a scoliotic posture, which was due to spasm of the right thoracolumbar muscles. She noted that a nodule was present in subcutaneous tissue overlying the right ninth rib posterolaterally. (Tr. 310). Also, Dr. Gladstone reported back flexion of 60 degrees, extension of 0 degrees with pain, and lateral bending of 30 degrees to left and right with pain. Fuller had no motor or sensory deficits. (Id.). Dr. Gladstone determined that Fuller had low back derangement and fibroma. She prescribed physical therapy three times a week to improve posture, to reduce spasm and pain and to enable Fuller to return to work in the construction industry as soon as possible. (Id.).
Fuller returned to Dr. Gladstone for treatment in January, July, and September 1991 and March 1992. On April 17, 1992, after another visit from Fuller, Dr. Gladstone reported Fuller's condition. Dr. Gladstone's clinical findings were that Fuller had a mild lumbar sprain and a tender nodule over the right rib. (Tr. 206). Fuller had flexion-extension to 70 degrees. (Tr. 212). Dr. Gladstone also determined that Fuller could carry up to fifteen pounds, could stand or walk up to two hours per day, could sit without limitation, and could do limited pushing or pulling. (Tr. 214).
Meanwhile, Fuller saw Dr. Mauro in December 1991 to determine whether Fuller was entitled to workers' compensation benefits. Fuller reported to Dr. Mauro that he was seeing his treating physician every three months, was not undergoing therapy, and was not working. (Tr. 204). He had no complaints pertaining to his scrotal area, but had constant pain in his mid and right back. After analyzing Fuller's range of movement, Dr. Mauro concluded that Fuller suffered from a permanent partial disability. (Id.).
The final doctor to evaluate Fuller was Dr. David MacPeek. Dr. MacPeek saw Fuller one time, on February 22, 1993. After examining Fuller, Dr. MacPeek concluded that Fuller could sit, stand, and walk for two hours each, lift ten pounds, bend and squat for two hours each, grasp for four hours, push or pull for two hours, and do fine manipulations for six hours. (Tr. 347).
Other background information was adduced at the hearing through Fuller's testimony. Fuller lives on the second floor of a four-family residence. (Tr. 32). He drove a car on occasion until July 1990. He takes the bus or subway to medical appointments. (Tr. 33, 35). He shops occasionally, goes to church once a week, and otherwise reads and watches television. (Tr. 56-59). Fuller receives workers' compensation benefits based on a finding of permanent partial disability. (Tr. 157).
Fuller has not sought employment since his injury in October 1989. He claims to have virtually constant pain on his entire right side. (Tr. 54). To alleviate the pain, Fuller takes Tylenol and Advil. He cannot afford prescription medication; however, the over-the-counter medication helps "a little." (Id.). Fuller testified that he can walk two blocks, can stand for half an hour, and can sit for half an hour before pain forces him to change position or lie down. (Tr. 45-47).
Finally, at the hearing a vocational expert, Edna Clarke, testified as to employment available in the national economy for a person with Fuller's condition, age, education, and work experience. Ms. Clarke gave several examples of employment available for a high school graduate who could lift and carry fifteen pounds occasionally, stand and walk for up to two hours, can sit for an unlimited time, push and pull on a limited basis, avoiding heavy objects. These jobs included a timekeeper in the clerical field, a button sorter, a ticket seller, a hosiery mender, and a laundry pricing clerk. Each of these jobs exists in the national economy in excess of 10,000 and in the local economy in excess of 500. (Tr. 86-87).
A. Determining Disability
A claimant is entitled to disability benefits under the Act if he is unable "to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment . . . which has lasted or can be expected to last for a continuous period of not less than 12 months." 42 U.S.C. § 423(d)(1)(A). The impairment must be of such severity that the claimant
is not only unable to do his previous work but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy, regardless of whether such work exists in the immediate area in which he lives, or whether a specific job vacancy exists for him, or whether he would be hired if he applied for work.
42 U.S.C. § 423(d)(2)(A).
The Secretary has promulgated regulations establishing a five-step procedure for evaluating disability claims. 20 C.F.R. §§ 404.1520, 416.920. The Second Circuit summarized this procedure as follows:
First, the Secretary considers whether the claimant is currently engaged in substantial gainful activity. If he is not, the Secretary next considers whether the claimant has a "severe impairment" which significantly limits his physical or mental ability to do basic work activities. If the claimant suffers such an impairment, the third inquiry is whether, based solely on medical evidence, the claimant has an impairment which is listed in Appendix 1 of the regulations. If the claimant has such an impairment, the Secretary will consider him disabled without considering vocational factors such as age, education, and work experience; the Secretary presumes that a claimant who is afflicted with a "listed" impairment is unable to perform substantial gainful activity. Assuming the claimant does not have a listed impairment, the fourth inquiry is whether, despite the claimant's severe impairment, he has the residual functional capacity to perform his past work. Finally, if the claimant is unable to perform his past work, the Secretary then determines whether there is other work which the claimant could perform.