USCA1 Opinion

February 3, 1993
[NOT FOR PUBLICATION]
UNITED STATES COURT OF APPEALS
FOR THE FIRST CIRCUIT
____________________
No. 92-1829
ANA GIMENEZ,
Plaintiff, Appellant,
v.
SECRETARY OF HEALTH AND HUMAN SERVICES,
Defendant, Appellee.
____________________
APPEAL FROM THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF PUERTO RICO
[Hon. Jaime Pieras, Jr., U.S. District Judge]
___________________
____________________
Before
Breyer, Chief Judge,
___________
Torruella and Cyr, Circuit Judges.
______________
____________________

Salvador Medina De La Cruz on brief for appellant.

__________________________
Daniel F. Lopez Romo, United States Attorney, Jose Vazq
_______________________
__________
Garcia, Assistant United States Attorney, and Jan B. Brown, Assist
______
____________
Regional Counsel, Department of Health and Human Services, on br
for appellee.
____________________
____________________

Per Curiam.
__________
a

district

Secretary of

Claimant, Ana M. Gimenez, appeals from

court judgment
Health

and

affirming

the

Human Services

decision of
that

she

entitled to Social Security disability benefits.

is

the
not

We affirm.

I.
_
Claimant
November 7, 1989.
1988;
the

applied

for

disability

She claimed an onset

her insured status expired

benefits

on

date of December 31,

on December 31,

1992.

At

time she filed her application, she was fifty years old.

Claimant's alleged impairments included herniated discs, left

hand injury, migraine headaches, osteoporosis, pinched nerves
and cardiac arrythmia.

Her claim

was denied initially

and

upon reconsideration.

An administrative law judge (ALJ) held

a hearing and determined that claimant could perform her past

work.
review.

The Appeals
Thus,

Council

denied claimant's

the ALJ's decision became the

request

for

final decision

of the Secretary.
From
disability
evidence

her

testimony

report

completed

emerges.

at
by

the

claimant,

Claimant worked for

nineteen years until it

was there she held

In this

productions

clerk

and

following

While she

She began

working as

position, she took care of the

involved

Her next position

keeping

handwritten

production reports and assisting with taking inventory.

then became

an inventory control clerk and

keeping

track

required

her

of
to

inventory.
be

seated

the

the same company for

accounts receivable books and did filing.

as

the

closed in December 1988.

several positions.

an accounting clerk.

hearing

These
fifty

She

worked solely on

positions

percent

Claimant's last position was as a receptionist.

of

generally
the

time.

At this job,

she

sat all of the

her

hands

time.

for tasks

She stated that

such

as

she used both of

operating a

calculator

and

working the switchboard.

Claimant

sustained

back

injury

in

1980

and

asserted that due to

back and hip pain, she could not remain

in

long; she often had

one position too

this pain.

After

working as

a drug

her job ended in December

store clerk.

This

because claimant could not stand.

in her left

missed work due to

big toe, left

1988, she tried

job lasted

one week

Claimant also alleged pain

leg and right

knee.

She

stated

that due to left foot spurs the foot would swell so much that
she could

not stand.

pain in her knees.

pain but

Claimant receives injections

She

is limited in

cardiac problems.

This

for the

also takes other medication for

the

the amount

her

she can use

medication gives her

due to

"some relief"

from the pain.

As for
the

time

of

the

her headaches, claimant testified

hearing,

she

had

been

suffering

migraines on a daily basis for the past six years.

migraine attack, she is unable
and

cannot

tolerate

from

During a

to concentrate, read or think

light.

The

however, alleviates the symptoms.

-3-

that, at

medication

she

takes,

Claimant stated that she also suffered from pain in

her left shoulder, arm,

hand and fingers.

the nerves in her fingers are

she

She

averred that

pinched and that, as a result,

cannot perform any tasks with her left hand (claimant is

left-handed).

Specifically, her

cramped and numb; she

hand all

the way.

left hand becomes

swollen,

cannot uncurl her fingers to

open her

She testified

that her

right hand

was

beginning to develop similar symptoms.

Claimant shares a duplex
able

to take

care of

her personal needs.

sister help with the cooking.

or

twice a

trash.

with relatives.

month, washes

mother and

She sweeps and mops about once

dishes, irons

and takes

out the

Her mother does all the laundry because of claimant's

problems

with her hands.

can,

drives an

with

help

Claimant goes to

automobile and

from relatives.

does her

television and
spends a

church when she

household shopping

However, she

household cleaning chores and yard work.

She

Her

She is

cannot

do heavy

She reads, watches

receives visitors two to three times a month.

lot of

time in

a prone

position due

to her

claimant suffered

from a

headaches.
The ALJ
combination
disease,

of

determined that
impairments

essential

including

hypertension,

degenerative

left trapezius

joint

myositis,

mild right and left carpal tunnel syndrome and a painful left
foot

hallux valgus (angulation of great toe).

He noted that

-4-

one

physician had

anxiety

disorder

treatment for it.

did

reported that
but

that

claimant suffered

claimant

never

had

from an
received

Thus, he determined, this mental condition

not reduce, in any significant way, her capacity for the

performance of basic work activities.

subjective complaints

of disabling

He credited claimant's
pain only to

the extent

that her residual functional capacity was limited to the full

range

of light exertion.

He

then concluded

that claimant

could perform her past work.

II.
__
A claimant for Social Security
bears

the initial

cannot perform

burden

of establishing

past relevant work.

of Health and Human Services, 690

____________________________
This

burden includes

disability benefits

proving that

that

he or

she

Goodermote v. Secretary
__________
_________
F.2d 5, 7 (1st Cir. 1982).
a claimant

is prevented

from

returning to

solely to the

his or

her type

particular job.

of work

See Dudley
___ ______

generally, not
_________
v. Secretary of
_____________

Health and Human Services, 816 F.2d 792, 795 (1st Cir. 1987)
__________________________
(per
1985)

curiam); Gray v. Heckler,

____
_______
(per curiam).

Security

Act is

supported

760 F.2d 369,

Our standard of review under the Social

whether

the

by "substantial

Secretary's determination

evidence."

Although the record may support

will uphold
the evidence

372 (1st Cir.

the Secretary
in the record

42 U.S.C.

is

405(g).

more than one conclusion, we

if "a reasonable
as a

mind, reviewing

whole, could accept

it as

-5-

adequate to support his

conclusion."

of Health and Human Services,

_____________________________
1981).

The resolution of

Rodriguez v. Secretary
_________
_________

647 F.2d 218,

conflicts in the

the Secretary, not the courts.

Id.
___

222 (1st

Cir.

evidence is for

On
arguments:

appeal

(1) the severity

prevented her from

and

claimant

presents

essentially

of her carpal

performing the full

three

tunnel syndrome

range of both

light

sedentary work; (2) due to her back and foot conditions,

she could not sit or stand for sufficient

engage in any work;

and (3) the ALJ did

her allegations of
these

claims, we

record.

pain.
note

Claimant's

progress notes
responses

not properly credit

Before turning to
that this

is

Social

the merits

an especially

evidence consists

from the

to

periods of time to

of three

State Insurance Fund,

Security

disability

of

sparse

very brief
four cursory

determination

questionnaires prepared by claimant's treating physicians and

two radiology reports.
the

record

residual

to

two

In addition, the Secretary submitted

non-examining

functional capacity

examined by

doctors

(RFC) forms

who

and

a consultative rheumatologist.

completed

had claimant

We will discuss

this evidence in light of claimant's issues on appeal.

1.
testimony, the

Claimant

argues,

that,

carpal tunnel syndrome

based

upon

is so severe

amounts to a serious nonexertional impairment.

her

that it

She refers to

Social Security Ruling (SSR) 83-14, entitled Capability to do

-6-

Other Work -- the Medical-Vocational Rules as a Framework for

Evaluating

Combination

Impairments.
states that
and

hands.

required to

Although

of

Exertional

not directly

and Nonexertional

on point,

sedentary work requires good use

Given

this, claimant

secure the testimony

assess the extent

this ruling

of the fingers

concludes,

the ALJ

of a vocational

expert to

to which her carpal tunnel syndrome eroded

the occupational base for light and sedentary work.1

We
securing

do not

hands.

that

the

In claimant's

ALJ

erred

In an arthritis

Id.
___
in

not

medical evidence,

one reference to any impairment

Gonzalez states
her left

believe

such testimony.

there is only

was

involving her

medical questionnaire, Dr. Victor M.

that claimant has swelling of

the joints of

hand and that the fourth finger of her left hand is

"trigger

despite the

finger."

He

provided

specific request for "a

no further

explanation

detailed description of

____________________
1. Claimant also relies on SSR 85-15, which concerns the use
of the Medical-Vocational Guidelines for solely nonexertional
limitations, for the argument that for unskilled, sedentary
_________
work, claimant must be able to use her hands for fine
manipulations such as picking, pinching, grasping, holding
and turning. We only note that the ALJ described claimant's
past work as semi-skilled in nature, a finding she does not
____________
dispute.
In any event, the two RFC forms stated that
claimant had no limits in performing fine manipulations.

Similarly, Sec. 201.00(h) of Pt. 404, Subpt. P, App. 2

(the Medical-Vocational Guidelines) which states that an
injury resulting in the inability to perform jobs requiring
bilateral manual dexterity would support a
finding of
disabled is inapposite.
Subsection (h) is an example
concerning an individual under 45 years of age who is
restricted to unskilled sedentary work.
_________
-7-

the affected major joints in terms of . . .

loss of strength

of hand function (grasp, grip, pinch)."

Nor did Dr. Gonzalez

complete

or

the

range

exacerbation table
not
___

list

of

motion

chart

as requested.

carpal

tunnel

Finally,

syndrome

the

periods

of

Dr. Gonzalez did

under

the

heading

so

diagnose

"diagnosis".
Indeed,

the

only

physician

to

claimant's problems with her hands was Dr.

doctor

to

whom

the

Secretary

consultative examination.
left

hand grip

syndrome.

However,

referred

He noted that

and related

the

Luis Olivari, the

claimant

claimant had a weak

weakness to

he noted that her

for

carpal tunnel

hand condition "might

improve with adequate treatment."

The Social Security regulations require claimant to

submit

medical

reports which

include "[a]

statement about

what you can still do despite your impairment(s). . . . "

C.F.R.

404.1513(b)(6).

claimant's ability to
Further, the
enable

handle objects. Id.

___

medical evidence

the Secretary

functional

This statement must

to

capacity to

Id. 404.1513(d)(3).
___

refer to

None of the

enough to

a claimant's

do work-related

404.1513(c)(1).

should be complete

determine

20

. .

"residual

. activities."

medical evidence submitted

by claimant contains this information.

In the

absence of any

entitled to rely on

such evidence, the

the RFC forms which both

ALJ was

indicated that

-8-

claimant

had

no limitation

manipulation.
using

the

examining
the

left

The

hands

only limit
for

her fingers

noted in

normal wrist motion

weakness,

manipulative difficulties

did

not

for fine

both forms

gross manipulations.

physician found
hand

in using

mention

that would indicate

was in

Further,

the

and, besides
any

other

that claimant

did

not retain

the

"good use

required for most sedentary

we
that

have pointed out

the

Secretary

of

work.

the hands

fingers"

See SSR 83-14.

___

in the past,

and now

should

the

have

and

Although

point out again,

examining consultant

complete an RFC evaluation, see Rivera-Torres v. Secretary of

___ _____________
____________
Health and Human Services, 837 F.2d 4, 6 (1st Cir. 1988) (per
_________________________
curiam), we find

that there was

sufficient evidence in

the

record to support the ALJ's conclusion.2

2.
July

Claimant argues

that two C.T. scans --

one in

1990 and one in October 1990 -- establish her inability

to work due to her

back and foot conditions.

The

July 1990

C.T. scan showed a narrowing of the disc spaces at L4-L5

L5-S1; the disc at

L5-S1 was bulging.

and

In addition, the scan

showed mild osteoarthritis changes of the L5-S1 and right L4L5

facet joints.

The

October 1990 C.T.

scan report stated

that claimant suffered from severe degenerative joint disease

____________________
2. We also note in this context that there is no evidence
that claimant ever sought treatment for the problems with her
hands, another basis for upholding the ALJ's decision. See
___
Tsarelka v. Secretary of Health and Human Services, 842 F.2d
________
______________________________________
529, 534 (1st Cir. 1988) (per curiam).
-9-

in

her

left great

changes.

toe

Claimant

points

physicians

who

consultant

who examined

completed

have the benefit

result,

she

with spur
out
the

that

RFC

them

translate

such data into

the

nonexamining
and

December 1989

because the

advisor

ALJ,

was

lay

As

required

person,

functional terms.

the

did not

"objective" medical data.

medical

interpret

and sclerotic

assessments

claimant in

of these

argues,

formation

may

a
to
not

See Berrios v.
___ _______

Secretary of Health and Human Services, 796 F.2d

_________________________________________

574, 576

(1st Cir. 1986) (per curiam).

We

reject

this

argument.

First,

nonexamining physicians completed his

21, 1990.
by

Dr.

one

of

the

RFC assessment on

May

At this time, the medical questionnaire, completed

Irizarry on

May

8,

1990, was

in

the

answering this

questionnaire, Dr. Irizarry refers

scan

9, 19903

of March

condition

as the July

which showed

essentially

scan -- degenerative

L4-L5-S1, osteoarthritis of the

claimant's

to a C.T.
the same

disc disease at

Also on file at this

an earlier questionnaire completed

in November 1989.

In

posterior facet joints and a

narrowing of the spinal canal at L5-S1.

time was

file.

by Dr. Irizarry

Although mostly illegible, it appears that

diagnoses

at

this

time

were

cervical

osteoarthritis and cervical fibromyositis.

____________________
3. Claimant failed to include a copy of the
March 1990 C.T. scan in the record.

report of the

-10-

Second, both nonexamining physicians had the report

of

Dr. Olivari,

the Secretary's

consultant.

Although, as

claimant points out, Dr. Olivari's examination occurred seven

months prior to the July 1990 C.T. scan, it nonetheless could
serve as a
from

the

basis for the RFC assessments.

State Insurance

Fund

(SIF)

First, it appears

progress notes

that

claimant's present back condition is related to an injury she

sustained

in 1980.
____

Second, claimant alleged that she had to

stop work in 1988 due to her back condition.

As there

is no

indication that claimant's symptoms worsened between 1988 and

July 1990

when the

observations

C.T. scan was

in 1989

claimant revealed

are

performed, Dr.

pertinent.

full range of motion

Olivari's

This examination

of

of claimant's spine.

There was mild difficulty in kneeling and some left trapezius

spasm.
no

However, there were no motor or sensory deficits and

inflammation of the major

normal.
(which the

Dr.

Olivari

joints; all deep reflexes were

diagnosed degenerative

joint disease

C.T. scan confirmed) and painful left foot hallux

valgus.
This is

more than sufficient evidence

base an RFC assessment.4

on which to

Turning to these assessments, both

____________________
4. Claimant argues that the physician who completed the RFC
assessment dated May 21, 1990, did not give a reasonable
explanation as to how he reached his conclusions.
A review
of the RFC form belies this contention.
Concerning her
exertional limitations, the physician indicates that he
relied on the following evidence: (1) complaints of cervical
and lumbar pain; (2) morning stiffness; (3) the March C.T.
-11-

physicians determined that claimant could frequently lift and

carry weights up to twenty-five pounds and occasionally could
lift and carry objects weighing up to fifty pounds.
could sit, stand and walk up to six hours per

Claimant

activity.

She

could occasionally stoop, kneel,

crouch, balance and

Her ability to push and pull was

unlimited up to the weights

for lifting and carrying.

crawl.

In
neglected to

this context,

we note

complete the

range of

that Dr.
motion

Irizarry also
charts and

the

periods of exacerbation tables.

This information is directly

related to residual functional

capacity and it is claimant's

burden at step
produce
also
____

four of the sequential

such evidence.

20 C.F.R.

See
___

404.1513.

evaluation process to

Goodermote, 690 F.2d

__________
Although

there is

at 7; see
___
a conflict

between the

RFC assessments

and claimant's testimony

her limits,

such

are for

Rodriguez,
_________

conflicts

647 F.2d at 222.

determination that

the

We therefore

as to

Secretary.

See
___

cannot fault the

claimant could perform the

full range of

light and sedentary work.

3.
corroborated

"[C]omplaints
by

consistent with

objective

of pain
findings,

medical findings."

need not

be precisely

but

must

they

Dupuis v.
______

be

Secretary of
____________

Health and Human Services, 869 F.2d 622, 623 (1st Cir. 1989)
__________________________

____________________
scan which revealed degenerative disc disease at
(4) vertebral muscle spasm; and (5) vertigo.
-12-

L4-L5-S1;

(per

curiam).

credibility

In

determination

there are specific

829

F.2d

reviewing such

entitled

to

Here, the

physicians

RFC

who

the

See Frustaglia,
___ __________

assessments of

reviewed

ALJ's

deference where

findings to support it.

at 195.

nonexamining

is

complaints,

the

the two

record

both

indicated that claimant's conditions did not prevent her from

engaging

in sedentary

supported by

or light

Dr. Olivari's

work.

This

conclusion is

report indicating full

range of

motion of claimant's head, shoulders, wrists, hips and spine.

Although the results of
kind

of conditions

claimant's

own

addition to the
support

the

alleged.

that can

description

of

that

her

daily

her pain

produce pain,
activities,

to above, do
was

as

in
not

severe

as

Claimant stated that she cleans her home regularly,

personal needs and drives

medication that alleviates her

physicians noted

Based

expected to

medical findings referred

conclusion

attends to her

from the

be

the C.T. scans reflect the

She takes

symptoms; one of her treating

mild improvement

S.I.F. indicates

a car.

and a 1988

that claimant had

progress note
no complaints.

on the foregoing, we agree with the ALJ's decision not

to credit claimant's allegations of totally disabling pain.

Affirmed.
________

-13-