The opinion of the court was delivered by: Robert L. Carter, District Judge.
Claimant, Gertrude Woodford ("Woodford"), brings this action
pursuant to 42 U.S.C. § 405(g) to challenge the final
determination of defendant, the Commissioner of Social Security
("Commissioner"), denying her Supplemental Security Income
Disability benefits ("SSDI"). Both parties move under Rule 12(c),
F.R. Civ. P., for judgment on the pleadings.
Woodford applied for disability benefits on October 27, 1993,
alleging that she was disabled since May 7, 1993, due to residual
injuries stemming from a fractured left ankle. (Tr. at 32).*fn1
Woodford's claim was denied on the initial and reconsideration
levels. (Id.). Woodford appealed the reconsideration denial,
and requested a hearing with an Administrative Law Judge ("ALJ").
(Id.). ALJ David Nisnewitz heard Woodford's case on October 24,
1995. (Tr. at 54-83). In a decision, dated January 24, 1996, the
ALJ found that Woodford had the residual functional capacity to
perform her prior job as a bookkeeper and other kinds of
sedentary work,*fn2 and therefore she was not disabled under the
SSDI guidelines, and was not entitled to benefits. (Tr. at 33,
36). On March 8, 1996, Woodford requested that the Appeals
Council review the ALJ's decision. (Tr. at 28). The Appeals
Council denied her request, making the ALJ's decision final. (Tr.
at 2-4). Woodford then filed the instant claim under
42 U.S.C. § 405(g), requesting review of the ALJ's and the Appeals Council's
B. Administrative Hearing Facts
Woodford is a 59 year old woman, with two years of college
education. (Tr. at 66-70). From the date she immigrated to the
United States in 1962, until the date of her injury, May 7, 1993,
Woodford was steadily employed as a bookkeeper. (Tr. at 65-78).
Woodford's bookkeeping jobs primarily required her to record
financial information while sitting at a desk, and occasionally
to walk around the office in order to retrieve financial
information. (Tr. at 67-70).
On May 7, 1993, Woodford fell into a roadside drainage ditch
outside her daughter's Westchester County home and fractured her
left ankle. (Tr. at 60-61). She was taken to Northern Westchester
County Hospital and a surgeon, Dr. Mark Altman, diagnosed her as
having suffered an "open, Grade II, bi-malleolar equivalent left
ankle fracture." (Tr. at 128). Dr. Altman performed an "open
reduction and internal fixation to the [left] fibula:" he
installed a metal plate and six screws in the ankle to increase
ankle stability during the healing process. (Tr. at 128-29, 152).
He also sutured Woodford's deltoid ligament in two places. (Tr.
at 129). Woodford was in the hospital for three days, and
convalesced with her daughter in Westchester County for three
months. (Tr. at 62). During this period, Dr. Altman prescribed
antibiotics and pain medication. (Tr. at 63-64, 133).
1. Treating Physician's Reports
Woodford ultimately moved back into her Elmhurst, New York
apartment and, on January 24, 1994, sought treatment from an
osteopath, Dr. William J. Kulak, M.D., who thereafter served as
her treating physician. (Tr. at 35, 64).
Dr. Kulak also indicated that a long term prognosis for
Woodford could not be developed at such an early stage in her
treatment; however, he predicted that there was a strong
probability that she would suffer long term injury, including:
permanent loss of ankle flexibility, recurring pain symptoms, and
ankle inflammation. (Tr. at 152-53). He noted that it was unclear
when Woodford would be able to resume work or recreational
activities. (Tr. at 153). For the initial treatment period, he
prescribed stretching exercises, anti-inflammatory drugs, and
recommended the use of a cane. (Tr. at 151, 153).
Dr. Kulak's follow-up report, dated April 4, 1995, summarized
medical examinations conducted on August 22, November 7, and
December 19, 1994, and April 3, 1995. (Tr. at 144-48). Dr. Kulak
indicated that, at the four examinations, Woodford complained
about various kinds of left ankle pain, specifically: pain which
radiated to her calf, and caused twitching and tightness in her
calf muscles when walking, (Tr. at 144); pain which caused a
"tired" feeling in her right lower extremity and back, and
intense "sleepy" sensations in her left foot, (Tr. at 145); and
calf and left ankle cramps that caused her to lose her balance
and fall. (Id.). Consistent with these symptoms, Dr. Kulak
noted that Woodford was still experiencing pain on "heel to heel"
and "toe to toe" walking. (Tr. at 146).
At each of the four examinations, Dr. Kulak conducted
flexibility tests on Woodford's ankles. He determined that
Woodford's range of motion in her left ankle was increasing, but
that flexing, rotation and palpitation of the left ankle still
produced pain. (Tr. at 145). X-rays he ordered in November, 1994,
confirmed that Woodford's ankle fracture had healed, but that
scar tissue, calcification or bone fragments had accumulated
around ligaments at the injury site. (Id.). Dr. Kulak noted
that these deposits could be expected to cause secondary symptoms
such as pain and inflammation. (Tr. at 146). Additionally, he
indicated that scar tissue was causing decreased sensation in
part of Woodford's ankle. (Id.). At all of the examinations,
Dr. Kulak prescribed the same course of ...