some evidence to show his or her condition remains unchanged or has worsened should not impose any undue hardship. Disability recipients are likely to remain under some medical treatment or supervision." Kuzmin, 714 F.2d at 1237. The Secretary has likewise satisfied her initial burden by coming forward with medical evidence indicating improvement in the plaintiff's condition. (See Tr. 310-32); Kuzmin, 714 F.2d at 1237. Therefore, as stated above, this court must next examine the Secretary's final decision under the substantial evidence standard.
There are four elements of proof to be weighed in determining whether there is substantial evidence to support the Secretary's decision: (1) the objective medical facts; (2) the diagnoses and expert opinions of treating and examining physicians on subsidiary questions of fact; (3) subjective evidence of pain testified to by the claimant and corroborated by family and neighbors; (4) the claimant's educational background, work history and present age. Blalock v. Richardson, 483 F.2d 773, 776 (4th Cir. 1972); Underwood v. Ribicoff, 298 F.2d 850, 851 (4th Cir.1962). Through his evaluation of the evidence in the case sub judice the ALJ determined that the plaintiff's condition has improved such that she is no longer completely precluded from engaging in substantial gainful activity as a result of her medical impairments. (Tr. 116 and 117).
The pertinent medical evidence in the case comes in the form of reports from several physicians and hospitals. Doctors Fiedler and McNamara are the claimant's treating physicians, and Dr. Schwab (a cardiovascular disease and internal medicine specialist) examined the plaintiff at the request of the Secretary.
In a discharge summary from the Medical College of Pennsylvania and Hospital dated March 18, 1982, signed by Doctors Chow (of the hospital) and McNamara it was reported that plaintiff was in no acute distress. It was further stated that plaintiff's lower extremities revealed no swelling and no tenderness. While the report does state that the surgery plaintiff underwent in 1980 did not "really" improve her phlebitis condition there is no basis given or implied for such a conclusion. (Tr. 297). In examination reports dated April 15, 1982, Dr. McNamara indicates only normal clinical findings regarding the plaintiff's condition. (Tr. 305 and 307).
In a discharge summary from Memorial Hospital Roxborough dated September 12, 1981 Dr. Fiedler diagnosed the plaintiff as having Thrombophlebitis of the left leg. However, as indicated by Dr. Fiedler in that report, all the tests given the plaintiff had normal results. In fact Dr. Fiedler's report states, "Dr. David Naide of the vascular service was consulted and he questioned the actuality of so many recurrent episodes of phlebitis considering the good clinical picture that they presented." (Tr. 283 and 284). In a report dated November 23, 1982, Dr. Fiedler stated that plaintiff has chronic Thrombophlebitis. However, in the same paragraph, Dr. Fiedler states, "Her symptoms are mainly subjective and hard to evaluate by concrete physical evidence of disease." (Tr. 329).
Dr. Schwab examined the plaintiff on May 18, 1982 and found her to be in no acute distress. All of Dr. Schwab's clinical findings were normal. The plaintiff was given a cardiovascular treadmill stress test on May 26, 1982 and Dr. Schwab reported that plaintiff performed the test "quite well." (Tr. 322-324). As a result of the clinical findings of his stress testing of plaintiff, Dr. Schwab labeled her exercise capacity as good to excellent. (Tr. 324). Dr. Schwab concluded that "The lady has no evidence of active phlebitis." (Tr. 324).
The ALJ has the duty to resolve conflicting medical opinions in carrying out his function of determining whether or not an individual is under a disability. 20 C.F.R. § 404.1526; Richardson v. Perales, 402 U.S. 389, 399, 91 S. Ct. 1420, 1426, 28 L. Ed. 2d 842 (1971); Good v. Weinberger, 389 F. Supp. 350, 355 (W.D.Pa.1975). In so doing, the ALJ is not bound to accept the plaintiff's own physician's conclusion without weighing it in balance with other evidence, both medical and vocational. Good, supra, 389 F. Supp. at 355; Urgolites v. Finch, 316 F. Supp. 1168, 1174 (W.D.Pa.1970). However, the opinion of the treating physician is entitled to a great deal of weight. This is so even where such opinions are unaccompanied by particular clinical tests or findings. Twardesky v. Weinberger, 408 F. Supp. 842, 846 (W.D.Pa.1976).
In the case sub judice the ALJ considered the opinions of the treating physicians but decided that the conclusions offered by Doctors Fiedler and McNamara could not overcome the overwhelming clinical evidence to the contrary. (Tr. 113-116). In light of the fact that all physicians and hospital reports failed to clinically establish "active" phlebitis in any way, and, further, in light of Dr. Schwab's findings it cannot be said that the ALJ erred in not accepting, as dispositive, the treating physician's conclusions of a continuing active disabling phlebitis.
The ALJ also found that the claimant's testimony of subjective complaints of pain was not credible so as to reveal a disabling impairment. (Tr. 115, 117). In so finding the ALJ pointed to the total lack of supporting clinical evidence from even treating physicians as well as the contrary findings of Dr. Schwab's thorough examination. (Tr. 116).
This case is ultimately decided under the Social Security Administration medical and vocational regulations. See 20 C.F.R. § 404.1501. The regulations require a five step sequential analysis. 20 C.F.R. § 404.1520(a). If the criteria of any of the first four steps are met the case is disposed of on that basis. See 20 C.F.R. § 404.1520(b-e). If, however, the fifth and final step is reached the factors of age, education, past work experience in combination with residual functional capacity must be considered to determine whether any work may be performed by the claimant. See 20 C.F.R. § 404.1520(f).
In the case sub judice the ALJ stopped at the second step of analysis and directed a finding of "not disabled." (Tr. 112 and 117); 20 C.F.R. § 404.1520(c). Title 20 C.F.R. § 404.1520(c) provides that the plaintiff must have a severe impairment in order to pass muster at that step of analysis. If plaintiff's impairments do not prevent him/her from doing "basic work activities" then plaintiff is deemed not to have a severe impairment and finding of "not disabled" is directed. 20 C.F.R. § 404.1520(c)."Basic work activities" are defined in 20 C.F.R. § 404.1521(b) as the abilities and aptitudes necessary to do most jobs. Examples of basic mental and physical abilities and aptitudes are given. 20 C.F.R. § 404.1521(b)(1-6). Based upon the evidence presented in this case the ALJ determined that plaintiff's impairments no longer rise to the level of severity so as to prevent her from engaging in basic work activity. That ruling subsequently became the Secretary's final decision. This court finds that the Secretary's final decision is supported by substantial evidence in that such decision is supported by "such relevant evidence as a reasonable mind might accept to support a conclusion." See, supra, Richardson, 402 U.S. at 401, 91 S. Ct. at 1427, quoting, Consolidated Edison Co. v. N.L.R.B., 305 U.S. 197 at 229, 59 S. Ct. 206 at 216, 83 L. Ed. 126. Accordingly, it was not error to terminate plaintiff's benefits as plaintiff no longer remained disabled within the meaning of the Act. Therefore, plaintiff's motion for summary judgment is denied and defendant's motion for summary judgment is granted.