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TEJADA v. CALLAHAN

December 9, 1997

MARIA TEJADA, Plaintiff, against JOHN J. CALLAHAN, ACTING COMMISSIONER OF SOCIAL SECURITY, Defendant.


The opinion of the court was delivered by: PECK

 ANDREW J. PECK, United States Magistrate Judge:

 To the Honorable Sidney H. Stein, United States District Judge:

 Plaintiff Maria Tejada brings this action, pursuant to Section 205(g) of the Social Security Act (the "Act"), 42 U.S.C. § 405(g), challenging the final decision of the Commissioner of Social Security (the "Commissioner") to deny her disability benefits. Both parties have cross-moved for judgment on the pleadings pursuant to Fed. R. Civ. P. 12(c). For the reasons set forth below, I recommend that the Court grant the Commissioner's motion for judgment on the pleadings and deny Tejada's cross-motion.

 PROCEDURAL BACKGROUND

 On August 5, 1993, plaintiff Tejada filed an application for Social Security Supplemental Security Income ("SSI") benefits. (Administrative Record filed by the Commissioner [hereafter, "R."], at 36-39.) *fn1" Tejada's application was denied on December 29, 1993 and again on reconsideration on March 2, 1994. (R. 53-56, 68-71.) At Tejada's request, a hearing was held before an administrative law judge ("ALJ") on December 6, 1994. (R. 199-229.) On February 11, 1995, the ALJ issued his decision finding that Tejada was not disabled. (R. 19-27.) The ALJ's decision became the final decision of the Commissioner when the Appeals Council denied Tejada's request for review on March 1, 1996. (R. 3-5.) This action followed. The issue before the Court is whether the Commissioner's decision that plaintiff Tejada was not disabled is supported by substantial evidence. (See generally Tejada Br. at 1-2; Gov't Br. at 1-2.)

 FACTS

 Tejada's Testimony Before the ALJ

 On December 6, 1994, the ALJ held a hearing on Tejada's SSI application. (R. 199-229.) The ALJ began by noting that Tejada claimed disability "because of cataract condition, a hypotropic condition, and diabetes mellitus." (R. 201.) Plaintiff Tejada testified before the ALJ through an interpreter. (R. 204.) She testified that she was 59 years old at the time of the hearing and had been born in the Dominican Republic. (R. 206-08.) Tejada received no education, spoke but did not read or write Spanish, and did not speak or read English. (Id.) Tejada worked full time between 1990 and 1992 as an assembly person, assembling "big plates" used for cars. (R. 209, 223.) Her job entailed standing for eight hours per day, frequent bending and lifting up to ten pounds. (R. 209-10, 223.) She left this position in 1992 for two reasons. First, she needed to attend her daughter who was in a coma. Second, Tejada's own poor health prevented her from working. (R. 210.) (See generally Tejada Br. 2-3.)

 Tejada had suffered from diabetes for the past 15 years and was taken to the hospital once in an ambulance because her sugar level had dropped to 50. (R. 204, 215.) She suffered from poor and blurry vision, but had not been told that she had cataracts at a recent eye exam. (R. 204-05.) She was receiving a further exam for cataracts in January. (R. 205.)

 Tejada testified that she could no longer work at the assembly job because she was "very tired" and lacked the strength. (R. 223.) She said she could no longer stand for a period of eight hours, nor frequently bend. (R. 223-24.) While she first stated that she could lift up to ten pounds (R. 218), she later asserted that she was unable to do so. (R. 224.) She could walk two blocks prior to experiencing fatigue, stand for 10-20 minutes in one spot, and could remain seated for a half hour. (R. 215-16.) She needed to hold on to something when bending. (R. 216.) She could not open and close the fingers of either hand. (R. 216-17.)

 Tejada's fourteen year old niece was living with her and taking care of the apartment. (R. 220.) Tejada's daughter took care of the food shopping and sent Tejada all her meals. (R. 220-22.)

 The Medical Evidence

 Diabetes

 Tejada was first seen at the William Ryan Community Health Center on February 12, 1991, and was diagnosed as having diabetes which was "poorly managed." (R. 121; see also Tejada Br. at 3.) Medical records show that from February 1991 through November 1994, the Ryan Center increased and adjusted the dosage of Tejada's insulin. (See Tejada Br. at 3.) In November 1993, the Ryan Center diagnosed Tejada as having diabetes mellitus with peripheral neuropathy. (R. 159; see Tejada Br. at 4).

 On January 5, 1994, Tejada was seen at the Ryan Center because she had run out of insulin and hypertension medication twelve days earlier. (R. 160.) Plaintiff was advised of the "importance of medication compliance DAILY." (R. 160.)

 On May 5, 1994, plaintiff walked into the Ryan Center, complaining of abdominal pain. (R. 166.) She was given orange juice and was taken to the emergency room for evaluation of low blood sugar. (R. 166, 215.) Tejada returned to the Ryan Center several times during the next two weeks for further evaluation of her low blood sugar. (R. 167-68.) Insulin treatment was discontinued, replaced by Micronase. *fn2" (R. 167-68.)

 Tejada saw a podiatrist in October 1994, who diagnosed diabetes mellitus and prescribed Oxford shoes. (R. 120, 176.)

 Vision Problems

 In July 1993, Tejada was given a general eye exam. Her vision was 20/30 in one eye and 20/25 in the other. (R. 103, 155.) On September 16, 1993, plaintiff underwent a consultative ophthalmologic examination by Dr. Doro. (R. 115-16.) Dr. Doro found that Tejada's uncorrected vision was 20/400 in each eye and her corrected vision was 20/100 in the right eye and 20/200 in the left eye. (R. 115.) The doctor opined that Tejada's vision was worse than could be explained by the examination findings. (R. 116.)

 On December 7, 1993, Tejada underwent a second consultative ophthalmologic examination. (R. 106-07.) Dr. Irwin Schwade found that Tejada's visual acuity and near vision were 20/400 in each eye with and without corrective lenses. (R. 106.) Tejada claimed that she was unable to see the fixation target with either eye, although she entered and exited the doctor's office without bumping into equipment or furniture. (R. 106.) Dr. Schwade diagnosed hyperopia (farsightedness), presbyopia, *fn3" and functional amblyopia. (R. 107.) *fn4"

 Arthritis

 On September 2, 1992, Tejada visited the Ryan Center and complained of shoulder pain, but there were no positive clinical findings. (R. 139-40.) She was prescribed acetaminophen for arthritis. (R. 139-40.) In July and August 1993, she had edema *fn5" in her legs of uncertain etiology which was described as being "trace" in July. (R. 153, 157.) She was advised to elevate her legs and wear support stockings. (R. 157.)

 On September 4, 1993, Tejada saw Dr. DeLeon, an internal medicine specialist, for a consultative examination. (R. 109-10.) Tejada told Dr. DeLeon that abdominal pain was occasional, that she came to the examination by train, and that she did her own shopping and cooking. (R. 109.) There was no leg edema in her extremities. (R. 110.) Tejada was able to bend forward to sixty degrees and she got on to the examining table without difficulty. (R. 110.) She had no back tenderness or muscle spasm, and the straight leg raising test was negative. (R. 110.) Examination of her neck, shoulders, elbows, and wrists was also negative, as was examination of her hips, knees, and ankles. (R. 110.) Tejada's grip strength was five out of five. (R. 110.) Neurological examination was normal. (R. 110.) There was no evidence of motor, cerebellar, or sensory dysfunction. (R. 110.)

 Dr. DeLeon diagnosed controlled hypertension, diabetes mellitus type two, and arthralgia involving the back, knee, and shoulder. (R. 110.) Dr. DeLeon felt that Tejada's prognosis was fair. (R. 110.) She was able to sit with no limitation. (R. 110.) Her abilities to walk, stand, carry, lift, and push and pull were "slightly" limited because of arthralgia. (R. 110.)

 On May 3, 1994, Tejada saw a podiatrist, complaining of pain and swelling in her ankles. (R. 165.) There was no erythema on examination. (R. 165.) The podiatrist diagnosed osteoarthritis. (R. 165.)

 Abdominal Pain

 In 1991 Tejada was diagnosed with abdominal tenderness and pain. (R. 130.) An ultrasound performed on April 24, 1991, revealed a prominent gallbladder, without evidence of cholelithiasis. *fn6" (R. 99.) An April 1991 upper G.I. series demonstrated mild gastroesophageal reflux. (R. 128-29.) Although plaintiff continued to complain of abdominal pain, abdominal examination was repeatedly within normal limits. (R. 123, 127-28, 132, 133, 135.) *fn7"

 On September 2, 1992, Tejada complained of abdominal pain, but again there were no positive clinical findings pertaining to her abdomen. (R. 139-40.) She was prescribed Tagamet for gastrointestinal upset. (R. 139-40.)

 At her January, March and May 1993 appointments, Tejada complained of abdominal discomfort, but examination of her abdomen was normal on each occasion. (R. 146-48, 152.) She was prescribed Mylanta and Tylenol in May 1993. (R. 152.)

 On June 21, 1994, Tejada went to the Ryan Center with various complaints. (R. 169.) Although there was mild distension and diffuse tenderness on palpation of Tejada's abdomen, there were no focal findings or peritoneal signs. (R. 169.) The doctor suspected that some of Tejada's complaints ...


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