own examining psychiatric consultant’s report, as well as failing to ask the 26 vocational expert the correct hypothetical questions at the administrative hearing. 27 The administrative law judge is also charged with not explaining the weight given Defendant filed a 1 CIVIL NO. 12-1894 (JA) 5 2 3 to each medical opinion, and not giving good reasons for the weight accorded to a 4 treating source’s opinion, without which a reviewing court, such as this one, cannot 5 assess whether the final decision is supported by substantial evidence. See e.g. 6 Vazquez-Rivera v. Commissioner of Social Sec., 943 F. Supp. 2d 300, 310 (D.P.R. 7 2013), citing Polanco-Quinones v. Astrue, 477 Fed. Appx. 745, 746 (1st Cir. 2012); 8 20 C.F.R. § 404.1527(d)(2); also see Hernandez v. Commissioner of Social Sec., 9 ___F. Supp. 2d ___, 2013 WL 5674498 (Oct. 17, 2013) at *7. 10 The defendant argues to the contrary, adding that plaintiff has focused on the 11 final decision relating to the mental residual functional capacity and does not take 12 issue with the administrative law judge’s assessment of plaintiff’s physical residual 13 functional capacity. 14 findings as to mental residual functional capacity are well supported by the opinions 15 of experts in Social Security evaluations, and other detailed evidence of record. 16 Similarly, the testimony of the vocational expert at the administrative hearing also 17 lends support to that final decision. 18 The defendant argues that the administrative law judge’s III. ADMINISTRATIVE PROCEEDINGS 19 At the administrative hearing held in Mayaguez, Puerto Rico on June 13, 2012, 20 plaintiff was well represented by attorney Arlene Diaz. Plaintiff testified that his 21 medical conditions began during active military duty when he hurt his back, 22 resulting in numbness down his left leg. 23 anxiety episodes and he described irregular sleeping habits. He is treated on a 24 monthly basis by Dr. Japhet Gaztambide Montes, psychiatrist, in Mayaguez whom 25 he has gone to for a second opinion. (Tr. at 32). He receives treatment for a 26 lumbar condition at the Veterans Hospital roughly every two months, by Dr. Olga 27 He also experiences depressive and 1 CIVIL NO. 12-1894 (JA) 6 2 3 Maldonado. (Tr. at 32-33). 4 times a week, and takes medication daily. The pain varies in intensity. He experiences sharp jabs while walking four or five 5 Plaintiff stated that his Military Occupational Specialty in the Army was 11 6 Charlie, which is heavy infantry, and he was in a mortar unit. He was also 11 7 Bravo, light infantry. He also worked in the telephone company in an administrative 8 position attending the public, customer service representative. Plaintiff had 9 difficulties adjusting to his civilian occupation when he returned from active duty, 10 even as a cashier. (Tr. at 35). He could not handle costumer contact. While he has 11 strength in his arms, his back bothers him. (Tr. at 36). He has sleep apnea and 12 sleeps with a machine that suffocates him and does not deliver sufficient air to his 13 brain. 14 drowsy. He generally does not drive to do shopping or to the mall because his wife 15 does that. The Veterans Administration awarded him a 90% disability pension. He sleeps during the day because the medication he takes makes him 16 Dr. Marieva Puig, vocational expert, summarized plaintiff’s previous job as an 17 infantryman which involves a lot of physical effort. She was asked to consider the 18 requirements of the previous employment for a person limited to light and unskilled 19 work, which does not require the risk of environmental dangers, such as heights, 20 driving vehicles, moving machinery, and does not have contact with the public. (Tr. 21 at 41). The expert then said that there existed jobs in Puerto Rico that could be 22 performed under these hypotheses, such as labeler, inspector (missing parts), and 23 classifier. Counsel asked if assuming back pain and the need to shift positions, the 24 vocational expert stated that plaintiff would be out of the labor force. (Tr. at 44). 25 If he cannot maintain concentration for more than an hour, he would also be out of 26 the workforce. (Tr. at 44-5). Counsel ended his participation in the hearing with 27 a comprehensive argument related to evidence of record. Tr. at 45-8). 1 CIVIL NO. 12-1894 (JA) 7 2 3 IV. MEDICAL HISTORY 4 Plaintiff suffered from back pain and high blood pressure while in military 5 training in 2009. He was first treated conservatively for the physical ailment but 6 received prescription medication for both. He returned from deployment with back 7 pain on July 1, 2010. X-rays revealed disc narrowing and end plate osteophytes in 8 the mid and lower thoracic spine, and mild osteophyte formation in the cervical 9 spine. He was placed on military medical hold that month. X-rays taken in August 10 and December 2010 revealed stable degenerative changes at the C2-C3 and C3-C4 11 levels, and osteophyte formation at L4-L5 vertebra. (Tr. at 751). Plaintiff received 12 physical therapy. He also received treatment for a mental condition apparently 13 triggered by a traumatic episode, seeing a severed head at the sight of a burned out 14 schoolhouse, suffered while on active duty in Djibouti, where he was stationed from 15 August 2009 to June 2010. He also went to sick call sometimes because of back 16 pain. 17 Administration, primarily for depression but also for sleep disorder and back pain. Indeed plaintiff has an extensive treatment from the Veterans 18 On August 16, 2011, plaintiff was evaluated by the consulting examining 19 psychiatrist Dr. Juan G. Batista. The doctor found plaintiff anxious and depressed. 20 Immediate, recent and remote memory were adequate. Short-term memory was 21 not. The doctor found adequate judgment, diminished attention, ability to conduct 22 simple calculations and of average intelligence. 23 296.34", which in the DSM-IV-TR is severe major depression with psychotic 24 features. Also diagnosed was post-traumatic stress disorder (PTSD). (Tr. at 655- 25 58). Dr. Zaida Boria, the consulting neurologist, evaluated plaintiff on September 26 14, 2011. She found plaintiff to be alert, and fully oriented. He was coherent and 27 relevant. The diagnosis was “AXIS I: A diagnosis of chronic lumbar musculoskeletal pain was made, with 1 CIVIL NO. 12-1894 (JA) 8 2 3 restrictions of range of movement. She noted that plaintiff could sit, stand, walk 4 and travel, as well as handle and lift common objects. (Tr. at 662-70). There were 5 no strength limitations of the lower extremities and no hand limitations. Plaintiff 6 was 6'5" tall and weighed 217 at the time. Gait was normal. 7 Dr. Japhet Gaztambide Montes was plaintiff’s treating psychiatrist from 8 January 26, 2011 to March 28, 2012. On the first evaluation and subsequent ones, 9 he diagnosed “AXIS I: 296.33" which in the DSM-IV is defined as major depression, 10 recurrent, severe without psychotic features. (Tr. at 1076, 1080, 1085). 11 doctor issued a mental residual functional capacity assessment of total disability 12 lasting over a year, that is from January, 2011 to March, 2012. (Tr. at 124-28). The 13 The administrative law judge noted in his rationale that notwithstanding the 14 constant back pain, such pain responded to medications and plaintiff was stabilized 15 when emergency room treatment was needed. (Tr. at 19). He determined that the 16 back pain did not significantly interfere with the activities of daily living. Within the 17 list of medications taken for the back pain were Naproxen and Flexeril, both 18 common NSAIDs, as well as Motrin, Toradol, Robaxin (methocarbamol-muscle 19 relaxer), Lodine and Norflex. (Tr. at 303). 20 prescribed Ambien, and later Buspar (anxiety). As to the mental condition, and 21 specifically depression, the administrative law judge noted that plaintiff responded 22 to treatment for depression, anxiety, and incipient post-traumatic stress disorder 23 and that the medications he had been taking since 2009 had remained unchanged. 24 Those medications included Abilify (depression), Klonopin, Zoloft (depression) and 25 Trazodone. 26 Metropolol tartrate, Norvasc, and Hydrochlorothiazide. (Tr. at 549-51). The Global 27 Assessment of Functioning (GAF) revealed moderate symptoms. To help plaintiff with sleeping he was Plaintiff also took blood pressure medication, such as Lisinopril, Dr. Roberto 1 CIVIL NO. 12-1894 (JA) 9 2 3 Gutierrez of the First Hospital Panamericano noted a discharge GAF of 60-65 on 4 February 24, 2012. (Tr. at 98, 116, 1078). 5 Statistical Manual of Mental Disorders, Text Revision (DSM-IV-TR), a GAF between 6 61 and 70 indicates some mild symptoms, but generally functioning well. A GAF of 7 between 51 and 60 indicates moderate symptoms. Plaintiff generally exhibited a 8 GAF in this range. (Tr. at 82, 114, 498). The diagnosis upon discharge at First 9 Hospital Panamericano was AXIS I: 296.33, major depression, recurrent, severe 10 without psychotic features. Treatment for depression continued through the year 11 2012. 12 According to the Diagnostic and V. REPORTS OF CONSULTATIVE AND TREATING PHYSICIANS 13 Plaintiff argues that the administrative law judge did not give proper weight 14 to the treating physicians’ medical reports. The administrative law judge gave 15 controlling weight to the (comprehensive) VA medical records in relation to the 16 thoracic and lumbar conditions, and plaintiff’s responsiveness to treatment. The 17 consultant psychiatrist, Dr. Juan G. Batista who evaluated plaintiff on August 16, 18 2011 was given great weight and credibility. Great weight and credibility were also 19 given to Dr. Zaida Boria, consultant neurologist, who evaluated plaintiff on a 20 consultative basis on September 14, 2011. (Tr. at 662-70). 21 On the other hand, no weight was given to the treating physician, Dr. Japhet 22 Gaztambide Montes. The period of treatment was from January 26, 2011 to March 23 28, 2012. (Tr. at 119-28). Dr. Gaztambide Montes agreed in part with Dr. Batista’s 24 conclusion but opined that plaintiff’s depression impeded work at all levels, and 25 imposed marked restrictions for activities of daily living, extreme difficulties in 26 maintaining social functioning, and extreme deficiencies of concentration, 27 persistence, and pace. (Tr. at 1086-90). Because the administrative law judge 1 CIVIL NO. 12-1894 (JA) 10 2 3 found that the conclusions are not supported by the evidence of record, he 4 disagreed. (Tr. at 20). 5 rejected the mental residual functional capacity assessments from Dr. Gaztambide 6 Montes, which basically concludes plaintiff is disabled for all practical purposes. (Tr. 7 at 124-28, 1072-80, 1081-90). The administrative law judge specifically considered and 8 It is well settled that even the opinions of treating physicians are not entitled 9 to greater weight merely because they are treating physicians. Rodríguez Pagán 10 v. Sec’y of Health & Human Servs., 819 F.2d 1, 3 (1st Cir. 1987); Sitar v. Schweiker, 11 671 F.2d 19, 22 (1st Cir. 1982); Pérez v. Sec’y of Health, Educ. & Welfare, 622 F.2d 12 1, 2 (1st Cir. 1980); Mercado v. Commissioner of Social Sec., 767 F. Supp. 2d 278, 13 285 (D.P.R. 2010); Delgado-Quiles v. Comm’r. of Social Sec., 381 F. Supp. 2d 5, 14 8-9 (D.P.R. 2005); Rosado-Lebrón v. Comm’r of Social Sec., 193 F. Supp. 2d 415, 15 417 (D.P.R. 2002). In disagreeing with the treating psychiatrist’s assessment, the 16 administrative law judge relied to a great extent on the extensive and detailed Army 17 medical records including Djibouti theater medical records as well as the similarly 18 detailed VA medical records. (Tr. at 339-96, 397-479, 655-59, 662-71, 749-983, 19 984-1050). 20 Boria. While the administrative law judge does not detail specifically where in the 21 roughly 500 pages relied upon in this extensive record (1,090 pages), there is 22 supporting evidence for his rejecting Dr. Gaztambide Montes’s conclusions. Aside 23 from reliance on Dr. Batista’s assessment, 24 encompassing the time period of January 26, 2011 to March 28, 2012 reveals 25 support for a mental residual functional capacity assessment which is not as 26 completely limiting as that made by Dr. Gaztambide Montes, including observations 27 made by Dr. Batista. These include records from the Rodriguez Army Health Clinic He also relied on the reports of Dr. Juan G. Batista and Dr. Zaida a review of the medical records 1 CIVIL NO. 12-1894 (JA) 11 2 3 in Fort Buchanan, Puerto Rico and Dwight D. Eisenhower Army Medical Center in 4 Fort Gordon, Georgia. Indeed, there are no evaluations in the lengthy record which 5 approach the degree of severity attributed by Dr. Gaztambide Montes, whose 6 reports are internally inconsistent. A prior report of Dr. Gaztambide Montes within 7 the evaluation period reflects a milder mental condition than a latter report including 8 the same period. On February 26, 2011, Dr. Gaztambide Montes found plaintiff to 9 be of average intelligence, oriented in person, time and place, with recent, remote 10 and immediate memory intact. (Tr. at 113, 1075). 11 classify plaintiff as obese when he clearly was, as reflected by his constantly being 12 overweight as reflected in his medical records, and being referred to a nutritional 13 specialist. (Tr. at 663, 1031, 1038, 1082). However, plaintiff was also described as 14 well built. (Tr. at 501). Apparently plaintiff weighed 240 pounds in late 2010, 15 according to his wife. (Tr. at 292). The record reveals an average weight of 215 lbs 16 although in mid 2009 he weighed 210 pounds. (Tr. at 380, 501). 17 Also, Dr. Gaztambide did not Controlling weight may be granted when the opinion of the treating physician 18 is well-supported by medically acceptable clinical and laboratory diagnostic 19 techniques. 20 C.F.R. §404.1527(d). The opinion of such a treating physician can 20 be rejected if it is inconsistent with other substantial evidence in the record. See 21 20 C.F.R. § 404.1527(c); cf. Rivera v. Astrue, 814 F. Supp. 2d 30, 37-38 (D. Mass. 22 2011). 23 administrative law judge, not to the court on judicial review. 24 administrative law judge was not required to give the opinion of Dr. Gaztambide 25 Montes controlling weight. See 20 C.F.R. § 404.1527(d); Berríos-Vélez v. Barnhart, 26 402 F. Supp. 2d 386, 391 (D.P.R. 2005); cf. Sánchez v. Comm’r of Soc. Sec., 270 27 F. Supp. 2d 218, 221 (D.P.R. 2003). In this case, the administrative law judge The weighing of such inconsistencies is a function delegated to the Thus, the 1 CIVIL NO. 12-1894 (JA) 12 2 3 stated that he gave no weight to Dr. Gaztambide Montes’ reports, although the 4 administrative law judge relies to a great extent on the assessments of Dr. Boria 5 and Dr. Batista (great weight and credibility). (Trat 19-20). Yet, the administrative 6 law judge must “always give good reasons” for the weight accorded to a treating 7 source’s opinion. See Pagan-Figueroa v. Comm’r of Soc. Sec., 623 F. Supp. 2d 206, 8 210-11 (D.P.R. 2009). 9 Plaintiff takes issue with the lack of “good reasons” for not giving controlling 10 weight to the treating psychiatrist’s assessment. However, the administrative law 11 judge relies on a comprehensive, longitudinal record of plaintiff’s treatment to the 12 point where the VA health professionals detail the percentage of the plaintiff’s visit 13 which is dedicated to counseling. (Tr. at 129-42, 343, 341, 372, 604, 775, 900-01, 14 919, 1007-08, 1040, 1048). The administrative law judge noted that while Dr. 15 Gaztambide Montes concurred in the diagnosis of recurrent severe major depressive 16 disorder, he stated that plaintiff’s restrictions impeded the performance of work at 17 all levels, and imposed marked restrictions for activities of daily living, extreme 18 difficulties in maintaining social functioning, and extreme deficiencies of 19 concentration, persistence and pace. 20 administrative law judge noted that this “clinic picture” is not supported by the 21 evidence of record. (Tr. at 20). Generally, the more consistent an opinion is with 22 the record as a whole, the more weight is given to it. 20 C.F.R. § 404.1527 (c)(4); 23 also see SSR 96-2p; Bouvier v. Astrue, 923 F. Supp. 2d 336, 347-48 (D.R.I., 2013). 24 The antithesis is also true. (Tr. at 1072-80, 1081-90). The 25 Plaintiff was hospitalized for depression at the First Hospital Panamericano 26 from February 24 to March 12, 2012 and his condition was determined to have 27 improved by the time of his discharge, although the diagnosis was recurrent severe 1 CIVIL NO. 12-1894 (JA) 13 2 3 major depression. An X-ray dated May 9, 2011 showed curvature of the thoracic 4 spine favoring mild levoscoliosis, as well as thoracic spondylosis. 5 osteophytes were present. (Tr. at 679). A back MRI dated July 21, 2011 revealed 6 degenerative spondylosis, degenerative disk disease at T11-T12 and bulges at L4-L5 7 and L5-S1. (Tr. at 1021). Earlier X-rays revealed degenerative changes of the 8 cervical vertebra and osteophyte formation on the superior end plates of the 9 anterior L4-L5 vertebra. But even more importantly, the progress notes of record 10 reveal a constancy of treatment and an unchanged continuation of medications 11 since 2009. Plaintiff argues that this constancy reflects a lack of improvement if 12 anything. 13 hospitalized there. His visits were frequent, at times weekly. The long term goal at 14 the VA was to eliminate his depression. 15 scheduled. Plaintiff took his medication regularly. The back condition was constant 16 but most of the time considered mild or moderate, although the pain was originally 17 at the higher end of the pain spectrum. 18 treatment three times between February 2011 and February 2012. (Tr. at 74, 88, 19 90, 95, 104). Marginal Plaintiff received primary care treatment at the VA and was never 20 Regular follow-up visits were always Plaintiff required emergency room VI. MEDICAL-VOCATIONAL GUIDELINES (GRID) 21 In relation to plaintiff’s residual functional capacity, when a nonexertional 22 limitation is found to impose no significant restriction on the range of work a 23 claimant is exertionally able to perform, reliance on medical-vocational guidelines, 24 known as the GRID, is appropriate. If the applicant’s limitations are exclusively 25 exertional, then the Commissioner can meet the burden through the use of a chart 26 contained 27 Medical-Vocational Guidelines, 20 C.F.R. pt. 404, subpt. P, App. 2, tables 1-3 in the Social Security regulations. 20 C.F.R. § 416.969; 1 CIVIL NO. 12-1894 (JA) 14 2 3 (2001), cited in 20 C.F.R. § 416.969; Heckler v. Campbell, 461 U.S. 458 (1983). 4 If the facts of the applicant’s situation fit within the GRID’s categories, the GRID 5 “directs a conclusion as to whether the individual is or is not disabled.” 20 C.F.R. 6 pt. 404, subpt. P, App. 2, § 200.00(a), cited in 20 C.F.R. § 416.969. However, if 7 the applicant has non-exertional limitations (such as mental, sensory, or skin 8 impairments, or environmental restrictions such as an inability to tolerate dust, id. 9 § 200(e)), that restrict his or her ability to perform jobs he would otherwise be 10 capable of performing, then the GRID is only a “framework to guide [the] decision.” 11 20 C.F.R. § 416.969a(d) (2001); Seavey v. Barnhart, 276 F.3d 1, 5 (1st Cir. 2001); 12 Sanchez-Ortiz v. Commissioner of Social Sec., ___F. Supp. 2d ___, 2014 WL 13 494872 (D.P.R. Feb. 7, 2014) at *7-*8. 14 VI: HYPOTHETICAL QUESTIONS 15 Aside from reliance on the GRID, the administrative law judge also relied on 16 the testimony of a vocational expert which assisted him in translating medical 17 evidence of physical and mental limitations into functional terms. Presented with 18 factors related to plaintiff’s mental residual functional capacity assessment, as well 19 as physical limitations, in the questioning of the administrative law judge, the 20 vocational expert determined that there were jobs plaintiff could perform given of 21 a light, unskilled nature, and which did no expose plaintiff to environmental hazards 22 and which did not expose him to the public. 23 one hypothetical question assuming levels of exertional and non-exertional 24 limitations. (Tr. at 41). The administrative law judge asked a hypothetical question 25 the inputs into which must correspond to conclusions that are supported by the 26 outputs of the medical authorities. Arocho v. Sec’y of Health & Human Services, 27 670 F.2d 374, 375 (1st Cir. 1982). “Nevertheless, ‘”the [administrative law judge] The administrative law judge asked 1 CIVIL NO. 12-1894 (JA) 15 2 3 is required only to incorporate into his hypotheticals those impairments and 4 limitations that he accepts as credible.”’ Simila v. Astrue, 573 F.3d 503, 521 (7th Cir. 5 2009) (quoting Schmidt v. Astrue, 496 F.3d 833, 846 (7th Cir. 2007).” Mercado v. 6 Commissioner of Social Sec., 2013 WL 5315763 (D.P.R. Sep. 20, 2013) at *5. 7 Plaintiff takes issue with the failure of the administrative law judge to have asked 8 certain questions related to his limitations. This argument always is cause for 9 pausing because of the non-adversarial nature of these proceedings and a 10 claimant’s right to a full and fair hearing. 11 Commissioner of Social Sec., 2013 WL 149640 (D.P.R. Jan. 14, 2013) at *10. 12 However, plaintiff was well represented by counsel at the hearing, as reflected by 13 the questioning of the vocational expert by plaintiff’s representative, and as 14 reflected in the argument presented to the administrative law judge at the end of 15 the hearing, which included directing the administrative law judge to the reasons 16 why plaintiff was sent to the Global War on Terrorism Warrior in Transition Program 17 at Eisenhower Clinical Center at Ft. Gordon, Georgia and later at Ft. Buchanan, 18 Puerto Rico, and the results of such treatment. (Tr. at 43-44, 45-48). Plaintiff’s 19 representative added what she considered the missing part of the only hypothetical 20 question and the vocational expert was candid in responding to that question as 21 well as to the others. 22 See Bermontiz-Hernandez v. VII. CONCLUSION 23 The final decision that plaintiff has the residual functional capacity to perform 24 light work as defined in 20 CFR 404.1567(b), except for work involving skilled and 25 semiskillled functions, limited to avoiding environmental hazards and not dealing 26 with the public, is based on the review of an extensive and detailed medical record 27 and reflects a reasonable balancing and weighing of evidence and the making of 1 CIVIL NO. 12-1894 (JA) 16 2 3 credibility determinations (Tr. at 19, 20) by the administrative law judge. See Gray 4 v. Heckler, 760 F.2d 369, 374 (1st Cir. 1985); Tremblay v. Sec’y of Health & Human 5 Servs., 676 F.2d 11, 12 (1st Cir. 1982); Rodríguez v. Sec’y of Health & Human 6 Servs., 647 F.2d at 222. 7 evidence lies with the Commissioner, not the courts. Id.; see Barrientos v. Sec’y 8 of Health & Human Servs., 820 F.2d 1, 2-3 (1st Cir. 1987). The rationale of the 9 administrative law judge is sufficiently detailed, and a reasonable weighing of the 10 evidence does not point to the Commissioner’s finding plaintiff to be disabled under 11 the Social Security Act. Thus, the court must affirm the decision, whether or not 12 another conclusion is possible. See Ortiz v. Sec’y of Health & Human Svcs., 955 13 F.2d at 769; Suarez-Linares v. Commissioner of Social Sec., 962 F. Supp. 2d 372, 14 379 (D.P.R. 2013). 15 controlling weight to the treating psychiatrist, Dr. Japhet Gaztambide Montes, the 16 final decision would be affirmed. In that weighing, the power to resolve conflicts in the For example, even if I, on review, were to have given 17 In view of the above, and there being no good cause to remand based upon 18 a violation of the substantial evidence rule, the final decision of the Commissioner 19 is affirmed and that this action is dismissed. 20 accordingly. The Clerk will enter judgment 21 22 At San Juan, Puerto Rico, this 15th day of April, 2014. 23 24 25 26 27 S/ JUSTO ARENAS United States Magistrate Judge

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