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December 30, 1981

Richard S. SCHWEIKER, Secretary of Health and Human Services

The opinion of the court was delivered by: POLLAK


Filippo Milazzo has commenced this action to review a final decision of the Secretary of Health and Human Services ("Secretary") denying his claim to a period of disability and to disability insurance benefits under Sections 216(i) and 223 of the Social Security Act, 42 U.S.C. §§ 416(i) and 423. The Secretary has moved for summary judgment.

 Mr. Milazzo, a gentleman born in Italy on August 9, 1921, reads, writes and speaks very little English. His education, received in Italy, is only through the fifth grade. From 1969 through 1977, Mr. Milazzo was employed as a clothing presser by the After-Six corporation. This is the only occupation he has known, working previously in Italy as a presser in a tailor's shop. In 1977, Mr. Milazzo left his employment complaining that he suffered from hypertension, cardiac insufficiency, emphysema and bad nerves. He initially filed for disability benefits on October 24, 1979, claiming that he had been disabled as a result of these impairments since June 29, 1977. The Social Security Administration denied the application both initially and upon reconsideration. On October 7, 1980, a hearing de novo was held before an Administrative Law Judge ("ALJ"). Mr. Milazzo and his sister, Salvatrice Milazzo, appeared and testified. Mr. Milazzo testified through an Italian interpreter and was, at that time, represented by counsel. *fn1" A decision, again denying benefits, was rendered on December 4, 1980. The ALJ's decision became the final decision of the Secretary when, on February 13, 1981, the Appeals Council of the Social Security Administration refused Mr. Milazzo's request for review. This appeal followed.

 Mr. Milazzo's pro se complaint is filed pursuant to section 205(g) of the Social Security Act, 42 U.S.C. § 405(g). *fn2" Section 205(g) provides that the findings of the Secretary as to any fact shall be conclusive on appeal "if supported by substantial evidence." The Third Circuit Court of Appeals has defined substantial evidence to mean

more than a mere scintilla. It means such relevant evidence as a reasoning mind might accept as adequate to support a conclusion.

  Smith v. Califano, 637 F.2d 968, 970 (3d Cir. 1981), quoting from Richardson v. Perales, 402 U.S. 389, 91 S. Ct. 1420, 28 L. Ed. 2d 842 (1971); Cotter v. Harris, 642 F.2d 700, 704 (3d Cir. 1981); Lewis v. Califano, 616 F.2d 73, 76 (3d Cir. 1980).

 Two requirements must be satisfied to qualify for benefits under section 223: First, the claimant must suffer from a medically determinable physical or mental impairment which can be expected to result in death, or which has lasted, or can be expected to last, for a continuous period of at least twelve months. 42 U.S.C. § 423(d)(1)(A). Next, the claimant's impairment must be so severe as to prevent him from engaging either in his previous work or, considering his age, experience, education or work experience, "in any other kind of substantial gainful work which exists in the national economy." 42 U.S.C. § 423(d)(2)(A). The ALJ found that Mr. Milazzo suffered from hypertension and periodic episodes of chest and shoulder discomfort. He noted, however, that both conditions were under control with medication, with "no evidence of significant cardiovascular or pulmonary pathology." (Tr. 25). The ALJ also found insufficient evidence of such pain as would have precluded Mr. Milazzo's return to his former duties. Finally, the ALJ found that claimant possessed the residual functional capacity to resume pressing clothes and was, therefore, not suffering from a "disability" within the meaning of the Social Security Act.


 The specific issue in this proceeding is whether these findings are supported by substantial evidence. Mr. Milazzo has claimed disability from a number of ailments. In particular, he complains of constant chest pain and difficulty breathing. The ALJ denied Mr. Milazzo's application, finding that the plaintiff's impairments were not sufficiently severe to be disabling. The ALJ's evaluation of the medical evidence supporting this determination is found in the following excerpt from the decision:

Claimant has hypertension, but this condition is generally stable and adequately controlled with medication with no evidence of significant end organ damage or pathology. Similarly, although claimant alleges episodes of chest discomfort, there is no evidence of any cardiovascular pathology or abnormality on examination, or in clinical studies, including chest x-ray and EKG. The general consensus of the medical record is that the claimant's periodic chest discomfort is musculoskeletal in origin. While claimant alleges breathing difficulty, examination also reveals no significant pulmonary dysfunction and claimant's lungs are clear. Studies, including pulmonary function examination, reveal no significant pathology. The claimant's periodic episodes of anxiety are adequately controlled with medication, including valium. There is no basic conflict in the medical record as all treatment sources indicate a paucity of objective evidence which would substantiate claimant's subjective level of symptomatology.

 (Tr. 23-24). This cursory review, however, excludes certain medical evidence which, on examination of the record, I find relevant.

 In a report dated December 8, 1978 (Ex. 10, Tr. 81), Dr. Mediano concluded that there was a fissure sign in plaintiff's left lung which, the doctor opined, was consistent with a diagnosis of thrombo-embolic disease. However, Dr. Mediano found good perfusion of plaintiff's right lung. On December 28, 1978, Dr. Mediano again examined plaintiff and, although noting that there was no active lung disease, indicated "no marked change since the study of 12-8-78." (Tr. 84). Plaintiff was also examined on December 28, 1978 by Dr. Martin Lachman. Although Dr. Lachman found improvement in the left lung, he noted a perfusion defect at the right base and commented that "(t)his would be due to chronic obstructive pulmonary disease or possibly to an additional pulmonary embolis." (Tr. 82). These reports were not mentioned in the ALJ's decision. On February 8, 1979, Dr. Singer diagnosed hypertensive cardiovascular disease and chest and shoulder pain which he diagnosed as probably being secondary to fibromyositis and/or bursitis. (Ex. 11, Tr. 85). The ALJ offered no comment on the probative value of either of Dr. Singer's findings. The record also contains a report of Dr. Giaccomo Vigilanza Coretto dated October 15, 1979. Dr. Coretto had examined plaintiff in Venezuela and had made the following diagnoses: arterial hypertension; cardiac insufficiency; slight pulmonary emphysema; and exaggerated emotiveness. (Ex. 12, Tr. 88). The ALJ offered no specific reason why Dr. Coretto's diagnoses were rejected. On January 10, 1980, Dr. Matez reported that Mr. Milazzo "is under my care for medical problems and is unable to work at this time." (Ex. 15, Tr. 93). The ALJ summarily dismissed Dr. Matez's conclusion, commenting that the doctor's opinion "is not adequately supported by findings from examination or clinical studies...." (Tr. 24). According to the ALJ, the opinion was "largely based on the claimant's subjective symptomatology." (Tr. 24). However, in a report dated February 11, 1980, Dr. Matez indicates that he had examined the plaintiff on January 10, 1980 and diagnosed musculoskeletal costrochondral discomfort. (Ex. 14, Tr. 92). In addition, Dr. Matez suspected cardiac problems and recommended a complete cardiac evaluation by a competent specialist.

 The Third Circuit Court of Appeals has recently and emphatically recognized that

there is a particularly acute need for some explanation by the ALJ when s/he has rejected relevant evidence or when there is conflicting ...

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