Sanchez-Quiles v. SHHS, 1st Cir. (1993)

USCA1 Opinion
November 10, 1993
[NOT FOR PUBLICATION]

UNITED STATES COURT OF APPEALS
FOR THE FIRST CIRCUIT
___________________
No. 93-1151
LUIS SANCHEZ-QUILES,
Plaintiff, Appellant,
v.
SECRETARY OF HEALTH AND HUMAN SERVICES,
Defendant, Appellee.
__________________
APPEAL FROM THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF PUERTO RICO
[Hon. Jaime Pieras, Jr., U.S. District Judge]
___________________
___________________
Before
Breyer, Chief Judge,
___________
Selya and Boudin, Circuit Judges.
______________
___________________
LCDA. Cristina Munoz Gandara on brief for appellant.

_____________________________
Daniel F. Lopez-Romo, United States Attorney, Jose Vazquez
____________________
_____________
Garcia, Assistant United States Attorney, and Jessie M. Klyce,
______
________________
Assistant Regional Counsel, Region I, Department of Health and
Human Services, on brief for appellee.
__________________
__________________
Per Curiam.
__________
district
court
Secretary
Claimant
judgment
of Health
social security
between July
Luis Sanchez-Quiles
which
and Human
affirms
that he suffered from severe back,
record and the

the
We
Secretary's decision is
mental
impairments
"medical
Findings
of
findings that
at
claim for
period
reviewed
substantial evidence.
of his back,
essence,
equivalent
heart,
to
and somatoform disorders,
least
the
are persuaded that
medical equivalence
are
the
Claimant alleges
thoroughly
the combination
in
heart, and mental impairments

have
listings for vertebrogenic, heart,

meritless.
1974.
supported by
was,
his
of
the insured
parties' briefs on appeal and
Claimant's contention that

and
during
and December 31,
during that time period.
decision
Services denying
disability benefits
2, 1971
the
appeals from
equal
must
in
be
the
is
based on
severity
and
duration
to
Claimant's
the
listed
alleged
findings
from
findings."
20
impairments
are
insured
period
the
not
C.F.R.
404.1526.
supported by
that
medical
approximate
the
aforementioned listings in severity or duration.

Claimant's
evaluate
his
unavailing.
contention
pain
as
that
the ALJ
erred
nonexertional
by
failing to
impairment
also
is
To be sure, "[p]ain may be a nonexertional factor to
be considered in
combination with
exertional limitations,
even
though it may also serve as a separate and independent ground for

disability." Da Rosa v.
_______
803
F.2d 24,
26 (1st
considered as
severe
Cir. 1986)(per curiam).
a separate
enough to
substantial
Secretary of Health and Human Services,

_______________________________________
prevent
gainful
ground for disability

the
claimant
employment.
"Where
pain is
... it
must be
from engaging
Where pain
is
in
considered
any
___
in
combination with exertional limitations, however, it need only be
found significant enough to prevent the claimant from engaging in

the full range
of jobs contemplated
by the exertional
for which the claimant otherwise qualifies."

of Health and Human Services, 666 F.2d
_____________________________
category
Gagnon v. Secretary
______
_________
662, 666 n. 8
(1st Cir.
1981).
The
ALJ
found
credible only to
of more
that
the extent that they
than sedentary
concerning his
claimant's
work
complaints of
were
precluded the performance
because (1)
the medical
back impairment, particularly
report, disclosed a full
pain
range of motion,
evidence
Dr. Arturo Feria's
little in the way
of
positive clinical findings, and an inability to "work hard, carry

light weights, and climb scaffolds
and stairs," (2) the
medical
evidence disclosed no
objective basis for claimant's
chest pain
complaints, since his
myocardial infarction did not
occur until
June 1975, and a "careful study" of progress notes indicated that

claimant's
pain
was
"occasional,"
during the insured period, which

the United States and Puerto
he experienced at
(3)
claimant's
activities
included multiple trips between
Rico, and claimant's testimony that
least some relief with
medications, indicated
that claimant's pain allegations were not fully credible.

It
is
true
that
the
ALJ
did
claimant's pain as a nonexertional

think
his
decision
significantly
and thus did
implies
explicitly
limitation.
that
reduce his access
not
claimant's
to jobs at
address
Nevertheless, we
pain
did
not
the sedentary level
not preclude reliance on the grid.1
So construed,
____________________
1 Where "a nonexertional limitation ...[is] found to impose

no significant restriction on the range of work a claimant is
exertionally able to perform, reliance on the Grid remains
3
the ALJ's
decision is
claimant sought
(August and
treatment for back
November)
in
1972.
There
September) in
treatment between
records indicate
but
not so
impairment.
was
much
as to
appears
his daily
two
appears to
only two
occasions
and August
suggest the
indicates that
occasions
(March
be a significant
1983.2
presence
and
gap in
The
1974
more frequently
of a
continuous
AlJ's conclusion that claimant's pain

to
be
correct.3
activities (which
house, wife and children and
that he could travel, and
The
claimant's
noted that
he took
could drive), the fact
his admission that he experienced some
relief with medication all tend

that the
pain on
1971 and
September 1972
In short, the
description of
The record
that claimant sought treatment
"occasional"
care of the
supportable.
sedentary work base
to support the ALJ's
conclusion
was essentially intact
during the
insured period.
Thus, claimant's contention that the ALJ erred by failing to
consider his pain as a nonexertional limitation ultimately fails.

____________________
appropriate."
Ortiz v. Secretary of Health and Human Services,

_____
_______________________________________
890 F.2d 520, 524 (1st Cir. 1989)(per curiam).
2We note that some of the records that the ALJ relied upon
are not in the record before us, thus this gap may not be as
significant as the record presently suggests.
But claimant has
not pointed out any records which suggest that his condition
became more dire during this period. Nor has he challenged the
ALJ's description of the missing records. Accordingly, we have
assumed that the ALJ's description is correct.
3The ALJ might be faulted for discounting the evidence of

claimant's chest pain
on the ground that
his myocardial
infarction did not happen until 1975. The record suggests that
claimant may have received treatment for a heart condition as
early as January-February 1975. (Tr. 291-92, 323-24).
Even if
he did not, common sense suggests that claimant's ischemic heart
disease did not appear overnight, and that at least some of
claimant's complaints of chest pain during the insured period may
have resulted from his heart condition. But the record does not
show that this pain was disabling during that time.
4
The
ALJ's
decision implies
persistent or
occupational
severe as
base.
construed, there
that
to significantly
Even
if
is no error
the ALJ's
in failing
nonexertional impairment where an

claimant's testimony
pain
and other
Thus,
pain was
reduce the
decision
not
restrictions.
is
not
to consider pain
Frustaglia v.
__________
so
as a
ALJ reasonably discredits
See
___
so
sedentary
concerning the limitations imposed
Health and Human Services, 829

_________________________
curiam).
claimant's
the
by back
Secretary of
____________
F.2d 192, 195 (1st Cir. 1987)(per
we may conclude that
there was no error
in the
ALJ's assessment of the disabling effects of claimant's pain.

Claimant also
faults the ALJ
mental impairment as a possible

applying
the
nonexertional
grid
pain
despite
and
addressed the claimant's
for failing
his
explanation for his pain, and in

the
presence
mental impairments.
pain.
to consider
of
We
The sole evidence
significant,
have already
in the record
concerning an alleged mental impairment during the insured period

states simply "[rule
This
is
mental
out] psychosomatic
plainly insufficient
impairment
that
to
was
disorder."
establish the
significant
222).
presence
enough
claimant's access to the sedentary occupational base.

record includes more frequent references
(Tr.
to
of a
impede
While the
to anxiety and neurosis
after claimant's myocardial infarction was
diagnosed in 1975, it
was the claimant's burden to prove that he became disabled before

his
insured status
Human Services,
______________
U.S.
expired.
818 F.2d
1042 (1987).
Cruz v.
____
97, 98 (1st
This he
failed to
Secretary of Health and

________________________
Cir.), cert.
_____
do.
judgment of the district court is affirmed.

________
denied, 497
______
Accordingly,
the

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USCA1 Opinion

November 10, 1993

[NOT FOR PUBLICATION]

LCDA. Cristina Munoz Gandara on brief for appellant.

that he suffered from severe back,

record and the

and somatoform disorders,

are persuaded that

heart, and mental impairments

listings for vertebrogenic, heart,

parties' briefs on appeal and

Claimant's contention that

and December 31,

during that time period.

aforementioned listings in severity or duration.

To be sure, "[p]ain may be a nonexertional factor to

though it may also serve as a separate and independent ground for

Cir. 1986)(per curiam).

Secretary of Health and Human Services,

ground for disability

combination with exertional limitations, however, it need only be

found significant enough to prevent the claimant from engaging in

for which the claimant otherwise qualifies."

the extent that they

precluded the performance

back impairment, particularly

report, disclosed a full

Dr. Arturo Feria's

little in the way

positive clinical findings, and an inability to "work hard, carry

and stairs," (2) the

objective basis for claimant's

complaints, since his

myocardial infarction did not

June 1975, and a "careful study" of progress notes indicated that

during the insured period, which

included multiple trips between

Rico, and claimant's testimony that

least some relief with

that claimant's pain allegations were not fully credible.

claimant's pain as a nonexertional

reduce his access

the sedentary level

not preclude reliance on the grid.1

1 Where "a nonexertional limitation ...[is] found to impose

treatment for back

AlJ's conclusion that claimant's pain

house, wife and children and

that he could travel, and

could drive), the fact

his admission that he experienced some

relief with medication all tend

that claimant sought treatment

sedentary work base

to support the ALJ's

was essentially intact

Thus, claimant's contention that the ALJ erred by failing to

consider his pain as a nonexertional limitation ultimately fails.

Ortiz v. Secretary of Health and Human Services,