The opinion of the court was delivered by: PARKER
Plaintiff Juan Feliciano brought this action under 42 U.S.C. § 1383(c)(3) seeking judicial review of the final determination of defendant Commissioner of Social Security that Feliciano was not disabled and therefore not entitled to Supplemental Security Income ("SSI") benefits under Title XVI of the Social Security Act. Both parties have moved pursuant to Rule 12(c) of the Federal Rules of Civil Procedure for judgment on the pleadings. The only issue is whether the Commissioner has complied with the "treating physician" rule as codified by the Commissioner in 1991 at 20 C.F.R. § 416.927.
The following facts are not disputed. Feliciano is a 49-year old laborer with a fifth grade education obtained in his native Puerto Rico. He is literate in Spanish, but cannot speak English. He is separated from his wife and children, lives alone in a rented room in the Bronx, and is supported by a grant of public assistance. He came to the mainland United States from Puerto Rico in the early 1970s. He worked several years painting and fixing apartments for landlords. He then worked for four years as a "landscaper," planting trees, pouring concrete, etc. In a work-related vehicle accident in November 1987 he suffered back injuries, was hospitalized and had surgery on his neck. He collected Workers' Compensation benefits for a period of time after the accident until 1991. He has not worked since the accident.
Since 1988, Feliciano has been treated at North Central Bronx Hospital for hypertension, diabetes mellitus, and injuries suffered in the accident. In 1991, and again in 1993, Feliciano's lumbosacral spine was x-rayed. There was no evidence of fracture or dislocation and the lordotic curve was maintained. Vertebral bodies and intervertebral disc spaces were intact. The pedicles and interpedicular distances were normal. The radiologist's impression was a normal lumbar spine.
Feliciano claims that he is unable to work because of chronic lower back pain caused by the accident. He states that he experiences the back pain "almost all the time," that it is made worse by lifting even 5-10 pounds, sitting or standing in excess of 15-30 minutes, or walking more than a few blocks. As a result of the pain, he claims that he spends most of his time in his room, reading or watching television. His daughter helps him cook and clean. He occasionally visits friends, attends church or plays dominoes with his friends in front of his building. He takes Motrin or Ibuprofen for the pain.
Feliciano filed an application for SSI benefits on April 22, 1991. The application was denied initially and on reconsideration, whereupon Feliciano requested a hearing before an administrative law judge ("ALJ"). After a hearing was held on October 15, 1991, the ALJ found that Feliciano suffered from diabetes, high blood pressure, high cholesterol and obesity, but was not disabled because he still retained the capacity to perform light work. Upon review of the ALJ's decision, the Appeals Council on September 25, 1992 found that the ALJ had failed to evaluate properly Feliciano's subjective complaints of low back pain and remanded the claim for a new hearing.
At the second hearing on December 15, 1992, Feliciano submitted the two reports of M.W. Pinon, M.D., a physician at North Central who had seen Feliciano every 3-4 months since 1990 for diabetes, hypertension, cigarette smoking, weight reduction, and chronic lower back pain, as additional evidence of disability. Dr. Pinon reported that Feliciano suffered chronic lower back pain, but noted that Feliciano appeared to have good movement of his back and that there was no reported motor loss, muscles weakness or sensory and/or reflex loss. He opined, by history, that Feliciano, could sit continuously for 30 minutes, stand continuously for 30 minutes, walk for two blocks without stopping, lift up to 20 pounds, and take public transportation. He further stated that Feliciano's condition was one which could reasonably be expected to produce the pain alleged.
Following the hearing, the ALJ arranged for Feliciano to be examined by another physician, M. Mancheno, M.D., and a report of this examination was entered in the record. Dr. Mancheno examined Feliciano and reported that Feliciano walked normally and had no difficulty getting on the examination table, had full range of motion in his hips, and normal reflexes. He noted that straight leg raising was negative on the left, but positive at 60 degrees on the right, x-rays of the lumbosacral spine were negative, that his muscle power and tone were normal with no sign of atrophy or wasting. He reported that Feliciano had tenderness from L3 to S1 of his lumbosacral spine and had bilateral paraspinal muscle spasm, but there was not significant restriction in range of spinal motion. Dr. Mancheno's diagnostic impression was a possible "discogenic disorder of the LS spine" and opined that Feliciano's range of exertion was moderate in lifting/carrying, pushing/pulling, standing/walking and sitting.
On May 8, 1993, the ALJ found that Feliciano was not disabled because he could still perform light work. The ALJ rejected Dr. Pinon's opinion that Feliciano suffered from an impairment that significantly limited his physical ability to do basic work activities on the grounds that (1) Dr. Pinon was not, in fact, a treating physician, (2) his report did not contain adequate clinical findings, and (3) his views were contradicted by other substantial evidence of record, including the report of Dr. Mancheno, the consulting physician.
At a third hearing on December 2, 1993, Feliciano submitted two medical report forms completed by Sikha Guha, M.D., another physician at North Central. He reported that Feliciano had been a patient at North Central since October 1991 and suffered lower back pain, especially on climbing stairs and rising from a seated position. Dr. Guha stated that x-rays were still normal, and a straight leg raising test and neurological examination were negative. He noted that Feliciano ambulated with a cane, that his spinal motion was restricted "in all directions," and there was paraspinal muscle spasm in the lower lumbar region on the right. Dr. Guha opined that Feliciano could sit 1-2 hours, stand 1-3 hours, alternately sit or stand 2-3 hours, lift up to 10 pounds, walk 3-4 blocks, and that he had to lie down during the day to relax his back. He further reported that Feliciano had no motor loss, muscle weakness or sensory and/or reflex loss, but had pain in grasping, pushing and pulling with his hands.
No further medical information was sought. On January 25, 1994, the ALJ denied Feliciano's claim on the grounds that the opinions of his treating physicians were not adequately supported by clinical findings and were not consistent with the medical evidence of record, including the most recent reports from North Central. In addition, the ALJ found that Feliciano's subjective complaints of pain were inconsistent with objective findings in the record as to his activities, medications and functional restrictions.
The Appeals Council denied Feliciano's request for review on May 20, 1994, on the ground that the ALJ considered the lack of clinical findings supporting the opinions of the treating physicians. Feliciano asserts that the Commissioner's decision must be reversed because no substantial evidence contradicted the evidence of Feliciano's treating physicians. He argues that (1) the opinions of his treating physicians are entitled to controlling weight under the "treating physician" rule, and ...