As noted, after this case was remanded in March 1982, the Department of Health & Human Services held two additional hearings, the first before ALJ Roseman and the second before ALJ Marden. Each ALJ issued a decision. Because the second decision explicitly adopts the findings of fact set forth in the first, Record at 230, it is appropriate to consider the two together in determining whether the benefit denial is supported by substantial evidence.
ALJ Roseman found that plaintiff suffered from psychogenic arthritis of the left knee, low back syndrome, chronic left ankle sprain, instability of the knees and upper respiratory infection of an exertional nature, but that he retained enough residual functional capacity to perform sedentary jobs.
Record at 258-59. The ALJ also found that claimant's testimony about his pain was not credible as to the severity and duration that plaintiff had described. ALJ Roseman found that plaintiff's mental and emotional problems did not significantly affect his residual functional capacity. Record at 259. The appeals council, in reviewing this last finding, determined that more evidence was needed. Record at 242. At the second post-remand hearing, ALJ Marden considered the evaluations of an additional psychiatrist, psychologist, and vocational expert and found that plaintiff's emotional and mental problems did not significantly reduce his functional capacity. Record at 235.
Alvarez objects specifically to the ALJs' findings concerning pain and the cumulative effects of emotional, mental, and physical problems. I will review each finding and the evidence supporting it separately.
Alvarez' testimony and medical records contain claims of various types of pain, most seriously in the left knee and ankle and in the lower back, of such severity as to render him unable to stand or walk for longer than fifteen minutes or sit for more than one half hour. Record at 351-52. Had the ALJ found this testimony credible, it would have established a claim of disability. Pain, in and of itself, can be disabling and claimant's assertions of pain must be given serious consideration, even where the assertions are not fully confirmed by objective evidence. Smith v. Califano, 637 F.2d 968, 972 (3d Cir. 1981). ALJ Roseman discussed the credibility issue in some detail. Record at 257-58. In discussing the reports of both treating and consultative physicians, the ALJ noted that findings were of tenderness and discomfort rather than of pain.
He also noted the paucity of objective evidence of conditions which would cause the ankle, knee, and back pain, the absence of loss of motion because of pain, and the absence of any consistent treatment for diagnoses which might be the basis for the pain.
Subjective complaints may provide the basis for an award of benefits even though the testimony is unsupported by objective medical data. Bittel v. Richardson, 441 F.2d 1193, 1195 (3d Cir. 1971). "This does not mean, however, that the ALJ may not gauge the credibility and weight of the subjective testimony against the other evidence in the record. . . ." Torres v. Harris, 494 F. Supp. 297, 300 (E.D. Pa. 1980), aff'd, 659 F.2d 1071 (3d Cir. 1981). The ALJ seems to have done that weighing in this case and found plaintiff's descriptions of severity and duration of pain not credible. I must defer to the factfinder on issues of credibility. Davis v. Califano, 439 F. Supp. 94, 98 (E.D. Pa. 1977). "If [the ALJ] explicitly addresses the issue in his decision and his conclusion is supported by evidence he has the discretion to reject a claim."
The ALJ did find that plaintiff's knee, ankle, and back problems precluded all but sedentary work, but that the back pain, from which plaintiff had suffered for many years during his working career, did not prevent all significant work activity. In making this finding, the ALJ correctly acknowledged that the absence of objective evidence was not dispositive, but was only a factor to be considered. Record at 257.
The ALJ's decision can be supported by the medical reports as discussed above, and by the fact that plaintiff had worked for many years with back pain and provided no evidence of exacerbation of the condition. Record at 257. Although the ALJ did not discuss it, I am impressed by the fact that not one of plaintiff's own physicians expressed the opinion that plaintiff's pain was disabling or even instructed him to restrict his activities. Based on these factors,
I hold that the AlJ's finding relating to plaintiff's pain is supported by substantial evidence.
Alvarez also takes issue with the ALJ's finding that his physical and psychological problems, when considered together, do not equal a disability. I disagree and hold that the ALJ's finding is supported by substantial evidence.
In assessing plaintiff's medical problems, the ALJs made the following findings: (1) many of his ailments were acute rather than chronic; (2) he had been successfully treated for lymphangitis and urinary infections and no longer suffered from these complaints; (3) he still required periodic treatment for ear infections and allergies, and for gastritis, when it was not controlled by proper diet and medication; and (4) his musculoskeletal impairments were the most serious problems affecting plaintiff's capacity for work and prevented him from performing other than sedentary jobs. Record at 256.
In seeking to evaluate the additional effect of Alvarez' psychological problems on his residual functional capacity, ALJ Roseman solicited the opinion of Dr. Julius Romanoff, a vocational expert. Dr. Romanoff opined that Alvarez had not utilized the available community resources in dealing with his problems and was currently in need of help. Record at 323-24. The effect of these problems on plaintiff's capacity to work, according to Dr. Romanoff, would depend on the severity of the identified emotional problems. At the time Dr. Romanoff testified, the only information in the record about plaintiff's mental/emotional condition, was contained in the reports of Dr. Schut, a psychiatrist, and of Edward Fish, who had administered a battery of psychological tests to plaintiff. Dr. Schut had diagnosed plaintiff as having a depressive neurosis. Mr. Fish found that plaintiff was very tense and anxious and suffered severe neurotic and somatic symptoms. Record at 213-17. Neither of these reports evaluated the degree of impairment caused by plaintiff's psychological problems.
After the hearing held by ALJ Roseman and before the one held by ALJ Marden, plaintiff was evaluated by Dr. Wallace, a psychiatrist, and Dr. Klores, a psychologist. Dr. Wallace rated the effects of plaintiff's impairments as mild in all cases except plaintiff's ability to perform complex tasks where the effect was rated moderate and his ability to perform simple tasks where there was no limitation. Record at 444-45. Dr. Klores rated plaintiff's limitations as mild or moderate. Record at 434-35. Although both doctors found that plaintiff suffered psychological problems, -- Dr. Wallace diagnosed hypochondrical neurosis with an explosive personality and Dr. Klores suspected a possible brain malignancy and suggested further tests -- each concluded that there were no severe effects on plaintiff's residual functional capacity from these problems.
The earlier psychological evaluations do not contradict those of Drs. Wallace and Klores and the plaintiff has submitted no psychological evidence of his own. Dr. Wallace's and Dr. Klores' evaluations of plaintiff's limitations based on psychological problems, therefore, should be given significant weight. These evaluations support the ALJs' finding that plaintiff's cumulative problems do not equal a disability.
In summary, I find that the Secretary's decision to deny disability benefits based on plaintiff's existing residual functional capacity is supported by substantial evidence. Summary judgment will be entered for the Secretary.
This 29th day of October, 1982, upon consideration of the cross-motions for summary judgment, and after review of the entire record, it is ORDERED that
1. Plaintiff's Motion for Summary Judgment is DENIED; and
2. Secretary's Motion for Summary Judgement is GRANTED.