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Sofia ALVARADO, Plaintiff-Appellant, v. Caspar W. WEINBERGER, Secretary of Health, Education, and Welfare, Defendant-Appellee

United States Court of Appeals for the First Circuit1975-01-31No. No. 74-1196
511 F.2d 1046

Summary

Holding. The court affirmed the Secretary's decision terminating Alvarado's disability benefits, finding that substantial evidence supported the determination that she was capable of gainful employment.

Sofia Alvarado appealed the Secretary of Health, Education, and Welfare's decision to terminate her Social Security disability benefits, which had been awarded in 1968 for a mental condition. The Secretary determined that as of January 1971, Alvarado was no longer unable to engage in substantial gainful activity. At the administrative hearing, Alvarado testified about her symptoms, including numbness, insomnia, and anxiety. However, Dr. Infanzón Ochoteco evaluated her condition as chronic depressive neurosis in substantial remission with good capacity for comprehension, work, and social interaction, and opined she could be rehabilitated for manual work. A vocational expert testified she could return to work as a kitchen helper or similar positions.

Alvarado challenged the decision on several grounds. She argued Dr. Infanzón lacked qualification because he was not board-certified in psychiatry and specialized in child rather than general psychiatry. She also contended his report did not support the conclusion that she could presently work, since he merely stated she could be rehabilitated. The court rejected both arguments, finding that board certification is not required for expert qualification under evidence law, and that Dr. Infanzón's overall positive findings adequately supported the vocational expert's opinion and the Secretary's determination. The court emphasized that the mere presence of a psychoneurosis does not constitute disability and that Alvarado bore the burden of proving continued disability through credible evidence.

Summary generated by law.co from the public-domain opinion. The opinion text itself is public domain.

Key issues

  • Whether a physician without board certification in psychiatry is qualified to testify as a medical expert
  • Whether a physician's statement that a claimant could be rehabilitated for work supports a finding of current employability
  • Whether subjective symptoms alone, without supporting medical evidence of impairment, satisfy a claimant's burden of proving disability

Procedural posture

Alvarado appealed the district court's affirmance of the Secretary's administrative decision closing her disability period, raising questions about the sufficiency of evidence supporting the termination.

Authorities cited

No cited authorities resolved to law.co cases yet.

Opinion

majority opinion

PER CURIAM.

This is an action brought under § 205(g) of the Social Security Act, 42 U.S.C. § 405(g) (1970), to review a determination by the Secretary of Health, Education, and Welfare closing plaintiff’s period of disability as of January 1971. Plaintiff had been awarded benefits as of October 1, 1968, because of a mental condition. The sole issue on appeal is whether the Secretary’s decision as affirmed by the district court was supported by substantial evidence.

Before the administrative law judge plaintiff testified that her head felt numb, that she woke up screaming and walked back and forth, and that she got a frightened feeling in her heart and had crying spells. The administrative law judge also had before him, in addition to Dr. Fuentes’ earlier report and certain additional medical records, the medical report of Dr. Infanzón Ochoteco, who diagnosed plaintiff’s condition as a chronic depressive neurosis in almost total remission of symptoms. He reported no disorganization of her personality, no need for supervision and no limitations on her ability to relate to or socialize with others or work around the house, nor was there any deterioration in her personal habits. He indicated that her ability to comprehend and follow directions, perform work requiring frequent contact with others, and perform simple, repetitive or varied tasks was good. He recommended that she undergo intensive psychotherapy and believed that she “could be rehabilitated to perform manual work.” On the basis of this report and personal observation of Mrs. Alvarado at the hearing, a vocational expert testified that she was capable of returning to her work as a kitchen helper or assuming other specified jobs available in the area. In light of this evidence the administrative law judge concluded that plaintiff was not unable to engage in any substantial gainful activity and thus found her no longer disabled under § 223(d) of the Act, 42 U.S.C. § 423(d) (1970).

Plaintiff first maintains that Dr. Infanzón was not qualified to examine her because he was not board certified in psychiatry and because his specialty was child rather than general psy chiatry. But under general principles of evidence law Dr. Infanzón would be qualified to give his opinion even were he not a psychiatrist at all. See McCormick, Evidence § 13 & n. 70 (E. Cleary ed. 1972). Certainly board certification has never been held a prerequisite to qualification as an expert medical witness. The medical opinion of specialists may be entitled to greater weight than that of general practitioners, Bailey v. Gardner, 269 F.Supp. 100, 107-08 (S.D. W.Va.1967). But even if Dr. Fuentes were considered more qualified than Dr. Infanzón there would be no necessary inconsistency in their opinions in light of the two years separating them. Although plaintiff did not follow Dr. Fuentes’ prescribed regimen of psychiatric care during this period, her ailment could have improved spontaneously. At any rate, it is for the Secretary to resolve conflicts in the medical evidence. Diaz v. Secretary, 372 F.Supp. 463, 465 (D.P.R.1973).

Plaintiff next argues that Dr. Infanzon’s report does not support the vocational expert’s opinion or the examiner’s finding that she could be gainfully employed because the physician concluded only that she “could be rehabilitated to manual work.” We do not think this necessarily equivalent to an assertion that she is not presently capable of employment, and even if it were it would have little evidentiary value as such, Laboy v. Richardson, 355 F.Supp. 602, 604 (D.P.R.1972), since a physician has no special expertise for such a judgment. Considered as a whole, Dr. Infanzon’s generally sanguine findings afford ample support for the Secretary’s conclusion that plaintiff Vas capable of gainful employment. The mere existence of a psychoneurosis or an anxiety reaction does not constitute a disability, Gum v. Secretary, 341 F.Supp. 611 (D.Md.1972); Darter v. Cohen, 299 F.Supp. 473, 476 (W.D. Va.1969). And neither the state of the economy nor employers’ reluctance to hire the handicapped is a relevant consideration. Caraballo v. Secretary, 346 F.Supp. 93, 95 (D.P.R.1972).

Plaintiff had the burden of proving that she was still disabled. Marker v. Finch, 322 F.Supp. 905, 909-10 (D.Del.1971). Although her subjective testimony was certainly probative, Stark v. Weinberger, 497 F.2d 1092, 1096—97 (7th Cir. 1974), subjective symptoms must be evaluated with due consideration for credibility, motivation and medical evidence of impairment. Dvorak v. Celebrezze, 345 F.2d 894, 917 (10th Cir. 1965). We cannot say on this record that the Secretary was under any obligation to find that she met that burden. See Richardson v. Perales, 402 U.S. 389, 91 S.Ct. 1420, 28 L.Ed.2d 842 (1971).

Affirmed.

. This award was presumably based on the report of Dr. Claude E. Fuentes, a specialist in psychiatry and neurology. Dr. Fuentes noted claimant’s complaints of numbness in her head, insomnia, inability to work in the home, and lack of appetite. He cited claimant’s assertions that she had been hearing voices and that she had the impulse to scream. Dr. Fuentes’ examination revealed that claimant was well developed and nourished, tearful, clean and neat. However, she had difficulty expressing herself, was unspontaneous and somewhat retarded. She was depressed and moody, and her orientation and memory were poor, her judgment and insight impaired. Dr. Fuentes’ diagnosis was “Involutional psychotic depressive reaction.” His recommendation was a continuation of treatment at the Ponce Psychiatric Hospital.

. These records furnished by the Bayamon Mental Health Clinic show that plaintiff received medical attention in the outpatient clinic from January 1971 to July 1972 and indicate many somatic complaints and complaints of nervousness, fear and depression. Plaintiff was treated with medication on each visit.