LOURENE REED, Plaintiff, v. LOUIS W. SULLIVAN, M.D., Secretary of Health and Human Ser

ORDER ON APPEAL OF SECRETARY'S DENIAL OF BENEFITS

LARRY McKINNEY, Chief Judge, District

This social security appeal is before the Court on the complaint of the plaintiff for review of the Secretary's denial of supplemental security income benefits (SSI) under sections 1611 and 1614(a) (3) (A) of the Social Security Act (Act). 42 U.S.C. § 405(g). The issues raised have been briefed and are ready for resolution. As set forth, the Secretary's decision is supported by substantial evidence and the Court AFFIRMS the Secretary's denial of benefits.

I. MEDICAL BACKGROUND

Records from Wishard Memorial Hospital (Wishard) indicate that Reed was treated from June 13 to June 26, 1987, and was diagnosed as suffering from insulin dependent diabetes mellitus with hyperglycemia, chronic alcohol abuse, a sprain of the left wrist, glaucoma, and pruritus. At the time of admission, Reed was found unresponsive in a hypoglycemic coma. Reed was treated with intravenous glucose and became agitated. She was then treated with Morphine and Haldol. Her hypoglycemia was quickly resolved and by the second hospital day she already showed signs of hyperglycemia. She was placed back on insulin. She was noted to have a problem with chronic alcoholism and her left wrist strain was x-rayed. No break was found. Reed was noted to have numerous symptomatic complaints which were treated and resolved rapidly. She was released on medication.

Records from Winona Memorial Hospital (Winona) indicate that the claimant was treated from December 7 to December 18, 1987, and diagnosed as suffering from uncontrolled diabetes and an old history of alcohol abuse. She was admitted to the hospital because her blood sugar was in excess of 500 mg. She was noted to have a history of alcoholism, but her diabetes improved significantly during hospitalization.

Reed was again treated from December 23 to December 30, 1987, and diagnosed as suffering from early pneumonia, arteriosclerotic heart disease, hypertension, a dependent personality disorder, and insulin dependent diabetes. She was placed on intravenous antibiotics for pneumonia and showed moderate improvement of her chest problem. Bone scan produced negative results. Ultimately, Reed was released on medication.

Reed was again treated from February 21 to March 2, 1988, and diagnosed as suffering from insulin dependent diabetes, osteoarthritis, gastritis, and metabolic acidosis secondary to her diabetes. She had been placed on fluctuating doses of insulin to control her diabetes, but continued to have hypoglycemic episodes. Reed's blood sugar was brought into the controlled range. and she was discharged to be followed as an out-patient.

Dr. Shafer, a State agency consultant who examined Reed, on May 8, 1988, reported that Reed suffered from insulin dependent diabetes, diabetic diarrhea, probable pancreatitis, blindness in the right eye, generalized fibromyositis, and a history of cirrhosis of the liver with decompensation which was now in remission. Reed was noted to have a 13 year history of insulin dependent diabetes with a history of poor control and several episodes of diabetic acidosis and several episodes of hypoglycemia. The blindness in her right eye was noted to be secondary to extensive retinal detachment which might have been traumatic in origin.

On May 12, 1988, Reed underwent an ophthalmologic examination and was diagnosed as suffering from an aphakic right eye with blindness since an injury in 1976, glaucoma in the right eye, and no glaucoma in the left eye. She was noted to have no light perception in the right eye and 20/20 vision in the left eye. Reed was using glaucoma medication in both eyes, but intraocular tension and fields in the left eye were normal.

Dr. Wooden, a State Agency consultant who performed a psychiatric evaluation of Reed on June 1, 1988, reported that Reed suffered from a history of alcohol abuse which had been in remission for the past 10-12 years, and mild to moderate adjustment disorder with depressed mood. Mental status evaluation revealed that Reed was depressed subsequent to the death of her three daughters during 1987. Reed reported that she was a restless sleeper and had racing thoughts in regard to the death of her daughters. Her memory functions appeared to be within the mildly impaired range as far as attention span and concentration were concerned. Her calculational ability appeared to be generally intact. Reed was capable of handling her funds. Reed's judgment was described as good. There was no evidence of any thought disorder. Her associations were generally tight and logical. There was no evidence of hallucinations, delusions, paranoid thinking or bizarre thoughts. Reed denied any drug abuse, but did admit a history of past alcohol abuse which was quite bad in 1973 and 1974. Reed denied alcohol abuse during the past number of years. Reed's prognosis was described as fairly good.

Records from Winona indicate that Reed was admitted on September 28, 1988 and diagnosed as suffering from brittle diabetes, hypoglycemic reaction secondary to her brittle diabetes, a history of hiatal hernia with reflux esophagitis, a history of chronic atrophic gastritis, a history of chronic pancreatitis, a history of diverticulosis, and a history of colon polyps. Reed was started on a low dosage of insulin.

Reed was again treated from October 10 to October 11, 1988, and diagnosed as suffering from an acute fracture of the proximal left humerus with the head of the humerus angulated posteriorly, insulin dependent diabetes, a history of pancreatitic insufficiency, chronic bronchitis, a history of diverticulitis, and a history of hiatal hernia with reflux esophagitis. The claimant's fracture was not an open fracture, and she was transferred to Wishard for further treatment of this impairment.

In summary, the medical evidence indicated that Reed suffers from insulin dependent diabetes, diabetic diarrhea, probable chronic pancreatitis, blindness in the right eye, generalized fibromyositis, a history of cirrhosis of the liver with decompensation now in remission, a history of alcohol abuse in remission, and an adjustment disorder with depressed mood.

II. PROCEDURAL BACKGROUND

Reed filed her application for SSI on March 21, 1988, alleging an onset date of January, 1987. The application was denied initially and on reconsideration. A hearing was held on May 11, 1989, at which Reed was represented by counsel. On June 28, 1989, the Administrative Law Judge (ALJ) issued a written decision holding that Reed was not disabled. Subsequently, the Appeals Council denied Reed's request for review on March 27, 1990. Thus, the ALJ's decision became the final decision of the Secretary. Thereafter, pursuant to 42 U.S.C. § 405(g), Reed filed this action with the Court for judicial review of the Secretary's final decision.

III. THE SECRETARY'S DECISION

The Act defines disability as an inability to engage in substantial gainful activity due to a medically determinable impairment which can be expected to last for 12 continuous months. 42 U.S.C. § 1382c(a) (3) (A). A claimant will be disabled only if his impairments are of such severity that he is both unable to do his previous work, and cannot, given his age, education and work experience, do any other substantial gainful work existing in the national economy, notwithstanding the availability of such work, or whether he would be hired if he applied for work. 42 U.S.C. § 1382c(a) (3) (B). The Act, unlike a worker's compensation system, does not contemplate degrees of disability or allow for an award based on partial disability. Stephens v. Heckler, 766 F.2d 284, 285 (7th Cir. 1985).

At the hearing, the ALJ was required to use the following five-step sequential procedure for evaluating plaintiff's claims:

1. If the claimant is doing substantial gainful activity, she is not disabled;
2. If the claimant does not have a severe impairment, she is not disabled;
3. If the claimant has an impairment or combination of impairments which is found on the Listings or is equal to a listed impairment, she is disabled;
4. If the claimant's residual functional capacity allows her to perform work she has done in the past, she is not disabled;
5. If the claimant cannot, in view of her residual functional capacity and her age, education, and past work experience, perform other work in the national economy, she is disabled.
20 C.F.R. §§ 404.1520, 416.920. First, the ALJ determined that Reed had not engaged in substantial gainful activity since March 21, 1988. Second, the ALJ found that the medical impairments listed above do interfere with her ability to perform basic work activities; and thus, Reed suffers from a severe impairment. Third, the ALJ held that Reed's impairments, when considered individually or in combination, are not severe enough to meet or equal the requirements specified in the Listing of Impairments. Finally, the ALJ determined that Reed is capable of doing medium work, is able to return to her past relevant work as a nurse's aide, cook, maid, and janitor; and thus is not disabled.

IV. GENERAL STANDARDS OF REVIEW

The district court's function on review of the Secretary's findings is to determine whether the record as a whole supports the decision. 42 U.S.C. § 405(g); Burnett v. Bowen, 830 F.2d 731, 734 (7th Cir. 1987). If the Secretary's findings are supported by substantial evidence in the record, the Court must affirm unless there has been an error of law. Waite v. Bowen, 819 F.2d 1356, 1360 (7th Cir. 1987). Substantial evidence is relevant evidence as a reasonable mind might accept as adequate to support a conclusion. Burnett, 830 F.2d at 734. Although courts cannot interject their own judgment for that of the Secretary, they "must not simply rubber stamp his decision in the absence of a critical review of the evidence." Veal v. Bowen, 833 F.2d 693, 696 (7th Cir. 1987). Therefore, plaintiff's proof must show that no reasonable person, based on the record as a whole, could have found as the Secretary did.

The burden to prove disability is on the claimant through Step 4. 42 U.S.C. § 423(d); McNeil v. Califano, 614 F.2d 142, 145 (7th Cir. 1980). However, the burden of proof is on the Secretary at Step 5, where the ALJ considers whether the claimant can do other work in light of his age, education, and past work experience. McNeil, 614 F.2d at 145; Steward v. Bowen, 858 F.2d 1295, 1297 n. 2 (7th Cir. 1988). This burden shifting at Step 5 is not statutory, "but is a long-standing judicial gloss on the Social Security Act." Walker v. Bowen, 834 F.2d 635, 640 n. 3 (7th Cir. 1987).

The substantial evidence standard "asks only whether substantial evidence exists to support the conclusion made below." Farrell v. Sullivan, 878 F.2d 985, 990 (7th Cir. 1989). Even if this case could have gone either way, neither the Seventh Circuit nor the District Court has the power to reweigh the evidence presented below. Id. The question is whether the ALJ's decision was supported by substantial evidence. The courts are not to reweigh the evidence presented at the hearing and will not determine whether the claimant was actually disabled. Stuckey v. Sullivan, 881 F.2d 506 (7th Cir. 1989).

V. DISCUSSION

The claimant raises two issues on appeal. First, Reed argues that substantial evidence fails to support the Secretary's conclusion that she fails to meet a listed impairment, either individually or in combination. Second, Reed argues that substantial evidence does not support the Secretary's decision that she retains the residual functional capacity to perform her past relevant work.

A. Listed Impairments

The ALJ held that Reed's impairments, when considered individually or in combination, are not severe enough to meet or equal the requirements specified in the Listing of Impairments. 20 C.F.R. § 416.920(d). Reed argues that she meets sections 9.08, 12.09, and 5.08 of the Listing of Impairments. Her arguments are without merit.

Under Social Security regulations, "[f]or a claimant to qualify for benefits by showing that h[er] unlisted impairment, or combination of impairments, is `equivalent' to a listed impairment, [s]he must present medical findings equal in severity to all the criteria for the one most similar listed impairment." Sullivan v. Zebley, 110 S. Ct. 885, 891 (1990) (emphasis in original). "A claimant cannot qualify for benefits under the `equivalence' step by showing that the overall functional impact of h[er] unlisted impairment or combination of impairments is as severe as that of a listed impairment." Id. at 892. Thus, "[f]or a claimant to show that h[er] impairment matches a listing, it must meet all of the specified medical criteria. An impairment that manifests only some of those criteria, no matter how severely, does not qualify." Id. at 891 (emphasis in original).

First, Reed argues that she has an alcohol condition that meets listing 12.09. Substantial evidence in the record supports the ALJ's determination that Reed's alcoholism is in remission and, except for a brief episode of grief reaction drinking in 1987, has been for over 10 years. While it is clear that she once had a severe alcohol problem, Reed, herself, stated that she no longer drinks. The record is completely devoid of any evidence that Reed currently abuses alcohol. Thus, substantial evidence supports the ALJ's decision.

Second, Reed contends that her weight loss satisfies listing 5.08. To qualify, a woman 65 inches tall must weigh 100 pounds or less for at least 3 months and expect to maintain that weight for at least 12 months, and have uncontrolled diabetes. However, the record indicates that Reed weighed less than 100 pounds only during December of 1987. Therefore, substantial evidence supports the ALJ's decision.

Last, Reed alleges a disabling diabetic condition equal to listing 9.08. In order to meet that listing, Reed must have diabetes with acidosis occurring at least on the average of once every 2 months. Evidence of episodes of diabetes with acidosis of sufficient frequency is not present in the record; thus, substantial evidence supports the ALJ's decision.

Much is made by the parties of the ALJ's statement that if Reed was to take her medication and follow her diet, she would not have episodes of acidosis. Reed argues that her noncompliance is due to her other impairments and should not be considered. However, because she does not meet the listing, whether she could control her diabetes is not determinative. Thus, the Court will not address the issue of noncompliance.

The Supreme Court has recently reiterated that for a claimant to show that her impairment matches a listing, it must meet all of the specified medical criteria. Reed has failed to demonstrated that she meets the requirement of any specific listing. Reed argues strenuously that the ALJ did not consider all her impairments in combination. However, she never specifies exactly how other medical findings substitute in severity for missing elements in one of the listings. She has this burden. Her arguments are more appropriate in the determination of remaining residual functional capacity.

B. Determination of Residual Functional Capacity

The ALJ determined that Reed retained the residual functional capacity (RFC) to perform medium work. Medium work involves lifting no more than 50 pounds, lifting 25 pounds frequently, and doing a good deal of standing and walking. Additionally, the ALJ found that Reed is capable of returning to her past work as a nurse's aide, cook, janitor, and maid. As before, the ALJ's determinations are to be upheld if they are supported by substantial evidence.

Reed testified that her past work as a cook required her to lift only approximately 10 pounds. Her work as a maid did not require her to do any lifting other than lifting the mattress to tuck in the sheet. At the hearing, Reed testified that she is able to do household chores and make certain her grandchildren get off to school. Reed also testified that she walks a block with her youngest grandchild. While another conclusion is possible, the above evidence constitutes substantial evidence to support the ALJ's decision. Therefore, the Court must affirm the final decision of the Secretary.

Reed argues that the testimony of a vocational expert is required. However, because the ALJ made a Step 4 determination that the claimant could return to past employment, no vocational expert is required.

VI. CONCLUSION

The Court finds that substantial evidence supports the ALJ's decision that Reed is not disabled. Therefore, the Court AFFIRMS the Secretary's denial of benefits.

IT IS SO ORDERED.

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REED v. SULLIVAN, (S.D.Ind. 1990)
(Oct 1, 1990)