Milagros Chaluisan v. Commissioner Social Security , 481 F. App'x 788 ( 2012 )

NOT PRECEDENTIAL
UNITED STATES COURT OF APPEALS
FOR THE THIRD CIRCUIT
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No. 11-3775
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MILAGROS CHALUISAN,
Appellant
v.
COMMISSIONER SOCIAL SECURITY
_____________
Appeal from the United States District Court
for the District of New Jersey
(D.C. Civil No. 2-10-cv-05918)
District Judge: Honorable Stanley R. Chesler
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Submitted Under Third Circuit LAR 34.1(a)
May 21, 2012
Before: RENDELL, FUENTES and HARDIMAN, Circuit Judges
(Opinion Filed: June 4, 2012)
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OPINION OF THE COURT
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RENDELL, Circuit Judge.
Milagros Chaluisan appeals a judgment of the District Court affirming a
final decision of the Commissioner of Social Security that Chaluisan is not entitled
to supplemental security income (otherwise known as SSI) benefits for the period
between 1984 and 1998 because she was not disabled under the Social Security
Act during that time. We will affirm.
I.
This case has a long and complicated history. Chaluisan, who has suffered
from scoliosis since she was a child, applied for benefits from the time of her
diagnosis, in 1982, to the present. She has been determined disabled, and awarded
corresponding benefits, for the periods between 1982 and 1984 and 1998 to the
present. Two separate ALJ decisions have determined that Chaluisan was not
disabled between 1984 and 1998.
The first of those decisions was issued on July 26, 2005. In twenty-five,
single-spaced pages, the ALJ reviewed all of the medical and other evidence and
applied the Zebley presumption to the portion of Chaluisan’s claim that pertained
to the period before she turned 18 (in 1988) and the adult Social Security standards
to the remainder. 1 As relevant to this appeal, the ALJ determined that
(1) Chaluisan engaged in substantial gainful activity as a cashier, and therefore
was not disabled as an adult, in 1988 and 1989; (2) the medical evidence did not
support a determination of adult disability between 1990 and 1998 because
Chaluisan did not present the range of physiological symptoms required to support
1
The “Zebley presumption” arose out of a settlement entered into by class
plaintiffs following the Supreme Court’s decision in Sullivan v. Zebley, 493 U.S.
521 (1990). The settlement provided for the re-adjudication of all SSI claims that
were denied for children before 1990 and allowed for inferences of childhood
disability in such adjudications under certain, prescribed circumstances. See
Zebley v. Sullivan, No. 83-3314, 1991 WL 65530, at *6-7, 9 (E.D. Pa. Mar. 14,
1991) (Stipulation and Order of Settlement).
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a determination that she suffered from a sufficiently disabling spinal disorder
because the records demonstrated that Chaluisan’s back pain during that time did
not require inpatient or other extraordinary treatment or medication (other than
with nonsteroidal anti-inflammatories, for a brief period), and therefore would not
have prevented Chaluisan from performing sedentary work; (3) disability from
1984 to 1988 could not reasonably be inferred under Zebley because the finding of
disability beginning in 1998 occurred after a period of adult non-disability and was
attributable to a worsening of symptoms at that time; and (4) applying current and
previous rules, the evidence did not support a finding of disability between 1984
and 1998.
Chaluisan appealed that decision to the District Court and, in a 2008
opinion, the District Court addressed each of the issues before us in this appeal.
First, the District Court found the ALJ had applied the correct legal standard from
Sullivan v. Zebley, 493 U.S. 521 (1990), to Chaluisan’s claim, but remanded the
case to the ALJ for further explanation of his conclusions and the basis for his
reliance on the Commissioner’s medical expert. Second, the District Court
determined that the ALJ gave proper weight to each treating physician’s opinion,
and, with one exception, properly explained his reasons for accepting or rejecting
each doctor’s testimony. The District Court remanded the case for further
explanation of the ALJ’s decision to reject the testimony of one physician, Dr.
Sabato. Third, the District Court determined Chaluisan was not denied a fair
hearing because tapes from her previous testimony could not be located. The
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District Court reasoned that the same information was contained in written records
and Chaluisan had the opportunity to testify.
Chaluisan appealed that decision, but we dismissed Chaluisan’s appeal for
lack of jurisdiction after the Appeals Council vacated the underlying
administrative decision. Another hearing was held before a different ALJ, who
provided further explanation as directed by the District Court and again
determined that Chaluisan was not disabled for the period 1984 to 1998.
Chaluisan again appealed to the District Court, where the case was assigned to a
different district judge.
In a 2011 opinion, the District Court declined to reconsider any of the
previous judge’s rulings, asserting that they were now law of the case. It found
that, on remand, the ALJ had sufficiently explained the basis for the disability
determinations, and it affirmed the determination that Chaluisan was not disabled
from 1984 to 1998. Chaluisan now appeals.
II.
On appeal, Chaluisan reasserts the same arguments that she presented to the
District Court: (1) the ALJs improperly denied her the presumption of disability
to which she was entitled under the Zebley settlement; (2) the ALJs failed to give
her treating physicians’ opinions adequate weight; and (3) the ALJs denied her a
fair hearing by failing to locate tapes of her testimony from earlier hearings. In
reviewing denials of SSI benefits, our review of legal issues is plenary. Sykes v.
Apfel, 228 F.3d 259, 262 (3d Cir. 2000). We apply the same deferential standard
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as the District Court to the Commissioner’s fact findings, asking whether those
findings are supported by “substantial evidence.” Id. Applying those standards,
we reject each of Chaluisan’s three arguments.
First, the ALJs did not misapply Zebley. Chaluisan argues that the Zebley
settlement requires an ALJ that finds a current disability to find disability as of the
claimant’s earliest application for benefits within the Zebley class period unless
there is a contrary medical judgment. 2 While one part of the Social Security
Administration’s “Hearings, Appeals and Litigation Law Manual” (“HALLEX”)
supports that assertion, see HALLEX 1-5-4-28A(V), that provision has no basis in
the language of the Zebley settlement itself, which provides only that, in cases
(like this one) where the claimant is found to be disabled in the current
proceedings, and evidence of the claimant’s past condition is not readily
available, 3 “the adjudicator will determine, based on the nature of the impairment,
2
Chaluisan’s brief misleadingly suggests that the Zebley standards apply to the
entire “Interim Period,” from 1984 to 1998. See, e.g., Appellant’s Br. 31 (“A
presumption of disability during the Interim Period is warranted because the
record establishes that Chaluisan meets the Zebley criteria . . . .”). In fact, the
Zebley standards apply only to the period before a claimant “attained age 18.”
Beginning on the day the claimant “attains age 18,” which, in this case, was
December 10, 1988, claims are evaluated according to the same disability
standards that apply to adults. See Social Security Administration, Office of
Disability Adjudication and Review, HALLEX: Hearings, Appeals and Litigation
Law Manual I-5-4-28-A-IV, available at http://www.ssa.gov/OP_Home/hallex/I-
05/I-5-4-28-A.html#I-5-4-28-A-IV (“HALLEX”).
3
Both of those conditions are met here. The 2008 District Court opinion
specifically found that Chaluisan did not qualify for the standard that applies to
claimants with “subsequent” disability determinations because the relevant adult
disability determination was made in the same 2005 ALJ decision that re-
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whether it is reasonable to presume that the class member’s past condition and
impairments were as severe as they are currently.” Zebley, 1991 WL 65530, at *9.
Notwithstanding HALLEX’s addition of a contrary-evidence standard in cases like
Chaluisan’s, the Zebley settlement controls. Internal social security manuals lack
the force of law and do not bind the Social Security Administration. See
Schweiker v. Hansen, 450 U.S. 785, 789 (1989) (per curiam); accord Moore v.
Apfel, 216 F.3d 864, 868 (9th Cir. 2000) (“HALLEX is strictly an internal
guidance tool, providing policy and other procedural guidelines to ALJs and other
staff members. As such, it does not . . . carry the force and effect of law.”).
The ALJs appropriately followed the Zebley settlement in this case. In the
2005 opinion, the ALJ opined that “it would not be reasonable to infer disability”
for the relevant period. App. 60. After the District Court remanded the case so
the Commissioner could further explain the basis for its decision, a second ALJ
concluded that a presumption that Chaluisan’s impairments were as severe as of
1984 as in 1998, when Chaluisan was again determined to be disabled, was “not
reasonable . . . in the circumstances of this case.” We find no legal error here.
adjudicated Chaluisan’s Zebley claim. See Chaluisan v. Astrue, No. 07-3130,
2008 WL 5427901, at *9 (D.N.J. Dec. 30, 2008). Chaluisan’s brief suggests that
she does not accept that determination, see Appellant’s Br. 34, but because she has
not directly challenged it on appeal, we are bound to accept it. Chaluisan admits
and, indeed, urges that evidence of her past condition is not readily available. See
id. at 35 (arguing that the “lack of records” for the “period at issue” precluded the
expert witnesses from rendering “any opinion as to the severity or effects of
Chaluisan’s impairments”).
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Second, the ALJs did not violate any rule concerning the evidentiary weight
due to treating physicians’ opinions. Treating physicians’ opinions as to the
nature and severity of a claimant’s impairment (but not as to the ultimate legal
issue of disability, see 20 C.F.R. § 416.927(d)(1)) are entitled to “controlling
weight” if the Commissioner finds that those opinions are “well-supported by
medically acceptable clinical and laboratory diagnostic techniques” and are “not
inconsistent with the other substantial evidence” in the record. 20 C.F.R.
§ 416.972(c)(2). The District Courts properly considered and rejected Chaluisan’s
argument in this regard, finding that the ALJs adequately explained their reasons
for accepting or rejecting each of the treating physicians’ opinions. We will not
repeat their analyses here other than to state that we agree with and adopt them.
Third, Chaluisan’s due-process argument lacks merit. We agree with the
District Court’s 2008 analysis: Chaluisan had ample opportunities to testify at the
2005 hearing; her subjective complaints were further represented by her medical
reports and the testimony of her treating physicians; and the ALJs properly
weighed all of the evidence, including subjective complaints and objective
medical evidence, and reached an appropriate, well reasoned determination. We
therefore will not reverse on this ground.
III.
Accordingly, and for the reasons set forth above, we will affirm the
judgment of the District Court.
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