Wright v. SSA

Wright v. SSA                         CV-00-27-B      10/13/00
                   UNITED STATES DISTRICT COURT
                FOR THE DISTRICT OF NEW HAMPSHIRE


ROBERT F. WRIGHT

     v.                             Civil N o . 00-027-B
                                    Opinion N o . 

KENNETH S. APFEL, Commissioner,
Social Security Administration



                       MEMORANDUM AND ORDER

     Robert F. Wright applied for Title II Social Security period

of disability and disability insurance benefits on June 1 2 , 1997,

alleging an inability to work since August 2 3 , 1996.1    After the

Social Security Administration (“SSA”) denied Wright’s applica-

tion, initially and upon reconsideration, Wright requested a

hearing before an Administrative Law Judge (“ALJ”).       ALJ Robert

S . Klingebiel held a hearing on Wright’s claim on April 1 4 , 1998.

In a decision dated July 2 0 , 1998, the ALJ found that Wright was




     1
        Wright’s coverage allows him to remain insured through
December 3 1 , 2001. See Tr. at 2 4 . (“Tr.” refers to the
certified transcript of the record submitted to the Court by the
SSA in connection with this case.)
“not disabled” because, although he was unable to return to his

previous employment, Wright remained able to perform other work

available in the national economy.    On December 6, 1999, the

Appeals Council denied Wright’s request for review, rendering the

ALJ’s decision the final decision of the Commissioner of the SSA.

     Wright brings this action pursuant to § 205(g) of the Social

Security Act, 

(g) (1994), seeking review of the

denial of his claim for benefits. For the reasons set forth

below, I conclude that the ALJ’s decision that Wright was not

entitled to benefits is supported by substantial evidence.

Therefore, I affirm the Commissioner’s decision and deny Wright’s

motion to reverse.


                             I . FACTS2

     Robert F. Wright was 49 years old when he applied for

benefits.   He graduated from high school and also received an

Associate Degree in aviation science. See Tr. at 4 1 .   Wright

     2
        Unless otherwise noted, the following facts are taken
from the Joint Statement of Material Facts (Doc. #9) submitted by
the parties.

                                -2-
worked as a jig grinder from 1977 until August 2 3 , 1996. See 

at 9 9 . He has not worked since August 2 3 , 1996, the date he

claims his disability began.

      Wright’s respiratory and sinus symptoms began with a cough

in March 1996. See Tr. at 172. On May 1 2 , 1996, the attending

doctor at Exeter Hospital treated Wright’s persistent cough and

resulting wheeze with steroids, bronchodilators, and antibiotics.

See id. at 170-73. He diagnosed Wright with asthma and mild

bronchospasm.   See id. at 171-72.    Wright’s initial symptoms

persisted and his family physician, Dr. Susan Therriault,

affirmed the bronchospasm and asthma diagnoses on June 4 , 1996.

See id. at 363.

      Wright, upon a referral from D r . Therriault, underwent a

pulmonary function test on June 2 0 , 1996. See id. at 197. The

findings of the test indicated “moderate obstructive lung disease

with some air trapping and minimal reversibility.”    Id.

     The following day, Dr. Hilton Lewinsohn examined Wright at

the Center for Asthma, Allergy & Respiratory Disease.    He



                                -3-
described Wright as a sick patient with a chronic cough, whose

clinical findings are consistent with either bronchitis or

asthma.   Under D r . Lewinsohn’s care, Wright’s cough and shortness

of breath improved with the use of bronchodilators and steroids

and as a result of Wright’s not returning to work for a few

weeks.

     On July 1 5 , 1996, Wright returned to work after his employer

furnished him with a respirator and exhaust ventilation system.

The respirator and ventilation system, however, did not help

to relieve his symptoms. In August 1996, Wright was still

experiencing trouble breathing.   On August 2 1 , 1996, Dr.

Lewinsohn diagnosed Wright with occupational asthma, due to hard

metal exposure, and chronic mucoid rhinorrhea.3   D r . Lewinsohn

told Wright to continue with his treatment regimen that included

Albuterol, Aerobid-M, and Nasacort.

     In October 1996, D r . D’Angelo diagnosed Wright with a

deviated septum, chronic sinusitis with nasal obstruction, and

    3
       Rhinorrhea is the discharge from the nasal mucous
membrane. Stedman’s Medical Dictionary 1359 (25th ed. 1990).

                                -4-
chronic bronchitis. On October 3 0 , 1996, D r . D’Angelo performed

a septoplasty4 and sinus endoscopy to correct his deviated septum

and alleviate his sinus symptoms. During the operation Dr.

D’Angelo observed abnormal polypoid5 changes in the sinus cavity.

         In the months following the operation, Wright’s asthmatic

condition waxed and waned, although his chest symptoms stabil-

ized.    Wright, however, continued to suffer from chronic sinus

infections and associated discomfort.     As a result, on January

1 5 , 1997, D r . Lewinsohn referred Wright to D r . Bruce Suzuki, an

ear, nose, and throat specialist.

     From January to September 1997, Dr. Suzuki treated Wright

for pansinusitis,6 postnasal drainage, probable allergic




     4
        A septoplasty is an operation to correct defects of the
nasal septum. Stedman’s Medical Dictionary 1405 (25th ed. 1990).
     5
       A polypoid has three or more of the haploid number of
chromosomes. Stedman’s Medical Dictionary 1238 (25th ed. 1990).
     6
        Pansinusitis consists of the inflammation of all the
accessory sinuses of the nose on one or both sides. Stedman’s
Medical Dictionary 1127 (25th ed. 1990).

                                 -5-
rhinitis,7 and early polypoid changes. A January 1997 CT scan

revealed acute superimposed upon chronic sinusitis with variable

rates of mucosal thickening in the various sinus cavities.   The

scan also showed that the ethmoid air cells were almost

completely opacified bilaterally.

     On January 2 8 , 1997, Wright returned to Exeter Hospital

complaining of shortness of breath.    The attending physician

diagnosed Wright with reactive airway disease and told him to

continue taking his regular medication. See Tr. at 190.

     Dr. Suzuki performed Wright’s second sinus surgery on

February 3 , 1997, to alleviate symptoms related to his persistent

sinusitis and asthma, both of which remained “unresponsive to

medical treatment.”    Dr. Suzuki’s operative note commented that

after Wright’s October 1996 septoplasty, Wright continued to have

a problem with “pansinusitis with purulent discharge, facial

pain, and exacerbated asthma secondary to purulent postnasal

discharge.”   T r . at 292.

     7
       Rhinitis is the inflammation of the nasal mucous
membrane. Stedman’s Medical Dictionary 1358 (25th ed. 1990).

                                -6-
     Another specialist, D r . Gary Epler, examined Wright on March

4 , 1997, and Wright underwent pulmonary function tests as part of

the examination.   Dr. Epler’s report diagnosed Wright with asthma

and possible constrictive bronchiolitis. Dr. Epler also noted

that Wright would not be able to return to work as a jig grinder

because of his inflamed airways and recommended that Wright work

in an “environment where irritant levels of dust, fume, or mist

exposure will not occur.”   Tr. at 301. A chest CT scan at that

time revealed the presence of bullous emphysema and pleural

plaques that were probably the result of asbestos exposure.

     On April 2 , 1997, Wright underwent revision functional

endoscopic sinus surgery of the maxillary and ethmoid sinuses,

performed by Dr. Suzuki. The operative report indicated the

presence of polypoid disease in some of the ethmoid air cells.

See Tr. at 305.

     Dr. Lewinsohn’s treatment notes from June 1997 through

September 1997 indicated that Wright’s respiratory symptoms

remained stable after this third sinus surgery.   The notes,



                               -7-
however, revealed that Wright continued to suffer from chronic

sinus infections and discomfort associated with those infections.

     Dr. Lewinsohn interpreted Wright’s pulmonary function tests,

performed in May and June 1997, as normal. The May 1997 test

revealed findings “comparable with the [diagnosis] of bronchio-

litis obliterans but not confirmatory of airways obstruction or

asthma.”    Tr. at 203. A June 1997 CT scan revealed emphysematous

blebs.8    See id. at 277.

     Dr. Suzuki, on October 6, 1997, reported that Wright’s

chronic sinusitis and respiratory problems are related to his

work place environment. See id. at 321. He noted that these

problems “will persist throughout the rest of [Wright’s] life due

to their chronicity and [his] prior exposure to chemicals”

and that “it would be best if he could avoid being exposed to

further chemical exposure as this would have a progressive

deleterious effect.”    Id. at 321-22.   A CT scan of the sinuses,

dated October 2 2 , 1997, exhibited Wright’s sinus disease.

     8
        A bleb is a large flaccid vesicle. Stedman’s Medical
Dictionary 193 (25th ed. 1990).

                                -8-
     Dr. Lewinsohn noted that in December 1997 and January 1998,

Wright complained mainly of sinus problems that abated only after

Dr. Suzuki performed wash outs or through the use of antibiotics.

At that time, his asthmatic symptoms appeared to have stabilized.

See Tr. at 337. D r . Lewinsohn also stated that the only drawback

to Wright’s entering a vocational rehabilitation plan was that

his current sinus treatments could result in some days when

Wright could not attend classes, depending upon when the classes

started.

     Wright’s treatment regimen for his sinus symptoms also

included another revision functional endoscopic sinus procedure

in March 1998 that disclosed further polypoid disease. At that

time, D r . Suzuki noted that although Wright’s symptoms appeared

to be somewhat improved, he felt that Wright should not return to

his previous workplace. See Tr. at 347.

     A few weeks after Wright’s sinus surgery, Dr. Lewinsohn

furnished an Assessment of Ability to do Work-Related Activities.

Dr. Lewinsohn concluded that Wright’s symptoms did not affect his



                               -9-
lifting, carrying, standing, and sitting capacity.    Wright’s

symptoms also did not affect his physical functions.    His

asthmatic symptoms, however, occasionally affected his ability to

climb.   The assessment also reported several environmental

restrictions necessitated by his symptoms.

     Dr. Lewinsohn’s findings echoed those of Dr. Hugh Fairley, a

non-examining state agency medical consultant, who assessed

Wright’s residual functional capacity (“RFC”) a few months

earlier.   On August 1 2 , 1997, Dr. Fairley determined that Wright

had the capacity to occasionally lift and carry up to twenty

pounds; to frequently lift and carry up to ten pounds; to be able

to stand and/or walk and sit for up to six hours in a day with

normal breaks; and to have an unlimited capacity to push and

pull.    Dr. Fairley also found that Wright had no postural,

visual, or communicative limitations, but he noted Wright’s

environmental limitations for exposure to fumes, odors, dusts,

gases and poor ventilation.   Dr. Burton Nault reviewed the record

and, on November 5 , 1997, affirmed D r . Fairley’s RFC assessment



                                -10-
as written.   The doctors concluded that Wright is capable of

performing light work in a setting that complies with his

environmental limitations. See Tr. at 319.



                      I I . STANDARD OF REVIEW

     After a final determination by the Commissioner denying a

claimant’s application for benefits, and upon timely request by

the claimant, I am authorized t o : (1) review the pleadings

submitted by the parties and the transcript of the administrative

record; and (2) enter a judgment affirming, modifying, or

reversing the ALJ’s decision. See 

(g) (1994).      My

review is limited in scope, however, as the ALJ’s factual

findings are conclusive if they are supported by substantial

evidence.   See id.; Irlanda Ortiz v . Secretary of Health and

Human Servs., 

 (1st Cir. 1991) (per curiam).

The ALJ is responsible for settling credibility issues, drawing

inferences from the record evidence, and resolving conflicts in

the evidence. See Irlanda Ortiz, 

. Therefore, I



                                -11-
must “uphold the [ALJ’s] findings . . . if a reasonable mind,

reviewing the evidence in the record as a whole, could accept it

as adequate to support [the ALJ’s] conclusion.”    

 (quoting

Rodriguez v . Secretary of Health and Human Servs., 

 (1st Cir. 1981)) (internal quotation marks omitted).

     While the ALJ’s findings of fact are conclusive when

supported by substantial evidence, they “are not conclusive when

derived by ignoring evidence, misapplying the law, or judging

matters entrusted to the experts.”    Nguyen v . Chater, 

 1 , 35 (1st Cir. 1999) (per curiam). I apply these standards in

reviewing the issues that Wright raises on appeal.



                         III. DISCUSSION

     The Social Security Act (the “Act”) defines “disability” for

the purposes of Title II as the “inability to engage in any

substantial gainful activity by reason of any medically

determinable physical or mental impairment which can be expected

to result in death or which has lasted or can be expected to last



                               -12-
for a continuous period of not less than 12 months.”   

(d)(1)(A) (1994).   The Act directs an ALJ to apply a five-step

sequential analysis to determine whether a claimant is disabled.9

See 

 (2000).   At step four of the process,

the ALJ must determine whether the claimant’s impairment prevents

him from performing his past work. See 

 § 404.1520(e).    To

make this determination, the ALJ must assess both the claimant’s

residual functional capacity (“RFC”), that i s , what the claimant

can do despite his impairments, and the demands of the claimant’s

prior employment. See id.; 

(a); see also

Santiago v . Secretary of Health and Human Servs., 

 , 7

(1st Cir. 1991) (per curiam).   The claimant bears the burden of

showing that he does not have the RFC to perform his past

relevant work.   See Santiago, 

 .

     9
        In applying the five-step sequential analysis, the ALJ is
required to determine: (1) whether the claimant is presently
engaged in substantial gainful activity; (2) whether the claimant
has a severe impairment; (3) whether the impairment meets or
equals a listed impairment; (4) whether the impairment prevents
or prevented the claimant from performing past relevant work; and
(5) whether the impairment prevents or prevented the claimant
from doing any other work. See 

 (2000).

                                -13-
     At step five, the burden shifts to the Commissioner to show

“that there are jobs in the national economy that [the] claimant

can perform.”   Heggarty v . Sullivan, 

 (1st Cir.

1991) (per curiam); see also Keating v . Secretary of Health and

Human Servs., 

 (1st Cir. 1988) (per curiam).

The Commissioner must show that the claimant’s limitations do not

prevent him from engaging in substantial gainful work, but need

not show that the claimant could actually find a job.      See

Keating, 

 (“The standard is not employability, but

capacity to do the job.”).

     In the present case, the ALJ concluded at step five of the

sequential evaluation process that Wright was “not disabled.”

See Tr. at 2 5 , 2 9 , 3 0 . The ALJ determined that Wright lacks the

RFC to work in an area where exposure to environmental irritants,

temperature extremes, dust, or fumes is likely.     See 

 at 2 9 .

The ALJ concluded that these non-exertional limitations preclude

Wright’s return to his former employment. See 

       Ultimately,

the ALJ considered Wright’s educational background, age, RFC, and



                                -14-
the testimony of the vocational expert in deciding that Wright

can perform light and sedentary work10 that exists in significant

numbers in the national economy. See 

 at 2 9 , 55-56.

     Wright makes multiple arguments in support of his motion to

reverse the ALJ’s decision.   First, Wright asserts that the ALJ

improperly calculated Wright’s residual functional capacity

because: 1 ) the ALJ did not properly evaluate Wright’s subjective

complaints of pain; 2 ) the ALJ ignored certain medical evidence

that was relevant to his residual functional capacity including

his treatment regimen and side effects from his medication; and

3 ) the ALJ failed to give the appropriate weight to the opinions

submitted by examining physicians. Second, Wright argues that

the ALJ improperly relied on the testimony of the vocational


     10
        Light work may involve “lifting no more than 20 pounds
at a time with frequent lifting or carrying of objects weighing
up to 10 pounds,” “a good deal of walking or standing,” and/or
“sitting most of the time with some pushing and pulling of arm or
leg controls.” 

(b) (2000). “If someone can
do light work, . . . [he ordinarily] can also do sedentary
work . . . .” 

 Sedentary work involves “lifting no more than
10 pounds at a time and occasionally lifting or carrying articles
like docket files, ledgers, and small tools;” occasional “walking
and standing;” and frequent “sitting.” 

 § 404.1567(a).

                               -15-
expert because the hypothetical question posed did not fully

reflect Wright’s functional limitations. I address each of these

arguments in turn.

    A.    Wright’s Subjective Complaints of Pain

    Wright argues that the ALJ failed to give adequate

consideration to his subjective complaints of pain, and other

symptoms, because the ALJ did not consider all the record

evidence in making his credibility determination.   Although

Wright does not expressly make this argument, he seems to contend

that his pain and other symptoms should be treated as non-

exertional limitations in his RFC assessment.   For the following

reasons, I disagree.

     1.    Standards Governing an ALJ’s Credibility Determination

    The SSA regulations require that a claimant’s symptoms,

including complaints of pain, be considered when determining

whether a claimant is disabled.   See 

(a)

(2000).   An ALJ must follow a two-step process to evaluate a

claimant’s subjective complaints of pain. First, the ALJ must



                               -16-
determine whether the claimant suffers from a medically

determinable impairment that can reasonably be expected to

produce the pain and other symptoms alleged.    See 

 §

404.1529(b); Da Rosa v . Secretary of Health and Human Servs., 

 4 , 25 (1st Cir. 1986) (per curiam).   Then, if such an

impairment exists, the ALJ must evaluate the intensity,

persistence, and functionally limiting effects of the claimant’s

symptoms so that the ALJ can determine how the claimant’s

symptoms limit his or her capacity for work.    See 

(c)(1); SSR 96-7p, 

, at *1 (1996).     At this

stage, the ALJ must consider “all of the available evidence,

including [the claimant’s] medical history, the medical signs and

laboratory findings, and statements from [the claimant], [the

claimant’s] treating or examining physician or psychologist, or

other persons about how [the claimant’s] symptoms affect [the

claimant].”   

(c)(1).

     The Commissioner recognizes that symptoms such as pain may

suggest a more severe impairment “than can be shown by objective



                               -17-
medical evidence alone.”   

 § 404.1529(c)(3).   Accordingly, the

ALJ must evaluate the claimant’s complaints of pain in light of

the following factors: (1) the claimant’s daily activities; (2)

the location, duration, frequency, and intensity of the

claimant’s pain; (3) precipitating and aggravating factors; (4)

the type, dosage, effectiveness, and side effects of any

medication that the claimant takes or has taken to alleviate his

pain; (5) treatment, other than medication, the claimant receives

or has received for relief of his pain; (6) any measures the

claimant uses or has used to relieve pain; and (7) other factors

concerning the claimant’s limitations and restrictions due to

pain.   See id.; see also Avery v . Secretary of Health and Human

Servs., 

 9 , 29-30 (1st Cir. 1986).   These factors are

sometimes called the “Avery factors.”   In addition to considering

these factors, the ALJ is entitled to observe the claimant,

evaluate his demeanor, and consider how the claimant’s testimony

fits with the rest of the evidence. See Frustaglia v . Secretary




                               -18-
of Health and Human Servs., 

 (1st Cir. 1987)

(per curiam).

    In assessing the credibility of a claimant’s subjective

complaints of pain, the ALJ must consider whether these

complaints are consistent with the objective medical evidence and

other evidence in the record. See 

(a).

While a claimant’s complaints of pain must be consistent with the

medical evidence to be credited, they need not be precisely

corroborated with such evidence. See Dupuis v . Secretary of

Health and Human Servs., 

 (1st Cir. 1989) (per

curiam).   The ALJ in making a credibility determination must also

make specific findings as to the relevant evidence he considered

in deciding whether to believe a claimant’s subjective

complaints.   Da Rosa, 803 F.2d at 2 6 .

    If the ALJ believes a claimant’s testimony about his pain

and other symptoms, the ALJ may consider the pain as a non-

exertional limitation. See Frustaglia, 

; Da Rosa,

803 F.2d at 26-27.   The ALJ must then consider this non-



                                -19-
exertional limitation in determining a claimant’s RFC. See id.

      2.     The ALJ’s Assessment of Wright’s Subjective
             Complaints of Pain

      In this case, the ALJ made a specific finding regarding the

first step of the pain assessment process. See 

(b).       He determined that Wright suffered from “underlying

medically determinable impairment[s],” including emphysema,

asthma, sinusitis, and bronchiolitis obliterans, “that could

reasonably cause the pain and other symptoms alleged.”      Tr. at

25.

      Wright concedes that his subjective complaints of pain, and

other symptoms, are not fully supported by the medical evidence

in the record, but he nevertheless argues that the ALJ erred in

failing to consider the “Avery factors” in assessing his

complaints of pain. See Pl’s Mot. to Reverse and Remand (Doc.

N o . 7 ) at 2 .   Contrary to Wright’s argument, there is substantial

evidence that the ALJ considered all of the record evidence,

including the Avery factors, in evaluating the intensity and

persistence of Wright’s symptoms of headaches, fatigue, and


                                   -20-
shortness of breath.

     The ALJ’s ample questioning of Wright that focused on the

Avery factors indicates that the ALJ considered those factors in

his credibility determination. See Frustaglia, 

(questioning about the Avery factors was one ground among others

for finding that a credibility determination was supported by

substantial evidence).      The ALJ questioned Wright extensively

about his daily activities, extracting details about his

activities on a “typical day” and a “bad day.”     Tr. at 45-51.

The ALJ also elicited information about the duration, frequency,

and intensity of Wright’s pain and other symptoms by asking how

often he has good and bad days, whether the bad days are

consecutive, and whether he is “completely knock[ed] out” on the

bad days.   

 at 4 7 , 4 8 .

     The ALJ also questioned Wright about any precipitating and

aggravating factors such as weather, fumes, and anything in

Wright’s control that might bring about the bad days.     See 

 at

4 6 , 4 9 . The ALJ further questioned Wright about the medications



                                  -21-
he takes to deal with his headaches and why he does not take

stronger medications. See 

 at 5 0 . Furthermore, the ALJ also

elicited information about other measures Wright uses or has used

to relieve his pain, such as lying down and sleeping. See id. at

47, 49.

     In order to assess the credibility of Wright’s complaints of

pain and other symptoms, the ALJ had to consider whether the

complaints, in light of the Avery factors, were consistent with

the objective medical evidence and other evidence in the record.

(a).   The ALJ, in his decision, referred to

Wright’s headaches and trouble breathing, but found that the

objective medical evidence did not support a finding of severity

sufficient to preclude Wright from performing all work.   See Tr.

at 2 6 . He found that there was no evidence of other restrictions

or limitations on Wright’s ability to work and that Wright’s

testimony did not suggest other constraints. See 

   Therefore,

the ALJ found that Wright’s subjective complaints “are not

entirely credible in light of discrepancies between [Wright’s]



                               -22-
assertions and information contained in the documentary reports.”

Id. at 26-27, 2 9 .

     Although I am concerned by the limited findings provided by

the ALJ to support his credibility determination, I conclude that

substantial evidence supports the ALJ’s adverse credibility

determination.   See Frustaglia, 

 (“Although more

express findings, regarding head pain and credibility, than those

given here are preferable, we have examined the entire record and

their adequacy is supported by substantial evidence.”).

       The medical evidence in the record supports the ALJ’s

finding that Wright’s symptoms are not severe enough to limit his

functional capacity beyond that already assessed.      At the time of

the hearing, Wright’s asthmatic symptoms had stabilized and were

not causing him any discomfort. See Tr. at 337, 339, 362.

Wright did, however, complain to Dr. Lewinsohn on multiple

occasions about having sinus headaches, sinus pressure, and

fatigue.   See 

 at 3 3 7 , 339, 3 6 0 , 361. The fact that Wright’s

CT scans diagnosed his acute superimposed upon chronic sinusitis



                                 -23-
and the fact that he underwent multiple surgeries to alleviate

his sinus pain, appear to support the intensity of Wright’s

chronic sinusitis symptoms. See id. at 186, 291, 2 9 2 , 305, 3 4 0 ,

347.   Even where the record could support another conclusion,

however, the ALJ’s decision must be upheld if there was

substantial evidence to support i t . See Rodriguez Pagan v .

Secretary of Health and Human Servs., 

 , 3 (1st Cir.

1987) (per curiam).

       The record provides little medical evidence supporting the

idea that Wright’s symptoms are severe enough to preclude Wright

from engaging in all types of work.    In a report dated October 6,

1997, Dr. Suzuki stated that Wright’s sinuses would never retain

normality, however, he further noted that Wright’s asthma-related

problems are what prevents him from returning to work.     See Tr.

at 321. Therefore, D r . Suzuki concluded that Wright should avoid

further chemical exposure in the workplace. See 

      A few weeks

prior to the ALJ hearing, Dr. Suzuki reported that, after a

recent sinus procedure, Wright’s sinus symptoms appeared to be



                                -24-
improving.   See id. at 347. Dr. Suzuki again reiterated that

Wright should not work in an environment where he might be

exposed to chemicals, however, he did not mention any other work-

related limitations stemming from Wright’s sinus condition.     See

id.

       Dr. Lewinsohn’s Medical Assessment of Ability to do Work-

Related Activities in March 1998 also reported environmental

restrictions on Wright’s ability to work. See Tr. at 324-32.

Dr. Lewinsohn, however, did not comment on any limitations

imposed by Wright’s sinus condition. See Pl’s Mot. to Reverse

and Remand (Doc. N o . 7 ) at 2 2 . The Physical Residual Functional

Capacity Assessment reported by Dr. Nault and Dr. Fairley on

November 5 , 1997, noted the same conclusion that Wright’s only

limitation related to exposure to fumes, odors, gases, etc.     See

Tr. at 312-19. The fact that multiple doctors failed to comment

on any limitation imposed by Wright’s sinus condition suggests

that Wright’s subjective complaints are inconsistent with the

medical evidence.



                                -25-
      Wright’s own testimony, specifically the information

relating to the Avery factors, also supports the ALJ’s decision

that Wright’s symptoms are not severe enough to suggest any new

physical limitations on his ability to work.   Wright complained

that five days out of a month he cannot do anything except lay

down and sleep, and on ten days per month he has to push himself

to engage in daily activities. See Tr. at 4 6 . Based on his

testimony, however, it appears that Wright can engage in daily

activities on almost twenty-five days per month. See id. at 44-

51.   On many of these days he can go for a walk and clean up

around the house. See id. at 4 5 . Furthermore, Wright claims

that he would like to return to work, and D r . Lewinsohn feels

that Wright is capable of beginning a vocational rehabilitation

plan.   See id. at 5 1 , 362.

      The record also indicates that on many days Wright took only

nonprescription medications to deal with his pain. See id. at

50.   He relied on Advil to alleviate his sinus headaches claiming

that other medications made him drowsy. See id.    The ALJ is



                                -26-
entitled to find that the non-use of stronger pain medications

shows an inconsistency with the severity of the pain Wright

alleged.   See Albors v . Secretary of Health and Human Servs., 

 (1st Cir. 1986) (per curiam) (“[An RFC assessment],

together with the fact that claimant apparently takes nothing

stronger than aspirin, supports the ALJ’s rejection of claimant’s

assertions of disabling pain.”).

     It remains the obligation, however, of the ALJ to decide

issues of credibility and to draw necessary inferences from the

record.    See Irlanda Ortiz, 

. The objective

medical evidence, along with the information relating to the

Avery factors, supports the ALJ’s finding that Wright’s pain and

other symptoms are not severe enough to further limit his ability

to work.   Therefore, I conclude that the ALJ’s determination that

Wright’s subjective complaints of pain were not entirely credible

is supported by substantial evidence and thus entitled to

deference. See Frustaglia, 

. Because the ALJ

could discredit Wright’s testimony about his symptoms and any



                                -27-
limitations imposed by those symptoms, the ALJ did not need to

consider the sinus headaches, fatigue, and shortness of breath as

non-exertional impairments in determining Wright’s RFC. See 

     B.     The ALJ’s RFC Determination

     1.     Standards Governing an RFC Determination

     An RFC determination specifies what a claimant is able to do

despite his limitations. See 

(a)(2000). The

ALJ is responsible for determining a claimant’s RFC. See 

 §

404.1546.    The ALJ uses a claimant’s RFC as the basis for

deciding what types of work a claimant can perform in spite of

his impairments. See id. § 404.1545(a).

     In determining a claimant’s RFC, an ALJ must perform a

“function-by-function” assessment of the claimant’s ability to

engage in work-related activities. See SSR 96-8p, 

, at *3 (1996); see also Ferraris v . Heckler, 

 (2d Cir. 1984)(holding that the ALJ’s findings on

claimant’s RFC were insufficient where the ALJ determined

claimant’s RFC in a conclusory manner without a function-by-



                                -28-
function assessment).    Moreover, the ALJ must specify the

evidentiary basis for his RFC determination.   See White v .

Secretary of Health and Human Servs., 

 4 , 65 (2d Cir.

1990) (noting that the failure to specify a basis for the RFC

conclusion is a sufficient reason to vacate a decision of the

Commissioner); SSR 96-8p, 

, at * 7 . When making his

RFC determination, an ALJ must “consider objective medical facts,

diagnoses and medical opinions based on such facts, and

subjective evidence of pain or disability testified to by the

claimant or others.”    Ferraris, 

; see 

(a) (stating that the RFC must be based on all relevant

evidence).

     Because an ALJ is a lay person, however, he “is not

qualified to assess residual functional capacity based on a bare

medical record.”   Gordils v . Secretary of Health and Human

Servs., 

 (1st Cir. 1990) (per curiam).    This

means that if the medical evidence only describes the claimant’s

impairments but does not relate those impairments to an



                                -29-
exertional level, such as light work, the ALJ may not make that

connection himself. See Gordils, 

; Rosado v .

Secretary of Health and Human Servs., 

 (1st Cir.

1986).    In these situations, an expert’s RFC evaluation is

“ordinarily essential . . . .”      Manso-Pizarro v . Secretary of

Health and Human Servs., 

 5 , 17 (1st Cir. 1996) (per

curiam).

     2.    The ALJ’s Determination of Wright’s RFC

     In the present case, the ALJ determined at step four of the

sequential evaluation process that Wright retained the RFC to

perform a full range of work, with the exception that Wright

could not work in an area where exposure to environmental

irritants, temperature extremes, dust, or fumes was possible.

See Tr. at 2 7 , 2 9 , 55-56.   In support of his decision, the ALJ

provided the following function-by-function assessment:

     The file supports a finding that Mr. Wright has a lung
     disorder which prohibits him from being exposed to
     temperature extremes, chemicals, dust and fumes . . . .
     There is no evidence of other limitations or restrictions. The claimant did not testify to any physical
     limitations . . . . Nonetheless, the undersigned finds


                                   -30-
    that the claimant has non-exertional limitations which
    interfere with his ability to work. The evidence
    supports a finding that he is not able to work in
    exposure to environmental irritants, temperature
    extremes or dust or fumes.

.   Although a more specific function-by-function

analysis is desirable, the ALJ’s RFC assessment accords with the

assessments offered by the state’s doctors and one of Wright’s

treating doctors. See id. at 313-19, 324-27.   Therefore, I

conclude that the ALJ’s RFC assessment was supported by

substantial evidence. See Gordils, 

 (concluding

that an RFC assessment by a non-examining physician along with

other findings from a treating doctor, not in the form of an RFC

assessment, constituted substantial evidence to support the

Secretary’s RFC determination).

     The state physicians concluded that Wright was able to

occasionally lift and carry up to twenty pounds; to frequently

lift and carry up to ten pounds; to stand and/or walk and sit for

up to six hours in a day with normal breaks; and to have an




                               -31-
unlimited capacity to push and pull. See Tr. at 313.      Dr.

Fairley and D r . Nault also found no postural, visual or

communicative limitations, but noted environmental limitations on

exposure to fumes, odors, dusts, gases, and poor ventilation.

See id. at 314-16. The state physicians’ overall conclusion was

that Wright was capable of performing light work, as long as

Wright avoided any air pollution. See id. at 319.

       Wright’s treating specialist, D r . Lewinsohn, also furnished

an Assessment of Ability to do Work-Related Activities.     Dr.

Lewinsohn concluded that Wright’s symptoms do not affect his

lifting, carrying, standing, walking, and sitting capacity.       See

id. at 324-25. Wright’s symptoms also did not affect his

physical functions. See id. at 326. His asthmatic symptoms

occasionally affected his ability to climb but did not affect

other postural activities. See id.      The assessment also reported

several environmental limitations including: sensitivity to

temperature extremes, chemicals, dust, and fumes. See id. at

327.



                                 -32-
     Lastly, Dr. Suzuki and D r . Epler also stated in their

treatment notes that Wright should avoid exposure to dust, fumes,

and chemicals in his future workplace. See Tr. at 301, 322.

Although Dr. Suzuki and D r . Epler did not perform full RFC

assessments, their opinions still bolster the ALJ’s RFC determi-

nation in this case. See Gordils, 

. Since the

ALJ’s RFC determination accords with the five doctors’ findings,

I conclude that they provide substantial evidence to support the

ALJ’s RFC determination.

     Although I find that substantial evidence supports the ALJ’s

RFC determination, I address Wright’s contention that the ALJ did

not consider all of the medical evidence in his RFC determina-

tion.   Wright asserts that the ALJ ignored all of the medical

evidence relating to his sinus condition, in the form of the

medical records, his treatment regimen, and the side effects of

his medications.

     The medical evidence that Wright contends the ALJ ignored

merely diagnoses and describes Wright’s impairments.   This



                               -33-
evidence discusses in detail Wright’s respiratory and sinus

problems including the related treatments, surgeries, CT scans,

etc.   This bare medical evidence, however, does not link the

diagnoses to any specific residual functional capabilities such

as sedentary or light work.    The ALJ, as a lay person, is not

qualified to make the connection between such bare medical

findings and corresponding residual functional capabilities. See

Gordils, 

; Rosado, 

.    Accordingly,

the ALJ would not have been entitled to rely on that evidence as

a basis for Wright’s RFC determination. See 

    Therefore, I

find no merit in Wright’s argument that the ALJ erred by ignoring

the medical evidence relating to his sinus problems.

       Wright also argues that the ALJ failed to properly weigh the

opinions of Wright’s treating specialists regarding his sinus

condition.    Wright contends that his treating specialists’

medical opinions imply the existence of functional limitations

arising from his chronic sinusitis. Furthermore, Wright claims

that the ALJ should have heeded these implied limitations in



                                -34-
making his RFC determination.     The record, however, indicates

that Wright’s treating specialists did not explicitly discuss any

functional limitations related to his chronic sinus condition.

See Tr. at 301, 321-22, 327. Wright concedes that one of his

treating specialists, D r . Lewinsohn, “does not comment on the

functional impairment imposed by the chronic sinus condition . .

. .”    Pl’s Mot. to Reverse and Remand (Doc. N o . 7 ) at 2 2 .

       As there are no explicit opinions regarding functional

limitations imposed by Wright’s sinus condition, the ALJ

essentially had no additional opinions to weigh in his RFC

determination.    As discussed above, the ALJ also had no authority

to infer implied functional limitations from the medical

evidence.    See Gordils, 

. Therefore, I find that

the ALJ made no error in his RFC determination.

       C.   The ALJ’s Reliance on Vocational Expert Testimony

       Wright next argues that the ALJ improperly relied on

vocational expert (“VE”) testimony based on a hypothetical

question that did not include impairments that the ALJ previously



                                  -35-
found to be severe. For the following reasons, I disagree.

     Once a claimant proves that he is incapable of returning to

his prior jobs, the burden shifts to the Commissioner to come

forward with evidence of specific jobs in the national economy

that the claimant is capable of performing.    See Arocho v .

Secretary of Health and Human Servs., 

 (1st Cir.

1982); 

(f) (2000).    The Commissioner can meet

his burden of proof on this issue by relying on the testimony of

a VE.   See Rose v . Shalala, 

 3 , 19 (1st Cir. 1994);

Berrios Lopez v . Secretary of Health and Human Servs., 

 (1st Cir. 1991) (per curiam).

     In order to rely on the VE's testimony, however, the ALJ

must pose to the VE a hypothetical question that accurately

reflects the claimant’s functional limitations. See 

       That

i s , the ALJ may credit the VE’s response only if there is

“substantial evidence in the record to support the description of

the claimant’s impairments given in the ALJ’s hypothetical.”

Berrios Lopez, 

; see Arocho, 

.



                                -36-
    At the hearing, the ALJ and the VE engaged in the following

dialogue:

    ALJ: Okay. And I’m going to ask you some hypothetical
         questions this morning which will take into
         account a number of different factors, but in all
         of the questions that I pose we are presented with
         the potential worker who is currently 50 years of
         age, who has not only a high school education, but
         an additional Associate’s degree . . . in aviation
         science, and a skilled work background . . . .
         And someone who is going to have some exertional
         limitations as a result of his medical condition
         such that the most that the individual would be
         able to lift and carry would be 20 pounds maximum,
         and with any repetitive routine carrying of
         objects or lifting [of] objects that would be
         perhaps in the 10-pound range. And if we’re
         dealing with someone who is particularly limited
         in terms of the environment, that is in terms of
         breathing and being exposed to a number of
         factors, and those would be of course the
         inability to be exposed to dust and fumes and
         odors, and also if we’re dealing with someone who
         would best be suited to work in an environment
         where there were no extremes of temperature,
         particularly cold temperature. In looking at the
         previous work that M r . Wright has performed as he
         did i t , and as it is generally performed in the
         national economy do you feel that he could perform
         this type of work based on these limitations?
    V E : No . . .
    ALJ: In looking at jobs in the occupational base of jobs
          other than semiskilled jobs, perhaps entry level types
          of jobs, do you feel that there would be any other


                             -37-
            examples that could still be performed?
     V E : Yes . . . .

Tr. at 55-56 (emphasis added).    The VE then discussed the type

and number of jobs in the national economy that Wright would be

able to perform given his functional and vocational limitations.

See 

 at 5 6 . The VE stated that Wright could work as a mail

clerk, security guard, office helper, or cashier. See 

     There is no merit to Wright’s argument that the ALJ erred by

not including any limitations based on his severe sinus condition

in the hypothetical.   As discussed earlier, the ALJ discredited

Wright’s complaints of pain and other symptoms and found that

they suggested no additional limitations on his ability to work.

Since these complaints were not supported by substantial evidence

in the record, the ALJ was not required to include any sinus-

related limitations in the hypothetical.11   See Berrios Lopez,

     11
        The ALJ also posed a second hypothetical to the VE that
included the vocational limitation of absenteeism, resulting from
Wright’s sinus symptoms. See Tr. at 5 7 . The VE responded that
the additional factor of absenteeism would preclude Wright from
engaging in the previously mentioned jobs on a sustained basis.
See 

 Wright argues that the ALJ erred in not referring to
this second hypothetical in his decision. The ALJ, however, does

                                 -38-


.

     Moreover, the functional limitations the ALJ did include in

the hypothetical were supported by substantial evidence.   The

limitations concerning Wright’s ability to lift and carry and his

workplace environment were consistent with the state physicians’

RFC assessment. See Tr. at 313-19. Furthermore, Dr. Lewinsohn,

Dr. Suzuki, and Dr. Epler all recommended that Wright avoid

exposure to dust, fumes, and chemicals. See 

 at 3 0 1 , 322,

324-27.   Because substantial evidence in the record supported the

description of Wright’s functional limitations, I conclude that

the ALJ properly credited the VE’s response to the hypothetical.



not need to address this hypothetical since his findings rejected
the grounds for the hypothetical. See Boynton v . Apfel, 

 2 , Civ. N o . 98-1987, 

, at **4 (7th Cir. 1999)
(table, text available on Westlaw). The ALJ ultimately
discredited Wright’s complaints of pain, and the opinions of his
treating specialists did not explicitly discuss any functional
limitations arising from Wright’s sinus symptoms. As a result,
the ALJ was not required to include sinus-related limitations
in a hypothetical to the V E . See Berrios Lopez, 

.
Therefore, the ALJ was also not entitled to rely on the VE’s
response in deciding whether Wright was disabled because sinus-related limitations were not supported by substantial evidence in
the record. See 

                               -39-
                          IV. CONCLUSION

      Because I have determined that the ALJ’s denial of Wright’s

application for benefits i s supported by substantial evidence, I

affirm the Commissioner’s decision.        Accordingly, Wright’s motion

to reverse and remand (Doc. #7) is denied, and defendant’s motion

for an order affirming the decision of the Commissioner (Doc. #8)

is granted.   The Clerk shall enter judgment accordingly.

SO ORDERED.




                                         Paul Barbadoro
                                         Chief Judge
October 1 3 , 2000

cc:   Raymond J. Kelly, Esq.
      David L . Broderick, Esq.




                                  -40-