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CLEMENTE v. BOWEN

September 29, 1986.

Alfredo Lugo CLEMENTE, Plaintiff,
v.
Otis R. BOWEN, Secretary of Health and Human Services, Defendant.



The opinion of the court was delivered by: BRODERICK

MEMORANDUM ORDER

VINCENT L. BRODERICK, District Judge.

 I.

 Plaintiff Alfredo Lugo Clemente brought this action pursuant to Sections 205(g) and 1631(c)(3) of the Social Security Act (the "Act"), 42 U.S.C. § 405(g), seeking review of a final decision of the defendant Secretary of the Department of Health and Human Services (the "Secretary") which denied him Social Security Disability Insurance Benefits and Supplemental Security Income. On December 24, 1984, I vacated the Secretary's decision and remanded the case for further administrative proceedings. On April 24, 1985, the Administrative Law Judge ("ALJ") issued a recommended decision that plaintiff receive benefits retroactive to October 24, 1984 because plaintiff was disabled as of that date. Transcript ("Tr.") 154. On July 2, 1985, the Appeals Council adopted the ALJ's recommended decision.

 Plaintiff now seeks reversal of the Secretary's decision to the extent that it fails to award benefits to plaintiff for the period extending from May 19, 1983 through October 24, 1984. He argues that he has sufficiently demonstrated his eligibility for benefits beginning May 19, 1983, and the decision denying him those benefits from that date to October 24, 1984 was not supported by substantial evidence. Specifically, plaintiff submits that the ALJ failed (1) to credit his allegations of pain and other symptoms, (2) to accord appropriate weight to the opinions of his treating physicians, and (3) to follow accepted standards in determining the date of the onset of his disability.

 Defendant contends that the decision that plaintiff was not disabled prior to October 24, 1984 should be affirmed. He claims that the finding that prior to October 24, 1984, plaintiff could perform at least light work was supported by substantial evidence, and that there was substantial evidence for each of the ALJ's particular findings.

 Plaintiff and defendant have each moved for judgment on the pleadings pursuant to Fed.R.Civ.P. 12(c). For the reasons which follow, plaintiff's motion is granted and defendant's motion is denied.

 II.

 Plaintiff was born on June 21, 1950 in Puerto Rico. Tr. 30. He was educated in Puerto Rico, completing high school and some college coursework. Tr. 18-19. The plaintiff's native language is Spanish. He is unable to communicate in or understand English. Tr. 19.

 Prior to coming to the mainland in 1981, the plaintiff worked in Puerto Rico as an inspector for the IRS for three years. He was last employed as an assistant building superintendent from January to September, 1982. Since that time the plaintiff has been unemployed. Tr. 19-20.

 At his administrative hearing on June 22, 1983, the plaintiff testified that his physical ailments made working in his previous jobs impossible. Tr. 21. According to plaintiff, he was diagnosed at a hospital in Puerto Rico in 1980 as having hypertension and an enlarged heart. Tr. 22, 115. He described his symptoms, including dizziness, shortness of breath, and chest pains, as severe enough so as to be completely debilitating. Plaintiff stated that the persistence of his symptoms has required him to depend on his sister for help with daily activities such as housework and grocery shopping. Tr. 23. He does not go outside without someone accompanying him, because his shortness of breath and dizziness arise after only walking three blocks. As a result of his physical problems, he spends most of his time reading and watching television. Tr. 23.

 In considering the medical evidence from May 19, 1983 to October 24, 1984, the period in question, the following is relevant:

 The plaintiff was admitted to the intensive care unit of Lincoln Medical and Mental Health Center ("Lincoln Hospital") on May 19, 1983 and discharged eight days later. Tr. 107. The plaintiff complained of chest pain. His blood pressure was 200/130. Tr. 130. Lincoln Hospital conducted a series of evaluations to determine the nature and extent of plaintiff's disability. Plaintiff's doctors and the cardiology service advised that several tests, including a renal ultrasound, a nuclear wall motion study (cardiac), and a stress thallium test, be performed. Nothing in the medical record indicates that any of these three tests was performed. Tr. 109, 126. Plaintiff's final diagnosis was hypertension and unstable angina. Tr. 108.

 The medical record indicates that Clemente had a seven year history of hypertension for which, several years earlier, Lopressor and Lasix had been prescribed. Tr. 85, 115. It further shows that plaintiff's mother and sister both suffered from hypertension; his mother was also afflicted with angina. Tr. 116.

 During the month prior to his admission to Lincoln Hospital in 1983, plaintiff had been experiencing chest pain, mostly on exertion. On one occasion he felt non-radiating stabbing chest pain while climbing five flights of stairs. The pain was relieved by rest and Lopressor. Two days prior to admission to Lincoln Hospital plaintiff had a similar episode of chest pain at a friend's house, which recurred the next night. On May 19, 1983 plaintiff while walking experienced non-radiating chest pain which lasted for 30 minutes. At this time plaintiff decided to go to the medical emergency room at Lincoln Hospital. While walking to the hospital he again experienced an attack of chest pain, which was relieved only after the medical emergency room administered 3 tablets of Nitroglycerin. Tr. 118.

 References to plaintiff's electrocardiogram ("EKG") taken at admission are made throughout the Lincoln Hospital medical record. This initial EKG revealed sinus bradycardia with ST waves elevated in the anterolateral leads. Tr. 109. ST segment elevation occurred in leads I and aVL and V5-V6, with a depression of the ST segment in leads II and aVF. Tr. 121, 130.

 A progress record dated May 21, 1983 indicates that the EKG at admission was suggestive of anterolateral ischemia now resolving. Tr. 122. Additional medical findings revealed that cardiac enzymes were within normal limits, and MB fractions were negative. Tr. 107.

 Plaintiff's progress during his stay at Lincoln Hospital is reflected in a series of reports and notes made by physicians in the intensive care unit and physicians from the cardiology service. An admission note shows that plaintiff had a history of prior chest pain, having been hospitalized in Puerto Rico in 1980 for 3 days. Tr. 115. On admission to Lincoln Hospital he was put onto ...


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